In their book, Think Big, Start Small, Move Fast: A Blueprint for Transformation from the Mayo Clinic Center for Innovation, the authors provide a healthcare-specific definition for transformative innovation:
Transformative innovation is an evolutionary form of innovation built on an undivided focus on the customer and customer experience. It uses design discipline and scientific methods to integrate and deploy new and existing technologies to improve experiences and efficiencies, and it is often associated with discovering and turning negative experiences into positive ones.
Transformation innovation is innovation that has an impact on the customer irrespective of scale. A transformational innovation substantially changes an experience. It does not matter if the substantial change affects a person, a group or people, or a whole organization. It is transformational irrespective of scale. We use this definition to guide every decision we make in the Mayo Clinic Center for Innovation. We constantly ask: Will our actions have the potential to profoundly impact the experience and delivery of health and health care?
A few points.
First, it is INCREDIBLY long. While it is possible to parse it down to its’ essence after reading the definition several times, I’m curious how they clearly communicate the concept to internal stakeholders with such a verbose definition.
Second, while I’m a big fan of having a strong focus on the customer and customer experience in health care, I’m becoming increasingly concerned that such a singular focus is negatively impacting the health care provider experience. I’ll be posting more on this topic in the near future.
Finally, with all that being said, I really did enjoy the book and believe it imparts important information that other health care systems can implement. I hope health care executives will read the book and see the benefits of starting their own innovation centers.
On May 17th and 18th, the fourth annual Idaho Healthcare Summit will take place in Boise, Idaho. This years event has a three-fold theme:
- Finding unique solutions to our healthcare issues.
- Creating a sustainable framework that facilitates collaboration and gets results.
- Becoming more flexible and creative in working within shifting federal mandates and healthcare transformations.
I’m looking forward to attending. It should be a great event!
Last week I had my annual physical at the same clinic where I’ve been a patient since returning to Idaho nearly 12 years ago.
It’s interesting to reflect on how the experience has changed over the years; unfortunately, not for the better.
During my first few yearly visits I was greeted by a cheerful receptionist that verified the basics (name, address, insurance, etc.) before handing me off to the nurse to take my vitals. Then I spent much of an hour with my primary care physician where I updated him about my health over the past year while he conducted a detailed physical examination. We even had time to chat about our hobbies!
That’s not the case any longer. The last several years have seen a dramatic change in the interaction between the patient and his or her primary care physician and other supporting health care professionals.
This year, after arriving at the clinic, I first encountered a patient access specialist who stoically received my information and scanned it into the system. Then I was handed off to the nurse who took my vitals in one room before walking me to the exam room. In the exam room, she sat at a computer with her back to me and asked a series of questions where she dutifully entered the answers in the EMR. During the entire Q & A period she only looked in my direction once! As she was leaving the room, she mentioned in passing that my primary care physician was running a little behind.
I spent nearly 25 minutes patiently waiting for my primary care physician (the 3rd one I’ve had in 12 years) to enter the exam room. Finally, she hurriedly arrived and went straight to the computer to review my medical record. During the truncated exam, she spent the majority of the time typing in information I relayed during our discussion. I’m pretty sure she types faster than I can! Honestly, that’s not a skill I want her – or any physician – to need in order to successfully perform her duties.
After approximately 17 minutes in the room, the exam was complete, and I was sent on my merry way until next year.
I want to make it clear that everyone I encountered at the clinic were very professional. But, it felt sterile and impersonal – not something you want in a medical “home.” Moreover, nobody really seemed to enjoy their job. There was no laughter and very few smiles. I really felt bad for all the employees. You could tell they were overworked and stressed and doing what they could to stay on top of the patient load. I think it’s safe to say the provider satisfaction level was also low.
My experience is not unique. I’ve talked with others and they’ve noticed the same changes in their interactions with their primary care physicians.
There are solutions to the problem, but it requires structural changes that are costly and potentially difficult to implement. Nevertheless, this problem must be solved as health care in the U.S. strives to focus more resources toward preventative medicine.
On Tuesday, Amazon, Berkshire Hathaway and JP Morgan Chase announced that they will be “partnering on ways to address healthcare for their U.S. employees, with the aim of improving employee satisfaction and reducing costs.” Currently, it’s unclear how they plan to tackle this important challenge.
What is clear is the announcement had an impact on health stocks. Also, it has already generated numerous pieces on the topic, some of which include:
As you might expect, no one – outside of Amazon, Berkshire Hathaway & JP Morgan Chase – have a clear idea what they’re planning. And, if we’re honest, I’m not sure the key stakeholders know, either.
But, changes need to occur to drive down health care costs, and maybe a trio of 800-pound gorillas from other industries are what’s needed to jumpstart the process. Time will tell if they’re successful for their own organizations and whether what they learn can be disseminated to others.
