Deliverable 4.1 Baseline survey of crossover value …single value chains, this is a process that...

PROJECT Nº H2020 - 731391 Cross4Health

Deliverable4.1

Baselinesurveyofcrossovervaluechainsinpartnerregions

*DisseminationLevel: PU**DeliverableType: R

Date: 20May2018Distribution: WP4

Editors: JoannaLaneContributors: HCN,AV,BIOTECYL,IS,NHT,ZENIT

*DisseminationLevel: PU=Public,CO=Confidential,onlyformembersoftheConsortium(includingtheCommissionservices),EU-RES=Classifiedinformation:RESTRAINTUE(CommissionDecision2005/444/EC),EU-CON=ClassifiedInformation:CONFIDENTIELUE(CommissionDecision2005/444/EC),EU-SEC=ClassifiedInformation:SECRETUE(CommissionDecision2005/444/EC)

**DeliverableType: R=Document,DEM=Demonstrator,pilot,prototype,DEC=Website,patentfilling,videos,etc.,OTHER,ETHICS=Ethicsrequirement

DocumentSummary

WorkPackage4isfocusedonpracticalactionstosupportAerospaceEnergyBiotechICTandMedical(AEBIM)crossovervaluechainsto(re)combineingeneratinginnovativesolutionsthathelpimprovepatient-centredcare.Thisdocumentreportsonabaselinesurveyofcrossovervaluechainsinpartnerregions.Specifically,thesurveyexploredcurrentpractices,barriersandsolutionstocrossoverinnovation.Forexample,whatbottleneckshavepartnersexperiencedthatcanlimitorslowdownthefunctioningofcrossovervaluechains.And,havetheybeenabletoprovideworkablesolutionstoovercometheseobstaclesandsoimprovethefunctioningofthesevaluechains.Importantly,thisexploratoryworkhelpedtoidentifypotentialindicatorsforcrossovercollaborationthatcanbeusedtoinformassessmentofprojectimpactsinthe2accelerationperiodsoftheCross4Healthproject.


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DISCLAIMER TheworkassociatedwiththisreporthasbeencarriedoutinaccordancewiththehighesttechnicalstandardsandCross4Healthpartnershaveendeavoredtoachievethedegreeofaccuracyandreliabilityappropriatetotheworkinquestion.However,sincethepartnershavenocontrolovertheusetowhichtheinformationcontainedwithinthereportistobeputbyanyotherparty,anyothersuchpartyshallbedeemedtohavesatisfieditselfastothesuitabilityandreliabilityoftheinformationinrelationtoanyparticularuse,purposeorapplication.Undernocircumstanceswillanyofthepartners,theirservants,employeesoragentsacceptanyliabilitywhatsoeverarisingoutofanyerrororinaccuracycontainedinthisreport(oranyfurtherconsolidation,summary,publicationordisseminationoftheinformationcontainedwithinthisreport)and/ortheconnectedworkanddisclaimallliabilityforanyloss,damage,expenses,claimsorinfringementofthirdpartyrights.


Executive Summary WithCross4Healthweaim tousevaluechain innovation to transformtraditionalvaluechains intonew ones – emerging industries – through crossover (borders and sectors) collaboration. As withsinglevaluechains,thisisaprocessthatconnectspeople,needsandopportunitiesbutitislesslinearandvaluecreationwillbemorenetworked.

Withintheemergingindustries,clusteractivityhasarangeofhealth-marketpriorities(Table2).ThepartnerregionshavearangeofprioritiesidentifiedinRegionalSmartSpecialisationStrategiesand/orother related strategies. These priorities include biotechnology (Castilla Y Leon - BIOTECYL),innovative medicine (Nord Rhein Westphalia - ZENIT), integrated care pathways and patientassistance(NouvelleAquitaine-AV),personalhealth(Skåne–IS)andsmarthealthdata(Norway).AVwastheonlypartnertoidentify‘other’prioritiesthatrelatedtoitsprimaryanddiversifiedmarkets:3Dprinting,spacedata,modelingandsimulation,navigation,drones,autonomousvehicles,human-systeminteraction,safeandsecuresoftwareandhardware(embeddedsystems).

Therearearangeoffactorsthataffectcrossovercollaborationsincluding:

• DRIVERS(theleadingonesidentifiedbypartnersare:digitaltransformation,serviceinnovation)

• BARRIERS(the3prioritiesidentifiedbypartnersare:regulatory,developmentdynamicsandbusinessmodels)

• ACTIONS(thethreeactionsratedmostimportantbypartnersare:industry-enduserdialogue,clinic-industry-investorcollaborationandinnovativefinancialsupport).

That said, the particular emphasis on industry-end user dialogue and related collaboration by allclusters (Table 4) reflects understanding that health systems and regional innovation ecosystemstendtooperateinafragmentedwayandthisisproblematicforSMEsandforhealthcareproviders.This is seen in the reluctance of healthcare providers to offer ‘test and learn’ platforms for newproducts.Essentially,thereisalagbetweenwhatend-usersneed,whatSMEsarecreatingandneedtotestandwhathealthcareproviders/fundersseempreparedtodo.

ExamplesofbarriersandsolutionstocrossoverinnovationprovidedbypartnersareinSection5.1.They are: understanding crossover opportunities, differences in regulations between sectors,crossover research environments, time delays, organisational transfers between different workingculturesandpublicsectorprocurement.

11 indicators forassessingcrossovercollaborationwere identified.Theyare:Newbusinessmodelexperimentation; favourable regulations; support for accessing public funds; support for accessingprivate capital; collaborative business; open innovation networks; push or pull technologydevelopment;usinglivinglabs;SMEabsorptioncapacity;socialcapitalfornetworkedvaluecreation.

TherearetwopartstothisindicatorpackageforusebyKeyAccountManagers(KAMs)oftheSMEsasastandalonepublicdocument:averyshortquestionnaireusinga7-pointLikertscale;adiscussionguidefortheKAMstousewithSMEswhendiscussingtheirscoringoftheindicators.

Discussionaboutthis indicatorpackageiscurrentlybeingfinalisedwithS3contacts ineachpartnerregionandwillberevisedasneededbeforeitisusedinthefirstaccelerationperiod.


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Table of Contents

ExecutiveSummary............................................................................................................3

ListofAuthors....................................................................................................................5

DocumentHistory..............................................................................................................5

ListofFigures.....................................................................................................................6

ListofTables......................................................................................................................6

Glossary.............................................................................................................................6

Consortium........................................................................................................................7

1Introduction....................................................................................................................8

2Whyidentifyingbarriersandsolutionsforcrossoverinnovationmatters........................8

3Clusterfocusandcharacteristicsinpartnerregions.........................................................93.1Emergingbusinessareasexpectedtodrivefutureclusterdevelopment...............................11

4Crossoverinnovationcharacteristics..............................................................................12

5Barriersandsolutionstocrossovervaluechains............................................................175.1Examplesofbarriersandsolutions.......................................................................................18

6Indicatorsforassessingcrossovercollaboration............................................................21

7Conclusionsandnextsteps............................................................................................29


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List of Authors

Partner AuthorsHCN JoannaLane

Document History Date Version Editors Status30.01.2018 0.1 JoannaLane Draft04.02.2018 0.2 JoannaLane Draft04.03.2018 0.3 JoannaLane Draft22.03.2018 0.4 JoannaLane Draft


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List of Figures Figure1:Modellingacrossoverapproachinregions............................................................................12Figure2:ThecrossovervaluechaininCastillayLeon(BIOTECYL)........................................................14Figure3:Stakeholdersinvolvedinthevaluechain(NHT).....................................................................15Figure4:Thedefiningcharacteristicsofeachstageinthecrossovervaluechain(NHT).....................15Figure5:AcrossovervaluechainunderdevelopmentintheSkåneregion(IS)...................................16Figure6:ThecrossovervaluechainmodelforAV................................................................................16Figure7:HowRegionSkåneprovidesanopenprocessforinnovativesolutions..................................20Figure8:InnovationprocurementlevelsinRegionSkåne.....................................................................21

