Hartford HealthCare's Dr. Barry Stein: Innovation isn't an option for hospitals — 'it's an imperative'

At Hartford (Conn.) HealthCare, a robust innovation strategy is led by Barry Stein, MD, vice president and chief clinical innovation officer, and based on five core pillars.

Those pillars, which guide every innovation initiative at the health system, comprise a robust innovation ecosystem, a wide portfolio of innovation activities, a comprehensive governance process, open communication channels, and innovation integration and continuous learning.

"The overarching things are the leadership and the relational piece — understanding how important innovation is and how to integrate innovation into an operating model," said Dr. Stein, an interventional radiologist. "You have to have a disciplined approach about it. In every lecture and every presentation, we put up these five pillars and then we explain how what we're doing that day fits into at least one pillar, so everybody feels like they're building the money jar, so to speak."

Here, Dr. Stein explains not what innovation looks like at Hartford HealthCare, but how it feels, and weighs in on the benefits of having practicing clinicians lead the charge in healthcare innovation.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What does innovation look like at Hartford HealthCare? What are the core goals and priorities that tie everything together?

Dr. Barry Stein:
I would love to reframe that question as, "What does innovation feel like at Hartford Healthcare?" because I'm not sure that you can spot it anywhere, but you can feel it everywhere. That's my philosophy about innovation in a big and complex healthcare system: for everybody to feel like they're working in an organization where innovation is as high a priority as any of the operating performance goals and vision, where innovation is vital to the future transformation of healthcare. 

Without innovation, we will not be able to transform healthcare, so that's sort of the overlying mantra. In terms of why we do innovation at Hartford HealthCare, it isn't an option anymore. For us to be able to differentiate ourselves and provide the care that our consumers are looking for, it's an imperative. We think about innovation at Hartford HealthCare as a simple equation: taking new ideas and translating those ideas to impact. One of the biggest failures in healthcare over the last decade was not a lack of great ideas, but a real inability for healthcare systems to translate these extraordinary ideas to impact. 

With that being said, we look at innovation as something in which we have to, first, curate and attract the best ideas, and then we have to have an environment that is really conducive to translating in a very efficient way those ideas to impact. How are we going about doing that? There are so many different competing priorities, but the North Star for our organization over the next five years is captured with "#123" — that is, to be No. 1 for consumer experience in the Northeast by 2023. It's a tall order, but that's our goal for the next five years, and almost everything in our organization, including resources and strategies, is driving toward that goal.

From an innovation standpoint, when we talk about which ideas we're going to translate into impact, we're only focusing on the ideas that drive toward that North Star, #123. I think that's a really important thing, because in a lot of organizations, innovation is just the shiniest object or the greatest idea of the moment, but it has no relevance to the overall goals and strategies of the organization. That's why most organizations fail to embed innovation, because it feels like it's happening on the side, for other reasons, done by other people. To embed that feel of innovation in the organization, everybody doing the work every day should be feeling that, No. 1, their ideas count, and No. 2, we have the culture and the infrastructure to be able to translate those ideas that we believe will have the biggest impact. Those are the goals of innovation: to drive and align with our strategic priorities, and to create a differentiated value proposition and competitive advantage in the marketplace.

Also underpinning this is the philosophy that we are creating an efficient and relatively frictionless healthcare innovation ecosystem and platform to accelerate these ideas so that all stakeholders are able to extract value. 

But you asked a question that keeps on coming back in my head: "What does it look like?" Let me try and put it into words. The work we're doing and the intentional strategy is around moving innovation from an "initiative" to embedding cultural competency with tangible improvements to the core operating model and beyond. 

Q: So, it's not just a list of smaller projects strung together, but a big, overall mindset change? 

BS: Yes, and another way I like to describe it is that it's also converting extraordinary human capital — meaning folks that are really good at what they're doing — and transforming that into social capital, where people are far more connected in ways that they hadn't been connected before, across multiple different disciplines and legacy silos, in what I like to call an adaptive space of where the magic happens. So it's really about taking all those extraordinary folks and creating an environment where they're now connected, as opposed to not connected. We're translating human into social capital, with "social" meaning "connected beings transferring information."

