|By Paul E. Plsek, MS, DirectedCreativity™ (Editorial Board member)
If we continue to do what we’ve always done, we will get the results we have always gotten. When it comes to health services delivery, patients, payers, and politicians are asking for different results: Better access...faster diagnosis and treatment...more convenience...greater sensitivity to cultural differences and health disparities...and so on.
Incremental improvement may no longer be good enough. The challenges we face today call for more novel approaches...in other words, innovation!
While there is, arguably, much innovation already in pharmaceuticals, surgical procedures, diagnostic equipment, and medical devices, too often these are embedded in health care service delivery processes that do not provide timely, patient-centered, safe, effective, efficient, coordinated, and equitable access to the benefits expected.1 We need innovation in health care service delivery that is on par with innovation in other aspects of the health care system.
Consider, for example, a patient experiencing a variety of symptoms pointing to possible cardiac problems: unexplained fatigue, shortness of breath, and dizziness. Innovative, high-tech equipment such as echocardiograms and computed tomography scanners exist to help diagnose or rule out the underlying causes for such symptoms. Once diagnosed, an array of pharmaceuticals, medical devices, and surgical procedures—many of which did not exist only a decade ago—are also available. However, what has remained largely unchanged is the patient's often frustrating experience of scheduling appointments, finding their way through medical office buildings and hospitals, and waiting both to get the care and to learn the results of tests.
We are capable of thinking differently. For example, we know that most patients face barriers to securing timely appointments and experiencing efficient flow through the typical process of care. For years, leaders in health care hired more physicians, or asked existing physicians to see more patients, which meant spending less time with each one. These incremental improvements undoubtedly helped. However, it was the innovative thinking behind advanced access (match capacity and demand, work down the backlog, do today’s work today, and so on), developed by Mark Murray and Catherine Tantau at Kaiser Permanente in the early 1990s, that has dramatically reduced waits throughout the system and so-called “sleepless nights” for patients.2
Further innovative approaches—such as “drive-throughs” for flu shots or other simple medical needs; having various specialists available by telephone for “curbside consults” while the patient is still in the primary care physician’s office; and having specialists visit patients in the emergency room rather than delaying the care in the hospital or community setting—are but a few of the many ideas that are being tested in parts of the health care system today.
Innovation has been clearly linked with long-term success and organizational adaptability in general industry.3 The success of companies such as Apple, Google, Toyota, and Proctor & Gamble illustrates this point. Studies have also shown that industry leaders who fail to maintain a steady flow of innovations inevitably experience setbacks.4
The imperative to think and do things differently is just as relevant in health care. The growing discontent of customers (patients as well as government and private payers), coupled with the challenge of delivering services in what is increasingly becoming a global marketplace, will bring to health care organizations the same demand for innovation that these factors have imposed on other industries.
Why is innovation important? Because patients, payers, and politicians are demanding it, and history shows that organizations that fail to deliver it will suffer.
1 Committee on Quality of Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health care system for the 21st century. Washington DC: National Academy Press, 2001.
Murray M, Bodenheimer T, Rittenhouse D, et al. Improving timely access to primary care: case studies of the advanced access model. JAMA 2003 289(8):1042-6. [PubMed]
3 Henry D. Creativity pays. Here's how much. BusinessWeek 24 April 2006. Available at: http://www.businessweek.com/magazine/content/06_17/b3981410.htm
4 See, for example: Foster R. Innovation: the attacker's advantage. New York: Summit Books; 1986; and Bower JL, Christensen CM. Disruptive technologies: catching the wave. Harvard Business Review 1995; 73(1):43-53.