Healthcare is having an Ernest Hemingway moment

Near-ubiquitous adoption of EHR platforms has created a foundation for innovation. And hospitals including Cedars-Sinai and Adventist are fostering emerging technologies, from cloud-based continuous monitoring to virtual reality for patient engagement.
By Tom Sullivan
07:33 AM
Ernest Hemingway healthcare innovation

Innovation is everywhere in healthcare. Right now. 

Upstarts, doctorpreneurs, stalwart hospitals are moving faster than ever, establishing big-budget innovation and transformation labs to conceptualize, develop and in certain instances commercialize cutting-edge products. Even smaller healthcare providers are getting in on the action and fueling modernizations, no less impressive, on lower dollar amounts.

The reason this is so different from just a few years ago: Now that almost all hospitals are actually using electronic health records systems the industry has a platform for emerging technologies. New apps, devices, business processes and care standards are possible where once they were not.

Wait, hold on, what does any of this have to do with Ernest Hemingway? 

That famous quote about timing in Hemingway’s Lost Generation novel The Sun Also Rises — one character named Bill asked another, Mike, how he ended up bankrupt.

“Gradually,” Mike said, “and then suddenly.”  

Whereas Hemingway’s characters were talking about going broke, that answer could also be applied to the digitization that has taken place in healthcare, which is to say it began slowly and then, almost all of the sudden, most of the industry was digitized.

Tremendous hurdles are ahead, to be certain. EHRs need modern software interfaces. Information exchange and data interoperability, long conquered in other industries, are just not going to be settled overnight.  

The industry is now far enough along, however, that non-profit hospitals such as Cedars-Sinai and Adventist Health are hosting technology incubators and putting the tools innovators create to work.

Cedars-Sinai Techstars
The Los Angeles-based non-profit hospital put out a call for applications in October of 2015 and received about 500 responses, ranging from apps to devices, software to services.

Cedars-Sinai executives whittled that last down to 11 by looking for startup founders with both technical chops and strong management skills. They also sought candidates with the emotional intelligence to be entrepreneurs, according to Omkar Kulkarni, Director of Cedars-Sinai Techstars Healthcare Accelerator.

“The hardest part was picking the companies,” Kulkarni said. “It’s a difficult process because everyone of the 500 applicants believe so truly in what they’re doing that they’re willing to give up their job to create a product they think is absolutely necessary.”

The upshot of that conundrum is the class of innovators Cedars-Sinai chose was solid, with a focus on cutting edge technologies to address legitimate and significant problems in healthcare. The innovations include virtual reality for engaging patients, messaging that connects providers’ offices, cloud-based continuous monitoring, stem cell related technologies, a scope that enables safer and more cost-effective intubations, as well as one offering what CFO Edward Prunchunas described as “the Priceline for hospital services” that helps patients schedule imaging scans during slow times and rewards them with discounted pricing.

For the three-month residential program, chosen innovators were surrounded by mentors, doctors and clinicians, had access to top-level executives and outside investment specialists to not only develop the technology properly but also determine how to make it fit the market, and chart a strategic marketing plan. 

“We’re taking the brainpower and innovative energy of our clinicians, physicians and employees and giving it to entrepreneurs,” Kulkarni explained. “In doing so we end up helping ourselves.”

Indeed, a few months after the first class ended, Cedars-Sinai has already partnered with two graduates, Grace and Well, which apply technology to end-of-life planning and text messaging for communication with patients, respectively.

“We did not enter this with the idea that it is going to bring a return on our financial investment,” Prunchunas said. “We’re looking instead at how these help us be more effecting and effective in what we do. When you look at these products long-term, they’re going to have significant savings for us. Can we calculate that from the beginning, no? But there will be long-term savings.”

An intangible aspect of the program, Prunchunas added, comes from being known as a place with innovations, being an early adopter, a trusted organization among innovators and patients alike.

Adventist Health
Adventist Health took a different route to innovation. The idea being to embed an entrepreneurial attitude into all of its leaders rather than hiring a new team, the hospital implemented the Spigit crowdsourcing idea generation tool and backed it up with $1.5 million worth of Innovation Grants.

“Funded proposals have addressed simulation labs, new approaches to online giving, clinical outcome improvements, digital way-finding, childhood obesity and community gardens to promote healthy communities,” said Adventist Health Chief Human Resources and Innovation Officer JoAline Olson.

The first idea challenge Adventist Health put into action emerged, appropriately enough, from the Clinical Information System department. CIS was wrangling with a kludgy and confusing process for filling incoming tickets or change requests that took several manual hours to complete. 

That particular example may not seem as sexy as augmented reality or way-finding — but the payoff has been widespread.

“Now the process to submit requests to CIS is a lot smoother for everyone and the turnaround time is much shorter,” Olson said. “The processes that were improved impacted the workflow of half of our 32,700-strong workforce.”

Hemingway on dreamers and business minds
The programs at Adventist Health and Cedars-Sinai are young. But both are looking toward the future optimistically.

Cedars-Sinai is set to kick off a second class of innovators in early 2017, again with 10-12 upstarts, and Kulkarni said he intends to repeat the program multiple times with the end goal of building innovation into the fabric of Cedars-Sinai.

That sounds a lot like Olson’s philosophy for Adventist Health.

Adventist, in fact, is expanding the Spigit-based crowdsourcing innovation program so that every group in the health system, comprising 260 hospital-based and rural clinics, 20 acute-care hospitals, multiple home care and hospice agencies and joint-venture retirement centers, will become self-reliant in designing their own innovation challenges, she said.

Olson’s ultimate aim — which evokes another Hemingway quote from The Sun Also Rises — is to both address existing problems and open the discussion around innovation to new and future possibilities.

“You paid some way for everything that was any good. Either you paid by learning about them, or by experience, or by taking chances, or by money,” Hemingway wrote. “You ought to dream. All our biggest businessmen have been dreamers.”

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