Collaborative efforts between Wake Forest School of Medicine and Wake Forest Baptist Health are designed to bridge the gap between research and clinical practice.
How do you speed up the innovation cycle? The Wake Forest Center for Healthcare Innovation in Winston-Salem, North Carolina, is determined to figure out the formula.
The Center involves a complex combination of people, projects, and institutions working toward a single mission: to accelerate medical research into solutions that impact patient care—a practice known as translational innovation.
Making the leap from the lab to the clinical environment, and scaling a solution across an enterprise, is a common challenge shared by health systems engaged in innovation activity. The problem is not a new one. An often-cited study published December 2011 in the Journal of the Royal Society of Medicine found that the time lag between making medical discoveries and moving them into mainstream healthcare is 17 years. Most agree this timeline is much too long in an industry that's demanding change and moving toward value-based care.
A glimpse into how Wake Forest Baptist Health and Wake Forest School of Medicine joined forces to address this challenge provides insights for other hospitals and health systems engaged in similar endeavors. HealthLeaders shares a look at the Center's infrastructure and strategies as part of our ongoing series about how different organizations and leaders approach innovation.
Supportive Infrastructure and Access to Resources
Founded in 2017, the Center is jointly funded by Wake Forest's medical school and the health system—a combination that may be a key ingredient to achieving its mission, says Eric Kirkendall, deputy director of the Wake Forest Center for Healthcare Innovation and director of digital health innovation at Wake Forest Baptist Health.
If proximity to other innovators plays a role in success, the Wake Forest facility has some distinct advantages. The Center occupies space in a renovated power plant, one of multiple buildings located in a 330-acre mixed-use development in downtown Winston-Salem known as the Wake Forest Innovation Quarter, which is devoted to the concept of of innovation. This is not simply a leasing arrangement; it is part of a grand initiative to position Wake Forest and the city as an innovation hub, says Russell Howerton MD, FACS, senior vice president, Wake Forest Health Network, and system chief medical officer of Wake Forest Baptist Health.
Julie A. Freischlag, MD, FRCS, EdD, who is the CEO of Wake Forest Baptist Health and dean of the medical school, serves as the leader of the Innovation Quarter. The concept was conceived more than two decades ago and developed in concert with government officials, business and development leaders, and the community. The Quarter includes nearly 2 million square feet of space, houses 170 companies with more than 3,700 workers plus more than 8,000 workforce trainees, as well as components of five academic institutions with 1,800 students.
Collaboration with other entities provides support and resources that expands the reach of the Wake Forest Center for Healthcare Innovation, says Kirkendall. In particular, the organization relies on Wake Forest School of Medicine Center for Biomedical Informatics, which provides research and data support; Wake Forest Innovations to address commercialization and intellectual property issues; and the Wake Forest healthcare delivery system, which enables the Center to test its innovations in clinical settings.
With so many Wake Forest entities involved in innovation, "one of our objectives is to simplify the process," says Kirkendall. "There are a lot of doors in this house; the Center for Healthcare Innovation likes to be the front door when people first want to engage in innovation within the clinical space."
While anyone within the Wake Forest system can present an idea to the Center, a governance program and intake process guide the team and help them evaluate whether the innovation fits with its mission and vision, and if the resources exist—or can be marshalled—to ensure its success.
An Open Membership Policy
The Center employs about 10 core staff, which include project and program managers, a software engineer, an application developer, and administrative assistants. Capacity expands exponentially through the facility's membership, which now includes about 60 people. Members have fulltime jobs elsewhere in the Wake Forest system, but contribute to the Center's activities. Most are somehow involved in bringing a particular innovation to life, says Kirkendall, but they also are required to participate in structured and unstructured activities to advance other members' initiatives.
Membership is open to anyone in the Wake Forest system, not just faculty members. By including hospital nursing leaders and managers, for example, who can test innovations in the clinical environment and train others how to use a new device or process, Kirkendall says the Center enhances the opportunities for innovations to make the leap from the lab into the patient care setting.
"All we ask is that members become meaningful contributors to our group collective," says Kirkendall. That can be through quarterly meetings, educational sessions, and events designed to propel each project forward.
