As an innovation research consultant working with healthcare services, I’d say one of the most significant trends in the last two years has been the creation of multidisciplinary, cross-service healthcare innovation centers. In a recent interview with Clinical Innovation and Technology magazine, I learned about their recent issue which featured this trend and revealed new developments I had not encountered in my book research (most of which was more than two years ago!)
All Rise with Innovation (by Beth Walsh)
A number of US institutions are establishing innovation centers for organizing clinical and knowledge competencies across the organization for internal enterprise-wide impacts. While some of the rationale for their development is attributed to the changes caused by the Affordable Care Act, some hospitals are getting into innovation because others are finding it valuable.
In another article in the same issue, Lyle Berkowitz supports my thesis in Design for Care by indicating the emerging drivers for innovation are being driven by cost and reimbursement, repeatable value propositions, rather than devices and technologies (which may add value and costs). New care practice models and workflows will be necessary as organizational and financial models change over the next 3-5 years as well. Healthcare practices take more time to validate and scale than, say, IT systems which have less risks to life and insurance with their deployment. I definitely agree that business model innovation will become a necessary and critical design process.
I’m not as optimistic about claims for informal “design thinking” approaches and rapid prototyping by teams that haven’t the experience in design and innovation. Unlike process improvement, what is meant by design thinking isn’t a set of methods to follow to result in better outcomes. Its a mindset shift similar to the gap between science and design. Contrary to the myth of “creativity” and invention, innovation consists of at least 50% research, with many of its methods quite unknown in most clinical settings. Innovation has serious discipline, skills learned in practice, and is not a project management tool for doing today’s work better. I’ve found that many clinical organizations are skeptical of the value of in-house innovation. There are opportunity costs for ineffective projects. There may be credibility issues if the innovation proposals are not measurably significant.
I think each organization’s approach must differ, if it is to be aligned with organizational competencies and the regional patient profiles. While the value proposition of each center is different, the universal theme is moving the larger organization toward the patient-centered paradigm and whole-person care.
One of the case institutions is the University of California Center for Health Quality and Innovation in Los Angeles, which consolidates knowledge and expertise from across the UC research centers. Their director is Terry Leach, a registered nurse (a good sign) who told the magazine:
Among its five medical centers, UCLA had expertise in virtually every field and could support a multidisciplinary innovation center and began to do so in October 2010. The bumps in the road have come in cataloging where that expertise lay and learning how to identify and disseminate best practices.
The center does not aim to reward researchers for autonomous behavior, she says. “The only way we’re going to survive as a system is if we inculcate collaboration into our mission. But there is no science of teamwork or collaboration.”
One of the major questions for all projects is how to work with patients as partners in their healthcare. “That’s a whole new paradigm for academic medical centers,” Leach says. RFPs are geared to rechannel the “vast intellectual capacity at the University of California and help us create a cadre of innovators.” Those that receive funding are expected to mentor others, take advantage of the institution’s leadership training and participate in the center’s annual colloquium to share their work.
These articles show that care practice and business innovation are emerging across the field in the US and beyond. However, the demand will soon outstrip the supply. The need for design, technology support, training, development, and facilitation overwhelms capacity. Clinics are not hiring design and innovation talent to support the desired competency, they are often trying to build the competency organically, which will essentially reify process improvement regimes. Moving clinical staff into innovation roles is similar to moving designers into clinical roles. We need experienced preceptors and “innovation attendings.” (I recommend something like this for engaging designers at the deep sociotechnical level of clinical work). It can be done, but with a huge helping hand from experienced consultation.
The shift to innovation management is a serious challenge for commercial product development firms that design and build technologies for sale in a competitive market. How much more so for institutions who are also in the midst of a patient-centered care shift, a community care shift, and an Obamacare shift? And whose mindsets have not changed substantially in decades?