Add 'Healthcare Innovation Center' to Buzzwords List

Any hospital chief worthy of his or her patients wants to be first on the block with the latest and greatest tools and technology. They buy the newest MRI machines, the highest-slicing CT scanners, and build the coziest of chemotherapy wings rivaling B&Bs for amenities.

But great hospital chiefs are always on a furtive lookout for the next best thing that promises to improve quality and save costs. Based on the volume of press releases received in recent weeks, I think I know what that new thing is: The Healthcare System Innovation Center.

"Over the past few months we've noticed a huge uptick in 'innovation centers' popping up around the country," Lindsay Martin, senior research associate for the Institute for Healthcare Improvement said in an interview with HealthLeaders. "It's definitely the new buzzword, and I don't think that's necessarily bad. It highlights a real need for innovation and people are excited about making some changes."

Dozens of healthcare systems already have created, or plan to spend millions of dollars to set up their very own centers, even building or buying new facilities or expanding centers they already have. Some are also filling a new C-suite position: a chief innovation officer, the person in charge of all things cutting edge. Why is this happening now?

It's starting to be okay for hospital leaders to say they can do better. It's becoming acceptable ­– even honorable – for healthcare leaders to acknowledge that their payment models or care transitions or even safety guidelines are imperfect and outdated, "but our team is smart enough and motivated enough to develop solutions."

Hospital boards, which used to reject grand ideas with no guaranteed returns, are allowing these expenditures in hope that the economies will be forthcoming.  They may fail, but hospitals will try again.

Unexpectedly, hubris and humility are coming together for the common good.

Of course, much of this has been legitimized by the federal Center for Medicare & Medicaid Innovation or CMMI, whose $10 billion treasure chest specified in the Affordable Care Act is expected to move improvement projects along. Launched five months ago, CMMI will give its imprimatur and funding to many of these efforts.  At least that's the hope.

Douglas Wood, MD, assistant director of the Mayo Clinic on Innovation, also is aware of many healthcare systems wanting to start innovation centers because so many have come to the Mayo for advice.

That's probably a good thing, he says. But how much of a role CMMI will play is so far unclear. Wood says the agency's efforts so far "have not been encouraging."

"CMMI has been trying to define its priorities, and at the moment, they've spent a lot of time working on accountable care organizations and addressing hospital readmissions and hospital-acquired conditions," he says.

"Once CMMI and Medicare get through the challenge of writing rules for ACOs, maybe then they can begin to focus a bit more on true delivery system innovation, and think about partnering with delivery systems that want to be innovators. I think then we'll see more progress," he adds.

National Quality Forum founder and former CEO Kenneth Kizer, MD, who is directing one newly launched center at the University of California at Davis, sent me this e-mail in response to my question about the growth of such centers:

"If I were skeptical, I would suspect that some of these new innovation centers have been born out of a desire to capitalize on the creation of the CMMI and its substantial funding," Kizer wrote.

"However, I think more importantly...it is because they have finally figured out that there is a real need to do things differently going forward. Since the preferred new and different approach is often not clear, there is a need to innovate to figure out how to do things better. And of course the funding that is available through the CMMI supports this desire."

There will be a need for some coordination between these centers. Repetition is sometimes good, but not when it reinvents the wheel, or is done in silos. And I wonder how that will come about so these brave healthcare systems won't waste precious resources.
How will these new and old innovation centers work together, avoid wasting precious resources and compete for funds?

Martin agrees that there's potential for redundancy. "Anytime you see an uptick like this there's a need to create a lot of networking so centers can learn from each other and avoid duplication," she said.

Now she and her colleagues at IHI are starting to hear officials from established innovation centers say "we need to create more formal structures for networking and talking with each other."

Kaiser Permanente, which arguably has one of the longest track records with its Garfield Innovation Center, has thought of that. It's hosting an event June 10 at its Center for Total Health in Washington, D.C., in collaboration with CMMI, CMS and ONC, to bring together about 150 thought leaders from new and hopeful healthcare innovation centers around the country.

Wood said he and others from the Mayo Clinic will be there too.

"Perhaps the meeting coming up next month will actually move CMMI along, and make it truly innovative," he says.

There's certainly no lack of ideas and projects, Martin says.

There's a need to design seamless transition strategies that accomplish the triple aim: better health, better healthcare while reducing costs. For example, when patients in disease management programs transition to palliative or hospice care, "everything has to be undone and redone ­– the bed, oxygen and so forth come out, only to be brought in by a different payer," she says. That interrupts care and costs more than it needs to.

There's innovation needed in preventing falls, improving patient satisfaction, discharge planning and in addressing the needs of patients with dementia. "A lot of organizations are starting to address these," she says.
Some will find their own niche, whether it's designing bundled payment collaborations, community health programs to keeping people out of the hospital, medical devices or electronic, wireless remote delivery systems, she says. "We'll start to see organizations differentiating how they are different, for example, focusing on a specific population," while others will focus on technological ways of delivery.

Here are a few examples of recently announced innovation centers:

• The Center for Technology and Innovation in Pediatrics at Children's Hospital Los Angeles and the University of Southern California.
• The Institute for Healthcare Policy and Innovation at the University of Michigan.
• The Armstrong Institute for Patient Safety and Quality and Johns Hopkins Health System.
• The Henry Ford Innovation Institute at Henry Ford Hospital in Detroit..
• The Center for Effectiveness and Safety Research at Kaiser Permanente, which also has the five-year-old Sidney R. Garfield Health Care Innovation Center.
• The Institute for Population Health Improvement at the University of California at Davis, which also has its Center for Health and Technology Innovation. The list doesn't stop there.

Other centers just a few years older include the Center for Innovation at Virginia Mason Medical Center in Seattle, the Center for Innovation in Chronic Disease Care at Cincinnati Children's Hospital and the Center for Quality Improvement and Innovation at the University of Pittsburgh Medical Center. Some of these are expanding as well.

I think it's a good thing that these centers are getting together to share their ideas. Ted Eytan, MD, Medical Director with Kaiser Permanente, said it well: "Innovation can be at times a very lonely place, because people who innovate are few and far between and often doing things that are way ahead of the competition. But this is a community that tends to seek each other out."

See Also:
13 Hot ACO Buzzwords All Providers Should Know
11 Hot Healthcare Buzzwords for 2011