For us to do anything and apply resources around innovation, it has to solve a relevant problem at Hartford HealthCare. Any solution coming in is going to solve a real, significant problem at our organization. Anybody coming in has to be able to articulate what their problem statement is, what the gap is that they're hoping to close. That gap has to be impactful for us, so that everybody on the ground understands why we're doing it, everybody feels like it's important and everybody understands how it's going to drive toward the bigger goals. My goal is to enroll everybody in the process.

Q: How do you go about doing that?

BS: The way we look at this is, ordinarily most organizations — and certainly in healthcare — are incredible performance engines, operating engines. We have metrics that drive us to the next level: That's the performance engine. And then we've got to think about how you start to include entrepreneurial innovation as part of that. They're almost the antithesis of one another. The operating engine represents predictability, and the innovation is unpredictability, an intentional departure. Bridging that gap has been really key. 

One of the strategies that we've used and that has been very successful is to express our strategy very much like other business units do in the organization, as certain fundamentals that people can track and understand. That's where those five pillars were born, and I think we've had tremendous success with that. 

Q: I've heard from other physician-innovators like yourself that in the future, slowly but surely, more clinicians will be moving into innovation in healthcare. I'd love to hear your perspective on that. 

BS: I always start with, "What's my lens? Why is this something that I'm passionate about?" When I came to Hartford HealthCare, which was Hartford Hospital at the time, we developed some cardiovascular MR angiography techniques, and it struck me that there was no real support system, not only in our healthcare system, but also in most others. We did some very impactful things globally and changed the paradigm, but what I realized was that there's no understanding in healthcare of how to manage entrepreneurship and innovation and startups.

As I progressed, I had the opportunity to go to MIT to do my business degree, specifically for me to focus on analytics, innovation and entrepreneurship. While I was there, I continued to think about how to develop an ecosystem with their principles and frameworks in the healthcare system. I came back and I started embedding what I'd learned, and it took off amazingly. 

As a clinician, I've been on the ground, I've taken care of patients, I know the pain points. The folks that are going to be helping translate these ideas, they look at me as one of them; they are my colleagues. It's as simple as that. It's the credibility, it's the relationships that you've built, it's the understanding of their pain points. When I stand up, they look at me as a guy who has done procedures with them for their patients. It does make a difference, and it doesn't mean that you're smarter or less smart — it's street credibility. These are my colleagues; I'm not an administrator to them, I'm their colleague that happens to have the opportunity to help the organization collectively move forward. 

My privilege is that I've also got this other dimension of knowing how to develop innovation ecosystems with incredible partners and friends that I developed up at MIT.

I'm hoping in the future that healthcare organizations understand how important it is that we've got to be solving relevant clinical healthcare delivery problems. The best advocates for those are the folks that actually do the work, and if you can assist them in an educational way to provide the frameworks and the sophistication around the business and marry the two, I think you have a really great chance of moving your organization very far.

Q: Another thing we're seeing is that a lot of clinicians are also now going on to get MBAs, like you did, and taking courses in data analytics, innovation and digital technology, then using it all to combine their skillsets and try to solve the big, longstanding challenges of healthcare.

BS: I love how you said that — "combining" all of it. Having the clinical skillset — having been on the ground, treated patients, taken care of them and understanding the language, and then having all these other capabilities exposed to you. I went to do my MBA for that reason.

There's another big piece here: the system dynamics thinking. To get these kinds of things going in your organization, there are multiple pillars, components, wheels that you have to get going. And once you get them all going, they start reinforcing one another. You've got more to communicate, you've got more to teach, you've got more people coming in, you've got a richer portfolio, you need better governance, and so forth. 

And then the last thing that I have to pitch is this: It's all a relational play; this is 100 percent relational. It's about touching people, figuratively, in a way that's important for them. That takes a lot of effort and time to make sure that everybody feels involved. This relational piece, I cannot stress enough. It all comes down to how you make the other person feel, that Maya Angelou quote, "People will forget what you said, people will forget what you did, but people will never forget how you made them feel."

More articles on innovation:
Mayo Clinic, Kaiser Permanente Ventures invest in cybersecurity startup
Hartford HealthCare tech accelerator finds home in new innovation center
Innovationeering: What's your (innovation) number?

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