NEFF: Panning for gold: innovation in health care

Hospitals are busy places. They are driven by needs that change rapidly and occur at high intensity, in ways that are difficult to anticipate. Just staying ahead of the immediate demands of patients, and their families, is challenge enough.

And yet, in unforeseeable ways, and at unexpected times, doctors, nurses and hospital staff generate ideas that are truly innovative. The idea might be a workaround, a process that can be replicated, a device that gets a time-consuming job done in a better or faster way—the opportunities are unlimited. These opportunities are generated as a byproduct of the day-to-day events that occur in health care settings.

Yet most hospitals never capture the innovation. The innovations are forgotten, diverted, diluted, or in some cases, killed—without ever being evaluated for their medical and business potential.

And the evaluation of business potential requires a different lens, or mind-set, than that typically used in health care. Patient-facing decisions are all about mitigating risk; first, do no harm. Business decisions, on the other hand, are balancing acts of risk and reward. So to create a flow of business opportunities requires creating a different frame of reference, one that is organizationally tolerated or, ideally, encouraged.

Some larger health care organizations have developed mechanisms to capture these innovations, in different frames of reference. Some have formed venture capital firms to seek out new ideas and try to form businesses out of them. Some have developed websites to ease the submission of innovative ideas to those charged with the responsibility of evaluating them for reproducibility, expansion and further refinement/investment.

In the most aggressive organizations, investments are made in staff whose mission it is to “troll” for innovation, looking under the rocks of everyday events for innovative ideas. These organizations don’t leave it to chance that a busy doctor or nurse will identify something as innovative and submit it; they send miners out into the field to pan for gold.

Two examples of innovative ideas that became businesses will illustrate a case of happenstance and an intentional effort to systematize. A nurse noticed that, when he couldn’t find a vein to draw blood from elderly patients, if he heated up a wet towel and placed it on the site, the vein moved closer to the surface and enlarged, making the blood draw much easier. The nurse ultimately formed a company that now offers heated pads to prepare for venous sticks.

In a more intentional example involving systemization, Indiana University Health has long been known as a leader in diabetes management. Its care pathways were well-defined. Innovators at IU Health learned that diabetes incidence was skyrocketing in China, and health care institutions there struggled to manage the problem. IU Health took its medical management processes, partnered with a Chinese hospital, and began managing diabetes patients over the web, via video link. A new diabetes management business was born.

The point is that, left to happenstance, innovation might or might not float to the surface of health care organizations, given all the other pressing needs. Truly innovative organizations will create disciplines, and organizational structures, to ferret out innovation and to support and fertilize those innovations. They will find ways to get comfortable with risk because innovation requires a tolerance for failure. Those organizations will not only become the leaders in their field but will thrive as they reduce cost, increase patient and staff satisfaction, and ultimately engender an innovative culture.•

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Neff is founder and president of Neff Consulting and has worked for more than two decades in health care and health care financing.