List of Tables Table1–Emergingindustriesthatcompaniesinpartnerregionclustersareactive............................10Table2–Clustercategoriesthatarethemainfociofpartnerregions.................................................11Table3:Keydriversforemergingindustriesinpartnerregions...........................................................13Table4:Actionstofacilitatecrossoverhealthinnovationsinpartnerregions.....................................13Table5:Whatslowsdownorblockscrossovercollaboration..............................................................17

Glossary Acronym Meaning

AEBIM AerospaceEnergyBiotechICTandMedical(AEBIM)

AI ArtificialIntelligence

Cross4Health AcronymofprojectfundedbyEuropeanCommissionunderGrantAgreementNºH2020-731391

CARMATAcrossoverprojecttodevelopanorthotopicandbiocompatibleartificialheartwhichiscompletelyimplantable,aswellasitselectricalpowersupplysystemandremotediagnosissystem.

CVC Crossovervaluechain

EC EuropeanCommission

EU EuropeanUnion

ICT InformationandCommunicationTechnology

MVA MediconValleyAlliance

NRW NorthRhineWestphalia

SME SmallandMediumEnterprises

TRL TechnologyReadinessLevel


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VR VirtualReality

Consortium ACRONYM FULLNAME

AV AerospaceValley

BIOTECYL ClusterdeSaluddeCastillayLeon

EUROB EUROBCreative

HCN HealthClusterNET

IS InnovationSkåne

NHT NorwayHealthTech(Coordinator)

ZENIT ZENITGmbH


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1 Introduction WithCross4Healthweusevaluechaininnovationtotransformtraditionalvaluechainsintonewones–emerging industries–throughcrossover (bordersandsectors)collaboration.Aswithsinglevaluechains,thisisaprocessthatconnectspeople,needsandopportunitiesbutitislesslinearandvaluecreationisbecomingmorenetworkedasadefenseaction1.Valuenetworkshavebeenmorefamiliarinthefieldsofe-commerceandmobile-commerce.Butoverthelast23years,networkeffectshaveaccounted for approximately70% of the value creation in tech2. Network effects3 will increase inimportance because new platforms and reinvented verticals are born networked e.g. syntheticbiology,augmentedreality,AI,IoT,robotics,smartcitiesandhealthcare.

Achievingthiswiththehealthsectorisbothneededandquitetricky.Theincreasingcostofadvancedhealthcare solutions and thedifferent levels of national health insurance coverages (full coverage,co-payments,fullypaidbythepatient)canbeabarrierforaccessinghealthimprovements,especiallyfor themost disadvantaged EU regions.While individual clinicians and other health professionalsmightbeopentoinnovation,publicprocurementprocessesinmanyhospitalsandcareprovidersarenot always very disposed to innovation. Competing for public sector contracts remains veryunattractive for SMEs even if they areofferingmore efficient and affordable solutions. Related tothis, is the difficulty SME’s can have in accessing clinical settings for testing and validating newsolutions inasectorwithnot-so-flexible legacysystems(especially intheEU134).Gettingaccesstoclinical test-beds via collaborationat thepre-commercial stage is oneway tounlock initialmarketaccess with the potential to take new products/services from proof of concept to large-scaledemonstrators.Butforthistohappenthereneedstobemutualunderstanding,incentivesandnovelbusinessplanstoworktogether.

2 Why identifying barriers and solutions for crossover innovation matters The 1st Open Call looks to maximise the utility of aerospace or energy innovations for use inpersonalisedcare.Toachievethis,thesewillneedtobeadaptedthroughcollaborationwithpartnersintheBiotech,ICTorMedicalDevicessectors.

1Organisationsaremovingfromsequential,linearmodelstomulti-directionalandsimultaneousco-productionwhereactorsarecreatingvaluetogethertobringcustomersthatextrabitofvalueataprofit.See:HerrelaMandPakkalaP(2009),Value-creatingnetworks–aconceptualmodelandanalysis,WorkreporttoEIBInstitute.Accessedon22March2018at:https://institute.eib.org/wp-content/uploads/2016/04/Final_Report_2009_Value-creating_networks_-_a_conceptual_model_and_analysis.pdf2JamesCurrier(2017),70%ofValueinTechisDrivenbyNetworkEffects.Accessedon22March2018at:https://medium.com/@nfx/70-of-value-in-tech-is-driven-by-network-effects-8c4788528e353Networkeffectsinclude:directeffects(protocols,personalutility,personal,marketnetwork),2-sided(marketplace,platform,asymptoticmarketplace);tech(techperformance)andsocial(bandwagon).4WatsonJetal(2015),Healthinnovationenablers:identifyingremedialactionstoremovecriticalblockagestouseofenablersinmodestandmoderateinnovatorregions,SummaryReport2,DanuBaltH2020(CSA)project.http://danubalt.eu/wp-content/uploads/2016/05/DanuBalt_Summary-Report-2_Finalv2-1.pdf


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Cross4Healthisespeciallyinterestedinsolutionsthat,todate,haveshowngoodresultsinaerospaceandenergyandarenow ready to crossoverorhave crossedoverbuthavenot yetbeen tested inlarge-scaledemonstrators.The formerwillneedtocreatecollaborationwithaSME(s) fromoneofthehealth-relatedsectorswhilethelatterwillhavealreadydonethis.

A minimum technology Readiness Level (TRL) 5 in the sector (aerospace or energy) which thetechnologyisbeingtransferredfrom,isrequiredi.e.proofofconceptshowsthattheproduct/serviceworks.Crossovertothehealthsectorwill likelymeanthattheproduct/serviceisstartingagainatalower TRL in the new sector. Cross4Health will help crossover collaborations at both stages ofdevelopmenttospeedupend-uservalidationinhealthsettings.

Whilethesetechnicalpre-conditionswillguidetheselectionofsolutionsforimprovingpersonalisedcare,therearebarriersthatneedtobeovercomefacilitatingcrossover.Thesebarriersare, inpart,generated by regional ecosystems where health systems and industry tend to operate in afragmentedway.

The purpose of this baseline survey was to explore current practices, barriers and solutions tocrossover innovation inpartner regions. Forexample,whatbottleneckshavepartnersexperiencedthatcan limitorslowdownthefunctioningofcrossovervaluechains.And,havetheybeenabletoprovideworkable solutions to overcome these obstacles and so improve the functioning of thesevaluechains.Importantly,thisexploratoryworkhelpedtoidentifypotentialindicatorsforcrossovercollaborationthatcanbeusedtoinformassessmentofprojectimpactsinthe2accelerationperiodsoftheCross4Healthproject(seeSection7).

Inorder tobetterunderstandwhat ishappening in thepartner regions thebaselinesurveysoughtinformationofthefollowing:iftheregionhostsorcontributestoacrossovervaluechain(s);whatarethestagesofthatcrossovervaluechain(s)andwhoarethecriticalstakeholdersineachstage;whatarethedefiningcharacteristicsofeachstage(activities,resources,capabilities,relationships);whereare the crossover points for stakeholders i.e. linkages and flows;what are the ‘choke points’ andwhatsolutions(ifany)havebeenusedtodealwiththem;andwhatarethefuturedirectionsoftravelthatCross4Healthcansupportasitbuildsaportfolioofinnovativeservices,processesandproductsmadeavailablethroughanintelligent‘plug-in’platform.

