Clinical innovations, systems thinking - Short Take on Disseminating Innovation

What - Dr. Lyle Berkowitz, a practicing internist, chief medical information office of 120 person primary care group at Northwestern Memorial Hospital in Chicago, and program director at Szollus Innovation at Northwestern, called to discuss status of medical innovation in the U.S. – how to spot it, encourage it, spread it, teach it, embed it.


Why – If U.S. health care is to improve, cost less, and get better outcomes, it must innovate to crawl out of its present rut and fixed ways of looking at things.


When - It’s happening fast now as we seek ways and as innovation centers spring up to “fix” the “broken system,” or “mess,” whichever term you prefer.


How – To spread, innovations must be perceived as benefit with risks outweighing risks; must be compatible with values, beliefs, past histories, and current needs of doctors; must be relatively simple; must find ways to test validity; and be observed and tried out by early adopters.


Where -. Innovation centers have been set up at Kaiser, Virginia Mason, Northwestern, Cleveland Clinic, Minnesota state government, Mayo, and University of Pittsburgh – and no doubt others.


Who – Personalities who spread the word and make it stick include : 1) innovators (venturesome, risk tolerant, novelty seekers, who are willing to venture outside to learn); 2) early adopters (those who see the opportunity and seize it early); 3) the early majority (who see the light shed by innovators and early adopters and climb on the bandwagon); 4) the late majority (who see the success stories and view change as inevitable); 5) the laggards (who refuse to change under any circumstances and are chained to the past by social, organizational, or political constraints)


To make innovation work , rules are:

1) Find a sound innovation.

2) Support innovation.

3) Invest in early adopters.

4) Make early adopters’ activities observable.

5) Trust and enable those who want to modify or reinvent original innovation.

6) Give those who fail some slack time to re-energize their risk-taking zeal.

7) Lead by example,

8) Read Donald Berwick, MD, MPP, “Disseminating Innovation in Health Care,” JAMA, volume 289, pages 1969 -1975, 2003, for details.

9. Never, never, never give up.