A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

Figures & data

Figure 1. SMART thinking matrix, source: MacLachlan et al., 2018

Table 1. Studies, type of data, topics of data and analysis methods used for each study

Study	Type of data	Topics	Analysis method
1	Systematic literature review corpus Case studies	AT innovation Adjacent innovation	Familiarization and exploratory data analysis, categorization, higher level categorization, description of corpus through histograms and inductive analysis
2	Semi-structured interviews	Prosthetics Eyeglasses Digital	Thematic analysis

Figure 2. Innovation definitions by OECD (product innovation, process innovation, marketing innovation and organizational innovation) and the AT innovation definitions that we have adapted from OECD (innovation, product, supply and provision)

Figure 3. Prisma flow diagram showing the flow of information through the identification, screening, eligibility and inclusion of papers and case studies (Moher et al., 2009)

Table 2. Search string 1 used to create a corpus relevant to AT innovation and 2 used to create a corpus relevant to adjacent innovation strategies with potential for adoption in the AT sector

SEARCH STRING 1: AT Innovation	SEARCH STRING 2: Adjacent to AT
Innovation OR framework OR process OR strateg* OR agenda OR ecosystem OR “service delivery model” OR “delivery model” OR “enterprise” OR “service model” OR “service provision model” OR “provision model” OR (model AND development) OR “procurement supply”	framework OR process OR strateg* OR agenda OR ecosystem OR “service delivery model” OR “delivery model” OR “service model” OR “service provision model” OR “provision model” OR (model AND development)
OR	AND
Finance OR marketing OR affordable OR “cost effective” OR procurement OR sustainab*	“appropriate technolog*” OR “inclusive innovation” OR “humanitarian innovation” OR “philanthropic innovation” OR “open innovation” OR “frugal innovation” OR “social innovation”
AND
Assistiv* OR wheelchair* OR “mobility device*” OR “mobility aid*” OR “sensory device” OR eyeglasses OR prosthetic* OR prosthes* OR orthotic* OR orthos* OR “augment* communication” OR “alternative communication”

Table 3. Inclusion and exclusion criteria used for literature review and case studies

Inclusion criteria	Exclusion criteria
Written in English Innovation strategy or process described Clear relevance to AT sector User-centric	Focus on output of innovation rather than strategy or process Theoretical overviews/ position papers No abstract available

Figure 4. Number of papers in AT innovation strategies, adjacent innovation strategies and a combination of these are presented across time, from 2010 to June 2020

Figure 5. WHO region (EMRO, WPRO, EURO, SEARO, AMRO or AFRO) for AT innovation strategies, adjacent innovation strategies and case studies

Figure 6. Countries relevant to AT innovation strategies, adjacent innovation strategies and case studies. Presented also by WHO regions

Figure 7. Percentage of supply, product and provision for AT innovation strategies, adjacent innovation strategies and case studies

Figure 8. Diagram to visualize the relationships between people, provision, utilization, policy and AT workforce. Examples of processes within provision and utilization are given. R&D: research and development. These processes are just examples, there may be additional processes not included in the diagram

Figure 9. SMART thinking matrix depicting micro, meso and macro system

Figure 10. Innovation strategies identified in AT innovation, adjacent innovation, and case studies

Figure 11. Innovation processes identified in AT innovation, adjacent innovation, and case studies

Figure 12. AT domain and type for AT innovation papers and case studies. ADLs: activities of daily living

Figure 13. Actors (left) and lead actors (right) found in AT innovation and adjacent innovation strategies papers and case studies

Table 4. Lead actors, innovation strategies and definitions of success observed from the selected case studies

Lead actor	Innovation strategies observed	Definitions of success
Accelerator	Business model, Disruptive, Incremental, Sustaining, Process, Service, Marketing, System	Accelerators help AT innovators overcome barriers to scaling AT and take the AT to market successfully.
Corporate	Disruptive, Radical, Incremental, Product, Service, Process, Technological, Marketing, Social, Business model	Positive profit or revenue or income or return.
University	Radical, Disruptive, Sustaining, Incremental, Product, Service, Process, Technological, System, Social, Business Model	Influencing key stakeholders. Number of assistive devices and services supported.
Government	Sustaining, Architectural, System, Process, Social	New or modified policies that conduct to AT innovation.
Community	Business model Marketing, Incremental, Disruptive, Sustaining, Service, Process, Product, System, Social, Technological	Local community is engaged in local AT production and service provision. AT innovation is user-led locally.
Open Source	Disruptive, Product, Service	Product or service is used, produced, reproduced, integrated to other products or services, and innovated across communities with varied languages and cultures. AT innovation is user-led. The product or service is used by United Nations agencies.

Figure 14. Themes feeding into overarching themes of open innovation and radical and disruptive innovation for the themes of eyeglasses, prosthetics and digital. Barriers and enablers are presented

MacLachlan, M., McVeigh, J., Cooke, M., Ferri, D., Holloway, C., Austin, V., & Javadi, D. (2018). Intersections between systems thinking and market shaping for assistive technology: The SMART (systems-market for assistive and related technologies) thinking matrix. International Journal of Environmental Research and Public Health, 15(12), 2627. https://doi.org/https://doi.org/10.3390/ijerph15122627

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Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ, 339(jul21 1), b2535. https://doi.org/https://doi.org/10.1136/bmj.b2535

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