Thursday, July 5, 2007

Clinical Innovations - Six Innovations - Innovation Number Five

Chief Innovation Officers Will Become Common.

Reprinted from Physician Leaders, June 14, 2006

As healthcare becomes more complex, as competition intensifies and as Americans go abroad in increasing numbers for care, health care organizations will add the position of chief innovation officer to their executive suite (currently consisting of the Chief Executive Officer, Chief Operating Officer, Chief Information Office and Chief Medical Officer).

The search for innovative ways to compete will make this new position necessary, to find less costly, quicker, better and more effective ways of doing things. The duties of the chief innovation officer will be hard to define and will be polymorphic. The chief executive officer will interact with his executive colleagues, preside over creative marketing teams, solicit ideas from providers on the front lines, outsource services to organizations that can do things better, and seek the means of tamping down continuing rising supply chain costs.

Within five years, I predict health care organizations of all sizes, shapes and functions--health plans, hospitals, practices, support groups, consultants and supply chain vendors, healthcare associations, and consumer groups--will select someone within their organization to be their chief innovation officer.

The chief innovation officer will generate ideas, sift through them, pick winners and lead organizations towards a future geared to productive change.

Right now, only a handful of health care chief innovation officers exist--at the health plan giant, Humana; at Alegent Health, mid-sized hospital system in eastern Nebraska and western Iowa; and at Cadient Group, a health care marketing agency. No doubt other chief innovation officers exist that have escaped my attention, but there are too precious few.

Many health leaders are already serving as functional chief innovation officers--CEOs and CIOs of hospitals and health plans, chief medical officers, physician leaders, nurse executives, nurses and managers in physician offices. I don't really care what title these persons bear, or whether they call themselves chief innovation officers--chief information officers, chief inspirational officers, or chief instigation officers--as long as they can create, generate, foment, elicit, implement, filter and test out new ideas.

The CIO's chief functions are to stimulate, generate and instigate ideas from managers, employees, people on clinical front lines, patients, staffs in medical offices, consumers and the public at large. Workable new ideas generally do not come from the top rungs of an organization, but from lower and bottom rungs, from service and interactive personnel on the front lines of care.

The CIO's other functions are to keep ideas flowing and to try them out, again and again, failing again and again, and then starting out again. My favorite definition at the moment for "innovation" is this one, which I read in the New York Times:
"Innovation is a constant process of trial and error. You need the willingness to fail all the time. You have to generate many ideas and then you have to work very hard only to discover they don't work. And you keep doing that over and over until you find one that does work." (Steve Lohr, "John W. Backus, 82, Fortran Developer Dies," March 20, New York Times).

John W. Backus assembled and led the IBM team that created FORTRAN, the widely used computer program language that opened the door in 1957 to modern computing. Perhaps this is my favorite quote because in the late 1960s, Russell Hobbie, a professor of physics at the University of Minnesota and I, used computer software, which Hobbie wrote in FORTRAN, to create a program that generated a differential diagnosis for abnormal laboratory results of some 600 tests that was used in 6 million laboratory reports.

What does a chief information officer do? Jonathan Lord, MD, chief innovation officer of Humana since 2002, says, "The CIO becomes the spiritual leader within the enterprise. His basic role to bring new ideas into healthcare and to find talented people who can handle ambiguity and who have passion for change--people who have comfort with new ideas, who can align beliefs, and who can co-create."

The CIO, in short, constantly co-generates idea, keeps the ideas flowing and tests them out to see if they work or fail.

Harry Lukens, chief information officer of Lehigh Valley Health Network in Allentown, Pennsylvania, has developed and chaired a group he calls the "Wild Idea Team." It has a rotating membership of 18 to 25 people, at all levels of the organization. The team places no ideas off limits, and there is only one rule "no snickering."

Healthcare needs more Harry Lukens, who take positively nothing for givens, tolerate no gratuitous snide snickering, forbid all internecine biased bickering and who believe out there lies some wild idea that may very well be the key to the future.

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