Care Redesign
Talk
Will This Innovation Truly Change Health Care? (08:28)

In such an enormous industry as health care, it’s a challenge to innovate at scale. For that reason, the digital team at Providence St. Joseph Health continuously questions whether an innovation could be a “big needle mover” — whether it could truly make a difference to health care if brought to scale. “There are a lot of really cool smaller things that can happen to improve patient care, etc., but we’ve got huge watermelons on the ground as an organization and as an industry,” says Aaron Martin, Executive Vice President and Chief Digital Officer for Providence St. Joseph Health.

The first step toward achieving scale is to assemble the right team. At Providence, that means breaking down silos between health care and technology employees by having members of each in the same room. “It’s really liberating for the physicians and clinicians we work with to be able to say something and then to see something sometimes minutes, days, weeks later in terms of impact,” says Martin.

After assembling your team, you need to give them the right purpose. At Providence, the digital team’s purpose is “to discover important innovations, demonstrate they work, and bring them to scale.” They spend the majority of their time on the discovery of innovations already in existence, both within Providence’s system and externally, and work on those. Demonstration is also important. “As we’re all very clear and aware, the price of failure in health care is much, much higher from a patient impact standpoint than, for instance, an experiment that didn’t work at Amazon,” says Martin. The biggest lift then comes from bringing an innovation to scale, which involves issues such as change management and culture.

How do you get an innovation to scale? Digitally. One of the most important tools is to bring your consumers online, says Martin. “You can do a lot more different things scalably than you can in an offline world.”

To entice people to go online with you, the general rule is to provide a 10-times better experience than the existing way of doing things. Take, for example, a focus group about telehealth. Product A is to drive 30 minutes to a clinic, sit in a waiting room for 30 minutes, sit in an examination room for 15 minutes, and then see a physician for 5 minutes. Product B is to open your phone and in 5 minutes speak with a physician. “Most people in that focus group will choose B, and then the next day they’ll go do A,” says Martin. “Human behavior is really hard to change because of the patterns that you get into. ‘This is how I get health care.’ So to do that, you have to have a shockingly better experience for them.”

Once you’ve enticed patients, you have to engage them. “A lot of the work we’re doing here is to engage consumers about their health care between episodes of care,” explains Martin. “And then if you get to that, that creates scale, that adoption of technology. And that drives a whole bunch of different benefits.” These benefits include lower-cost access to care, effective population health, new revenue streams, and improved clinician experience.

“A key thing we learned at Amazon is to innovate on things that won’t change,” says Martin. “When I was working there, we knew that three things were never going to change no matter where you are in the world or what time period: people will always prefer lower prices over higher prices, they’ll always want broader choice and selection, and they’ll always want better convenience. The same thing goes in health care. People will prefer, over the period of time, lower costs, better outcomes, and better clinician and patient experience. As long as we’re working on one of those three things — we call it the Quadruple Aim in this industry — then we’re going to be OK.”

From the NEJM Catalyst event The Future of Care Delivery: Relentless Redesign at Providence St. Joseph Health, January 19, 2017.

More From Care Redesign

Do Hospitals Still Make Sense? The Case for Decentralization of Health Care

The future is here: moving care out of the hospital and into the home and community.

Sociotechnical dimensions used to analyze EHR-related health IT safety concerns

Frustrated with Your EHR? Don’t Blame Your Vendor — Safety Is a Shared Responsibility

Two informatics experts urge individuals and organizations to work together toward safer EHR-enabled patient care.

Relative Health Care System Performance and Spending in 11 High-Income Countries

From Last to First — Could the U.S. Health Care System Become the Best in the World?

The United States could achieve the best-performing health care system in the world by undertaking coordinated efforts that address four challenges.

Addressing the Prescription Opioid Crisis: Advancing Provider Education and Collaborating with All Stakeholders

Providers have a large role to play in tackling the opioid overdose epidemic, but they can’t go it alone.

Collaboration Between Doctors and Computers - Machine Learning

Lost in Thought — The Limits of the Human Mind and the Future of Medicine

It’s ironic that just when clinicians feel that there’s no time in their daily routines for thinking, the need for deep thinking is more urgent than ever.

Root Cause Analysis: Typical Domains of Root Cause: Medical Errors

Does Every Hospital Admission Deserve a Root Cause Analysis?

Will applying the RCA rubric to hospital admissions better help define and manage care?

Uniquely Identified: The Impact of a National Health Index

What does the NHI mean to a New Zealand clinician, researcher, and health care consumer?

The Intersection of Home-Based Primary Care and Home-Based Palliative Care

My Favorite Slide: The Intersection of Home-Based Primary Care and Home-Based Palliative Care

What are the overlapping provider skill sets needed to care for homebound patients?

Simplifying Person-Centered Care with Use of the Personalized Perfect Care (PPC) Bundle

Personalized Perfect Care

The Personalized Perfect Care Bundle: Making quality metrics easier to understand and more patient-centered.

Laboratory Formulary to Facilitate Better Ordering: Outcome of Orders for Restricted Inpatient Tests in 2016

Improving Care and Cutting Costs: Implementation of a Laboratory Formulary to Facilitate Better Laboratory Ordering Practices

Can a formulary system help to prioritize cost-effective lab tests in the same way it has done for prescription drugs?

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Prescribing a Remedy for Loneliness

What should clinicians do for patients for whom social isolation and loneliness is the biggest…

Coordinated Care

115 Articles

Enhanced Cure Rates for HCV: Geisinger’s…

To reduce the burden of hepatitis C in central Pennsylvania, Geisinger Clinic designed a comprehensive…

Social Needs

75 Articles

Signal or Noise? Navigating Health Care…

A discussion from the Institute for Healthcare Improvement National Forum. Part 2 of a two-part…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now