SAN FRANCISCO – Boston-based Partners HealthCare has long been one the more innovative and forward-thinking health systems in the U.S. But many hospitals don't embrace the same culture of innovation, said Adrian Zai, MD, director of research at Partners eCare, speaking at the HIMSS Big Data and Healthcare Analytics Forum on Wednesday.

Yes, most healthcare providers understand that data and analytics are essential for quality improvement and operational efficiencies. And most realize that the shift to value-based reimbursement means they should probably rethink some of their care delivery processes and IT infrastructure, said Zai.

But too many are still either unwilling or unable to approach innovation with the gusto and strategy that could help them drive big improvements in their patient experience and bottom line.

"Innovation improves competitiveness, ROI and culture," said Zai. "It is critical to innovate now more than ever as we shift to value-based care."

Toward that end, he offered the following six tips for health systems looking to position themselves for success in the 21st Century world of accountable care.

1. Make innovation part of your culture

Hospitals should work to encourage their providers to pursue quality improvement projects in earnest, said Zai. They should honor and celebrate new ideas. Where possible, they should also create innovation centers, where various stakeholders can exchange ideas.

The transition to value-based care demands a fundamental rethinking of long-ingrained processes, so anything health systems can do to encourage creative thinking among clinical and operational staff should be pursued, he said.

"Decades and decades of infrastructure, developed solely for fee-for-service, mean we have that legacy and all those existing workflows may not work for value-based care environment," he explained. "We have to rethink all the existing clinical workflows while driving outcomes and controlling costs. If you’re still moving along in fee for service, watch out – you don’t want to be left behind."

2. Formalize your strategy

On the other hand, "ad hoc innovation is not enough," said Zai. 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.

That's why "formalizing your innovation strategy is critical," he explained. "You have to get leadership support from the very top to back you up. And to create an infrastructure that promotes innovation across your organization. Otherwise, you're just hitting your head on the wall."

Then, "once you have that strategy," he added, "you have to start identifying what I call the fertile fields – the areas of big need, areas you need to improve upon as an organization. It takes leadership to show where are the fertile fields and show where the innovation."

Take gaps in care, for example – "that's not always transparent across the organization," said Zai. "Many projects designed to improve outcomes don't always measure disparities of care.

A culture of innovation that's properly formalized, with top-down support, can help target smart ideas where they're most needed.

3. Create a governance structure

Along those lines, said Zai, it's key to develop a framework for how innovation will be put to work enterprise wide. Hospitals need to do some hard thinking about the clinical value of certain innovation projects, as well as their technical requirements and business case.

"Once you have leadership buy-in you can start building a framework and organizing your team," he said. At Partners, ever-innovative, the normal state of affairs was a profusion of "little projects, left and right."

So the health system decided to create what it calls an Innovation Council, which can assess specific projects' value to the larger organization, develop metrics to gauge their success, decide on an estimated timeline, figure out how they will work with IT infrastructure and clinical workflow and more.

But essentially, he said, "the only question you have to answer is whether this innovation project has any clinical value. If you think there is clinical value that's going to help us in any way, we should move on it."

4. Innovate through collaboration

"All the innovation that's happened in the past has to do with the removal of artificial divides," said Zai. Whether it's the evolution of team-based and integrated care or the advancement of patient-centered population health management, the most beneficial advances in healthcare delivery have come from a recognition that collaboration works.

So when looking to drive innovation, it's valuable to "promote interdisciplinary innovation teams," he said.

"There are still artificial divides that hinder innovation," he said. For instance, too many hospitals still have walls between research and clinical operations: "We compartmentalize these two areas such that one has nothing to do white the other. But everything we do in innovation and research should trickle down into operations."

5. Think 'out-of-the-box' for funding

As they pursue innovation, hospitals large and small should embrace innovative ways of fostering and financing new projects, said Zai.

For instance, IT vendors can offer more than just the standard buy-sell relationship and are an opportunity that could be creatively leveraged for greater good.

"More vendors have demonstrated to come up with very creative solutions," he said. "Make vendors part of your innovation strategy."

Likewise, smaller hospitals should "reach out to academic medical centers," he said, availing themselves of the resources and expertise those larger organizations can offer.

"Small hospitals should be thinking about academic medical centers because they are working like mad dogs today," he said. Smart partnerships could help do a lot of the heavy lifting for organizations with fewer resources.

6. Use small pilots to innovate

Starting small and scaling up helps control risk, minimize cost and optimize results over time, said Zai. Pilot projects and iterative models are the way to go.

"I've seen too many big IT projects that cost millions and millions of dollars and have yet to show any return," he said. "Test small projects in a limited environment instead of steering the Titanic. Don’t steer the Titanic unless you are sure the results are positive."

The next HIMSS Big Data & Healthcare Analytics Forum is scheduled for October 22-23 in Boston.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com