September 18, 2019
Healthcare Innovation Can’t Happen if We Don’t Know What it Is
“Innovation is key to solving America’s healthcare problems.”
So ran a 2017 headline on a major news media site. The article went on to point out the obvious: we need new technology, drugs, models of care delivery, and data analytics to fix our healthcare system and make people healthier.
In fairness to the author, the article itself went into more detail about exactly what innovations were needed to improve care. The title, though, highlights an ongoing problem within healthcare: the definition of the word “innovation.”
In practice, different healthcare organizations define the word differently. Most people would probably be comfortable with the technical definition, “The introduction of something new.” By that measure, no degree of new or different is too small. But subjectively, how New or Different does it have to be to qualify? If every lawn mower manufacturer had their blades spinning counterclockwise until Acme Grass Machines come out with a clockwise-spinning mower, it would meet the official requirements of innovative, but the market probably wouldn’t get too excited. Gimmicky, sure. Innovative? Doubtful.
So, official definitions aside, a new thing needs a functional component to qualify as innovative. Even then, the degree of functional difference is subjective and colors individual’s idea of innovation. An innovative hospital might roll out a mobile option for patients to pay their bills on their smartphone, while the patient may shrug because that option has been available for years with other service providers and retailers. And, they’d both be right.
Today in healthcare we are at an odd and uncomfortable moment with the confluence of two titanic forces: the established healthcare industry, broadly made up of for- and non-profit providers, traditional payers, and policymakers. The other is comprised of large tech companies, health/healthcare-focused startups, and consumer-facing organizations (primarily, though not exclusively, retailers). Each of these groups, as well as each of the component parts, has a slightly different idea of innovation. Those discrepancies have created significant tension as the industry tries to move towards a more effective, efficient model.
Courtney Williams, Senior Advisor at Jarrard Inc., said that for her clients, “the pressure to be innovative is overwhelming and/or frustrating. It’s hard to prioritize creativity and innovation, and encourage it culturally, when you’re on the brink of closing services and posting razor-thin margins.”
Mike Biselli is President and Co-Founder of Catalyst HTI, a healthcare industry integrator in Denver that promotes collaboration and physically houses organizations ranging from individual startup founders to entire health system departments. Biselli, therefore, sits right at the intersection of the many healthcare stakeholders. His view is consistent with Williams, and he sees people sometimes talking past each other about innovation “There are stated, unstated and unknowing ways in which people communicate about innovation,” he said. Sometimes that creates tension. Other times, it doesn’t reach the point of tension because many stakeholders aren’t even thinking about innovation or aren’t sure how to define it – so it’s not part of the conversation.
People look at healthcare and say that it’s too slow, too old, too inefficient. They’re right, and they should expect better. Innovation and disruption – whether from internal iconoclasts or external challengers – should be a call to accelerate change, not resist it, as we saw in a session at SHSMD Connections 2019. At the same time, the healthcare executive who points to declining margins and says, “we need to be thoughtful and protect our assets” is also right. Healthcare also moves slowly because lives are on the line – mess up and people die. As a result, innovation in that context will be more incremental and much slower, if changes are defined as “innovation” at all.
The hope is to find some kind of Goldilocks middle ground. What could that look like? Some of it is structural and administrative. For example, finding ways to get a pilot program started with a vendor in three months instead of 18. Some of it is creating ways for front-line employees to pass ideas for improvement up the chain and have real action on them (something that, positively, is happening in more and more systems).
Some of it is simply bringing healthcare up to speed with how people operate in the rest of their lives. “The ultimate purpose of healthcare is to care for patients, so innovation with the end goal of getting the patient – the consumer – to engage with a health system is worthwhile.” said Reed Smith, Vice President of Digital Strategy at Jarrard Inc. Smith, in his role as digital evangelist, points to technology as a fulcrum to accelerate purposeful innovation: “Digital tools are the norm, and that has to translate to healthcare. Innovation that centers around trust has real opportunities to make an impact. People want to engage where there is trust, and technology can be used to convey that feeling.”
Some of it – perhaps most of it – is acknowledging a broader definition of the term. “Innovation in healthcare means understanding a systemic problem and addressing the root cause,” said Sheila Biggs, Senior Managing Advisor at Jarrard Inc. That definition leaves a lot of room for personal interpretation, without removing any of the urgency to fix what’s wrong with our healthcare system: sick people forced to wade through an inefficient, expensive maze to get care. Innovation in healthcare, continued Biggs, “is increasing the quality of life for patients.”