Article Text

Download PDFPDF
Original research
Innovating in healthcare delivery: a systematic review and a preference-based framework of patient and provider needs
  1. Joseph S Salama1,2,
  2. Alex Lee1,
  3. Ashkan Afshin1
  1. 1 Health Metrics Sciences, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2 Department of Health Policy, London School of Economics and Political Science, London, UK
  1. Correspondence to Joseph S Salama, University of Washington School of Medicine, Seattle, WA 98195, USA; salama01{at}


Healthcare innovation is becoming a popular but poorly defined option for those who are seeking new ways of reducing costs while also improving the quality of care. The process of innovating in healthcare delivery can be improved by identifying and understanding the unmet needs of patients and providers. We conducted two systematic literature reviews to identify the needs of these stakeholders throughout healthcare delivery and developed a conceptual framework for innovating in healthcare. Our results reveal tension between patients’ and providers’ preferences across three major categories—treatment and outcomes, process of care and structure of care. Therefore, innovating in healthcare may be better understood as addressing the unmet needs of each stakeholder by easing or eliminating tensions between stakeholders. This conceptual framework may serve as a useful instrument for health policymakers, payers and innovators to alike make better decisions as they invest in healthcare innovations.

  • accessible
  • affordable
  • delivery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors JSS conceived of the study and prepared the first draft. JSS, AL and AA conducted the literature review. AA provided overall guidance. All the authors finalised the manuscript based on the peer review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.