3 Cluster focus and characteristics in partner regions AV,BIOTECYLandNHTare innovationclusters in their regionswhile ISandZENITare intermediaryresources.AVhasover800membersincludingover500SMEs,BIOTECYLisatanearlierdevelopmentstageandhaslessthat50membersrightnow.NHThasmorethat200membersatdifferentstagesof companydevelopment. Table 1 shows those emerging industries inwhich clustermembers areactive.Digitalhealthandmedicaldevicesarethemainfocusofactivity.Beyondthesesixemergingindustries:


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• TheprimarymarketsforAVareaeronautics,spaceandembeddedsystems.Diversificationmarketsinclude:drones,agriculture,smarttransportationandenergy

• Additionalfociforotherpartnersincludebiosmilars(BIOTECYL)andBiotech(ISandNHT)

ISandZENITareembedded intheir regional innovationecosystemsandhaveclose linkswiththeirclusters(2inSkåneand6inNorthRhineWestphalia). ISactivelypioneersnewmethodstoprovidethe right support toemergingenterprises.ZENIToffersexpertise in funding, researchcooperation,innovationmanagement,knowledgetransfer,technologyassessmentandinternationalisation.Moreparticularly:

• MediconValleyandtheMVAllianceisacross-borderclustercoveringSkåneandGreaterCopenhagen.Ithas350companiesworkinginBiotech,PharmaandMedtech.Also,withinSkåneisMobileHeights,aclusterforITandmobileserviceswithsomeofitsmembersinterestedineHealthandmHealthsolutions.

• ZENITisengagedwith6clustersthatwereestablishedbetween2004-2007-ClusterInnovative.MedizinNRW;Gesundheitsheitswirtschaft:NRW;MedEcon.Ruhr;BrancheninitiativeGesundheitswirtschaftSüdwestfalen;GesundheitsregionKöln-Bonn;MedLifeAachen.Takentogether,theclustershavebetween400-500payingmembers,companies,researchinstitutions,hospitals,healthinsurersandotherssupportingtheregionalinnovationecosystems(lawyers,patientexperts,economicdevelopmentagencies).

Table1–Emergingindustriesthatcompaniesinpartnerregionclustersareactive

Looking at innovation cluster members who are engaged in these emerging industries, feedbackshows:

• AV-Lessthan25%ofclustermembersareengagedinthoseindustriesandlessthan10%ofclustermembersarestart-upsinhealthcare-relatedemergingindustries

• BIOTECYL–AllmembersworkinBiotechandofthesemorethanaquarterarestart-ups


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• NHT–Morethan¾ofclustermembersareengagedinthoseemergingindustriesandmorethanhalfofthoseclustermembersarestart-ups.

Within the emerging industries, cluster activity has a range of health-market priorities (Table 2below). There is no clear priority for four of the partner regions (represented by AV, IS, NHT andZENIT) while BIOTECYL has one core priority: biotechnology. AV was the only partner to identify‘other’prioritiesthatrelatedtoitsprimaryanddiversifiedmarkets:3Dprinting,spacedata,modelingandsimulation,navigation,drones,autonomousvehicles,human-systeminteraction,safeandsecuresoftwareandhardware(embeddedsystems).

Table2–Clustercategoriesthatarethemainfociofpartnerregions

3.1Emergingbusinessareasexpectedtodrivefutureclusterdevelopment

When asked what emerging healthcare-related business areas are expected to drive the futuredevelopmentoftheirclusterthefollowingwereidentified:

• Newcaredeliverymodelssponsoredbyprivateinsurancesandindividualsincludingfriendsandfamilymembers.Changeswillinclude-shiftfromtreatmenttoprevention,caredeliveryawayfrominstitutionathomes(NHT)

• Activeimplantablemedicaldevices,custom-made,includingartificialorgans(thankstomodellingand3Dprinting,newmaterials),connected,safeandsecure(AVandZENIT)

• Systemsforperformingamedicalorsurgicalact(“smartassistance”),e.g.assistanceindecisionmaking,inprecisionofthegesture(thankstoeffectivehuman-systeminteraction,augmentedreality,robotics…)(AV)

• HealthcaretechnologiesandservicesenabledAI,VR,robotics,3Dprinting,sensortechnologies(NHTandZENIT)


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• Simulationfortraining(includingeducation):systemsanddevicesbasedonmodelling,virtualandaugmentedreality,seriousgames(AVandZENIT)

• AffordableIT-basedsolutionse.g.mHealth(AV,BIOTECYLandZENIT),electronicdevicesbasedon“Check-list”-principle,simpletouseandmobile,toperformandensureanyhumanactinmedicalenvironmentandforthesafefunctioningofappliances(AV),

• eHealthexploitingbigdata(BIOTECYL)• Caresupplysystems(ZENIT).

Alloftheaboveareforeseeninthecontextofactiveandhealthageingandprogressinpersonalisedmedicine.

4 Crossover innovation characteristics It’sbroadlyacceptedthatacrossoverapproachtoclusterpolicycangeneratesignificantbenefitsforregionaleconomiesandinnovationpolicies.Thefollowingmodelpresentedinarecentreport(EPLPonSMECompetitiveness,2017)andproducedbyinnoAG,showstheelementsthatcanhelpshapecrossoverinnovationandtheimpactsthatcanbeexpected(Figure1).

Figure1:Modellingacrossoverapproachinregions


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Whilefourstrategicinnovationdriverswereidentified,publicprocurementpracticehasthepotentialtobeafifthstrategicdriverforemergingindustries.ThisisreflectedinthePublicProcurementandPre-Commercial Procurement Initiatives. The latter especially provides a first customer referencethat enables SMEs to build competitive advantage in markets. It does this by enabling publicprocurers tocomparealternativesolutionsto identify thosethatcanbestaddress identifiedpublicneeds. However, while this makes public procurers more active with R&D needs, it does notsufficiently facilitatesharedunderstandingofend-userneedsbetweenSMEsandserviceproviders.Thisiswhyclinic-industrycollaborationthatincentiviseclinicparticipationaslivinglabs/testbedsandSMEaccesstovalidateproductsiscritical(seeTable4).

Table3:Keydriversforemergingindustriesinpartnerregions

And so,publicprocurementwas includedas a key strategic innovationdriverwhenpartnerswereasked what are the key drivers for emerging industries in their regions (Table 3). More partnersidentifiedserviceinnovationanddigitaltransformationasstrategicdriversthattheotherchoices.

Table4:Actionstofacilitatecrossoverhealthinnovationsinpartnerregions


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The three leading actions identified by partners that are being used to help crossover healthinnovation to happen are: industry-end user dialogue, clinic-industry-investor collaboration andinnovativefinancialsupport.Inrelationtothefirstofthese,AVmentionedtwoapproachesitusestoenableinformeddialogue:

• Animation of thematic work groups with health professionals, medical and aerospacecompanies,andresearcherstofostercollaborativeR&Dandsettingupofprojects

• “Technopush“(lessused) -presentationofaerospace technologies (andsuccess storiesoftransferstowardshealthcare)tohealthprofessionalsandmedicalcompanies.

Partners were then asked if crossover value chains exist in their region. If they did, were theybetweensectorsand/orcross-border.Fromthispartnerswereaskedtoproduceaflowdiagramthatshows: stages in theCVC, stakeholders involved in each stage, thedefining characteristics of eachstage (activities, resources, capabilities, relationships) and where are the connection points forstakeholdersi.e.linkagesandflows.

