Wednesday, April 9, 2008

Clinical innovation - 12 Things I've Learned from Blogging about Innovation

12 Things I’ve Learned from Blogging about Innovation

“Imagination is more important than knowledge”

Albert Einstein

“Let computers compute. It’s the age of the right brain.”

“Bright Ideas” headline, New York Times, April 6, 2008

In November 2006, I started a blog, I was in the midst of writing a book Innovation-Driven Health Care: 34 Key Concepts for Transformation (Jones and Bartlett, 2007). I wanted to get my arms around the Innovation Universe. Little did I know that I had embarked on writing a daily blog , talking to hundreds of like-minded people, and culling what I could from the health care innovation literature.

Here are 12 things I’ve learned.

One: We’re all in this together. People from every health care sector – 636, 000 doctors, 39 million people with health care conditions, 3.4 million nurses, 64,000 in hospital administration, 1167 HMOs and PPOs, 182,000 dentists, 21,000 pharmacy chains, 59,000 pharmacies, 45,000 pharmacists, 135 million households, and 12 million healthcare workers – have innovative ideas on how to make things better.

Two: Think small. Chunk. Chunking is defined as “Allowing complex systems to emerge out of links among simple systems that work well and are capable of operating independently (Edgeware, VHA. Inc, 1998).

Three: Invite wild and crazy ideas. Gather your people from the front lines of your organization and ask for wild and crazy ideas. Enforce only one rule: no snickering.

Four: Appoint a chief innovation officer for your practice – no matter how small and no matter what level of authority. In medical practices, the best CIO is often a nurse. If you’re a doctor, have her follow you around and ask, “How could I do this better?”

Five: Respect health consumer intelligence. Theywill make a few mistakes, but they will learn quickly, particularly if they’re spending their own HSA in high deductible plans.

Six: Let patients do their own electronic history. Permit patients, guided by clinical algorithms, enter their own history based on their gender, age, and chief complaint. The result is a thorough, accurate, documented, record with minimal data entry costs.

Seven: Engage patients at their communication and convenience level. Emmi Solutions, Inc, in Chicago, allows doctors to “prescribe” interactive online programs, downloadable at home, for patients – led by pleasant voice, anatomic illustrations, and plain language – telling them exactly what to expect from upcoming surgery.

Eight: Make it simple for patients to “talk to each other” and share information online: For patients there’s a website called and for doctors there’s a professional networking site named, (“sermo” is Latin, for “conversation”, which now has over 60,000 doctor members, and for medical students and residents there’s

Nine: Get a dialogue going between innovators everywhere. Perhaps the best site now going in this venue is www., sponsored by Humana, Inc.

Ten: Don’t fear borrowing ideas from retail or engaging retailers in the innovation process. Examples are retail clinics, worksite clinics, posting prices, or in being transparent in what you’re doing or how good you are compared to the competition.

Eleven: Remember this: If it doesn’t work for physicians, it isn’t like to help patients. A glaring current example, is the miserably low physician adoption rate of electronic medical records (EMRs), which sound good in theory but fail in execution. There are simpler ways for patients to communicate – email.

Twelve: Learn from leading innovative organizations. Visit their sites and watch their smoke. Here’s a list for starters. See, April 3, #477 in a series.

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