The future success and sustainability of health care providers are inextricably tied to innovation and scale. In an increasingly uncertain future for the health care industry’s regulatory, policy, and payment environment, providers will likely experience downward pressure on top-line revenue and an increasing drive toward value, regardless of its form. Disruption of our care delivery and business models, achieved in part through promoting digital innovation at scale, will be one of the critical components to succeeding in challenging times.
How can health care organizations develop and scale innovations? In the Digital & Innovation group at Providence St. Joseph Health, we apply approaches from consumer industries and follow a deliberate process to scale up innovations.
Start with a Focus on Solving Big Problems
Achieving scale in innovation begins with focusing on solving the biggest problems you face. The process starts with answering the following question: “What’s really going to move the needle for our consumers and for ourselves as providers?” At Amazon, where I managed Kindle’s North American publishing business before coming to Providence St. Joseph in 2014, we focused on three goals for online retail: lower prices, better convenience, and broader selection. No project was approved unless it would move the needle at scale in one of these areas. In health care, solving big problems should help to achieve the Quadruple Aim: lowering costs, achieving better clinical outcomes, and improving the patient and clinician experience.
A common organizational trap is funding technology before internal processes are ready to accept it. In a lot of situations, we’ve identified big problems that could be helped with technology, but we’ve recognized that we need to work on core processes further before we deploy technology. Many organizations also make the mistake of funding a technology rather than solving a problem. This leads people to focus on the vendor ultimately selected, instead of the problem the organization is trying to solve. The solution set then becomes constrained to the selected technology vendor’s capabilities.
Build Solutions That Address the Big Problems
Once the focus on the big problems is established and the problem statements are created, the next step is to develop product ideas, build small pilots called Minimum Viable Products (MVPs), test and learn around those MVPs, gather data and take measurements, and then repeat the process until you can determine what will deliver demonstrable value when extended at scale. Along the way, it’s critical that we incorporate consumer feedback — the consumers being both our patients and our providers. This approach ensures that we build the right things that satisfy the needs of our customers and our system.
Use Lean Innovation to Test Experiments Rapidly, and Fail Fast (and Cheaply)
Lean innovation is a product development process used in many industries, particularly technology, to quickly test new products for market viability. We’re using this technique at Providence St. Joseph Health to develop new services and products. Lean innovation uses a series of small experiments (the MVPs) that prove value to patients, clinicians, or both. By incorporating customer and provider feedback continuously as the product is being developed, this approach spreads the risk of the product development out over time, which makes product development less expensive.
Turn Solutions into Strategy
The digital teams at Providence St. Joseph Health use the process outlined here in building out our digital capabilities. One product we’ve built is CircleTM, a women’s health mobile app that delivers relevant content, products, and services to a family’s Chief Medical Officer — Mom. Circle began as a tool for expectant and new mothers to manage their own and their new baby’s health with a personalized experience, clinically approved answers to FAQs, timely and local to-dos, and convenient access to relevant resources. The personalization platform for Circle has now been extended to pediatrics up to age 18, and will soon be spanning across the spectrum of women’s health.
There are many benefits to engaging our patients and clinicians digitally: more convenient access to health care at lower cost, more effective population health, new revenue streams, and an improved clinician experience. As such, our strategy is to entice new and existing consumers to get online with us by building an online experience that is an order of magnitude more convenient than what they experience offline. We then build relationships and engage with them on an ongoing basis between their care episodes by delivering personalized health and health care experiences.
Make Thoughtful Investments in Organizational Culture
Certainly, building an innovative product or service is not sufficient on its own. In addition to building the right products and services, innovation at scale requires thoughtful investments in culture and change management, as well as training for caregivers who will ultimately be responsible for deploying and adopting new tools and technologies, organization wide. We must be self-critical and accept that in the past the industry hasn’t done the most effective job at giving our customers and providers the most effective tools, information, resources, convenience, access, etc., that they need.
For this reason, there is a well-earned amount of skepticism when any innovation is introduced in health care. A Lean product approach can help. Customers and providers are highly involved in product development and become evangelists when successful MVPs are eventually released as finished products.
Lean innovation in health care, and the development of digital tools, are essential to achieving the full benefits of reducing total cost of care, enhancing quality and access, and improving our ability to effectively deliver on our population health goals. Innovation also mitigates the potential for disintermediation by new entrants into the health care industry. Ultimately, digital innovation brings us closer to our patients, helping health systems move from having transactions with patients and consumers to developing enduring relationships with them.
This blog post originally appeared in NEJM Catalyst on March 2, 2017.