Figure2:ThecrossovervaluechaininCastillayLeon(BIOTECYL)

The commonality between what AV, BIOTECYL, IS and NHT provided (Figures 2-5) is a steppedapproachforcrossovervaluechains.Whatislessobviousaboutstakeholders(exceptforAVinFigure5) is:Aretheyequallyengaged ineachstage?Doesan individualstageand/orconnectiontootherstagesdependonstableorfluidstakeholderrelationships?Areanystakeholdergroupshardtogetinvolved?TheNHTflowcharts(Figures3and4)showwherestakeholdersareinvolvedandsomeofthedefiningcharacteristicsofeachstage including linkagesbut (i) inFigure2stakeholdersmaybeinvolved inmore than 1 stage e.g. EarlyHTA can be involved at the technology development andclinicalvalidationstages(ii)inFigure3theflowsareinferred.


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Figure3:Stakeholdersinvolvedinthevaluechain(NHT)

Figure4:Thedefiningcharacteristicsofeachstageinthecrossovervaluechain(NHT)

Thatsaid,NHTareveryawareoftransitionpotential.WithRDI,NHTcanforeseeanextensivetechtransfer potential from Oil & Gas and aerospace sectors for use in Health Technology sector.Specifically:

• Manufacturing:Oil&Gas,defenceandaerospacesectorsarebasedonextensiveknowledgewithinmanufacturingofcomplextechnologies,equipment,sub-seafloatingplatforms,satellites,missilenavigationssystemsetc.Themanufacturingskillsandfromqualityassurance,compliancetoestablishingtheassemblylinescanbeusedinothersectors.

• Servicesandcaredeliverymodels:Transitionintheelectricitymarketfromsinglesupplier,oftenthestate,toavaluechainwhereseveralactorshaveledtoadeliveryofbetterqualityandperformancetothebenefitofenduser.Itmightbeworthinvestigatingthetransitionprocessandnewbusiness/servicemodelofthischangeandwhatlessonwecandrawtowardsestablishingabetterservicesandcaredeliverymodelinhealthcarebyengagingseveralactorsinthecaredeliveryvaluechain.


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Figure5:AcrossovervaluechainunderdevelopmentintheSkåneregion(IS)

TheCrossovervaluechain shown inFigure5 is stillunderdevelopment in theSkåne region. Ithasbeen generated by HealthTech Nordic funded under INTERREG. They are working across thedevelopmentprocess,adaptingtotheneedsespeciallyofstart-up.Specifically:

• Earlyconceptdesignandevaluation• Resourcesforrapidprototyping• Settingupfocusgroups• Facilitatingproductvalidation• Contacttohealthcareorganizations.

TheSkåneregionexample is theonlyonewherethere issomeexplicitattentiontoshorteningthevaluechain.That’snottosaythisisn’thappeningintheotherregionsbutitisnotobvious.

Figure6:ThecrossovervaluechainmodelforAV


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ThecrossovervaluechainflowchartforAerospaceValleyisleftuntillastbecauseitbetterillustratesthe complexity and messiness of a crossover value chain. Figure 6 shows how stakeholders areinvolved. It also shows the defining characteristics of each step/stage including linkages and logicflow.

5 Barriers and solutions to crossover value chains

Table5:Whatslowsdownorblockscrossovercollaboration

Thethreemainbarrierstocrossovervaluechainsidentifiedbypartnersare:regulatorydifferencesinparticipatingsectors,participatingsectorshavingdifferentdevelopmentdynamicsandperhapsmostcritical,thosesectorshavingdifferentbusinessmodels.

That said, the particular emphasis on industry-end user dialogue and related collaboration by allclusters (Table 4 above) reflects understanding that health systems and regional innovationecosystemstendtooperateinafragmentedwayandthisisproblematicforSMEsandforhealthcareproviders.Thisisseeninthereluctanceofhealthcareproviderstooffer‘testandlearn’platformsfornewproducts.Essentially,thereisalagbetweenwhatend-usersneed,whatSMEsarecreatingandneed to test and what healthcare providers/funders seem prepared to do. This choke point iscompoundedbythethreemainbarriersidentifiedpreviously.


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5.1Examplesofbarriersandsolutions

ThefollowingbarriersandsolutionswereidentifiedmostlybyAV(4)andIS(1)withsomesupportingcommentsfromZENIT.

Understandingcrossoveropportunities(AV,NHT)

Barrier-Healthprofessionalsdonotfinditeasytocommunicatetheirmedicalneedsclearlytoothersectors. In part, this is because they often can’t imaginewhat crossover opportunities exist,whatcouldbedonebyutilizingthetechnologiesandknow-howavailablefromothersectors.

Solution–Regularinteractionsbetweenprofessionalsandexpertsincrossvaluechains.

AerospaceValleyorganizedworkshopswithtechnologyprovidersfromnon-healthsectors(solutionproviders) and health professionals who wanted to communicate a medical need they have.Moderateddialogueoveranaverageofthreemeetingshelpedaneedtobeclarifiedmorepreciselyandmatchtheneedwithprecisesolutionsavailable.Healthprofessionalswanttoengagewithothersectorsandsuggestedthatmatchingneedsandsolutionsisatwo-wayprocess.Havingsaidthis,itistheprocurementstaffofhealthcareproviderswhoactasgatekeepersandneedtoalsobeengaged.

Norway Health Tech is a partner in Norwegian Pumps and Pipes (NP&P) initiative, which aims attransferof technologyandknowledgefromNorwegianOilandgassectortoHealthcare.NP&P isaplatform to bring together professional groups who may not otherwise have the opportunity tointeract for the transferofknowledgeand technologyknowhow.NHT is in theadvisorygroupandregularly advise and contribute in the activitiesofNP&P.Cross4Healthwill further strengthenandpromotethisinitiativeatEuropeanlevel.

Differencesinregulationbetweensectors(AV,NHTandZENIT)

Barrier -Different industrieshavedifferent regulatoryrequirements, for instancerequiredivergentquality management or risk management systems. Experience with CARMAT (innovative artificialheartdevelopedbyacrossovervaluechain)andcrosssectoralprojectinitiatedinNP&Pshowssomesimilarities in dealing with risk management in health, oil and gas technologies and aerospacesectors.Thephilosophyisthesameandtoolstoquantify,analyseandmeasurerisksappearsimilar.Themostobviousdifferencesare:relianceonthespecificityofclinicaltrialsinHealth,theconceptofrisk-benefit balance, and the risks threshold tolerated based on previous studies (not set as inAeronautics).

Solution - All regulatory requirements (that are quite complex for the pharma or medical deviceindustry) must thus be provided within the crossover value chain. Alternatively, new regulatoryrequirementswill beneeded tobedefined for the emerging industry. The experienceof CARMATshows that Aerospace SMEs working on critical complex systems could "easily" diversify towardsHealth butwould need some regulation support. Regulationdoes not block transfers fromEnergyand Aerospace to Health, but slows down them. Regulatory assistance vouchers could facilitatetransferandbeattractivetoSMEsnotreadytopay10-20k€forsuchassistance.

There is apotential to transfer knowledgeand skills from regulatory services sector in EnergyandAerospace to health technologies sectors. In Norway, several regulatory and quality assuranceservicecompanieswithorigininOilandGasanddefencesectorshaveovertheyearsdiversifiedtohealthtechnologies.Theavailabilityofsuchserviceproviders intheopen innovationspacescanaswellfostertheknowledgetransferbetweenthesectors.


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SmartSpecialisation(IS,NHT)

Barrier–Lackofsmartspecialisationstrategies

The ability of Medicon Valley (Greater Copenhagen and Skåne) to create growth from newbusinesses was evaluated as weak (Boston Consulting Group 2012). Growth from the life sciencesectorwasmainlydrivenbyfewlargecompaniesintheregion,namelyNovoNordiskandLundbeck.Growthfrommediumandinparticularsmallsizedcompaniesintheregionwasmarginal.Withintheregional innovation ecosystem at that time, cultural and monetary incentives to go theentrepreneurialwayweremissing.

