On Tuesday morning at the Saddlebrook Resort in the Tampa suburb of Wesley Chapel, Michael Schmidt offered healthcare leaders gathered at the Florida Health IT Summit, sponsored by Healthcare Innovation, a look at the forward-looking Orlando Health Strategic Innovations program that’s been created by the seven-hospital Orlando Health integrated health system.
The involvement of patient care organizations in technology development through internally created tech development centers is advancing rapidly now, said Schmidt, whose title is managing director of the Strategic Innovations program. Indeed, the latest estimate is that at least 66 health systems now have innovation programs, an estimate that Schmidt said he thought was conservative. That figure is not surprising, given that, from 2017 to 2018, there was a $2.4 billion increase in digital health funding (with the total going from $4.5 billion available in 2016 to $5.7 billion available in 2017, to $8.1 billion available in 2018), with overall venture capital funding available for health IT development of all kinds now nearing $6 billion nationwide, and 325,000-plus health-oriented apps now available to consumers.
Indeed, Schmidt believes, as the healthcare industry becomes more and more digital, organizations will need to find ways to align their strategic, operational, and economic models under the umbrella concept of innovation.
In that regard, he told his audience, he and his colleagues at Orlando Health were ready to begin to create a vibrant innovation process. And in that, he said, “There are two types of innovation—external and internal.” External innovation encompasses the adoption of existing information and other technology, while internal means self-development or partnering. In that context, he said, “We took a look at ourselves to see where we were. We were high on the external scale, but had not had a good internal process for identifying” potential tech innovation coming from inside the system.
Still, the path forward for organizations that would innovate through the creation of any kind of test-bed program is inevitably complex, as there are no simple, clear, universal models to follow in doing so. “If you were at HIMSS this year,” he said, referring to the annual HIMSS Conference, held this year in Orlando, “you heard people say that if you’ve seen one innovation program, you’ve seen one innovation program. I think that’s true. Everybody focuses on their skills and strengths. And it’s hard to know which piece of the puzzle to put down first, and how they fit together.”
In their process, Schmidt and his colleagues at Orlando Health focused on four key elements, in their process. As described in his PowerPoint presentation, they are:
> Clearly Define an Innovation Intent
> Establish and Track Metrics
> Cast a Wide Net to Educate and Inspire
> Balance the Strategy
Speaking of their process, Schmidt shared that, “At the outset, we had about 40 interviews with internal stakeholder leaders. And how could we build a strong innovation program? After we did that, uncovering our problems, we created a strategy, and then moved to operationalize the program. Because we didn’t have a dedicated program at the start, we had had difficulty retaining physicians and others who wanted to participate in this,” he said. What’s more, he said, “the intellectual property landscape was really the Wild, Wild West, because when we started out, we didn’t have a clear process for capturing the best ideas and doing things with them.”
Throughout the process so far and continuing forward into the future, Schmidt told his audience, he and his colleagues have adhered to six strategic imperatives that have been established at the organization-wide level. They are:
> Enhance Quality & Safety
> Earn Physician Loyalty
> Become the Best Place to Work
> Drive Growth & Innovation
> Strengthen Economics
> Enhance Ease of Use
Among the questions that he and his colleagues have continually asked themselves, Schmidt said, are these:
> How will the program(s) be resourced? Will it be the same for program operations, idea evaluation, portfolio management, etc.?
> Where will innovation sit within the broader organization? Strategy? IT? Performance Excellence?
> How will projects be financed? Developed? Deployed?
> How will intrapreneurs allocate their time between innovation and their “day jobs”?
> What are the goals of the program? How will those goals be communicated?
> How will incentives be aligned to achieve those goals?
> What employee policies exist and what changes need to be made to account for intellectual property ownership?
> Who from the organization will be involved?
> Will you involve partners in the community and/or industry?
> How will you source those relationships?
“We made sure our plan and policy incentivized physicians and others to partner with us,” Schmidt emphasized to his audience. “And we made sure to pull in all the key folks from across Orlando Health, for these projects. We wanted to make sure every part of the organization knew about us. And after that, we really started identifying what the key components of the platform would be.”
The Orlando Health leaders ended up setting aside $20 million in funding for the program, and then developing a multi-step process involving workshops, judgings, and an approvals process that has brought forward the most promising ideas into development. To date, Schmidt reported, more than 200 participants have participated in 12 workshops, with more than 65 ideas shared so far.
And a multidisciplinary selection committee has applied five criteria to judging development ideas. Two of the criteria—strategic alignment and internal impact—come from the Orlando Health level; while three others are at the level of the Foundry, the test bed micro-organization they’ve created: team member experience, commercial potential, and solution innovation. Meanwhile, in 2018, 63 ideas were submitted, 22 were advanced, and four were selected. And so far in 2019, 34 ideas have been submitted, 17 have been advanced, and four have been selected.
“Metrics are very important for us,” Schmidt explained. “We wanted to provide team members and physicians a core place to go, so that physicians and others would know where to go for feedback. And then we need to supply them with dedicated funding and support, to help innovation flourish at Orlando Health. The Foundry is a four-phase annual program running on an annual cycle. Late summer through fall, we run workshops to familiarize people with the program; shortly after that, we open our application window. So basically, September through December, anyone can submit an idea. After that, we have a dedicated committee that assess the ideas and chooses finalists. That program lasts 8-12 weeks; we’re wrapping up right now this time around, and then we go towards funding.”
Importantly, Schmidt told his audience, “We only choose the number of ideas we can manage. Right now, we’re choosing four ideas a year. Over time, that will grow. But we don’t want to have dozens of projects that then stall out.”
Among the strengths he sees in the program have been senior leadership buy-in and physician and team member enthusiasm. Among the opportunities going forward remain to clearly communicate and process the journey; set expectations for legal and intellectual property policies early and often; and identify ways to better close the feedback loop for all applications and expand the innovation culture.
What are the potential challenges that colleagues in other patient care organizations should keep in mind going forward in this area? Schmidt shared two important considerations. First, future ideas will require IT resources, and with regard to the human resources in IT, those might be limited for a number of reasons, including electronic health record-related work; in addition, it will be important to secure buy-in for reaching out for external support when needed. Second, he said, ideas and inspiration may fizzle without dedicated project management, with project management becoming increasingly challenging, as development portfolios grow.
