Building a culture of innovation for better patient health

It’s no secret that COVID-19 accelerated digital transformation in nearly every sector, including healthcare. At Amazon Web Services (AWS), we’ve seen our healthcare customers use technology to speed medical research, improve patient care, advance precision medicine, bring therapeutics to market faster, and more.

As we work towards a healthier equilibrium globally, how can the industry capture this momentum to create lasting transformation? As much as healthcare leaders want to disrupt conventional care models, balancing risk and the need to innovate is challenging in the sector because so many decisions have life and death consequences. This balance has created an underlying cultural norm that is highly risk averse and often reticent to experiment.

A question I often hear from C-Suite leaders is, “How does AWS innovate, and how can I build a similar culture of innovation in my organization?” Many of our customers routinely ask us to share lessons we have learned as we have grown. For organizations looking to foster a culture of innovation, here are three best practices to keep in mind.

  1. “Work backwards” from your customer

At AWS, we start by diving deep to understand customers and “work backwards” from their challenges. It’s not only about being close to customers, but understanding their situation, objectives, and perspective so we can invent on their behalf. This process ensures we don’t invent in isolation, and helps keep customer needs at the center of everything we do.

Maimonides Medical Center in Brooklyn, New York recently applied this approach to address patients’ needs at The Brooklyn Health Home, which provides community-based care management services to seriously ill patients. The system wanted to proactively reach out to members who were particularly vulnerable during COVID-19 due to chronic health conditions, social determinants of health, and socioeconomic status. For proactive and light-touch engagement, the system used AWS to build a chatbot that enabled outreach to high-risk patients. They chose an SMS-based chatbot because of the simplicity and accessibility of text messaging as a familiar form of communication for patients. The system sent “Wellness Check-in” text messages in English and Spanish to over 5,000 at-risk New Yorkers, offering health and social services support. 87% of respondents identified a food, unemployment, or housing need. The campaign helped to surface critical issues and allowed Maimonides to mobilize supportive services.

  1. Know what risks to take and what to walk away from

This is easier said than done in healthcare. Providers are held to the maxim, “First do no harm.” Trials are controlled. Odds are calculated. Safety is paramount.

So how do you decide when to move quickly and take a risk? At AWS, we use a construct called “one-way and two-way doors” to evaluate decisions. Specifically, a “one-way door” has significant and irrevocable consequences – such as building a data center. By contrast, most decisions are “two-way doors” – they have limited and reversible consequences – such as experimenting with a new feature on an app. When we see a two-way door – and have evidence to believe it’s a good idea – we walk through it. If it fails, we have the opportunity to apply our learnings to new experiments. 

Some of our nation’s most innovative healthcare organizations employ this construct to allow for differentiated decision-making. One example is Houston Methodist Hospital. Taking a fast-to-succeed/fast-to-fail philosophy, their Center for Innovation experiments with pilots and beta tests until they find the right technology. For example, the system recently began a pilot introducing voice technology into operating rooms. The solution will allow surgeons and support staff to interact with a digital voice assistant before, during, and after surgeries. It can query data from the patient’s EHR, allow clinicians to start and stop verbal timers, and allow staff to complete verbal safety checklists. This use of voice technology in the operating room has never been done before, so Houston Methodist inherently took a risk in launching the project. However, by piloting the technology before undergoing a full-scale rollout, Houston Methodist turned this decision into a two-way door.

  1. Organize for speed, agility, and innovation

At AWS, we encourage teams to experiment frequently to invent on behalf of customers. Where possible, we also strive to create “two pizza teams” - teams that are no larger than can be fed by two pizzas. Having smaller teams minimizes the need for communication, reduces time spent in meetings, accelerates the decision-making process, ensures the team has ownership and autonomy, and enables each team to provide deep focus in one area. These small teams also need empowerment to experiment.

One example of a health system that successfully uses a “two-pizza” approach is Froedtert & the Medical College of Wisconsin health network (F&MCW). F&MCW embraced an engineering culture to develop its digital care experience and has fostered an agile team topology. Each team is structured around a value stream and has no more than six members. These teams manage the entire spectrum of an experiment from start to finish. For example, when the CDC recommended that all employees be screened daily upon entrance to facilities, a team of three moved quickly to develop a digital experience, which provided the ability to self-screen for COVID-19, display a clearance passport, receive alerts in case of risk of COVID-19, schedule testing, and offer free video visits. The team deployed a prototype in ten days and officially launched 20 days later. Since then, over 20,000 workers have used the service and more than 12,000 screenings are performed daily.

The healthcare industry is at a pivotal moment when it has an opportunity to accelerate innovation using the lessons learned from the last two years. We’ve seen enormous potential in the power of cloud computing to drive innovation, unlock siloed data, and develop personalized care strategies—all while operating securely. At AWS, we’re inspired by the work that our customers do each and every day to care for us. And we look forward to continuing to help healthcare organizations use the cloud to bring greater access, affordability, and personalized medicine to patients worldwide.

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