Solution – Build on regional strengths and establish short and long term smart specialisationstrategies

TheBeacons schemewas launched to combine regional strongholds in anovel, innovativewaybyaligningforcesbetweenSwedenandDenmark,betweenthepublicandprivatesector,andthroughwidespread cross-disciplinary collaboration across a range of life science fields. Using the DrugDeliveryBeaconasapilot, theMediconValleyAlliance andInvest inSkåneformally launched theMedicon Valley Beacons in November 2011 with funding from the European Union Interreg IV AProgramme,which aims to increase the region's competitiveness and attractiveness. In 2013, fouradditional scientific strongholds were identified as potential Beacons:systems biology,immuneregulation,structuralbiologyandindependentliving.MVAandInvestinSkånearecurrentlyscopingout exactly what to focus on within each stronghold together with experts and stakeholders inMedicon Valley. Each Beacon is characterized by a high degree of cross-disciplinary collaborationbetweenthepublicandprivatesector inDenmarkandSweden.TheambitionisfortheBeaconstohave achieved international recognition as world class centers of excellence by 2020 thusunderpinningMediconValley'sstatusasaleadinglifesciencecluster.

A numberof initiatives to transfer technology and knowledgehavebeen started after crashof oilpriceintheinternationalmarketin2013andthecrisesintheoilandgasindustryinNorway.Thishasledtoanationaldebateondiversificationandbuildingthefutureonexistingregionalandnationalstrength.Consideringthehugesocietalchallengesandneedofnewandinnovativetechnologies,anddisruptivebusinessmodelstodeliverhighqualityandpersonalizedcareinthefuture,thehealthcaresectorhasbeen identifiedwithahugecrossoverneeds.Today,NHT is leadinganational initiativeEnergy2Helath which aim at knowledge, skill, technologies and human resources transfer fromEnergytoHealthsector.

Timedelays(AV)

Barrier – SMEs are concerned about time delays in launching a project in a sector they are notfamiliarwith.This is compounded if there isa lackof clearvisionabout thepotentialmarket.Thismakes them reluctant to commit their own funds when a seed funding is not available. Severalpromisingprojectshavenotstartedyetbecauseofthislackoftimecombinedwiththelackofclearvisionofthepotential.

Solution-Dedicatedfinancialsupports(associatedwithaquickandeasyprocess)willhelptomakecrossover projects much more attractive. Practically this means market vouchers, and reducedadministrativeburden(associatedwithaquickandeasyprocess)togetCross4Healthsupportshouldmakecrossoverprojectsmuchmoreattractive.

Organisationaltransfersbetweendifferentworkingcultures(AV)

Barrier - In anairplaneanda subseaoil platform, teamsoften changewhich is not the case in anoperating room, so the pressure of the hierarchy seem to be much more present in the Health


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sector.Thismightpreventsomeorganizational transfers.Also, incaseofaprobleminaplane,thelife of the pilot is asmuch endangered as the life of the passengers, which is not the case for asurgeonfacingdifficultiesduringasurgery.So,thefeelingiscompletelydifferent,andhumanfactorsconsiderations are not the same. This kindof examples illustrates thedifficulties of organizationaltransfersbetweensectors.Solution – Crew Resource Management (interpersonal communication, leadership and decisionmaking in the cockpit), checklists, no-blame of errors to detect and prevent similar faults, use ofpedagogic simulation, etc. have been successfully transferred to medical context, based on riskmanagement experience ofmainly aeronautics, space, defence and nuclear sectors. Basically, thisrequiredsomeadaptationoftheseprocessestothemedicalsector,facingsimilarchallengesinriskmanagementbutalsoculturaldifferencesimpactingtheirorganisation.

Publicsectorprocurement(IS)

Barrier–Procurementinhealthcareandinenergyandaerospacesectorshavecompletelydifferentprocedures,where intheformercasepurchase isdrivenbycomplexpubliccontract tendering. AttheEU level thereare initiatives likePPI,PCPandEIPSmartCitiesandCommunities for leveragingbetterpublicprocurement.Butthesehavenotreallychangedlocalprocurementpractice.Healthcareinnovationsinvariablyimplychangefortheintendedusers(e.g.cliniciansandpatients),thechancesofpromising innovationsbeingadoptedaresmallwithoutexplicitattentiontomanagingchangeatorganisational and workforce levels. Specifically, there is a need to Improve the competencies ofhealth care supply chainmanagementand staff inmakingprocurementdecisions regardinghealthinnovationproducts

Figure7:HowRegionSkåneprovidesanopenprocessforinnovativesolutions

Solution-Tointroduceanewapproachtoinnovationprocurementthatallowinnovationprojectstobedevelopedbeforeandduringaninnovationprocurementprocess.Forexample,inRegionSkåne,theyarelookingforsolutionstoclearlypreventfallinjuriesinthehealthcareenvironment.Asafirststepaworkinggroupisformedwithindividualswhobringarangeofperspectivesandexpertisetothe issue.They formulateadeepsharedunderstandingof the issuetobeprojected insubsequentdialoguewiththemarket(Figure7below).Anopeninvitationisofferedtothemarkettostimulate


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newsolutionsthataddresstheneed.Thereisthencompetitivetenderingwithattentiontotry/test,developandverifybeforetestinginthehealthcareenvironmentbeforefullscaleadoption.

Figure8:InnovationprocurementlevelsinRegionSkåne

Perhapsascritical, thereare3 levelsof innovationprocurement inRegionSkåne (Figure8).At thebottom iswhat is termed ‘innovation friendly procurement’. Thismeans being open towards newproducts and entrepreneurs. The result can be a new product but there is a lower degree ofinnovation here. At the second level is ‘strategic innovation friendly procurement’ whereprocurement seeks a new product in a strategically important area e.g. healthcare or theenvironment.Atthetopofthepyramidis‘procurementofinnovation’.Thishappenswhentherearenosolutionsavailablelocallyandsoanewsolutionisneededtosolveaproblem/meetaneed.Theresultisanewproductoranewwayofusinganexistingproduct.

6 Indicators for assessing crossover collaboration DrawingonthefindingsinSections3-5,thepurposeofofferingasetofindicatorsistomonitorandimprovefactorsthatmightaffectcrossoverpracticeandperformancebyCross4HealthfundedSMEsin partner regions. It does this in ways that address differing circumstances for the Cross4Healthaccelerator programme in partner regions while generating evidence that is comparable andprovidesabasisforidentifyingappropriateassessmentoptions(strategicandoperational).

Initially,11 indicatorshavebeen identified.Thesearebasedon findings inSection3 ‘Cluster focusandcharacteristicsinpartnerregions’,Section4‘Crossoverinnovationcharacteristics’andSection5‘BarriersandsolutionstoCVC’.