The ECRI Institute has published their annual Top 10 Hospital C-Suite Watch List for 2018. This list is published each year:
“…to highlight new technologies and patient care developments that should be on the radar of healthcare leaders because these topics are likely to enter the conversation as you consider new technologies and infrastructure changes, large and small.” (p. 3)
The list includes:
- Mobile medical apps to improve addiction treatment adherence
- Direct-to-consumer genetic testing
- Acuity-adaptable rooms to minimize room transfers
- Insertable cardiac monitors that communicated with smartphones
- Virtual reality for pediatrics to reduce pain and anxiety
- Noninvasive devices for treatment of Alzheimer’s disease
- Microneedles for near painless blood draws
- MRI systems for neonatal intensive care units (NICU)
- GammaTile Radiation Therapy System for treatment of brain tumors
- Microhospitals for health care access in rapidly growing areas
If you’re interested in receiving your own copy of the list, visit this link.
Idaho is a vibrant, growing, state with lots to offer its’ residents. I’ve been fortunate to live here for much of my life and greatly enjoy the people, along with its many outdoor activities. Thus, I’m always interested in getting a “pulse” on the state – especially when it pertains to health.
One such source is the County Health Rankings & Roadmaps program, which is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. This program assesses multiple data sources to evaluate health factors (i.e., health behaviors, clinical care, social & economic factors, & physical environment) and health outcomes (i.e., length of life & quality of life) to provide a county health ranking per state. Thus, I will highlight a few of the findings from the 2017 County Health Rankings: Idaho report to see how Idaho compares to the US median on several measures.
Of course, we should start with the premise that the health of US citizens is substantially lower than many other industrialized nations. But, to my knowledge, a comparison of Idaho to other countries does not exist, so instead comparisons will be made to the US median.
Below are a few of the findings from the report:
- The number of preventable hospital stays for ambulatory-care sensitive conditions per 1000 Medicare enrollees is 32 (vs 56)
- The percentage of children under the age of 18 in poverty is 18% (vs 22%)
- The percentage of adults that report a BMI > 30 is 28% (vs 31%)
- The percentage of the population with adequate access to locations for physical activity is 75% (vs 62%)
- The percentage of newly diagnosed chlamydia cases per 100,000 population is 337.6 (vs 294.8)
- The percentage of the population under age 65 without health insurance is 16% (vs 14%)
- The number of reported violent crime offenses per 100,000 population is 212 (vs 198)
- The percentage of households with overcrowding, high housing costs, or lack of kitchen or plumbing facilities is 16% (vs 14%)
Overall, Idaho is doing better than the US median on the majority of measures, but we can always do better.
Health care delivery in the United States is currently undergoing substantial changes to address issues of cost, quality, and access. I developed the first version of this slide in 2012 and have been updating it as new trends are identified. I’m curious to see how many of the “Future State” items will become “Current State” over the next 5 years.
For anyone that follows the trajectory of proposed health care changes in the United States, you’ve probably noticed that authors and speakers have a tendency to use a variety of verbs to convey the urgency of realizing it. Some of the verbs I’ve seen attached to health care include “transform, “disrupt,” and “reinvent.”
Now I understand – and agree with – many of the calls to bring about change in the U.S. health care system. But, I can’t help wondering if too much time is spent attempting to identify new verbs to explain it at the expense of digging in and making it happen.
Those of us with a strong interest in seeing change come to fruition have been afforded an amazing opportunity to undertake this noble challenge of addressing this fundamental issue: fixing health care over the next twenty years.
We did not arrive at this place overnight, nor will we solve the numerous challenges without thoughtful effort. But, if committed people are unwilling to step up and lead, then we will remain in this morass that is slowly drowning us all.
So, let us focus less on identifying verbs to explain the change and work toward bringing it about with all expediency.
“…the potential sources of danger that we believe warrant the greatest attention for the coming year. The list does not enumerate the most frequently reported problems or the ones associated with the most severe consequences—although we do consider such information in our analysis. Rather, the list reflects our judgment about which risks should receive priority now.” (p. 2)
The list includes:
- Ransomware and Other Cybersecurity Threats to Healthcare Delivery Can Endanger Patients
- Endoscope Reprocessing Failures Continue to Expose Patients to Infection Risk
- Mattresses and Covers May Be Infected by Body Fluids and Microbiological Contaminants
- Missed Alarms May Result from Inappropriately Configured Secondary Notification Devices and Systems
- Improper Cleaning May Cause Device Malfunctions, Equipment Failures, and Potential for Patient Injury
- Unholstered Electrosurgical Active Electrodes Can Lead to Patient Burns
- Inadequate Use of Digital Imaging Tools May Lead to Unnecessary Radiation Exposure
- Workarounds Can Negate the Safety Advantages of Bar-Coded Medication Administration Systems
- Flaws in Medical Device Networking Can Lead to Delayed or Inappropriate Care
- Slow Adoption of Safer Enteral Feeding Connectors Leaves Patients at Risk
If you’re interested in getting your own copy of the Executive Brief, visit this link.