One would think that resource-rich organizations are able to foster new ideas better than poor, cash-constrained startups.
However, it is remarkably difficult to innovate within a large health system on an ad hoc basis, for the same reason that it is difficult to innovate in a large corporation. For one, it’s all too easy to feel like a cog in a large machine. Fear of failure, perceived lack of reward, and a paucity of institutional support are other reasons why innovation stagnates in otherwise resource-rich organizations.
But little-fish-big-pond problems are not the only ones that plague innovation. This phenomenon is well-recognized as part of the key reasons why disruptive innovations are notoriously difficult to launch from within a corporation.
If you feel this way, you may be an “intrapreneur.”
In a way, healthcare has spearheaded the forefront of universal connectivity with common objects. In the world of Big Data, healthcare is now uniquely positioned to take the next step.
A few years ago, I needed hand surgery. Shortly after checking in to the outpatient surgery department, the helpful nurse attached EKG leads onto my arms and chest, and a pulse oximeter to my finger. The monitor next to my bed flickered and came to life. Then, colorful telemetric and oximetric tracings in a nursing station computer reflected an exact copy. A record in the hospital intranet traced my wellbeing overtime. Wireless connectivity allowed an extra pair of eyes to watched me and to ensure aberrant flickers do not go unnoticed… Continue reading
This article originally appeared in American Journal of Managed Care.
Image credit: mindwerx.com
Fifteen years after the publication of Institute of Medicine’s landmark report To Err is Human, healthcare process improvement (PI) is finally beginning to take root. Quality improvement (QI) has become a pillar of healthcare for both academic clinicians and private practice alike.
The workhorse of the Donebedian adage of “structure + process = outcome” is on standardization. In a world of static, well-defined products, proper application of PI can dramatically reduce variability.
While incremental improvement continues to be necessary in healthcare – we are a long way away from a six-sigma industry – continued standardization and scientific research alone are no longer sufficient to evolve healthcare.
A signature is our handwritten imprint on a document for authenticity.
A signature is also a unique identifier for what is distinctly us, like DNA and fingerprint.
Your work, too, deserves a signature. It deserves a sign of authenticity, and if you are proud of that work, mark it yours. If the quality of the work is not to your par, then don’t put it out.
Just as importantly, the work is itself a signature. Innovation is as much about doing something new as it is doing something you. An easy and sobering way to decide is to first write down all the components of a project onto a list. Then, strike away all the parts that could be accomplished by someone else. Your team will always solve those problems. But if nothing is left, then you have learned that the project doesn’t need you.
That which remains, then, is uniquely you. It’s your value-added. Your signature.
Society of Imaging Informatics in Medicine (SIIM) is having its 2015 meeting in Washington DC from 5/28-5/30. SIIM is a wonderful event with something to offer to engineers, clinicians, and radiology trainees alike. For a resident it is also an opportunity to learn something new.
Aside from all the cool sessions during conference, also do remember to touchbase with old friends and meet new people. The point of a great conference is the great people.
During the day, though, it can be daunting to keep abreast all the things that are going on.
Here are 7 events that compelled me as can’t-miss sessions – to be used as a roadmap for myself at the conference, and shared with you now:
A World Without PACS
Woodrow Wilson A
Thursday, 8:00 am – 9:30 am
Traditional PACS – solutions with vendors, hardware, and software all integrated as a single offering, is a decades-old technology – Slowly, imaging in America is moving towards vendor neutral archives (VNA).
Version 2.0 is a good thing. Except when it’s not.
Being 2.0 means embracing something brand new, something different, revolutionary, totally revamped from the old 1.0 that’s just not as good. It’s simple math, really. 2.0 is twice of 1.0.
The terminology we use for what software developers call a “major version release” is a popular way to address all things new and cool. For instance, in 2010, Justin Bieber released his My World 2.0 album, charming fans world-wide with the #1 hit Baby.
