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Highlights from the 12Th CEO/Innovators Roundtable May 18-19, 2017 Boston, Massachusetts

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Highlights from the 12Th CEO/Innovators Roundtable May 18-19, 2017 Boston, Massachusetts Highlights from the 12th CEO/Innovators Roundtable May 18-19, 2017 Boston, Massachusetts By David G Anderson, PhD, Barbara Anderman, MA, and Larry Vernaglia, JD, MPH Table of Contents Introduction .................................................................................................................................................................3 Leveraging Culture to Propel Innovation ....................................................................................................................4 Innovative Responses to Payment Reform ..................................................................................................................6 Designing Health Care for the Consumer ....................................................................................................................8 Artificial Intelligence. How is it Being Leveraged Within Health Care? ................................................................... 10 Case Studies in Transformation: Success Stories .......................................................................................................12 2 Introduction Designed to bring together the most dynamic minds in health care, consumer empowerment, clinical integration, and many care, the CEO/Innovators Roundtable serves as an open and other innovations are still very much “in process.” robust forum to debate the latest challenges and opportunities The two days of the roundtable were divided into five panels, facing the industry. Over two days, health system and health each led by a group of panelists who shared their own plan leaders, physician-group leaders, medical practitioners, successes and ideas, and who guided the conversation among technologists, and health policy experts shared their unique the room full of participants. The five sessions were: insights, discoveries, opportunities, and challenges as they strive to transform the industry. Summaries of the discussions in each of these panels appear below. A new administration in the White House increased uncertainty about the trajectory of health reform. What new regulations, or deregulation, will bring is unknown, but this 1 Leveraging Culture to Propel Innovation lack of clarity hasn’t stopped organizations from innovating. Leading health systems and academic medical centers, new academic medical centers, payers, and tech startups are all Innovative Responses to Payment Reform developing innovative solutions to bring high-quality lower- 2 cost health care to the United States. The focus was on “Making Change Happen.” Eight years of Designing Health Care for the Consumer federal health reform stimulated unprecedented innovation 3 in the financing, delivery, and management of health care across the country. Yet, many of these innovations fell short of Artificial Intelligence. How is it Being their potential because of the massive scale, complexity, and 4 Leveraged Within Health Care? rigidity of our health care institutions and markets. And, while the cost trend moderated during the recession, it does not appear to have flattened permanently. As a result, accountable 5 Case Studies in Transformation 3 Leveraging Culture to Propel Innovation Maninder “Mini” Kahlon of Dell Medical School described Michele Chulick Dell Med’s effort to position itself as a “business model Former President, Children’s Health System of Texas Ventures innovator” for academic medicine. Dell Med leadership is Todd Dunn committed to tying innovations to tangible improvements in Director of Innovation, Intermountain Healthcare Transformation Lab, health and diffusing these improvements around the country. Intermountain Health However, leadership doesn’t believe that dissemination is Maninder Kahlon, PhD achieved solely by publications, and pursuing NIH grants Vice Dean for Strategy & Partnerships, University of Texas, is not Dell Med’s main goal. Instead, they are developing a Dell Medical School proactive approach to commercializing innovations that are Pravene Nath, MD ripe for dissemination. As Mini said, “We’re going to select Former Chief Digital Officer, Stanford Health Care and nurture ideas from nurses, front desk staff, operations staff, and patients, To succeed, the ecosystem will have to Panelists began by describing their views of innovation and be bigger than just us. It will include pharmacists and the the factors they think contribute to its success. Todd Dunn community, and it will have to address the business model, of Intermountain Healthcare noted that innovation requires so incentives can be realigned.” empathy and curiosity. While most health care providers A thoughtful discussion followed the panelists’ comments, have great empathy, innovators must embed empathy in their centered around four main themes: products and services by getting as close to their customers as Pixar does with its movie-making or Procter & Gamble does The challenges academic health system with its “Living It” program. (P&G employs ethnographers 1 cultures face in encouraging innovation to live with “lead customers,” observe how they live their everyday lives, and identify their needs first hand.) In a The importance of getting patients and comment picked up by others, Dunn contrasted companies’ 2 users involved in innovation innovation engines with their operating engines and said that innovation requires processes to integrate them effectively. The question of how closely tied Dunn cited the innovation process model developed by GE 3 health system venture units should FastWorks, based on Eric Ries’ book, The Lean Startup, as be to operations providing a theory, principles, and tools for accomplishing this. The need for top leadership to 4 lead innovation Michele Chulik emphasized the need for capital and stamina to support innovation. At one point, Children’s Health System of Texas had 16 TeleNICU sites and over 100 kiosks in Academic health systems and innovation schools. However, the ROI for these outreach efforts in rural areas was not always sufficient to preserve them through the Participants from several academic medical centers questioned Great Recession. whether the diverse interests and diffuse cultures of AMCs could support transformational innovation. One participant emphasized Pravene Nath described an aggressive effort by Stanford Health the importance of aligning institutional and physician interests: Care to introduce consumer-oriented digital technologies, “We can’t develop cost-saving innovations if it causes our including building a custom patient portal with iOS and physicians to lose money.” Another participant acknowledged Android smartphone apps. According to Nath, Stanford that while faculty members are natural innovators in their fields, Health Care learned a number of important lessons from this it is hard to identify the “innovative ecosystem” in AMCs. Nath experience: (1) how receptive patients and consumers are with of Stanford asked whether AMCs’ appetite for innovation may a modern and streamlined user experience; (2) how easily outstrip their ability to deliver. As he said, “We had so many consumers can get confused by multiple apps launched by different ‘Stanford apps’ that it confused patients and ourselves, the same health care organization; and (3) how difficult it is to and we lost control over our ability to launch new ideas.” A anticipate all the ways consumers will use these apps. 4 participant from one of the country’s largest AMCs summed for nurturing ideas; and (4) the Transformation Zone, where up the discussion by contrasting incremental innovation with leadership makes one or two big bets on the future. The transformation. He described Netflix CEO Reed Hastings’ implication of Moore’s framework is that incubation is best decision to move the company into the content business carried out separately from operations, which should be and his commitment of a substantial amount of his time to focused on performance and productivity. Kahlon of Dell making this happen. While a new medical school such as Dell Medical School agreed with moving incubation to another Med has more degrees of freedom, it is difficult to imagine organization to “let 100 flowers bloom.” However, she felt an existing AMC leader spending half of his or her time that most innovation should be conjoined with operations. spearheading this type of radical transformation. And operations itself needs to change. Dell Med has tried to move away from the traditional departmental structure Involving end users in innovation of medical schools by developing “domains” and initiatives within and across departments. A number of participants emphasized the importance of involving patients and end users in the innovation process. Chulick of Children’s Health System of Texas argued for Dunn of IHC described the patients-in-residence in Stanford’s embedding innovation in operations, saying that this helps “Medicine X” program and emphasized the importance of innovators understand sources of value and promotes getting people (e.g., Chief Experience Officers) and systems sustainability. Dunn emphasized that innovation teams need in place to understand consumer and patient needs. Dr. to link closely with providers, clinicians, and even patients Rasu Shrestha of UPMC described directly integrating two at the bedside. “The closer you are to the patient, the better radiologists from the Radiology Department to rotate through off you will be,” he argued. “I report to the chief information UPMC’s innovation center in order to put end users in the officer,
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