: 10.56472/25835238/IRJEMS-V5I10P107
Akshatha Aravind "Two Kinds of Fit: Decomposing Institutional Compatibility in Cross-Border Health-Technology Transfer Between the United States, United Kingdom, and India" International Research Journal of Economics and Management Studies, Vol. 5, No. 10, pp. 49-58, 2026. Crossref. https://doi.org/10.56472/25835238/IRJEMS-V5I10P107
Explanations of why health technologies succeed or fail across borders usually rest on one idea: an innovation must fit the institutions of the market it enters. This paper argues that the idea hides two different relationships. Delivery-system fit is the match between a technology and the clinical, regulatory, payment and workforce arrangements of the health system that uses it. Capital-formation fit is the match between a venture's costs and growth timeline and the expectations of whoever finances it, who may sit in a different country from both the venture's founders and its patients. Delivery fit belongs to a venture in a particular destination; capital fit belongs to the venture as a whole and travels with it into every destination at once. Four documented cases linking the United States, the United Kingdom, India, Rwanda and the Cayman Islands show the two layers diverging. Babylon Health's Rwandan service outperformed in-person care on several quality measures while its parent company went bankrupt. IBM's Watson for Oncology met a partial clinical misfit in India while remaining well funded until it was sold. Narayana Health's Cayman Islands hospital shows a third response: relocating to a jurisdiction that is neither origin nor main market. The paper sets this decomposition against institutional distance, implementation frameworks, venture-finance research and international new-venture theory, states four propositions and a survival model for future testing, and presents its contribution as a proposed analytical decomposition rather than a confirmed theory.
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Capital-Formation Fit, Delivery-System Fit, Cross-Border Health Technology, Institutional Distance, Venture Financing, Reverse Innovation, Jurisdictional Arbitrage, Health-System Adoption.