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TherearetwopartstothisindicatorpackageforusebyKAMs:averyshortquestionnaireusinga7pointLikertscaleand;adiscussionguidefortheKAMtousewithSMEswhendiscussingtheirscoringoftheindicators.Thelatterincludes:crossreferenceoftheindicatortoearlierfindingsinthereport;validationquestionstofacilitatedeeperdiscussionofthe indicatorwiththeSMEand/orwithintherelevant Cross4Health partner cluster/intermediary; indicator rationale. This indicator package iscurrentlybeingdiscussedwithS3contactsinpartnerregionsandwillberevisedasnecessary.CVCquestionnaire

CVCSTATEMENTsStronglyStronglydisagreeagree1 2 3 4 5 6 7

CVC1 Collaborativevaluechainsworkbestwherethebusinessmodelsembracecollaboration,amodularapproachtotechnologyandbuildnewbusinessprocessesaroundboth

CVC2 Currentregulationsinourregion/countrymakeiteasiertoset-upandrunanewbusinessbasedoncrossovercollaboration

CVC3 Fast-trackproceduresareinplacetosupportapplicationsbySMEstoavailablepublicfunding

CVC4 Privateinvestorsunderstandtheneedsofcrossovercollaborationsandofferarangeoffundingoptions

CVC5 Stakeholders(industry,endusers,investors,regulatorybodies)workwelltogethertohelpgetcrossoverproductstomarketfaster

CVC6 Talkingwithend-usersisessentialinunderstandingmarket-pullfactorsforourproduct/service

CVC7 Publicprocurementpracticedisincentivisesaccesstoapotentiallylucrativemarket

CVC8 Ourproduct/serviceisdrivenmorebytechnologypushratherthanmarketpull

CVC9 Alivinglabisaresourceefficientwayoftestingourproduct/service

CVC10 Weareorganisedmoreforradicalinnovationthanforincrementalinnovation

CVC11 Weareworkinginaknowledgerichlocationcharacterisedbynetworkspill-overs.

DiscussionguideIndicator CVC1NewbusinessmodelexperimentationCrossreference Table3(Digitaltransformation,serviceinnovation),Table4(Newbusiness

modelexperimentation,shorteningthevaluechain),Table5(Developmentdynamics,businessmodels),5.1Timedelays,organisationaltransfersbetweenworkingcultures.

Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?


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Validationquestions • Aretraditionalvaluechainsobsoleteandifyes,whyisthat?• Collaborationcombinedwithnewtechnologies(InternetofThings,

smartmobilewearabledevices,socialnetworks,virtualaugmentedreality,3Dprinting,roboticsetc.)buildsnewpathstovaluecreation.Towhatextentarethesehelpingyourcrossovercollaboration?

• Clinic-industry-investorcollaborationisseenasapriority,providingtest-bedsfornewproducts/servicesandperhapspre-commercialprocurementagreements.Forstakeholderstobeincentivisedtorealisetheirpotentialcrossovercollaborationrequiresnewbusinessmodelexperimentation.Arehealthcareprovidersinyourregionopentosuchexperimentation?Ifyes,whathashelpedthistohappen,ifno,whynot?

• Lookingtothefuturehowdifferentwillbethemarketpullinurbanandruralareasandwhataretheimplicationsofthisforbusinessmodelling?

Rationale Thenworldhaschanged:consumerbehaviour(moreempowered,networkedandnon-traditional);businessinnovation(digitallynativedevelopmentdynamics,newmanufacturingmodels);massivedemographicshifts(ageingpopulationswithdistinctexpectations)and;differenteconomics(competingforspace,accesstoresources,staticpublicbudgets).Newbusinessmodelexperimentationisneededtocreatevalue,achievecompetitiveadvantageandlong-termgrowth.Basictothisisaworkingcultureopentocollaboration,embracingamoremodularapproachtotechnologyandassociatedservicesandbuildingnewbusinessprocessesaroundboth.

Indicator CVC2FavourableregulationsCrossreference Table4(Serviceinnovation),Table5(Regulatory),5.1Differencein

regulationbetweensectorsIndicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Docurrentregulationsinyourregion/countrymakeitmoreorlesseasy

toset-upandrunnewbusinessesbasedoncrossover(sectorand/orborder)collaboration?Ifyes,provide1-2examples.Ifno,whatisthemostimportantchangeneeded?

• Inyourexperience,doestheenforcementofIntellectualPropertyProtectionlawsandcontractsinyourregion/countryhelporhindertheabilityofSMEsincrossovervaluechainstogetnewinnovationproductsfrom‘benchtobedside’andthenintomarkets?Pleaseexplain.

• Howdocurrentregulationsstimulateentrepreneurshipandcreatespaceforexperimentationincrossovercollaboration?

• Isthereaspecificlaw/regulation/policyontechnologytransferbetweensectorsactiveinyourregion?Ifyes,whathaschangedfortechnologytransfersinceitcameintoeffect?

• Docurrentregulationsactasabarrierorenablertoclinic-industrycollaborationsinyourregion?Ifyes,thenhowdotheycontribute?Ifno,thenwhatneedstochangetomakesuchcollaborationspossible?

Rationale Anessentialpre-conditionforattractingandretainingbusinessistheoperationandregularreviewoffavourableregulationsandrelatedlegislation.Sustainableclustersallowacombinationofforeignownership,


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enforceintellectualpropertyprotectionlawsandcontracts,instillclearrulestoaccessandoperateinthelocalmarket,andhaveclearemploymentregulationsinplacethatarefavourabletoECs’citizens.Inpracticethisshouldextendtotransparencyofdecisionsandnocorruption.

Indicator CVC3SupportforaccessingpublicfundsCrossreference Table5(Lackofinnovationfunding),5.1TimedelaysIndicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Whatfasttrackproceduresareinplaceregionallyornationallyto

facilitateapplicationsbySMEsincrossovercollaborationstorelevantnationalandEUFundinginstruments(ESIF,Horizon2020,SMEInstrumentetc.)?

• AreSMEsabletogetaccesstofundinginyourregion/countrytosupportpreparationofnationalandEU(Horizon2020andESIF)fundingapplications,(includingcommissioningexternalconsultantstosupportthem)?Ifyes,whatbenefitsdoesthisprovide?Ifno,isthisbecauseaccesstothesefundsneedstobeimprovedorbecausenopreparationfundexists?

• WhatpreventsorstimulateslocalSMEstobecomeinvolvedinpartnershipswithSMEsorthirdpartiesinothersectors(e.g.universities,publicresearchcentresorhealthcareproviders)inordertoaccessnationalandEUFunds?

• WhathaveNationalContactPointsfornationalandEUFundinginstrumentsputinplacetopromoteawarenessoftheseinstrumentsandaccesstoadviceonhowtosecurefunds?

• InwhatwaysdotheconditionsrequiredforaccessingnationalorEUFundsblockoropenopportunitiesforinvestingincrossoverinnovationthatcanhavesignificantrealworldvalue?

• DoesexperienceofuseofEUFundsinyourregion/countryshowexamplesofwastefuluseonprojectsdrivenbylobbieswithoutaccountabilityforeconomicgrowthandemployment?Ifyes,giveanexample.

Rationale NationalandEUFundingisavailableforstart-ups,entrepreneursandcompaniesofanysizeorsector.Awiderangeoffinancingisavailable:businessloans,microfinance,guaranteesandventurecapital.Thedecisiontoprovidefinancingismadebylocalfinancialinstitutionssuchasbanks,venturecapitalistsorangelinvestors.Thesefinancialplayersdeterminetheexactfinancingconditions(theamount,duration,interestratesandfees).Thatsaid,becauseofthefragmentationofthebankingsectorandsubsequentgreatdivergenceinlendingratesandcreditofferamongcountries,adifferentiatedapproachtoimprovingSMEs’accesstofundingforcrossovercollaborationswillneedtotakeintoaccountcountry-specificcircumstances.

Indicator CVC4SupportforaccessingprivatecapitalCrossreference Table5(Lackofinnovationfunding),5.1TimedelaysIndicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Whatstringentrequirements,includingpersonalguarantees,doSMEs

inyourregionreporthavingtoprovideinordertoobtainfinancingfromcreditinstitutions?


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• Whatactionshavebeentakenatnationalleveltoregulatethefinancialindustryinwaysthatexplicitlyprotectandstimulateeffectivelendingtotherealeconomy,inparticulartoSMEs?

• WhatpartnershipsareinplacebetweenbanksandotheroperatorsinvolvedinSMEfinancing(accountancyprofessionals,businessorSMEassociationsorchambersofcommerce)?

