How to Ensure That Your Healthcare Innovation Doesn’t Flop

By John Glaser
November 27, 2020

Here are four observations that may help to demystify the process of innovation and ensure that it actually produces results.

 


These days, everyone working in health care is chasing innovation, hoping to thrive in this era of increased accountability for not only quality but cost and truly patient-centered medicine. Those devoted to business as usual are often anxious; they keep hearing that innovation is essential, but see it (often rightly) as difficult or impossible to execute in their own organizations. This anxiety is compounded by the fear of having their lunch eaten by Amazon.com or Walmart (new to health care, but not to innovation), or other entrants who aren’t constrained within the familiar ruts of traditional care.


Here are four observations that may help to demystify the process of innovation and ensure that it actually produces results.


INVENTIONS ARE NOT INNOVATIONS. Many organizations define innovation in terms of novel technologies, processes and business models. They may regard artificial intelligence, a just-in-time supply chain or bitcoin as innovations. These things, at least in their early phases, are more accurately called inventions. Inventions are important, but they only rise to the level of innovations when they are broadly adopted to transform the behavior and functioning of users, organizations or society as a whole. In other words, innovations are inventions that have successfully scaled.


The Wright brothers’ airplane, first successfully flown in 1903, was an invention. The innovation was the first scheduled commercial flight (in 1914, between St. Petersburg, Florida, and Tampa), a phenomenon which has since scaled all the way up to 4.5 billion passengers on commercial flights last year. The polio vaccine was an invention. Its incorporation into routine medical care, resulting in the almost complete eradication of the disease, is the innovation.


Many health care providers don’t have the resources — the incubators, venture funds, top researchers and lab facilities — to generate a steady flow of inventions. As a result, they may feel like their ability to innovate is hampered. But inventing and innovating involve two different skill sets. Jonas Salk didn’t patent the polio vaccine, allowing others to adopt public health innovations to disseminate it. Inventions are everywhere, just waiting for innovators to scale them.


Similarly, an organization that pursues inventions — perhaps by setting up an incubator or a venture fund — should not assume that those efforts will automatically lead to innovation. If your innovation group isn’t making progress at changing things, despite an abundance of good ideas, maybe it is really an invention group.


INNOVATION DOES NOT AUTOMATICALLY REQUIRE RADICAL CHANGE. Innovations can come in any size — from incremental to radical. Innovating might mean adopting a new approach to an existing service — for example, starting to offer robotic surgery, a material improvement on minimally invasive techniques. Or it might mean offering a new service — for example, post-acute care, a potentially radical innovation that affects multiple parts of an organization and might even redefine it in some fundamental ways.


Incremental innovations don’t necessarily have less impact on the quality of care. Incorporating vigorous hand-washing into clinicians’ routines — once considered an innovation — is the very definition of incremental. It doesn’t take a lot of extra time or cost very much. But its impact on cutting infection rates and saving lives is incalculable.


A thousand small tweaks can transform a mediocre performance into a great one. When scholars study how organizations wind up dominating their industries or fields, they often find a pattern of continuous incremental innovation over a period of years. The organization’s members learn to incorporate a habit of making small changes and reaping their value, rather than treating innovation as a temporary inconvenience, after which they can return to their old patterns.


RADICAL INNOVATION DEMANDS CHOREOGRAPHY. While any organization can embrace incremental innovation, many dread radical innovations and don’t actively pursue them. They fixate on the “radical” part, recognizing that it will turn their organizations upside down in ways that inconvenience everyone to some degree. They can’t see beyond the havoc to the transformation at the other end. As a result, they often wait for a radical change to find them, which only increases the havoc.


A good example might be the 2009 U.S. government mandate to adopt electronic health records, or EHRs. While the debate over this approach to radical innovation will probably rage for another decade, two facts are indisputable. First, the health care industry as a whole had not at that point made significant progress in adopting electronic records voluntarily and left to itself might still be relying on paper folders today. And second, it was a necessary change if the health care system were ever to reap the staggering potential benefits of digitized information and networks.


Some providers embraced the innovation, planned for it and reshaped their organizations to take advantage of it. Others had it thrust upon them, treated it as primarily a burden to be endured, and reshaped their organizations reactively, to the extent they reshaped them at all. It’s no wonder that the results 10 years later are mixed. However, no one is seriously suggesting a return to paper. One hallmark of radical innovation is that it precludes a return to the way things were.


As the switch to EHRs shows, radical innovations demand “choreography” if they’re going to fulfill their promise. The changes they require may be both broad and deep, involving an intricate dance among multiple parties and facets of the organization. All will need to learn the routines, and some may need dance lessons.


The choreography of radical innovation often extends beyond a single institution and involves multiple complementary innovation strategies. For example, the incorporation of the polio vaccine into routine medical care required a way to manufacture large quantities of the vaccine as well as massive changes in medical education, health policy, public health resources and public awareness.


SOMETIMES WE DON’T NEED TO INNOVATE, WE JUST NEED TO IMPROVE. Just as we must avoid confusing invention with innovation, we must avoid confusing innovation with improvement. While all innovations should lead to improvement, innovation is a technique rather than a goal in itself. Sometimes tried-and-true improvement tools like process redesign are better for our immediate purpose.


Whether we are innovating or just improving, the questions are the same: What do we need to do? What resources are required? And how will we know if we have been successful? The innovation journey will be more effective if we remember that organizations don’t need to invent to innovate, that a steady stream of incremental innovations can lead to significant gains, that radical innovations require careful management and that innovation is the means, not the end.

 


Copyright 2019 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.

 

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