What is innovation? The answer to that question may depend on who you ask. Do a quick online search and results are likely to include a variety of definitions and articles related to innovation in business and technology. Turn on the TV and hear all about innovation, whether about a new, ‘innovative’ menu at a casual restaurant chain, or about the next ‘innovative’ product launched by a tech company. For public health, PHNCI set out to define innovation, not simply to adopt a buzzword, but to inspire and encourage transformational public health practice, suitable for keeping up with 21st century advances taking place all around us.

So where did we land? After convening experts in innovation and those in public health, we developed a draft definition and a set of characteristics to support and drive culture that encourages innovative practice in public health.

Public health innovation refers to the development of a new process, policy, product, or program that increases quality, impact, and efficiency.

Public health innovation embodies the following characteristics:

• Is novel, new, or creative;
• Reflects the dynamic state of change inherent in public health transformation;
• Occurs by internal or cross-sector collaboration;
• Involves co-production of the process, policy, product, or program with partners, stakeholders, and/or customers;
• Has the potential to generate a new or improved means to create value;
• Lends itself to adaptation and adoption/replication and diffusion;
• Generates real-time information for evaluation and course correction; and
• If related to technology, uses open-source technology (i.e., the technology is in the public domain) so as to facilitate adaption and adoption/replication.

Not surprisingly, characteristics that are deemed supportive of an agency with a culture of innovation are similar to those of a high-performing agency. Each:

• Employs human-centered design;
• Promotes generative discussions and is biased towards collective action;
• Anticipates change in attitudes and behaviors; or
• Builds on community assets.

It is our intention that this definition helps the field differentiate between good, and important, public health work that needs to continue and areas where innovation has the potential to transform practice, and the community, by taking new approaches, working across sectors and adopting practices that promote and support shifts in the status quo.

According to Innovation in Governmental Public Health: Building a Roadmap, co-published by PHNCI and the Institute for Alternative Futures, innovations are the first step in transforming public health practice. The journey to transformation can be conceptualized as practices that move along three points on a spectrum: from emerging, to leading, and ultimately prevailing.

Marking the beginning of transformation, “emerging” practices are public health innovations. They come from one or a small group of health departments and/or other agencies, and are brand new to the field. Leading practices are innovations that have been adapted and adopted or perhaps replicated by other health departments and/or other agencies. Although no longer considered innovative, they are not recognized as the usual way of doing business. Leading practices are widely viewed as best practices, and an increasing number of health departments are likely to emulate them.

Finally, prevailing practices are those that are accepted and are in play throughout the public health practice community. They are no longer considered leading practices because they have been diffused throughout the public health practice community. As an innovation first emerges, it may be transformative for the health department that develops the practice. If the health department is not the leader of the innovation, the health department should be performing a major role in the innovations work. As evidence of the effectiveness of an innovation grows and it becomes a leading practice, and ultimately is recognized as a prevailing practice, it can transform the field of public health.

With a definition in place and a roadmap in hand to guide agencies as they move toward innovation, PHNCI intends to ascribe meaning to this work by both sponsoring projects and disseminating stories in a manner that allows for adaption, adoption and replication. After a competitive Call for Proposals process, PHNCI is awarding $1.55 million to support innovations in public health agencies. These cross-sector innovations align with PHNCI’s definition and are in the areas of health equity, data collection and analytics, health in all policies, systems redesign and access to services. From eliminating the food deserts that limit the food choices of underserved populations to working with law enforcement to address mental health issues and reduce crime recidivism to redesigning the public health system through governance and financing options, these grantees are taking strides to address complex system challenges in new and meaningful ways.

What possibilities exist in public health practice to unearth the next iPhone? Join us to find out so that in the future, when you Google ‘innovation,’ the results yield story after story about the great work of health departments!

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