Social franchising: Scale and spread of innovation in Canada

Abstract Objectives The Canadian healthcare system is caught in a perpetual cycle of pilot projects which precludes the spread of innovative projects. Social franchising is a governance and operating model used to support the scaling of certain types of social initiatives. This paper presents an overview of social franchising, discusses its applicability to HIT innovations, and proposes a framework based on this model for the Champlain BASE™ eConsultation program. Methodology A literature review on social franchising was performed to evaluate this model in non-healthcare and healthcare realms. A search was performed in electronic databases to identify peer-reviewed articles. Grey literature was also used to inform this review. Results Social franchising has been embraced internationally in healthcare and non-healthcare environments. Peer-reviewed articles related to social franchising and healthcare focused on patient outcomes in family planning and reproductive programs in low- and middle-income countries. Evidence related to developed and high-income countries was scarce, which may be attributed to the newness of this model. Evidence shows the model's ability to rapidly spread programs without sacrificing quality. A National BASE TM model using social franchising is proposed for the Champlain BASE™ program, which represents a recently developed eConsultation project with potential to address the challenges related to access to specialists. Conclusion Social franchising is the fastest growing healthcare approach in low- and middle-income countries. High-income countries (e.g. UK, Germany) are beginning to experiment with the model. The Canadian healthcare system should consider the model as a viable framework to scale and spread innovative HIT programs.