Why Sickcare Innovation Centers Don’t Deliver
If you work for a big, established company, you’ve probably been noticing the sudden rise of a new trend: the innovation lab. Companies as diverse as Delta Air Lines, Target, Google, Pfizer, Marriott, Autodesk, Fidelity Investments, Ford, Verizon, and Stanley Black & Decker are jumping on the bandwagon.
As discussed on this site recently, open innovation labs like this bring The Garage Experience inside the four walls of the corporate business environment – freely available for everyone to use and experience.
The new thing in sick care administration is to create healthcare innovation centers, modeled somewhat after other industry R/D and skunk works. Their goal, ostensibly, is to innovate our way out of the sick care mess. They focus mostly on quality, cost, process improvement, patient experience, sometimes doctor experience and access to care and range in size, scope and vision. A recent review identified 50 hospital innovation centers. Steve Blank calls it innovation theater.
As you would expect, there are now conferences, webinars and white papers about health innovation centers, best practices and their impact to date. Accelerators are changing to accommodate the realities of the sickcare industry.
Sick care (over 90% of the US “healthcare” spend is for taking care of sick people) innovation center leaders and participants will need to address some issues to be effective and deliver impact:
1. The last mile. All the systems engineering in the world won’t make a difference until we crack the code on how to change human behavior.
2. The rules. Most will have relatively limited impact until and unless the reimbursement rules substantially change. Rules drive ecosystems that create business models that deploy and scale innovation. Right now innovation centers are trying to use new tactics but can only deploy limited innovation strategies without a new playing field. They are living in the no man’s land between the now and the new.
3. Systems thinking overcoming silos. Healthcare is notoriously siloed at almost every level, from department to department to one sick care system to the next.
4. Patient willingness and ability to engage. The assumption is that more patient “engagement” will be mean better outcomes. That needs to be validated and we need to do a better job of targeted patient segments who want to take responsibility for their care and assume the consequences for the results.
5. Shifting value factors. Medical care is becoming commoditized. Patients can’t judge quality and cost since they are so opaque so they use service, speed, convenience and experience as proxies. There is relatively little correlation between satisfied patients and the quality of care they receive.
6. Data integration and interoperability. Resolving the protect but share dictum will be challenging.
7. Measuring and defining innovation. Big orbit change is necessary, not incrementalism. Innovation is a measure of the multiple of user defined value that results when compared to the existing competitive offering.
8. Lead innovators, don’t manage innovation. We need leaderpreneurs and followers with an entrepreneurial mindset willing to fail at low cost.
9. Innovation management systems. There are many ways to foster, package, test, validate, prioritize and deploy components of an R/D portfolio. The process needs to efficient, effective and transparent to the users .
10. Execution. Inspiration and perspiration. In the end, no idea, invention, discovery, or process is worth much without a team who can execute or deploy it.
11. Long sales cycles prolonged processes of decision making.
12. Different business models to develop digital health and process improvement products
13.Overcoming the main barriers to physician adoption: a)evidence based safety and effectiveness, b) concerns about liability, c)getting paid to do whatever you propose that d) will not interfere with workflow, take more time and further abbreviate face time with patients.
Healthcare innovation centers seem to have a different focus than community based entrepreneurship centers. Yet, they should both be focused on the same thing: transfering value to patients. Physician centered value centers should have the following features:
1. Focus on creating value transfer to patients, not startups
2. Create a separate value proposition for the different kinds of physician entrepreneurs: private practitioners, technopreneurs, intrapreneurs, investors, consultants.
3 Include rapid prototyping facilities
4. Integrate non-MDs from other industries to create a larger, more eclectic community of interest
5. Include patients and others who might help with the customer discovery and development process
6. Include human subjects trial support
7. Accomodate the schedules of practicing clinicians
8. Use state of the art teaching technologies
9. Have an active and effective mentoring process
10. Create a business model that doctors will buy
1. Use a clear step-by-step innovation method
2. Establish an Advisory Group to guide innovation concepts and proposals
3. Focus on consumer needs, rather than technologies to direct the innovation
4. Generate Big ideas by focusing on core outcomes, not the symptoms
5. Minimize early funding by focusing on a minimal viable product
6. Support projects with innovation experts (design, engineering, business)
7. Utilize an iterative prototyping to quickly build and test the best product
8. Nurture publicity and storytelling to raise visibility, excitement and funding
9. Include industry experts/ vendors/ investors to support commercialization
10. Develop power users to give hands-on training and coaching for innovations to build key behaviors and practical experience
“What is the source of this hostility to innovation?”, “Is the under-performance in innovation episodic or systemic?” and, “What is causing this value-destroying gap between stated intent and actual reality?” Reasons include a relentless focus on the now, instead of the next and the new, cultural resistance to change, failure to embrace open innovation and rules and regulations that make if hard to kill fee for service medicine.
In fact, like many industry innovation centers, my observation is that few sickcare innovation centers are creating much high value impact and should be closed, particularly if they are just high priced, high tech suggestion boxes.
Like most corporate behemoths, BIG MEDICINE has a hard time innovating and it can’t be done from inside. That’s part of the reason doctors have been disintermediated and marginalized from the value creation process.
Sick care innovation centers might be a fad or an important tool for fixing what’s broken. We’ll have to see. In the meantime, enjoy yourself at all those conferences.
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