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Are disruptive innovations recognised in the healthcare literature? A systematic review
  1. Viknesh Sounderajah1,2,
  2. Vanash Patel1,3,
  3. Lavanya Varatharajan4,
  4. Leanne Harling1,5,
  5. Pasha Normahani1,
  6. Joshua Symons1,
  7. James Barlow6,
  8. Ara Darzi1,2,
  9. Hutan Ashrafian1,2
  1. 1Department of Surgery and Cancer, Imperial College London, London, UK
  2. 2Institute of Global Health Innovation, Imperial College London, London, UK
  3. 3Department of General Surgery, Watford General Hospital, West Hetfordshire NHS Trust, Watford, UK
  4. 4Department of Bariatric Surgery, Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK
  5. 5Department of Thoracic Surgery, Guy’s and St Thomas' NHS Foundation Trust, London, UK
  6. 6Imperial College Business School, Imperial College London, London, UK
  1. Correspondence to Dr Hutan Ashrafian, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; hutan{at}


The study aims to conduct a systematic review to characterise the spread and use of the concept of ‘disruptive innovation’ within the healthcare sector. We aim to categorise references to the concept over time, across geographical regions and across prespecified healthcare domains. From this, we further aim to critique and challenge the sector-specific use of the concept. PubMed, Medline, Embase, Global Health, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium were searched from inception to August 2019 for references pertaining to disruptive innovations within the healthcare industry. The heterogeneity of the articles precluded a meta-analysis, and neither quality scoring of articles nor risk of bias analyses were required. 245 articles that detailed perceived disruptive innovations within the health sector were identified. The disruptive innovations were categorised into seven domains: basic science (19.2%), device (12.2%), diagnostics (4.9%), digital health (21.6%), education (5.3%), processes (17.6%) and technique (19.2%). The term has been used with increasing frequency annually and is predominantly cited in North American (78.4%) and European (15.2%) articles. The five most cited disruptive innovations in healthcare are ‘omics’ technologies, mobile health applications, telemedicine, health informatics and retail clinics. The concept ‘disruptive innovation’ has diffused into the healthcare industry. However, its use remains inconsistent and the recognition of disruption is obscured by other types of innovation. The current definition does not accommodate for prospective scouting of disruptive innovations, a likely hindrance to policy makers. Redefining disruptive innovation within the healthcare sector is therefore crucial for prospectively identifying cost-effective innovations.

  • reverse innovations
  • global health
  • mHealth

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  • Contributors HA, LH, AD and VS planned the systematic review. VS and VP conducted the search. LV, JS and PN conducted the analysis. All authors contributed equally to the writing of the paper. HA, JB and AD undertook the senior review of the work on completion of the manuscript preparation. HA is responsible for the overall content of the study.

  • 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 Data are available in a public, open access repository. All data, extracted from peer-reviewed publications, are readily available through traditional means (PubMed, Google Scholar).