While most team members spend most of their time off-site, to facilitate collaboration, the Center offers communal workspace and sophisticated conferencing equipment, says Kirkendall. Many of the teams hold regular meetings at the facility, which often include representatives from the Center for Biomedical Informatics.
4 Elements Behind the Center's Strategy
Kirkendall says there are four elements behind the Center's innovation strategy:
- Focusing on realized value versus potential value. Many innovation centers focus on the potential value of their initiatives, says Kirkendall. "As a Center, we focus on realized value. I prefer tangible, measurable accomplishments."
- A different perception of scale. Kirkendall examines scale through a different lens than many others in the industry who he says are referring to technical scale. "I like to think about the impact of what we're doing," he says. "To me, the impact is value [multiplied by] scale. You can have the same impact if you create a tremendous amount of value for a small population or you flip that around and you're creating a small amount of value for a very large population."
- Agility. Academic medical centers are traditionally slow to pivot, he says. "That's not historically our forte. As we move across the translational innovation spectrum, it's important for us to learn quickly. It's the 'fail fast' mentality to a certain degree, although I think the value is in the learning—not in failing."
- Creativity. Creativity also propels innovation forward, says Kirkendall. For the Wake Forest Healthcare Innovation Center, this means "bringing in some of those developmental processes and best practices from startup culture."
3 Keys to Accelerate Innovation
Culture also plays a role in a successful innovation enterprise, says Kirkendall. While faculty in academic environments tend to "hold things close to the vest," he says Wake Forest is an "extremely collaborative place. It's fascinating how everybody pairs up and works together. There's not much in the way of the turf wars; everyone shares their issues and the things that they're trying to address."
Kirkendall offers three ways this type of culture helps catalyze the innovation process:
- Developing collaborative relationships with clinical service lines. Without building rapport, you can't just walk onto a hospital floor and roll out an initiative, Kirkendall says. "First and foremost, you must have good collaborative relationships with your service lines." Through its open membership policy, the Center play a key role in building that bridge and encourages innovators to develop partnerships with the clinical personnel who may be impacted by their work.
- Executive sponsorship from research and clinical organizations. Being funded by both the School of Medicine and the healthcare delivery system is "extremely important," says Kirkendall. "We answer to both, which can be challenging because you have more people [involved], but without being in lockstep with them, we couldn't move a lot of these projects along." While many academic healthcare innovation centers are associated with schools of medicine or their research infrastructure, being equally responsible to the health system offers access to frontline providers and helps the Center identify the leading challenges that the system is seeking to resolve.
- Recruiting experts as members and building alliances with external resources. Kirkendall says the collective expertise, talent, and innovative spirit of the Center's membership, as well as access to outside resources is also a key component to the way the organization operates. "If somebody walks in with a new idea, I immediately think about how I can connect the dots with the expertise of our members," he says. "If we don't have [what we need] internally, we reach out externally."
The Center has experienced some early success stories with accelerating projects, for example, by bringing an innovation to fruition that was more than 15 years in the making before the Center became involved. The digital health tool, known as mPATH, educates patients about colon cancer screenings while they sit in their physicians' waiting room. Because the tool also helps patients register for appointments, if indicated and appropriate, use of mPATH doubled the number of patients signing up for screenings, according to a study published in April 17, 2018, in the Annals of Internal Medicine. The device is now in use in two locations, with plans to scale to 14 more inside of Wake Forest and 12 locations outside the system in the near term.
"We've got a lot of early wins, and we're just starting to get into the big-win category, says Kirkendall, who believes all elements are now aligned for the Wake Forest Center for Healthcare Innovation to experience "some huge successes.''
“As we move across the translational innovation spectrum, it's important for us to learn quickly.”
Eric Kirkendall, deputy director, Wake Forest Center for Healthcare Innovation
Mandy Roth is the innovations editor at HealthLeaders.
The Wake Forest Center for Healthcare Innovation is part of an innovation engine driven by Wake Forest's medical school and the health system and is situated within a 330-acre development devoted to innovation.
Membership is available to anyone employed by Wake Forest—not just faculty.
"Realized value," scale, agility, and creativity are essential components of the Center's strategy.
Translational innovation closes the gap between medical research and its application in patient care.