You haven’t been to Kaiser Permanente if you think everything’s been invented – Innovation Retreat 2012

The title of the post is real quote by Lynda Applegate, who is the Sarofim-Rock Professor of Business Administration at Harvard Business School and serves as the Head of the Entrepreneurial Management Unit. She said it to us while sharing this famous quote

Everything that can be invented has been invented.(Charles Duell, 1899, the Commissioner of the US Patent Office)

She’s been spending time with innovators at Kaiser Permanente, and so have I. This post is not just about the annual Kaiser Permanente Innovation Retreat, it is also about another signature program, Medicine and Management, that brings together 43 physicians from across Kaiser Permanente to learn how to be better leaders.

These two programs are related because they demonstrate what I learned at both:

Innovation in the post-EHR health system

What’s it like to be in a health system that has had a fully functioning EHR for 2 years? This year for the first time, Innovation Fund awards were incorporated into the learning program, and the completed projects give a great glimpse of the future of health care. 

In the post-EHR health system, the focus is not on what the EHR will do, it’s on the people who will use it (including patients). For example: the innovations developed place EHR data/access in ambulances so sick children being transferred across distances are warmly received, they combine EHR data with evidence based guidelines and rules engines that watch over patients with kidney stones or osteoporosis (no hitting the refresh button on your desktop computer needed), they create electronic mashup dashboards that take EHR data and provide guidance on how to build facilities or operate them in real time.

The innovations also come from all parts of the health system – physicians, primary care and specialist, nurses, information technologists, health educators, you name it. The thing that I see is not just the search for the idea, but the search for the cost-effective idea that helps the most people.

In this environment, an idea that allows people to have the right amount of health care, sometimes more, sometimes less, the right amount for total health (mind, body, spirit, individual, family, community, society), the most respectful of our members’ time, are the best ones. 

People don’t want to innovate, they need to innovate

Both the physicians in the Medicine and Management Program and the Innovation Fund winners have far reaching visions for health and health care. This quote from Urologist Ron Loo, MD, shows that the drive is unstoppable, and also that it’s not about the innovator, it’s about the group that they collaborate with to execute the good idea. Here’s the workflow he suggested to me on our internal social network:

  1. When you have an idea, find some friends who are much smarter than you.
  2. Convince them that your idea will change the world.
  3. If they agree with you, make a plan.
  4. Money will follow, especially if your friends are rich; if not, they will help you secure funding because they are smarter than you and they believe in your idea.
  5. Execute the plan (“Vision without execution is hallucination” T Edison)
  6. Repeat steps 1-5 as many times as you can before you die. It gets easier each time especially if you can complete step 5 more times than not. An added benefit is that your smart friends won’t consider you so dumb after a while.
  7. Embrace the risk, and feel really good about what you do.
Everyone can use a helping hand

These programs are a non-trivial investment. Even in a health system with aligned incentives, innovators need a helping hand, which is the point of this post.

If people say things to me like (which they really never do :)), “you could do that because you are Kaiser Permanente,” I might say back, “we could do that because we invested in the people who power Kaiser Permanente, and you have talented people who power your health system, too.”

What about health systems where incentives are not aligned? There are just as many people who need to innovate in all of health care, there’s no monopoly on that at Kaiser Permanente. Are they given the opportunity to do it? In many places, absolutely, and please post in the comments about your experiences having these opportunities.

It is all of ours/society’s responsibility to give health professionals (and the people they serve) the ability to innovate. This post is therefore intended to create the drive in all health systems to invest formally in innovation at all levels of organizations, with patients included, of course. Always with patients included.

There are places to learn about this such as The Innovation Learning Network ( @healthcareILN ). More innovation in more places means less, “we couldn’t do it,” and more like this quote from Jack Cochran, MD:

Special thanks to the team at Kaiser Permanente Information Technology, led by Phil Fasano, Kaiser Permanente CIO, and the Hawaii, Northwest, Group Health, Colorado, Southeast, and Ohio Permanente Medical Groups for their time and attention to the future.

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