More on innovation:

To examine the potential for change, BusinessWeek has joined with the Chicago-based innovation consulting firm Doblin (a member of consultancy Monitor Group). Larry Keeley, co-founder and president of Doblin, has pioneered a tool, Innovation Portraits, that reveals patterns of innovation in a specific industry. Of the many possibilities, we examine eight that are fermenting swiftly and hold high promise for transforming health care. They were chosen because of their intensity, measured by the number of innovations in a specific area, and their importance, determined by the impact the innovations could have on the practice of medicine.

The eight ideas all have something to do with delivery.  Although none of the ideas are new, few have been implemented well—or at all.  Opportunities abound.

Here is what is awful: rejecting retail health care because “a patient shouldn’t purchase health care at the same place they buy groceries/supplies/incidentals as the quality can’t be as good” or rejecting direct practice because “there is no way medical care can be delivered over the internet” or rejecting medical tourism because “there is no way that a consequential number of Americans will ever want to receive care overseas.”

Rejection because “it’s something new” is awful.

For whatever reason (precedent mostly), the health care industry is averse to new ways of doing things. If a new way of performing a task is accepted, it is definitely not without significant debate—and even then it’s not implemented everywhere.

We need a lot of things to happen to get us out of our health care mess. In traditional health care organizations, innovation needs to start at finding new and better ways to deliver care.

Why do we have such an aversion to innovation in health care?  And how do we go about changing that?

Here are some thoughts and possibilities (feel to add/subtract as you feel necessary, but only if your argument sounds nothing like the first paragraph of this post):

1. Let your patients participate in design. Really, ask them what they want. Ask them to design around their needs. As Max Chafkin in this INC. article writes, “The companies that win will be the ones that listen.” What does that mean? Focus groups. Interviews. Questionnaires. “Overhearing” conversations in the hallways or in the cafeteria. Blog. Twitter. Facebook. It sounds crazy, but “user innovation” is possible. From the same article:

This idea goes against a basic principle that has been taught in business schools since the invention of mass production: Employees make stuff, and customers buy it. But this notion seems anachronistic in a marketplace of ever-narrowing niches and nearly unlimited consumer choices. Meanwhile, a generation of so-called Web 2.0 companies has succeeded by encouraging customers to contribute to, and in some cases create, the product being sold. Not only do we have instantaneous access to countless television programs though video websites, but anyone with a YouTube account and a digital camera can create a show of his or her own. Professionally edited, dead-tree newspapers are besieged by digital news sites that are produced and edited by their readers. The 240-year-old Encyclopaedia Britannica finds itself eclipsed — at least in terms of readership — by Wikipedia.com, which pays its writers nothing and requires that they possess no expertise at all.

2. Create a department that !only! pursues delivery innovations. Kaiser Permanente’s Sidney R. Garfield Innovation Center “is a living laboratory where ideas are tested and solutions are developed in a hands-on, mocked-up clinical environment. Many aspects of delivering healthcare can be innovated and examined at the Center using real-world scenarios and activities, such as simulations, technology testing, prototyping, product evaluations, and training.”

It’s important to have a centralized figure collecting ideas and making the necessary connections that turn an invention into innovation. Ram Charan says in a Fast Company interview:

Let me explain some simple things. First, as Thomas Edison said, an idea is called invention. Converting an idea into revenues and profits or something a customer uses is innovation. Today, in the Internet society, you can buy ideas. You can have ideas flow to you from outside your department and outside your company. Innovation is selecting an idea and converting it to the production of a product, service, or new business model that creates growth and profit. The conversion of an idea for most companies, if not all, requires more than one person to make it happen. And that is why it is a social process.

And sums up his thoughts like this:

Necessity is the mother of invention. Those companies that are not getting top line growth organically, they are absolutely pressed to figure out how to create these collaborative changes for innovation. This is the era of the renaissance of innovation. If you don’t do innovation, cost cutting is not enough. You will be left behind.

3. Stop waiting on the government. CMS regulations handed down (and then copied by private insurers) are ruthlessly tearing through your organization. Preventing hospital acquired infections should have been a top priority before payers stopped paying for them. As we all know CMS is constantly looking for reasons not to pay your organization. Why not make it about constant improvement instead of constant reaction?

4. Waiting to hear from you…

I know we’ll figure it out. Crisis produces innovation. But wouldn’t you rather make a proactive decision?

Will any of this work? I’m sure of it. Will all of it work? Not likely. But here is the message: continuing to criticize delivery innovations as pie-in-the-sky developments is dangerous. It’s even more dangerous to stand by and do nothing. Let us be p-r-o-a-c-t-i-v-e, I’m begging…

Do you know what Twitter is? (Here, read this if your answer was anything but a confident YES!)

I wish I could describe what Twitter will mean to health care, especially to health care organizations.  But I can’t. Because I don’t know.  But I have a hunch it is going to do something for health care.

