When people think of creative professions, jobs in the healthcare industry are probably not the first to come to mind.
Between surgical checklists, precise medical billing codes and rigid protocols for everything from placing a catheter to donning personal protective gear, healthcare may seem like a prison for the creative mind.
In reality, creativity and imagination are crucial to treating patients. We see the results of innovative ideas in healthcare every single day.
For instance, thinking about patient safety in new, unexpected ways is what led to the Institute of Medicine's landmark "To Err is Human" report, published in 1999. Testing and combining drugs and substances in ways never done before is one way to create new treatments and vaccines. And some outside-the-box thinking is what brought Toyota's lean style of management to healthcare.
In the past, many healthcare innovations emerged from the work of scientists and researchers, which were published in academic and medical journals. Over time, they were incorporated into the actual practices of clinicians.
Increasingly, however, hospitals are launching innovation centers of their own to work with researchers and design thinkers to tackle the biggest challenges in clinical quality, patient safety, health information technology, healthcare costs, billing and payment, and access to care.
"Healthcare systems — like systems in other industries — have come to a point where they are really trying to develop novel, targeted and cost-effective solutions to challenges," says Peter Fleischut, MD, chief innovation officer at NewYork-Presbyterian Hospital and associate professor of anesthesiology at Weill Cornell Medical College. "I think over time, it's only natural for systems to want to organize that activity and align all of the different responsibilities of innovation, which is what we are seeing happen now."
The rise of innovation centers
Since the concept is still gaining traction among hospitals, many innovation centers are only a few years old.
According to data published by The Commonwealth Fund in April 2015, many innovation centers were launched in 2010 — the same year the Affordable Care Act was passed — and quite a few more have launched since.
New York City-based NewYork-Presbyterian Hospital, for example, collaborated with an accelerator called Blueprint Health to open a dedicated innovation space last summer. As chief innovation officer, Dr. Fleischut oversees innovation at NewYork-Presbyterian.
NewYork-Presbyterian Hospital wasn't the only one to expand its innovation efforts last year; Johns Hopkins Sibley Memorial Hospital, a community hospital serving the Washington, D.C. area, also launched an innovation center in 2014.
Sibley's 3,000-square foot center — known affectionately as the Hub — is in the same space that used to house the hospital's paper medical records before the widespread use of EHRs. The center is overseen by Nick Dawson, executive director of innovation at Johns Hopkins Sibley Memorial Hospital.
Investing in innovation for the future
As exciting as the prospect of launching an innovation center may be, the concept of dedicating resources to such an open-ended venture is bound to make some hospital executives nervous about the return on investment.
The average innovation center annual budget sits around $1.9 million, according to the Commonwealth Fund survey. Many centers receive 75 percent to 100 percent of their budgets from their home institution, although funds may also come from foundations or government sources.
Although both Dr. Fleischut and Mr. Dawson understand why many hospital leaders expect long-term cost savings when it comes to such a big project, they encourage focusing on other metrics, such as improving patient satisfaction. Focusing too much on the ROI distracts from the main goal of innovation centers which is to create products and processes that improve efficiency and quality. Even if not every project an innovation center works on creates a lucrative revenue stream, ignoring innovation altogether puts hospitals at the risk of becoming irrelevant.
"It's a clichéd thing to say that we are in a time of unprecedented change in healthcare, but it's true," said Mr. Dawson. "Margins are not what they used to be, physician reimbursement is not what it used to be and the entire payment structure is changing. What we've learned from other industries is that companies that fail to pivot during times of great change risk going away and getting left behind."
The innovation centers at NewYork-Presbyterian Hospital and Johns Hopkins Sibley Memorial Hospital are both funded through their respective institutions. Mr. Dawson notes the cost of funding Sibley's project has been a modest amount — "less than a fraction of a percent of the hospital's operating budget," he says.
Neither Dr. Fleischut nor Mr. Dawson specified the exact cost of launching the innovation centers at their respective institutions.
Although the Hub doesn't cost much in the grand scheme of things, Mr. Dawson recognizes the professional and moral responsibility to use its resources responsibly. In its second year, the Hub will set targets to generate new revenue and offset costs of running the center.
Tackling healthcare's biggest problems
Hospitals that weigh the costs and benefits of having an innovation center and ultimately decide to launch one are committing to a very big, exciting project.
"To launch an innovation center, you need to have a solid infrastructure," says Dr. Fleischut. "You need to have an idea of how all the center's activities are going to be aligned with each other and the culture of the institution, and what the center's ultimate strategy is going to be."
Creating a center's infrastructure and physical space can take months, even years. In addition to setting up the tangible parts of a center, hospitals need to focus on the intangible as well: pinpointing the center's focus. With all the problems persisting in healthcare, how do innovation centers prioritize which to tackle first?
For hospitals, picking the ultimate focus of their innovation center is how they distinguish themselves from others. The Hub at Sibley defines itself by focusing on the people-facing problems in healthcare more than the tools, according to Mr. Dawson.
"We don't begin with the end in mind — be it a mobile application or specific tool or process — we begin with the end user in mind," says Mr. Dawson. "If you're not solving for people, you could come up with the greatest thing in the world and no one would ever adopt it."
One problem the Hub decided to tackle was needle stick-related nurse injuries. The Hub's design thinkers met with frontline workers to discuss how they get stuck with needles. They then visited the reptile house at the Smithsonian's National Zoo to see how workers avoid getting bitten and Chipotle Mexican Grill to see how workers avoid cutting their fingers when they slice meat. They analyzed a number of other innovators in different industries before creating their own needle stick-prevention prototype, for which they filed a provisional patent.
"Our prototype will probably never be a real product that will create a multimillion-dollar revenue stream, but that's not the point anyway," says Mr. Dawson. "The point was to show the operating room how a design process could work in a way that really serves the interests of clinicians and patients."
NewYork-Presbyterian Hospital's innovation center defines itself by its work in HIT.
"The innovation center has a team of information technologists from across all different facets of IT that focus on solutions in two main areas: patient engagement and provider collaboration," says Dr. Fleischut.
The tech-focused center has sponsored a hackathon, and recently a 10-week challenge calling for innovative solutions to enhance patient care and provider communication open to both the general public and hospital employees. The winning entry was a mobile application that facilitates care team communication and collaboration, patient clinical information search and exchange, and care team alerting.
In 2015 NewYork-Presbyterian also launched NYP Connect, a cross-campus mobile communication tool that securely and efficiently connects NewYork-Presbyterian staff members and providers to streamline patient care.
Although NewYork-Presbyterian Hospital's innovation center and the Hub at Sibley have met different needs, claiming one's turf in the world of innovation is not a necessity for new centers, according to Dr. Fleischut.
"There isn't really competition between innovation centers because every system has singular and unique issues," says Dr. Fleischut. "There's also more value in the synergy of centers working in a collegial way."
Mr. Dawson echoed Dr. Fleischut's thoughts saying, "The only thing lamentable about innovation centers working on the same problems is when they do so in silos." He is happy to see more design thinkers discuss their projects through online communities and share ideas without the encumbrance of competition.