• Inordertosupportbusinessesincrossovercollaborations(takingintoaccountsize,turnoverandfinancingneeds)whatspecificprogrammesareavailableinyourregion/country:e.g.equity(suchasbusinessangels,crowdfundingandmultilateraltradingfacilities),quasi-equity(suchasmezzaninefinance)ordebtinstruments(suchassmall-ticketcompanybonds,guaranteefacilitiesandplatforms)?

Rationale Poorlydesignedregulationofthefinancialindustry,combinedwiththesevereandpervasiveeffectsthatfollowedthe2007-2009financial,economicanddebtcrisis,canmakeitharderforSMEstoaccessfinance.Aninnovationclustercansignificantlydifferentiateitsofferingsandimproveitsattractiveness(andinturnimproveitsabilitytoachieveeconomicdevelopmentgoals)byprovidingaccesstobothcapitalanddebtfinancing—accessthatotherwisewouldnotbepossible.Successfulinnovationclustersfacilitateandbringtogethervariousfinancingoptions,suitableforcompaniesindifferentstagesofmaturity,fromstart-upstomultinationals.Finally,publicseedfundscanserveasunderwritingforprivatefinancingprograms,openingthegatestofinancingthatotherwisewouldnotbeavailable.

Indicator CVC5CollaborativebusinessCrossreference Table4(Newbusinessmodelexperimentation)Table5(Development

dynamics,Poorstakeholderengagement),5.1Understandingcrossoveropportunities;smartspecialisation;organisationaltransfersbetweendifferentworkingcultures

Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Howdocrossovervaluechainswithinyourregionbuildoncurrent

knowledge-basedandindustrialstrongholdsordevelopradicallynewonesandstimulatejointactionsacrosssectorsandborders?

• Provide1-2specificexamplesofhealthinnovationcrossovervaluechainsoperatingwithinyourregionthatengagehealthprofessionalsandpatientsingeneratingandtestinginnovativeproducts?

• CanyougiveanexampleofthesuccessfuluseofpublicorprivatefundstogetacrossoverinnovationproductfromTRL3-4toTRL9usingthewholeinnovationvaluechain?

• Isyournationalgovernmentorregionalauthorityactivelyworkingonpoliciesthatsupportcross-borderandcross-sectoralvaluechains?Ifyes,pleasegiveanexampleofwhatishappening.

• Istherefragmentationbetweenregulatoryworkandresearchinvestmentinyourregion/countrythatbreakscrossovervaluechainsbycreatingobstaclestogettingaccessfornewinnovationproductstomarkets?Ifyes,pleasegiveanexample.

• Whatfutureplans(inthenext3-5years)aretheretofurtherimprovetheinteractionbetweenstakeholders(researchers,complementaryinnovators,industry,healthcareproviders,cliniciansandpatients)intheseandothercrossovervaluechains?


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Rationale Inallcountriesexcellencecanbefoundinsomeindividualenterprises.Discussiononimprovingcompetitivenessoftenconcentratesonhowtoachievemoreindividualexcellence.Thisisusefulbutnotsufficient.Thecompetitivenessoftheindividualfirmdependsuponthecompetitivenessofthevaluechaintowhichitbelongs.Theongoingprocessofknowledgesourcing,transformationandexploitationcomprisestheentireinnovationvaluechain.Critically,forpolicymakersandinstitutionalintermediaries,valuechainanalysishelpsusfindoutwherethebottlenecksare.

Indicator CVC6OpeninnovationnetworksCrossreference Table4(Industry-enduserdialogue),5.1smartspecialisation;

OrganisationaltransfersbetweendifferentworkingculturesIndicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Whatarethemaincharacteristicsofanyopenhealthinnovation

networksoperatinginyourregione.g.networking,collaborationbetweenkeystakeholders,businessentrepreneurship,proactiveIPmanagementthatcreatesmarketsforcrossovertechnology?

• Howconfidentisyourorganisationand/orSMEsinyourregioninusingexternalknowledge/ideasaswellasinternalknowledge/ideas?

• Describeacaseexamplewherekeystakeholdersworkedtogethertosolveaproblembydevelopingandtestinganewinnovationproduct

• HavechangesbeenmadeinthemanagementanduseofIPlocallytomaximiseinnovationopportunities?Ifno,whynot?

Rationale Openinnovationnetworkscanprovideaplatformforknowledgesharingcharacterisedbyhighlevelsoftrust,refinedinformationexchangeandjointproblemsolvingbetweenacademia,industry,publichealthcareandpatients/carers.Thisquadruplehelixinteractionisnowmorecriticalduetothefocusonpersonalisedmedicineandthedriveforaffordablesolutionsinhealthcaredelivery.

Indicator CVC7PublicprocurementpracticesupportingcrossoverinnovationCrossreference Table3(Publicprocurementpractice)5.1Publicsectorprocurement;time

delaysIndicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Whatensuresconsistencyintheinformationprovidedtopotential

contractors?• Inthelastthreeyears,whatproportionoftendercallshavebeenopen,

restricted,closedorquickquote?• AreprocessesinplacetoimprovelocalSMEaccesstopublic

procurementopportunities?Ifyes,whatarethese?Ifno,whynot?• Doespublicprocurementinyourregion/countryhelptodevelopand

maintainopenhealthinnovationecosystemswithco-creationacrossbordersand/orbetweensectorsalignedwiththeDublinDeclarationonquadruplehelixinnovation?

• Ispre-commercialpublicprocurementinplaceforprocuringR&Dservices?Ifyes,howdoesitwork?Ifno,whynot?

• Whatcompetenciesdoyoursupplychainmanagershavetohelpthemcriticallyappraisenewinnovationproductsagainstcurrentlyusedproducts?

• Aremethodsinplacetoovercomeriskaversionintheuseofpublicprocurementbudgetsbyhealthcaresupplychainmanagersinyour


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region?Ifyes,whatarethey?Ifno,whynot?• Dohealthcareserviceswithintheregionandtheirsupplychain

contractorshaveinclusiveemploymentpolicies?Ifyes,howdoesitwork?Ifno,whynot?

Rationale InsufficientuseofpublicprocurementisakeyissuetobeaddressedinordertofosterSME’sinnovationcapacity.Itsweightisreflectedintheoften-citedfactthatpublicprocurementaccountsca.17%oftheEU’sGDPcorrespondingtomorethan€2000bn.Thiscanbeexploitedtofosterinnovation.Currentrulesdonothinderinnovationprocurementalthoughtheycouldalsodomoreinfosteringit.SMEsaremorelikelytoengageinpre-commercialandotherinnovativeprocurementinitiativesiftheyareseenasrisk-benefitsharing,non-complexandcompatible.Moreover,procurementprocessesneedtobeseenastransparentandcorruption-free.

Indicator CVC8PushorpulltechnologydevelopmentCrossreference Table3(Digitaltransformation,Serviceinnovation),Table5(Development

dynamics),5.1Understandingcrossoveropportunities;Differencesinregulationbetweensectors;Publicsectorprocurement

Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • Istechnologicaldevelopmentinyourorganisationdrivenmoreby

“marketpull”or“technologypush”?Pleaseexplainwhy.• Howdostakeholdersinacrossovervaluechainmanageriskacrossthe

lifetimeofinnovationprojects?• Whatfactorsinfluencethedevelopmentofcrossoverideasthroughto

newproducts/services?• Howeffectiveisthemanagementofregulatorycomplianceaspectsof

theinnovationprocessespeciallybetweenT3-5onthetranslationalresearchladder?