In health care, we also like new versions. Typically used to describe a move towards all-digital access, a post on The Health Care Blog describes the evolving wave of patient self-scheduling methods as “2.0.” An Academic Radiology paper describes radiology education using computing devices over paper as “Radiology Education 2.0.” Even an iTunes app providing a set of emergency radiology teaching cases calls itself Radiology 2.0 (incidentally, because the software is in its first release, the app is actually “Radiology 2.0 v1.0”).
In fact, versioning in health care is so popular that when The American College of Radiology decided to push a new approach to imaging, it decided to skip 2.0 and start with Imaging 3.0.
There are many forms of innovations. Sometimes medical innovation is nanotechnology, molecular imaging, high-precision targeted therapy, or 3D-printed prosthetic, which are advancements whose adaptation rate are limited by the rate of research. This is a good thing.
And then, there exists technology that has become commonplace in every other industry but is still considered “innovation” in medicine due to their glacial adaptation rates in hospitals and clinics. Case in point: When was the last time you saw a pager that doesn’t belong to a healthcare provider?
Today’s world provides us with tools that make humans more capable than ever. Writers who used to make elaborate trips to exotic locations to gleam material for the next espionage thriller while talking to their book agent on the landline with expensive long distance fees can now do the research at their computers while setting up an Amazon self-publishing account. Radiologists who used to be at the mercy of transcriptionists to translate their verbal stutters into fluent medical poetry days later now generate reports within minutes using voice recognition technology.
These are empowering tools, putting the ability to affect outcome directly in the hand of those holding the highest stakes. In general terms, it makes sense that with advancements in technology, professionals can now (1) do the same amount of work with better quality, or (2) do more work at the same quality.
Unfortunately, inadvertently what happens is we tend to be expected to accomplish more and do better (occasionally one also expects to feel less tired at the end of it!) Business school professors would teach that technology advances push the entire pareto-efficient frontier forward. That is, assuming that you are already working at your absolutely most efficient way such that any improvement in speed will automatically have a quality tradeoff, then adapting a new technology may change the nature of the curve such that you can now move both “up” and “to the right.” The truth is, I am so rarely pareto-efficient in the first place that if a new technology can somehow land me onto my existing frontier, it was well worth the cost. And while technology like this, this, and this don’t literally breaking any frontiers, they do have the added benefit of putting productivity in my conscious thought and – at least temporarily – make me healthier and more productive.
Tools are supposed to make our lives better, easier, more connected. The oldest tools came about because humans needed to overcome certain barriers. The first caveman who invented the first stone knife was probably very popular – all these other guys are still tearing leather and meat by brute force probably all wanted one because it made their lives far easier.
At some point we started inventing – and wanting – tools that precede our needs, tools that we want before we need them. Maybe this is a good thing. If done correctly, this means we will never be left wanting for better functionality again: the invention always anticipates future demands. Every once in a while, a game-changer comes into the market that makes this true. More commonly, we are left with the promises of a better future, new dreams, which the new tool fails to deliver, which has the effect of creating new demands that now go unfulfilled. (And of course, the occasional invention that neither makes promises nor delivers results simply get forgotten.)
It follows, then, that in a world of a litany of mediocre new inventions, there is a high likelihood that we end up creating new needs rather than satiate them – I see an ad for X, I realize I have a need Y which X promises to do, I buy X to realize that it doesn’t do Y very well, but now I can’t un-realize / un-want Y.
Thus, the irony if our information age may be that sometimes consolidating our tools and admitting that “no, I do not need this functionality” might make us more content, or perhaps even more productive.
Anyone who has worked on a complex problem knows that simplicity is the result of many, many hours of hard work.
- Colin Dunno, Designer at Dropbox, in response to the question, “What is the need for all the world class designers at Dropbox, for a product that seemingly has zero complexity?”
Like a figure skater on ice, to score you have to do hard moves but make it look easy. If the product of your complex work looks complex, then there’s room for improvement.
Healthcare has plenty of room to improve.