Three Must-Haves for Generating Innovation in Healthcare IT


innovation in healthcareThe term innovation signals invention, improvement, and breakthrough—in other words, what’s new. What’s old, however, may have more of a role in determining the success and sustainability of innovation in healthcare than the industry tends to recognize. Specifically, avoiding the repetition of past mistakes needs to be a central goal when building an environment for successful innovation in healthcare IT.

Innovation is dependent on “letting go of yesterday’s values and beliefs that keep the company stuck in the past,” writes Vijay Govindarajan, Coxe Distinguished Professor at Dartmouth’s Tuck School of Business and Marvin Bower Fellow at Harvard Business School, in his Harvard Business Review article about the innovation strategy he poses in his book, The Three Box Solution: A Strategy for Leading Innovation.

According to Govindarajan, “To get to the future, you must build it day by day. That means being able to selectively set aside certain beliefs, assumptions, and practices created in and by the past that would otherwise become a rock wall between your business of today and its future potential.”

This article describes three key cultural principles for successful innovation in healthcare IT and explains why the right data infrastructure is critical to enable these advances.

Is the Organizational Culture Helping or Hindering Innovation?

Past decisions and existing technology (e.g., a data warehouse) can prevent teams from identifying new or modified strategies that might improve processes and outcomes. Innovation can’t occur when concerns outside of business goals get in the way. For example, worrying about whether a new strategy puts leadership’s reputation on the line. Organizational cultures that don’t give teams the freedom to fail risk losing the opportunity to discover new, more effective strategies.

With the freedom to fail, however, CIOs and other leaders must learn to admit when an old strategy isn’t serving the organization and it’s time to find a new solution. The key is to enable all promising directions, which is done with a company culture that allows the freedom to admit something didn’t work out and move on.

Three Principles of a Successful Environment for Innovation in Healthcare IT

Cultures that foster a successful environment for innovation observe three keep principles:

  1. Give teams the freedom to fail.
  2. Remember the adjacent possible.
  3. Leverage organizational networks.

Principle #1: Give Teams the Freedom to Fail

It’s difficult to walk away from a failed innovation that required tremendous financial and human resources. In business terms, this is a “sunk cost”—money spent that can’t be recovered and, therefore, shouldn’t be a factor in future decision making. The ability to move on from a failed project and the resulting loss is essential. Give teams the freedom to fail—to try again with a renewed focus and clearly defined goals for the next data project. To innovate, team members need the freedom and time to think about new concepts and solutions—the ability to follow a hunch.

Starting over is easier said than done. Very often, the person leading the new project is also the person behind the previous ineffective (sunk cost) project. Starting over requires admitting failure, which is less likely to happen when cultures instill a fear of reprisal for doing so. This type of insecurity discourages innovation.

The solution is establishing a culture in which team members are free to fail. This means that they must feel 100 percent comfortable admitting that their previous direction isn’t delivering its intended value. It’s only in admitting failure that the individual and organization can wipe the slate clean, learn from the experience, and move forward.

Organizational leaders (e.g., CIOs, CFOs, and CEOs) bear the bulk of the responsibility in establishing and upholding this freedom-to-fail principle. The goal is to overcome a culture that fosters insecurity by allowing its team members to accept and embrace failure as an inherent part of successful innovation. The faster this is done, the faster an organization moves toward successful solutions. Leaders must ask themselves if they have a culture that doesn’t tolerate failure and inhibits innovation. If the answer is “yes,” then they must work to change it. The goal is that all team members know they have the freedom to ask, “What can we do better?” without concern of repercussions.

Principle #2: Remember the Adjacent Possible

“People arrive at the best new ideas when they combine prior (adjacent) ideas in new ways,” writes James L. McQuivey, vice president and principal analyst at Forrester Research in the Harvard Business Review. “The more ideas circulate, the more they’ll collide in new ways to generate new things.” In effect, the idea behind the adjacent possible is that we’re more successful working with resources that are available, and we can let these resources define our path forward.

The adjacent possible is theoretical biologist Stuart Kauffman’s proposal that biological systems become more complex over time; the changes are small, gradual, and based on what’s readily possible (adjacent), rather than dramatic leaps. Members of the tech industry have adopted the adjacent possible and applied it to advances in their own fields.

