Innovation is not all bright shiny things. Innovation leaders became more strategic during the pandemic; here are some of the most unusual ideas and insights they shared with HealthLeaders to move healthcare forward.
With the worldwide coronavirus pandemic as the impetus, 2020 was a banner year for healthcare innovation. While technologies like telehealth played a key role in changing the way healthcare is delivered, the year also brought a shift in overarching strategies and approaches to innovation.
Through interviews and virtual events, such as the HealthLeaders Healthcare System of the Future, and the HealthLeaders Innovation Exchange, we had the opportunity to speak to numerous innovation leaders at hospitals and health systems about their approaches to innovation and emerging ideas.
Following are 10 of the most intriguing innovation ideas we heard during 2020 that could provide inspiration for innovation initiative during 2021.
1. Turn Competitors Into Collaborators
"In many ways, COVID deconstructed a lot of the bureaucracy that was standing in the way of innovation," says Jayne Morgan, MD, a cardiologist and director of innovation at Piedmont Healthcare in Atlanta. One key advancement that occurred during the pandemic was greater cooperation between organizations that are normally considered competitors.
"In Georgia, says Morgan, "we had a lot of collaboration at different levels between Piedmont, Grady Health System, Emory Healthcare, and Wellstar Health System. In general, we are competitors. COVID turned our competitors into collaborators. We all had to come together to serve the community, to survive, and to make certain that we could protect our staff. That's something that we hadn't seen before."
2. Bifurcate Physician Compensation Models
"It's really hard to get incentive models right, especially when you're competing in really more than one business model," says Dan Liljenquist, JD, senior vice president and chief strategy officer, Intermountain Healthcare. "The biggest overarching strategic realization we had in recent years is that we were actually in two different businesses. In one business, we take about $5 billion of capitated risk through our insurance company and through other payer relationships. Then we have another $5 billion or so in fee-for-service revenue, partly on those risk-based contracts as well. But you can't have the same incentives and manage those effectively, unless you identify who's doing what and tying it out.
As a result, we restructured our business, breaking the organization into two separate business units. One business unit—Community Based Care—is focused on value-based care and keeping people well. The business unit—Specialty Based Care—focuses on interventions when they were needed. There are different revenue models and incentives depending on the business unit, and you need to be clear about the underlying economic models and what you need to be successful. The biggest challenge I've seen in our organization is to delineate between the types of care. For a long time we just said integrated healthcare is good in every aspect and every circumstance, and you've got to really manage to where the economics are."
3. Create a Touchless Patient Experience
"At Houston Methodist, we're on this journey of creating a true touchless patient experience," says Michelle Stansbury, vice president of IT Innovation, Houston Methodist. "COVID has enhanced our process. If you stop to take a look at the experience that your patients go through trying to access services, there are multiple phone numbers they can call. There are multiple access points that sometimes lead to nowhere. You then wonder how they are even getting the services that they are getting?"
4. Develop Digitally Enabled Whole Person Care
"One of our most significant initiatives falls under the umbrella of building connected communities of care to further drive the concept of a digitally enabled whole person care, says Steve Miff, PhD, president and CEO, Parkland Center for Clinical Innovation (PCCI) in Dallas, Texas. "There are three buckets. One is generating better whole person insights. Certainly, COVID has helped us accelerate that by identifying, at much more granular level, who are the more vulnerable individuals across the community. We use that information to drive better integration and embed virtual care across the continuum. We then transition and enable more person-empowered health management. Part of it is care transformation, the other part is increasing the capacity for self-care."
5. Re-Engineer the Care Model
"We've invested in re-engineering the entire care model," says Aimee Quirk, JD, CEO, innovationOchsner, of Ochsner Health. "It blends a lot of different concepts including consumerism, digital health, and taking a broad view of data to encompass all determinants of health. The model also uses predictive capabilities which employ that data to prevent adverse events and team-based care to ultimately add value to everything we do." She continues, "We're also re-engineering our chronic disease model to involve more continuous home-based care to turn those outcomes around. It upends the way our physicians traditionally practice, but adds a lot of value for them and for the way our patients experience care and especially their health. Patients are more empowered, better able to access care, and better able to manage decisions they make daily related to their health and behaviors."
6. Digitize Community Health Workers
"At OSF HealthCare … we've built some of our capacity and care management through innovation and have implemented a couple of different care models to meet our patients’ needs," says Michelle Conger, chief strategy officer of OSF HealthCare and CEO of OSF Saint Gabriel Digital Health. "One of them has really been around digitizing community health workers. One of the things we've struggled with is the adoption of virtual care and the acceptance of that, particularly in more at-risk communities. During the pandemic, we created pandemic health workers, which are really community health workers. They're the liaison between the technology and our virtual care center, and their personal contact has built trust.
7. Operate as a Single Organization, Rather than Separate Entities
The challenges of managing large numbers of COVID-19 patients and the ability to share resources in real time have transformed the way the 10 hospitals in the MedStar Health system work together, says Mark Smith, MD, chief innovation officer, MedStar Health, and director, MedStar Institute for Innovation. Like many health systems, the Columbia, Maryland-based organization had grown over time through mergers and acquisitions of hospitals in Maryland and Washington, D.C.
“In the early days of our organization, we operated more like 10 independent hospitals, which were being woven together into an integrated and distributed care system,” he says. “But it was COVID that caused us to respond operationally as a single, one MedStar system. We moved patients between and among our 10 hospitals to balance clinical care requirements and not overload any individual site. The result is that we now, more than ever, consider ourselves to be one unified system of care. I don't think there's any going back from that.”
8. Focus on Payment Reform
"We need to develop a better model to work together to accelerate payment reform," says Karen Murphy, PhD, RN, executive vice president and chief innovation officer for Geisinger and founding director of the Steele Institute of Health Innovation. "As an industry and as a country, we have to come together with policymakers to figure out how to advocate in a way that really gets where we all want to be. Advocacy efforts in the past have really been pushed by either addressing legislation or policy—after the fact. I think we've demonstrated during this pandemic the need for payment reform. Providers all did the right thing and are in a financially devastating place right now."
9. Incorporate Benefits Navigation Into Primary Care
"I believe primary care is probably one of the most essential levers that we have for improving experience and quality of care, and, ultimately, also lowering costs," says former Haven COO Jack Stoddard, MBA, who is now executive chairman of New York–based Eden Health, which offers a unique approach to healthcare delivery. "Integrating benefits navigation with care delivery is novel. Combining those two is a recognition [of] how people experience healthcare."
10. Ditch the Digital; Cross the Divide to Reach Individuals Who Need Care Most
"There is never going to be one-size-fits-all with technology," says Paul Alexander, MD, MPH, chief transformation officer, RWJBarnabas Health who participated in the HealthLeaders Healthcare System of the Future fall virtual event. "The reality is, we have members in the community who don't have broadband, and others who are very mindful of the amount of time they spend on their mobile because they don't have enough minutes. At the end of the day, if we create a system that only could specifically address access for those individuals, and promote interface with the healthcare environment, it would be wonderful."
Mandy Roth is the innovations editor at HealthLeaders.