The Olympics and party conventions give me hope that we can build on the desire to be a part of something larger than ourselves to unite and improve.  Leanne Carlson defined innovation as the art and science of how we evolve for the future (Carlson LK. 2006. Innovating for the Future. The Physician Executive. 33(6):30-34).  Innovation requires:

• Focus and will
• A supportive culture, celebrating learning rather than blame
• Blend of structure and self-organization
• Willingness to respect what appear to be contradictory polarities
• Resources, including training, time, money, and recognition

 The VHA Foundation commissioned the Doblin Group to study innovation in healthcare.  Their report, The Power of Innovation, which analyzed healthcare innovation from 1994-2004, contained several interesting findings.  Most healthcare innovation centered on products and product performance.  However, the greatest long-term value resulted from innovation in the business model, networking, process improvement, and the patient care experience.  Fewer than 2% of the innovation projects produced more than 90% of the value.  Examples included:

• Business model innovation: Rapides Primary Healthcare in Alexandria, LA teamed with local businesses to offer a payroll deduction plan for primary medical and dental care, bypassing insurance middle-men and passing on the savings to workers who could not afford healthcare insurance and did not qualify for Medicaid.  The plan has experienced steady growth of participating employers, employees, and their families.
• Network innovation: Using a mobile classroom, the Montana Mobile Education Delivery and Learning System (MEDLearn) has provided training in the most current medical techniques and procedures to over 700 rural healthcare providers annually in  a variety of areas, including trauma, team leadership, pediatric acute life support, neonatal resuscitation, and airway management.
• Process innovation: Midland Memorial Hospital, Midland, TX, secured access to and implemented a comprehensive electronic health record sytem developed by the federal government for Veterans Administration Hospitals.  By using open source software, Midland was able to keep the project affordable and shortened development and implementation times. 
• Patient care experience: Memorial Hospital, South Bend, IN, is a Solucient Top 100 Hospital, committed to using continuous innovation to improve care, attract and retain the best employees and partners, and differentiate itself in the marketplace.  Its strategy, “Innovation Everywhere!” creates patient-care experiences that are so positive that they can only be described as “WOW.”  The hospital commits 1% of annual revenue to support innovation in hospital operations, new business ventures, and community health.  The WOW wizard group provides innovation skills training to 700 staff members annually.  The Memorial Leighton Heart and Vascular Center, which came to fruition in Memorial Hospital’s prototyping facility, is recognized nationally as a model of innovative design and care excellence.

Common to all of the above innovations is a conviction that patient needs drive innovation and that an outstanding patient care experience drives differentiation and competitive advantage.  These examples give me hope that our current healthcare non-system is full of promise and opportunity as well as challenges.

In The Second American Revolution, a man dressed as Thomas Paine pours water into a glass of wine as he decries that dilution robs wine of its richness.  I have always felt that diversity of opinion can be a source of richness provided that (to paraphrase the German philosopher Georg Hegel) we can move beyond our differences (thesis-antithesis) to embrace solutions (synthesis).

What do you think?

• What examples of innovation based on focus and will, a supportive culture, and a willingness to respect contradictory polarities come to mind as you read this post
• Can innovative solutions not only improve care but also help us and our organizations survive and thrive in the future
• Although disruptive innovation is humbling, can it also be a source of hope

As always, I welcome your input to improve healthcare collaboration.

Kenneth H. Cohn