In his book on innovation, Where Good Ideas Come From, author Steven Johnson describes a scene from the 1995 film Apollo 13 to illustrate the adjacent possible. A team of NASA engineers must figure out how to convert a carbon dioxide filter on the damaged spacecraft into a carbon dioxide filter (or carbon scrubber) that will work on the lunar module. Specifically, they need to modify these filters so that they can work with the module’s ventilation system. Otherwise, Johnson explains, “the astronauts [who are using the module to return to Earth] will poison the lunar module atmosphere with their own exhalations.”

Back at Mission Control, the NASA engineers begin by getting the spare parts available on the lunar module out on the table. “The space gear on the table defines the adjacent possible for the problem of building a working carbon scrubber on a lunar modular,” Johnson explains. In other words, the pile of spare parts holds their solution and, together with a free flow of ideas, defines their path forward.

Johnson sums up the lesson from the scene, as it relates to the adjacent possible: “The trick to having good ideas is not to sit around in glorious isolation and try to think big thoughts. The trick is to get more parts on the table.” More experiences generate more spare parts. If accessing these spare parts requires admitting limitations of the old data warehouse, for example, then a culture that doesn’t accept failure wipes out a portion of the new possibilities. The adjacent possible invites a full spectrum of possibilities and underlying technology to put a solution to work.

Principle #3: Leverage Organizational Networks

In Where Good Ideas Come From, Johnson uses the concept of a network to explain ideas. “A new idea is a network of cells exploring the adjacent possible of connections that they can make in your mind,” he writes. In healthcare, the environment and the community form this network—a culture of communication and strong partnerships.

The development of any idea is dependent on the flow of creative thoughts within a highly communicative network. This is true whether the supporting community is physically present or not. Even when the spark for an idea comes from someone sitting by themselves, that idea is based on a whole career of experiences—many from current coworkers and influencers. This organizational network principle in conjunction with the freedom to fail and the adjacent possible, fosters a strong environment for innovation.

This environment encourages a balance between the more contemplative tendencies of introverts and the need for fluid interaction between co-workers and colleagues. Organizations need to give their teams time for innovative thinking and isolated concentration, while at the same time, plenty of opportunity for group work and brainstorming sessions. Brainstorming fosters the free flow of information, while solitary innovative contemplation lends structure to the new ideas.

In writer and lecturer Susan Cain’s Ted Talk on the power of introverts, she advocates for time to think in solitude and argues against a sole emphasis on outgoing social tendencies in leaders. Cain—who delves further into this topic in her book Quiet: The Power of Introverts in a world that Can’t Stop Talking—poses that communities and organizations miss opportunities when they don’t facilitate networks between extroverted and introverted thinking. She supports workspaces with a blend of “chatty, café-style types of interactions” and “privacy and much more freedom and much more autonomy.” Organizations that fully leverage their networks strike a balance: they support contemplative work while also enabling collaboration.

Innovation in Healthcare IT Begins with the Right Approach to Data Infrastructure

A major challenge for leadership, when it comes to leveraging the adjacent possible and building an environment for innovation, is overcoming assumptions about their healthcare data infrastructure. If, for example, a CIO assumes the data warehouse is fulfilling their organization’s needs, then what will it take to get them to consider new possibilities for improvement?

The right data is an essential part of the adjacent possible because it guides decisions—it’s one of the spare parts teams must have on the table. The data warehouse is one of the tools that brings the data together and makes it usable. Additional “adjacent possible” parts on the table include a clinician champion who’s motivated to improve and a problem to solve. After all, without the acceptance that there’s a problem to solve, there’s no opportunity for improvement.

A team can come up with ideas about how to improve outcomes, but they need data to substantiate those innovative ideas and identify the right ones. To support innovation, this data needs an infrastructure by which different teams can share it and build on it. Information is too often siloed across an organization, rather than integrated, so there’s no exchange or communication between different departments (e.g., clinical, financial, or operational). Data needs to be integrated so that it’s usable for improvement—a data warehouse is one of the tools that brings it all together and makes the data actionable.

Opportunities for Innovation Depend on Culture

The primary barriers to innovation within a healthcare organization might not be the data infrastructure, but the culture that drives that infrastructure. The infrastructure itself (the data warehouse) is a critical tool in innovation, but it only functions optimally within an environment that fosters innovation—one that enables the adjacent possible, gives teams the freedom to fail, and leverages organizational networks.

With respect to this three-principle foundation for innovation—giving teams the freedom to fail, remembering the adjacent possible, and leveraging organizational networks—CEOs need to empower key players in data infrastructure to openly admit when they hit a dead end and need to identify a new direction. With these three principles in place, organizations will reveal solutions that might have otherwise remained hidden.

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