Encouraging Innovation



How do you encourage innovative ideas and what are the possible steps to follow to support it?

Answers from Herb Smaltz:

Larger organizations offer greater challenges

Great question.  One of the things that I noticed as I moved to increasingly larger and more complex organizations throughout my career was that the larger the organization the harder it was to foster innovation.  For one thing, in larger organizations most of us work hard to standardize our environments to drive down costs and complexity.  Innovation isn't standard.  For another, most of us in healthcare have been working with highly constrained operating and capital budgets (in comparison to other information intensive industries like financial services industry for instance).  While innovation doesn't have to cost a lot of money, it does help to have some discretionary dollars to nurture innovative ideas.

Fund innovative ideas

One of the most effective ways that I've found to encourage innovative ideas is to explicitly set up a program tied to your organizational governance that seeks to fund innovative ideas.  While I was serving as the CIO of the Wexner Medical Center at the Ohio State University (WMCOSU), we set up what we called a "Small IT Innovation Projects" fund as a part of the organization's overall IT budget and IT governance processes.  The senior IT governance body at WMCOSU had representation from across the organization (e.g., CMO, CNO, CFO, CIO, Vice Dean for Research, Vice Dean for Education, etc.) which was important to ensure that innovative ideas had a fair hearing from a broad expertise base.  The following is a summary of the program's guidelines and selection/eligibility criteria:

This category of funding, ‘small innovative projects' was implemented by the IT Governance Committee as an opportunity to direct a portion of the IT budget toward funding innovation projects that, in our case, require less than $100,000 of investment funding.  Senior leadership provided the IT department with $300,000 of capital annually to allocate towards these small innovation projects.  Anyone from food service workers to physicians could present an idea under the program.  The criteria that the IT Governance Committee used to evaluate innovative ideas included:

  • Requests had to be under $100,000 (which allowed us to fund at least 3 projects a year from our allocation)
  • The investment did not commit the organization to costs beyond the one year funding (this was a balance between the CFO's desire for these projects to not automatically create new costs – if the project demonstrated business value then it would be considered for additional funding beyond the initial year)
  • Must have a named individual business owner or sponsor (a responsible individual, as opposed to a nebulous department, that was responsible for leading the project)
  • Had to first be vetted and validated by one of the IT Governance Subcommittees (WMCOSU had four primary subcommittees (Patient Care, Research, Education and IT Infrastructure) that provided governance oversight for these domains
  • Had to make a business case that the innovative idea would have a financial impact on reducing cost or increasing revenue
  • The outcome of the project had to be measurable
  • Any operating costs associated with the small innovative project had to be covered by the authoring business unit (in an ideal world this wouldn't be a constraint, but was a trade-off we had to put in place to reduce the risk profile for our CFO)

Ideas would be handled as they surfaced so that idea authors saw quick action on their ideas (i.e., we didn't pile them up and then take them all at once – that would have been seen as bureaucratic, but rather put them on the agenda and had the authors present the ideas as they surfaced).

Some very cool ideas surfaced such as a project to demonstrate how natural language processing tool could be added to WMCOSU's enterprise data warehouse to enable query and analysis of unstructured text reports as well as a demonstration in the early days of RFID to demonstrate the impact of locating equipment and people to expedite care processes. 

This process of setting up a fund and tying the review and approval process to an organization's pre-existing governance committees/processes exists in a number of other health systems.  For instance, my friend and colleague, Sue Schade, at Brigham and Women's had a similar fund with similar guidelines and procedures, though her fund was twice as large as mine.  In short, creating an explicit, visible process for ideas to percolate up to a representative governance body that can quickly provide seed funding is the best way that I've found to encourage innovative ideas and also provide a means to prove them out.

Answers from Scott Holbrook:

Innovation starts with listening.  Clearly understand an issue/problem is critical in crafting a solution.  We have a problem when we do not listen to an expert or an end user who is describing their situation.  It is magnified by not walking in the "shoes" of the people with the problem. For innovation to begin will need to spend time with people who repeat this process each and every day.  Once the data gathering is done, then innovation can begin.  The gathering of information may take minutes or weeks, but a clear understanding is required.

Maintenance of the Solution

In the healthcare IT product world, innovation may start with a new release but it is not over when the release is delivered.  The maintenance of the solution is the real telling of success.  If fewer calls occur after the install, then innovation is achieved.  If the call centers lights are lit-up, then innovation did not occur.  If the features in the release require great effort to install and support, then innovation has not occurred.

A number of years ago a small group of us started a company called KLAS.  One of the major focuses of KLAS was to provide a voice for "power users" of applications.  In the RFP process and even within contracts vendors were promising thins they could not do and in some cases had no intention to provide.  While companies had innovated in building a product, some had not listened to their users about now to make the product better.  For the companies that listened closely to their users, they continued to innovate and have happy clients.

Users are the primary concern

For the companies that think users are secondary or they do not understand the big picture.  These companies begin to implode.  They are the companies who believe they have a monopoly on innovation and knowledge. Many of these companies do not mind the store and their customer cease to frequent the use of the product.  They are not innovating with the users.  They tend to build what they think is important and forget they are the people keeping them in business. Some companies believe the direction is more important than the solution and innovation. 

One of the KLAS executives visited a larger healthcare IT corporation.  After the introductions, the VP of Sales said to KLAS you are costing us millions of dollars of business with your reports.  The KLAS executive said, "No. You are costing yourself millions of dollars of business with your poor product quality and service."  Innovation is not a quick idea that solves a problem.  Innovation is a process that requires constant change and update.  If we innovate, we must remember not to stop listening.  In good innovation we need to listen even harder to find the next improvement.

Innovation starts with listening:

  • Understanding that all people have value—from the top to the bottom of an organization
  • Experts need to be listened too—not just the whiner with a loud voice or a big title, but those that deal with the issue(s) each day
  • Making time to clearly understand the needs and listening from all angles
  • Once you development the innovation, then review it with the experts—validate and re-validate
  • Repeat the process and move the solution (innovation) closer to the ultimate solution.

To me innovation begins and ends with listening!!!

September 2012