Checklist: Moving innovation projects from pilot to production

Automation, customization and – above all – an ability to show value and ROI are must-haves for hospitals looking to make promising tech take root.
By Mike Miliard
11:05 AM

So, you've got an innovation initiative of the ground. You've come up with a use case to tackle, secured executive support, scrounged together a budget, and have made some encouraging headway in advancing the new technology in a pilot setting. Now it's time to scale it up and spread that ingenuity across the organization.

But how? Even the most exciting innovation project won't count for much if it's only used by a handful of hospital staff. The key is to get it to catch on and proliferate enterprise-wide, so even the most recalcitrant clinicians might see its value and embrace its transformative potential. Here's a checklist to help make that happen.

1. Have a sound strategy.

"Ad hoc innovation is not enough," said Adrian Zai, MD, director of research at Partners eCare earlier this year. It's crucial, he said, to align innovation initiatives to specific areas of need, and to be able to scale up promising programs when applicable.

"Formalizing your innovation strategy is critical," he said. To truly drive diffusion and uptake of new ideas, it's crucial to have "infrastructure that promotes innovation across your organization – otherwise, you're just hitting your head on the wall."

2. Understand different approaches to spreading knowledge.

In a recent article in Harvard Business Review, "How to Hand Off an Innovation Project from One Team to Another," Joe Brown, a portfolio director at IDEO, laid out the stakes: "If innovation projects are going to succeed, they’ll need to survive a handoff from an innovation team to an execution team," he said. "And every time you create a handoff, you risk dropping the baton."

Brown identified four basic strategies for how to handle those transitions, and said which you'll use will depend on the specific goals of your organization:

  • First, "The Owner’s Manual," requires extensive documentation – slides, spreadsheets, etc. – to enumerate the project's value and instruct others on how to embrace it, he said, and "works best when there is no more ambiguity left in the challenge, when the project is ready for implementation by technical teams," he said.
  • Second, "The Architect," occurs when a leader from another department "embeds" with the innovation team and "then acts as a connector, knowing all of the avenues already explored and all of the learning gained."
  •  Third, "The Ambassadors," also depends on teams embedded in each stage of the innovation, helping "ensure that no learning is lost and that each phase of work is designed to feed smoothly into the next." Such a strategy not only helps those who will be adopting the innovation, but helps the innovators have a better "awareness of what downstream teams need most."
  • Fourth, "The Hive," centers around multidisciplinary teams that "tackle challenges across the initiative’s life cycle," and works best when innovation teams comprise "people from every major function and discipline" of a given organization. Think, for instance, of a pop health innovation pilot developed by clinicians, IT teams, data scientists, case managers, etc.

3. Know the importance of specific roles.

Simon Wardley, a researcher for the Leading Edge Forum, a think tank focused on bridging the gap between operational strategy and new technology, identified three personalities essential for evangelizing and eventually operationalizing new innovations: pioneers, settlers and town planners.

Pioneers are  "able to explore never before discovered concepts, the uncharted land," he said. "Their type of innovation is what we call core research. They make future success possible" – even if their initial ideas don't always work right, or are baffling to new users.

Settlers "can turn the half baked thing into something useful for a larger audience," Wardley explained. "They build trust. They build understanding. They learn and refine the concept. They make the possible future actually happen. They turn the prototype into a product, make it manufacturable, listen to customers and turn it profitable."

And Town Planners, by leveraging economies of scale, "are able to take something and industrialize it," he said. "They build the platforms of the future and this requires immense skill. You trust what they build. They find ways to make things faster, better, smaller, more efficient, more economic and good enough. They build the services that pioneers build upon."

All three are important to spreading innovation, but it's just as important to understand which leaders a given organization fit which role – and ensure they're put in a position to fill it to their potential.

4. Assess any and all possibilities for automation.

One of the first orders of business when looking to scale up innovation is to "find every process you can automate," said Richard Milani, MD, chief clinical transformation officer at New Orleans-based Ochsner Health. "You have to do an inventory before you go pilot to scale: 'What things are we doing now are automatable?'"

It's important to be ready for the implications of big growth, Milani said. "Right now you might be saying, 'I can do this manually for these three use cases,'" he explained. "Well, those three use cases might be going to 3,000 use cases in a few months. You're not going to be able to keep up with a lot of those manual tasks. You're going to want to see what is automatable that is being done by humans today. And it's worth trying to put that in to test it, because when you scale, it's going to be tough to keep up.

"That's probably the single most important thing you need to do before you broaden it," he added. "Everything else sort of ties to that, because some of the sub-things are like interfaces, and 'is the technology bullet-proof, are you going to have resources to scale, all that sort of stuff."

5. Customize for your customers.

"One other important area is to be able to build in customization for physicians if that's possible," said Milani. "You may have a process that's one-size-fits all, but docs are not always one size fits all, and physicians like to be able to have their own preference settings. So even you and I might be using the same innovations, I might like it one way and you might like it a slightly different way."

It's key to be able to anticipate and "try to collect in advance what are the things physicians feel they need to control, to be able to modify it in whatever it is you're rolling out," he said. "See if you can try to create preference settings for some of those modifications. That's going to come up when you roll something out across a bigger area, and if you already have that figured out and built in, it just makes it go so much smoother."

6. Foster a collaborative spirit.

Real momentum can be accomplished by breaking down barriers to better diffuse the new ideas across the organization, said Partners' Adrian Zai. The most effective innovation depends on the "removal of artificial divides," he said.

Whether it's team-based care projects, new technology rollouts or complex, interdisciplinary approaches to population health management, healthcare improvements depend on healthy collaboration. So when looking to drive innovation, it's valuable to "promote interdisciplinary innovation teams," said Zai.

"There are still artificial divides that hinder innovation," such as between research and clinical roles, he added. But at Partners HealthCare, "we compartmentalize these two areas such that one has nothing to do white the other."

It's all done with the big goal in mind, he said: "Everything we do in innovation and research should trickle down into operations."

7. Be ready to show value.

"You want to be able to provide feedback, in a timely fashion, to the users," explained Ochsner’s Milani. "Is this working? Do they have a way of knowing it's working? What are the benefits?

"Whatever you're innovating, whoever the users are have to perceive value," he said. "You have to demonstrate value to the players in the system, whether it's patients or doctors or nurses. How are you showing them continuous value in an ongoing way. You need to provide that feedback. It could showing that your blood pressure is better controlled, or that there are fewer EHR clicks and you're saving time. Whatever the innovation is, you need to show it in a meaningful way, as feedback to the users. Otherwise, people won't use it."

Focus on Innovation

In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation.

Twitter: @MikeMiliardHITN
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