The role of patients and carers in diffusing a health-care innovation: A case study of "My Medication Passport".

Background: Patients are increasingly recognized as playing important roles in improving health services. Little is known about the mechanisms by which patients develop and diffuse local innovations in a complex health-care system.

Objective: To ascertain how diffusion of an innovation, My Medication Passport, occurred and roles played by patients in it.

Design: Case study: quantitative mapping of innovation's diffusion and analysis of the routes and occupations of those through whom the innovation spread; documentary analysis; reflective assessment of patient's roles.

Setting And Participants: NHS Trusts, third sector organizations, patients and health-care professionals.

Interventions Studied: Co-produced action to raise awareness and influence use of the innovation; order database which enabled ease of access to the innovation.

Main Outcome Measures: Geographical spread of innovation; occupations of individuals; types of organizations using the innovation.

Results: The innovation spread from initial development and use in Northwest London across the UK and beyond. Key roles played by patients were as follows: co-producer; advocate; relationship builder; relationship broker; planner; presenter; awareness raiser; trainer; networker. Patients identified and introduced potential audiences and users to MMP, using social, organizational, sectoral, lay and professional networks to do so. They organized a range of awareness-raising and communication activities, monitored feedback, evaluated the impact and responded to new interest.

Discussion And Conclusions: The roles of patients in diffusing innovations are under-recognized. Collaborative working between patients, carers and health-care professionals in planning and progressing the use and supporting diffusion of the innovation was important. Principles described in this study are relevant to progressing other patient-led ideas for innovative changes relating to health service development.