Want to Innovate? Dignity's Rich Roth Tells You How

In a HealthLeaders interview with chief strategic innovation officer Rich Roth, he shares how to innovate 'within and outside of healthcare in a way that challenges the status quo.'

As more hospitals and health systems enter the realm of innovation, advice from early leaders of innovation can help executives navigate this increasingly important terrain.

Chief Strategic Innovation Officer Rich Roth has served at San Francisco­–based Dignity Health since 2012, and also co-manages the system's strategic investment fund.

According to Roth, two of the greatest achievements to come out of Dignity's innovation arm include:

• A partnership with Propeller Health to launch a digital therapeutic device that decreased ED asthma admissions by 54%, improved outcomes, and reduced costs.
   
• The launch of naviHealth, a company involved in Dignity Health's bundled payment efforts, which Roth says has enabled the system to provide care beyond discharge to keep patients well. Among the advantages: Savings are shared with physicians, more patients are able to stay at home versus a skilled nursing facility or long-term care, and "We've been able to treat more than 60,000 patients under these bundles, saving the government, on average, $1,500 a case," says Roth.

Editor's note: Earlier this year Dignity Health and Dignity Community Care joined together to form CommonSpirit Health, a single healthcare organization formed with Catholic Health Initiatives (CHI).

Following are excerpts from a recent conversation between HealthLeaders and Rich Roth on his advice about innovation for health systems. The transcript has been lightly edited for space and clarity.

HealthLeaders: Could you provide an overview of Dignity's innovation operations?

Rich Roth: Dignity Health was one of the first health systems to launch a strategic innovation function, and I have the honor of leading it. It was set up by our CEO and board to make sure that we're creating; testing; incubating; and scaling novel services, programs, partnerships, or technologies both from within and outside of healthcare in a way that challenges the status quo and has the potential to improve access to care, offer new avenues to grow and to serve, and to look at a more efficient way to deliver care in a rapidly changing healthcare environment.

HL: What advice do you have for other health systems that are in the early stages of innovation?

Roth: The most important thing is you can't divorce yourself from operations. You can't create artificial environments because artificial environments ultimately don't work for you or [your] partners. You need to bring in your operating leaders [during the early stages].

Second, don't be so siloed that only one measure might work. We have had examples of companies that thought they were measuring variable A and it turned out that variable A didn't yield a lot of fruit. But because we also measured variables B, C, and D, one of those actually made all the difference.

The third thing is do the hard work. It is easy to get a pilot in, but it's hard to sustain and to scale. That means bringing along your IT department, your privacy and security teams—all the safeguarding things that you know are in place for key reasons. You have to do the hard work at the front to have them engaged, supportive, and along for this transformation.

HL: What innovations do you think will have the greatest impact on health systems?

Roth: Historically, the community health world and the medical world have been disparate and different. Given the increased understanding of barriers to care, we've [realized that we've] got these incredible resources in the community, [such as] organizations focused on food security, homelessness, culturally relevant disease management, FQHCs, or other types of things.

As an industry, we've unfortunately built up separate worlds. To succeed in taking care of the community, we have to link these resources. One of the biggest themes that we'll probably see moving forward is how do you best link the social and community world with the medical world to care for patients that are at their most vulnerable, and fuel that partnership with data exchange—with the ability to refer to one another and track outcomes between networks.

The second thing is personalization. The healthcare system has been set up a bit like a one-stop shop. However, what we're seeing is people affiliate and choose membership with things that feel customized to them.

The third thing is using automation (e.g., machine learning and AI) to improve the work environment for our caregivers so that they can provide better care to our patients. [That means] taking things that have strain and friction in their work environment and figuring out how we simplify and automate them to achieve better performance.

HL: What do you think is the greatest source of innovation for health systems?

Roth: One of the things I've been most excited about is the governmental innovation coming out of the CMS Innovation Center. I think they've done things that have transformed healthcare at scale with their bundled payment program or with the ACO program. They've linked the concept of payment, incentives, and operational design in a way that makes rational sense and creates long-lasting change.

We happen to be in the Silicon Valley and there's amazing technology innovation that goes on here every day. Linking that into care model redesign is another incredible part of innovation. Finally, I would say the front lines [are] coming up with great ideas and great ways to improve things. And for us, it's about managing the portfolio between governmental innovation, Silicon Valley or [private equity and venture capital] innovation, and then what our employees need and create and want to help improve every day. Within that ecosphere, you can find great winds and it may [vary] from one year to another.

Editor's note: There is no relation between Rich Roth and Mandy Roth, HealthLeaders innovations editor.