• Howefficientisthemanagementoffieldtesting/trialling/prototyping?• Whatdoyoudotomanageproductlaunchesfornewcrossover

products?Specifically,doyoulaunchinnovations?Rationale Thethreecatalystsfortechnologydevelopmentarelocatedat

differentstagesofthetranslationalresearchpathwaybasedontheHarvardCatalyst‘T-Spectrum’:T0andT1(scientificexcellence);T2andT3(research&development);T4andT5(commercialisation).AtalocallevelSMEsneedto:carryoutanincreasingproportionoftheirR&Dactivitiesclosetowherethesecustomersarelocated;developa“reverseengineering”approach,whereaffordabilityformsthebaselinefromwhichtodevelopentirelynewproductsandservices;putinplacemechanismsfornewideastoreachdecisionmakers,regardlessofwhereintheorganisationtheyoriginate.Thecriticalshiftisnotthenumberofpatentslodgedbutcommercializingthemsuccessfully.

Indicator CVC9UsinglivinglabsCrossreference Table3(Resourceefficiency,Serviceinnovation),Table4(Industry-Clinic-

Investorcollaboration),Table5(Developmentdynamics,Lackoftest&learnplatforms),5.1Understandingcrossoveropportunities

Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • DoyouhaveanyLivingLabsoperatinginyourregion?Ifyes,thenhow


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arenovelinnovationactivitiesinyourLivingLab(s)coordinated?• IfSMEsinyourregioncontinuetousethetraditionalprojectmodel

whyisthis?• Whatarethebenefitsand/orproblemsyouorothershaveexperienced

insetting-up,joiningorrunningaLivingLab?• Doyouhaveplansforusingalivinglabtoservicecrossoverinnovations

thatcanbenefitthehealthsector?Ifyes,howwillithappen?Ifno,whynot?

Rationale ALivingLabisareal-lifetestandexperimentationenvironment.Inparticular,theybringexperimentationoutofcompanies’R&DdepartmentsorUniversityDepartmentstoreal-lifeenvironmentswiththeparticipationandco-creationofusers,partners,andotherparties.Assuch,theyhavebeencharacterisedbytheEuropeanCommissionasPublic-Private-PeoplePartnerships(PPPP)foropeninnovation.TheLivingLabisalsoanassetthatcancontributetopre-procurementprojectsaimedatsupportingpublicauthoritiestoundertakerelevantactionsthatstimulatecrossoverinnovation.

Indicator CVC10SMEAbsorptioncapacityCrossreference Table3(Digitaltransformation),Table4(Innovationsupportservices,New

businessmodelexperimentation),Table5(Developmentdynamics)Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • DoSMEshaveenoughcapacitytoabsorbnewtechnologies,processes

andinnovationsthatcanhelpimprovetheircompetitiveness?Ifno,whynot?

• Doyouregularlymonitortrendswithinandoutsideyourregiontoidentifynewopportunitiesforexploitatione.g.usingtechnologysurveillance?Ifno,whynot?

• Towhatextentdoyouchangeyourpracticestokeepupwiththemarketandcompetitors.Alsotowhatextentcanyoucontrolandmanageyouroperatingenvironmenttoyourownadvantage?

• WhatimprovementsinITChaveSMEsandotherpotentialcrossoverinnovationstakeholdersmadeinthelast3yearsinordertoimprovetheflowofinformationexternallyandinternally?

• Howdoestheabilitytoinnovateimproveyourcompetitivenesse.g.byexpandingyourportfolioofnewproductsandservices?

Rationale AbsorptioncapacityisaSME’sabilitytounderstand,absorb,andapplynewknowledgeobtainedfromexternalsources.SMEswithgreaterabsorptivecapacitiestendtoenhancetheirlearningcapabilities,whichhelpsthemeffectivelyutilizeexternalknowledge.Toenablethis,thecompositionofaSMEsexternalnetworkanditsinternalcapabilitiesarecriticalindeterminingthelevelofcrossoverinnovationpracticeandperformance.

Indicator CVC11SocialcapitalfornetworkedvaluecreationCrossreference Table4(Industry-enduserdialogue,Clinic-Industry-investorcollaboration),

Table5(Developmentdynamics,poorstakeholderengagement),5.1Understandingcrossoveropportunities

Indicatorstatus Isthisindicatoractiveorinactiveinyourregion?Validationquestions • AsaSMEhowdoyoubuildproductivesocialtieswithhealthcare

providers,patients,suppliers,otherindustryinyoursectorplusothersectors?


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• Openinnovationreliesonexternalconnections(theabilitytomakeandmanagerelationshipswithotherfirms,healthcareproviderswhomightbuyyourproducts,patientsandend-usersasco-producers).Howdoyoubuildandmaintaintheseconnections?

• Whatplanshaveyouhaveforexpandingand/orimprovingexternalconnectionsinthenext3years?

• Whatmakesyouthinkyouareworkinginaknowledgerichlocatione.g.characterisedbynetworkspill-overs,oraknowledgepoorlocation?

• Arethecrossovervaluechainsand/ornetworksinwhichyouareengagedbasedonsufficientlevelsoftrustandflexibilitythatallowsmembersworkingtogethertoberesponsiveandadaptabletonewopportunities?Ifno,whynot?

Rationale Socialcapitalisastrongresourcethatdevelopsfromproductivesocialties.Itsusedependsentirelyuponthevaluesandobjectivesoftheactorsinvolved.Itdependsoncommitmentbystakeholderstotheprincipleofopeninnovation.Networksprovideaprimaryrouteforsocialcapitaltobespentandaccumulated.Effectivenetworksarecharacterisedbyhighlevelsofcommitment,trust,fine-grainedinformationexchange,andjointproblemsolving.

7 Conclusions and next steps Therearearangeoffactorsthataffectcrossovercollaborationsincluding:

• DRIVERS (the leading ones identified by partners are: digital transformation, publicprocurementpractice,serviceinnovation)

• BARRIERS(the3priorityonesidentifiedbypartnersare:regulatory,developmentdynamicsandbusinessmodels)

• ACTIONS (the three actions rated most important by partners are: industry-end userdialogue,clinic-industry-investorcollaborationandinnovativefinancialsupport).

While clusters/intermediary bodies and their SMEmembers are generally well engaged regardingthesefactors,dialogueandinteractioncanrepresentwhatastakeholderispreparedtosaypubliclyrather than admit to genuine concerns affecting practice and performance. The indicators anddiscussionnotesprovidedinSection6areintendedtohelpSMEsandKAMsmovebeyondmanagingperceptionsorsimply‘playingthegame’.

Practically,thesetofindicatorsofferedinSection6areintendedfortheKAMsresponsibleforSMEs(successful in the two Cross4Health Open Calls), to use with their SMEs. They will provideCross4HealthpartnersandKeyAccountManagerswithabaselineofSMEperceptionsofbarrierstocrossover innovation in a SMEs operating environment. This will complement the use of a shortversionofanInnovationHealthChecktoolwithSMEs(toidentifyandtracktheirinhouseinnovationcapacityandperformance)andmonitoringofCross4Healthkeyperformanceindicators.

Taken together, these will inform (i) targeted service innovation support to be provided byCross4Healthpartnersandaccreditedexternalexperts(ii)reviewbypartnerclusters/intermediariesofpoliciesandpracticesrelevanttoweaknessesintheoperatingenvironmentidentifiedbySMEsandifneeded,actionstoremoveorbettermanagethoseweaknesses.

Asanextstep,ashortbriefingnotebasedonthisreportandtheindicatorpackagehasbeensharedwith S3 contacts in the partner regions to review and validate the indicator set. If needed, theindicatorsetanddiscussionnoteswillberevisedtoincludeCVCindicatorsalreadyinuse.Thisispart


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of the process of engagementwith S3s during theirmid-term review and beyond (T6.3 andD6.1-D6.3)

Deliverable 4.1 Baseline survey of crossover value …single value chains, this is a process that...

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