Innovation

Innovation: such a pregnant word. Innovation usually accomplishes something pretty basic – a solution to a problem we know or don’t know we have, a new or long standing problem. Innovation can be a tool, a process, technology, or a service. Innovation includes widespread use of the solution. Setting diagnostic or clinical treatment aside, the health journey for the whole team primarily involves people: behavior and relationships. Innovation in health behavior and relationships leads us to magic levers of best health. This week I heard about primary care teams that weren’t built around the licensed clinicians (physicians, physician assistants, nurse practitioners, nurses) The key people seemed to be the patients, their caregivers, and the offices’ health coaches (5-7 coaches per clinician). Patients have assigned coaches to partner in their health journey and serve as a bridge to services and clinicians. I was hearing about Iora Health and Mass General’s Center for Primary Care Innovation. This could be innovative! It’s a magic lever. Phew!

I say could be because the challenge with so-called innovations such as health coaches is to accomplish  widespread availability. What did it take to nurture that potential innovation and how does it spread? Well, somebody was dissatisfied with the status quo, became an entrepreneur and had the gumption to find or create a space for the idea, process, and service to germinate and flourish. The entrepreneur(s) had to align incentives (funding to develop a test and a payment model to feed the service) in a market that needed and wanted the result. It takes a very different kind of change agent to create and pilot something than spread it.
Innovation has stages to widespread adoption: Stage I could be coming up with the new solution and implementing it in several places. Stage II spreads it with a system. Stage III is widespread proliferation.  I’ve spent most of my career in Stage II, as a change agent from within trying to change culture. I would listen, identify problems, build coalitions, and support the adoption of tools, processes, technology, and services within an organization. Seldom was it a new idea, mostly it was adoption of something existing. The challenge was 70% culture, 25% funding, and 5% workflow. Now I’m playing in the sandboxes of Stage I, the  entrepreneur, and Stage III, policy. I’m working on tools and services that can profoundly affect behavior and relationships. More in my next post.  I’m also involved with two federal initiatives that could impact the spread of innovation: Patient Centered Research Institute (PCORI) that I’ve written about here and Automate the Blue Button Initiative (ABBI) that I will write about in the future.
Is the new thing an innovation if it doesn’t spread? Spreading the magic levers of innovation in our health journey – the subject of many lifetimes.

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