So it seems appropriate for all of us to take notice of Tech Soup’s non-profit Twitter event today:

Join new media consultant and blogger, Marshall Kirkpatrick and Michaela Guerin Hackner, Director of Online Strategy at World Learning, as they dive deeper into how and why to use Twitter to benefit your nonprofit. We’ll look at more complex ways Twitter can be incorporated into your marketing strategy, help with professional development, and build your community of supporters. This is a great chance to discuss ask any further questions you have of our expert event hosts.

Here’s the link for the event.

Here’s my Twitter feed.

Kaiser Permanente’s Sidney R. Garfield Innovation Center “is a living laboratory where ideas are tested and solutions are developed in a hands-on, mocked-up clinical environment. Many aspects of delivering healthcare can be innovated and examined at the Center using real-world scenarios and activities, such as simulations, technology testing, prototyping, product evaluations, and training.”

From an ADVANCE article:

“The center’s focus is to get front-line staff — the people who are delivering care — to come together and work with designers, architects and technologists to innovate or improve a physical space, a new technology or some type of work process,” explained Jennifer Ruzek, director of the center. “It’s really important that all the disciplines work together, because if you want to improve a complex process such as medication administration, nursing, pharmacy and physicians all need to come together.”

This is cool on multiple accounts—an organization has taken health care delivery innovation so seriously that they have created a center to facilitate continuous improvement.  The benefits:

“You can get large groups of people from different disciplines together, speaking the same language experientially, to reach consensus on what is the best design that meets their needs and the patients’ needs,” Ruzek said. “We’ve found that when you take people out of their day-to-day environment, a few things happen: First, they’re not distracted by what’s going on in a live facility. People begin to step back and think about the big picture. Nurses, as you know, are great at working around challenges. But here, you’re asking them to think differently — they come up with ideas that solve challenges, rather than just working around them.

“Second, we’ve found the experimental prototyping process at the Garfield Center speeds up decision-making. We rule out ideas that don’t work quickly and arrive at solutions faster.

“And third, it’s much easier to try out ideas in a mock environment rather than disrupting a real hospital unit or clinic.”

This makes so much sense, why are there not more organization sponsored dedicated environments to explore delivery innovations?

Tomorrow’s Today’s health care organizations need to offer more services than what have been traditionally offered.

Services that, today, are not necessarily revenue positive—some call them mission-based. (Right now) It’s about making the people in the communities those organizations serve healthier.  From the Duluth News Tribune:

The record player speaker crackles with big band tunes as exercises commence.

Every Tuesday and Friday morning, 12 seniors stop by to practice a series of exercises — from volleying balloons to holding up their feet while sitting — designed to strengthen muscles that help them balance.

Most say they definitely have seen results.

“I had some bad falls,” said Ted Barker, 85, of Duluth. Since joining the year-old class, the lanky man’s gait is straight and steady, and he hasn’t fallen.

“I feel I’m much better off,” Barker said. “This is a great thing.”

The class is part of a grander shift at the clinic to become more patient-friendly.

So we all know the problem that arises when health care providers offer non-traditional services that help people: they don’t get paid.  Making the business case on an individual level to individual patients can be helpful individually—but that possibility does little to improve the health of the community as a whole (not to mention producing negligible results in the cost-savings department).

The physician’s focus may be at an individual level—that’s fine.  The organization’s (hospitals, clinics, etc.) focus must be both individual and collective.  It’s just that our system necessitates an organization prove a service’s efficacy in order to be considered reimbursable.  Wait, it does?

Do you think telemedicine would be more popular if this is how it was delivered?

The Wall Street Journal again writes on potential overnight issues at hospitals.  Evidently there are many.  The Institute for Healthcare Improvement is taking lessons from England’s National Health Service:

The Institute for Healthcare Improvement, a nonprofit group in Cambridge, Mass., is adapting lessons from the United Kingdom, where hospitals also have been learning to cope with new work rules using pilot programs called “Hospital at Night.” Traditionally, U.K. hospitals were fully staffed at night with doctors who worked during the day and slept at the facility overnight. Under new rules, U.K. hospitals are trying to deliver the same care with far fewer doctors on site, with the result that many doctors are coming on for night duty who haven’t seen patients during the day. The pilot programs include new systems for identifying the most ill and deteriorating patients, and for handing off patients between shifts.

While American hospitals have never had the U.K. model of fully staffed hospitals at night, many of the issues are the same. “We’ve had to address many of the problems that have beset nighttime care for decades, which are a problem for health care wherever it is practiced,” says David Gozzard, chief medical officer of Conwy & Denbighshire NHS Trust, one of the hospital systems in the U.K. program. Dr. Gozzard, who is working in a fellowship program at the Institute for Healthcare Improvement, says the U.K. program has enabled his hospital system to reduce the number of patients who need emergency resuscitation during off hours.