Everyone has looked through a microscope. It is a brilliant tool for getting the basic work of science done, and its image alone is sufficient to communicate concentration, precision and discovery.

It also is a metaphor for a major conundrum in the biomedical research space: One needs great focus to get a detailed understanding of biomedical challenges, but one needs collaboration's wider aperture to solve them. There is a complex interdisciplinary intersection that runs through the biomedical ecosystem, where research, data science, information technology and project management meet.

Leading interdisciplinary teams

In his upcoming HIMSS21 session entitled "Leading Interdisciplinary Teams," Dr. Andrew S. Ritcheson, vice president of public health at ICF International, will provide details from his own experience and management methodologies on how to address risk, opportunity and reward, and how to optimally balance the microscopic focus with the wide collaborative aperture through culture and behavior change.

"The COVID-19 pandemic has forced us all to reassess how we make and sustain connections with people in our lives," Ritcheson said. "This also has provided an opportunity to pause and examine our leadership practices. Interdisciplinary team leadership feels even more timely and relevant as we both 'return to normal' and find that 'normal' has been redefined.

"Today's healthcare challenges are rarely met by a solution owner from a single discipline or are the privileged domain of a lone subject matter expert," he continued. "Our work tends to be located at a crossroads where healthcare, data science, information technology and other disciplines combine to advance the understanding of disease prevention and cure."

Extraordinary challenges like curing cancer, creating biomedical AI or overcoming the opioid epidemic cannot be resolved with single-discipline approaches, he added.

Managing complexity

"Like any crossroads, there is complexity to be managed," Ritcheson explained. "This complexity increases with each new disciplinary intersection, offering an ever-expanding range of risk, opportunity and reward. This crossroads challenges conventional management models, and forces the evolution of new collaborative approaches and, in particular, those that are interdisciplinary.

"Clinical and biomedical challenges lie in the spaces in between disciplines, and interdisciplinary leadership creates something new by enabling a team construct and specific operating environment that facilitates crossing boundaries and thinking beyond the limitations of our traditional disciplinary demarcations," he added.

In his HIMSS21 session, Ritcheson will discuss the four key components of the interdisciplinary team construct and why they are important.

"It helps to establish why teams are important to study in the first place," he said. "After all, how we arrange ourselves to take on major health challenges is just as important as what we do to solve them. Take for example the fact that hundreds of thousands of hospital deaths in the United States are preventable. Research suggests that team-based failures are a major contributing factor to poor health outcomes like these. Ineffective care resulting from bad teamwork represents a public health issue. Teams matter.

"Interdisciplinary teams encourage links between disciplines in a coordinated and coherent whole, and is a change from traditional, top-down, hierarchical approaches," he explained. "Interdisciplinarity supports how you and your teams organize, communicate, contribute and collaborate to achieve breakthroughs that would not be attainable by single disciplinary effort."

The spaces in between disciplines

Ritcheson points to a Ken Blanchard quote: "None of us is as smart as all of us." Ritcheson says that captures the spirit of interdisciplinarity well.

"Clinical and biomedical challenges lie in the spaces in between disciplines, and interdisciplinary leadership creates something new by crossing boundaries and unifying the value of multiple perspectives," he said.

"There is a core constellation of factors that tend to define an interdisciplinary team," he continued. "The first is that they are heterarchical. A heterarchy is a system where the members share the same power and authority. This creates a participatory, non-hierarchical structure of shared leadership."

The second component is mutuality, which means that members of the group prioritize relationships. A commitment to the creation and nurturing of interpersonal relationships is a necessary precondition for effective interdisciplinary work, Ritcheson said.

Sharing common goals

"The third is interdependency, which describes how members of the team share common goals and know that working together is both individually and collectively beneficial. They are all in it together as collaborators not adversaries," he explained. 

"Finally, interdisciplinary teams have psychological safety. Leaders must work to cultivate and promote psychological safety, whereby team members have a shared understanding and expectation of trust, respect, openness, communication and shared learning."

Psychological safety also enables access to more diverse, "out-group" perspectives, capabilities and effort, he added.

Ritcheson also will address the four core leadership models and how they are different.

"Contributors to the healthcare space tend to organize themselves in relatively predictable configurations with respect to their specific work and challenges: expert, managed, multidisciplinary and interdisciplinary," he noted. "These configurations have substantial differences.

"An expert model tends to be closed, dyadic and transactional. Think of a 1:1 setting," he explained. "This is task-specific and time-limited, and does not really provide much cause for being interdisciplinary, because of how compact the structure is."

Hierarchical with centralized authority

Managed leadership models are hierarchical, with centralized authority and vertical functional distribution, he explained. The leader is usually the key resource and decision-maker, and there is little cross-functional integration.

"A multidisciplinary team pulls together a more diverse range of experts with an intent to draw on and integrate knowledge, tools and practices from different disciplines, but stays within their boundaries," he said. "A well led multidisciplinary team's posture is more democratic and agile, and connections are made more rapidly.

"An interdisciplinary leadership model creates and sustains a team arrayed with permeable disciplinary barriers," he added. "In this model, the lead role and responsibility is fully integrated and shared by all members. Interdisciplinary leadership exists on a spectrum, and is dynamic and situationally variable. It is constructed and maintained through ongoing team processes.

"Managing complexity and delivering value and innovation in the healthcare space requires shifting away from less dynamic, specialty-driven vertical structures, and toward an interdisciplinary model," he said. 

"However, interdisciplinary teams cannot simply be willed into existence, or used to rename existing modalities. It has to be done, and it has to be practiced."

Critically, interdisciplinarity is not the opposite of specialization, he added. It is about balancing the roles of adequacy and mastery in the production of new knowledge and breakthroughs, he said.

Ritcheson will offer more detail during his HIMSS21 session, "Leading Interdisciplinary Teams." It's scheduled for August 12, 1-2 p.m., in Venetian Lido 3104.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.