Introduction: HIPSS System-Level Services to support the uptake of systemic policies to transform health systems. This report details the development and structure of the Health Innovation Procurement Support Services (HIPSS) System-Level Services, which offer a structured, collaborative framework designed to enable European health systems to move beyond fragmented, project-based innovation rarely adopted and drive towards improving sustainable adoption to drive systemic transformation. The HIPSS systemic policy journey is to enable a co-creation space for health systems to interact, share experiences and improve their PPI policies to support transformational projects to be sustainably adopted by health systems. The premise of the HIPSS framework is that Public Procurement of Innovation (PPI) can function as a system-level policy lever capable of reshaping how health systems learn, adapt, and evolve over time. However, PPI’s systemic can function as a system-level transformation mechanism for healthcare delivery when it is embedded within a coherent policy framework that aligns actors, strategies, and long-term commitments. HIPSS systemic policy journey is service design for health systems to enable this alignment and co-creation with internal and external stakeholders driving change in different contexts. Systemic innovation challenges—such as fragmented governance, misaligned incentives, weak scaling pathways, and legal uncertainty—are primarily governance challenges that undermine the integration of innovative technologies. The HIPSS Systemic Policy journey is the service designed to go through a process of co-creation and collaborative interactions for health system professionals in order to support the improvement or uptake of systemic policies to drive change within each particular role within a health system. Services are a direct response to these persistent systemic gaps, providing the tools necessary to address governance reform and build the strategic alignment required for long-term structural change. The HIPSS System-Level Service is a guided space and co-design framework structured as a five-step systemic journey. This journey targets the HIPSS Systemic Stakeholder Triangle (Policy-makers, Health Managers, and Healthcare Providers). The journey is divided into two phases: Collaborative Foundation (Steps 1–3): Focuses on shared understanding, consensus building, and introducing the HIPSS Systemic Policy Framework (a trapezium model classifying policies versus projects, and demand-side versus technology-driven innovation). This phase ensures alignment and introduces crucial systemic tools for deployment, such as the "Permeability to Value" methodology for Value-Based Procurement (VBP) tenders and the Transformation Readiness Assessment framework. Adaptation and Strategic Vision (Steps 4–5): Focuses on contextualizing the accumulated knowledge and co-creating a localized strategy. This involves a Collaborative Health System Gap Analysis to prioritize local challenges, culminating in the Joint Construction of Local PPI System Strategy and Vision using tools like the Theory of Change (ToC) and "Seeding Futures" methodologies. The content and methodologies embedded in these steps were co-created through a series of workshops. These workshops leveraged aggregated knowledge from scoping reviews, health system analyses, and expert interviews, focusing on practical challenges like scaling PPI scenarios and overcoming systemic enablers (Technological, Capacity, Structural, Legal, Political, and Cultural) for technology adoption. The platform offers a flexible, structured journey that is adaptable to regional contexts and varying levels of health system maturity. Services can be delivered through self-guided modes, facilitated local workshops during the pilot phase, or collaborative open learning sessions involving multiple health systems simultaneously. The definition of these services, formalized in this report, establishes the architecture for the next critical step: the execution of a pilot phase. This pilot will empirically assess the applicability, usability, and impact of the co-created HIPSS mechanisms, allowing for the adjustment of services based on the emergent and specific needs of the participating health systems. By maintaining continuous validation, particularly through the refinement of the Systemic Stakeholder Personas, the HIPSS service ensures its tools and strategies remain relevant and effective for driving transformation across European healthcare systems. (https://cordis.europa.eu/project/id/101158221)
Cordero et al. (Tue,) studied this question.