Innovative Environments In healthcare: Where And How New Approaches To Care Are Succeeding

Bates DW, Sheikh A, Asch DA
Source: Health Affairs
Publication Year: 2017
Type of Literature: White
link: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2016.1311
Abstract

Organizations seeking to create innovative environments in healthcare need to pay attention to a number of factors. These include making available sufficient resources, notably money and physical space, but also coordination and consultation regarding intellectual property and licensing; enabling access to engineers, software developers, and behavioral scientists; making providers and patients available to innovators; having a sufficiently long-term view; and insulating the innovation group from operational demands. If there is a single essential key to success, it is making innovation a strategic priority. Academic health systems are enormous generators of innovation in the form of generalizable research in biomedical sciences. Typically, much of that innovation is externally supported, and little is directed to improving care processes internally. In industries other than healthcare, organizations invest their own funds in research and development to promote innovation, and this investment is seen as a metric for a firm’s commitment to its future. Increased investment in care-process innovation is long overdue.

Insights Results

Overview of article

  • This article aims to illustrate the choices that organizations must make in how they support innovation and to demonstrate the innovation process so that readers can apply and adapt the process to their own circumstances

Results

  • Organizations seeking to create innovative environments need to address intellectual property concerns, data/software access, access to providers and patients for innovators, and concerns with operational demands. Contextual factors are also important and include financial pressure to improve value, transparency, regulation and, policies. Having highly visible senior leadership support, a focus on the acceleration of adoption of innovations and favorable financial returns to investigators is also important
  • The most important key to success is making innovation a strategic priority
  • Many academic health systems have or are establishing innovation centers, all with different focuses. Such focuses include technology transfer, creation of new companies to diversify revenue sources, and increasingly improvement of health of the populations that they serve. However, a barrier to systems is that they are typically not academically rewarded for innovation
  • Innovation can depend on the environment as categorized below: 1) Innovation in matrixed environments – A matrixed environment is a grid, rather than traditional hierarchy. In this environment, it is important to develop a number of ideas simultaneously, but choose one in the end and support only the most successful. Challenges to innovation within a matrixed environment include difficulty in leveraging specialized expertise across the center, and the number of ideas brought forth. Leadership is thus powerful. In matrixed organizations, the process of innovation resembles community-based participatory research, meaning the process of primary care innovation must originate from those in charge of delivering primary care; and 2) Innovation inside academia – Examples of innovation in academic centers is increasing as exemplified through 5 centers: 1) Cleveland Clinic Innovations – Through a process called INVENT, inventors submit their innovations to a large team of market analyses and medical product experts for assessment; 2) Mayo Clinic Center for Innovation – This center seeks to improve clinical value using a design-based approach that combines principles of human factors design and consumer experience with the scientific method. To date, the Center has developed many decision aids that help facilitate conversations between patients and providers, and eConsults, a service that allows patients to video chat with specialists real time; 3) University of Pittsburgh’s Center for Medical Innovation – Identifies small companies that offer services beneficial to their health system’s enterprise (e.g., provision of workshops, free consulting services); 4) University of Pennsylvania Center for Healthcare Innovation – Focuses on redesigning service delivery within its existing business lines, reflecting third view to use their own resources to grow internally. Winners of innovative project competitions are tutored in design and asked to work with the innovation team with the goal of further testing and scaled-up implementation; 5) Geisinger Health System’s Proven care – Proven care sells its care improvement tools to help guide redesign of specific clinical systems

Key takeaways/implications

  • Areas of opportunity to make healthcare more efficient include involving delivery care in less intensive settings, improving provider efficiency (e.g., allowing patients/caregivers to do tasks traditionally completed by providers), improving care and coordination in the subacute and home care sectors, and increasing the scale and spread of effective innovations
  • Pitfalls in innovation include failing to insulate innovation groups sufficiently from operational domains, underinvesting in innovation, failing to set up methods for reinvesting innovation profits, and not taking a sufficiently long-term view, all frequently found in academic healthcare settings
  • For centers interested in innovation, it is suggested to do more better projects and identify the root cause of the problem before deciding on a solution
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