Thomas J. Graham, MD, is the director of strategy and innovation in the department of orthopedic surgery at NYU Langone Health in New York City.
In this role, Dr. Graham, formerly the chief innovation officer of Cleveland Clinic and a founding member of the Healthcare Innovators Professional Society, pursues a goal of "value-based innovation," advancing the development of solutions to treat wider swaths of the patient population more quickly, effectively and affordably.
One value-based innovation project currently in the works centers on the idea of "embedded innovation." It pushes back against the idea of a centralized innovation hub for the entire health system, installing instead individual innovation centers within each department, beginning with the NYU Langone Center for Orthopedic Innovation. In this way, Dr. Graham explained to Becker's Hospital Review, "innovation at NYU Langone is more of a 'neural network' that allows all innovators to access resources and permits collaborations to occur organically. It also allows innovation to flourish."
Another project will focus on "business engineering," which will leverage NYU Langone's brand, innovation and clinical expertise to help grow and commercialize early-stage healthcare companies. Beyond providing guidance, NYU Langone will also serve as a strategic investor, helping some of the companies bridge the "capital gap."
Here, Dr. Graham further discusses NYU Langone's approach to innovation, which he describes as a team sport: "It thrives at the intersection of knowledge domains where creative collisions foster idea exchange," he said.
Editor's note: Responses have been lightly edited for length and clarity.
Question: What does innovation look like at NYU Langone Health? What are your goals and priorities for your role?
Dr. Thomas J. Graham: At NYU Langone Health, innovation is an enterprise imperative. Putting ideas to work is the responsibility of all of our caregivers from across our entire system. Our goal is to leverage our creative culture to improve and extend human life while providing economic opportunity for the individuals and communities we serve.
Several years ago, I coined the term "value-based innovation." What that means is NYU Langone is solving big problems for large populations in faster and more efficient ways, and exercising fiscal responsibility and sensitivity to ultimate cost.
We've shown that, contrary to popular belief, innovation does not increase the cost of healthcare. It's incumbent on innovation leaders to consistently emphasize and defend this fact. We have to show that innovation delivers the margin of difference to address the modern challenges related to access, outcome experience and cost.
The goal I have is for NYU Langone Health to maintain a culture of creativity and be the premier laboratory to develop and deploy the types of novel advancements that stem from the "virtuous cycle" — taking innovations from the bedside or laboratory bench to reality in order to help patients.
Q: What are some barriers to healthcare innovation? How do you overcome these obstacles?
TG: First, we need to remind everyone in the ecosystem that innovation is hard: It's nonlinear, long to success and fraught with failure. Often, it's as much about the journey as the result. I believe that there are two major barriers that innovation leaders must recognize and strive to overcome if they are to champion a culture of creative thought at their institutions.
The biggest barrier is that resources and patience can run out before an adequate innovation architecture is established or the full force of becoming a "high innovation environment" can be demonstrated. You see some systems give up on their innovation effort before it has a chance to bear fruit or deliver an ROI — that is always disappointing. Fellow C-suite executives who embrace innovation should be cautious about holding the innovation capacity to the exact same standards as other functions or initiatives; the value of a robust innovation capacity might need to be measured by a different scorecard, including its power to recruit and retain top talent.
The second barrier is making sure that access to the innovation apparatus is distributed across the entire enterprise so everyone has an outlet for their creative thought. At NYU Langone, we recognize that everyone is an expert at their job. Each of our caregivers, whether a "doc" or working on the loading dock, probably has ideas to improve what they do to help patients or advance the institution. Maintaining and marketing a conduit for ideas to get from the front line to the stewards of the strategy and resources for the enterprise is vital. We host ideas festivals and thought leadership forums, such as our quarterly Innovation Pitch, where any of our nearly 60,000 employees can present their ideas to make NYU Langone better to judges including our CEO, CFO and Mr. Ken Langone himself.
How do we overcome these obstacles? The answer is the same for both: education. There must be a champion for innovation at these large organizations, and he or she must continually communicate the nature and importance of reducing creative thought to practice. They must be prepared to interact with creative colleagues in every corridor of their organization and with all the potential partners from across the entire healthcare landscape.
Q: What's the biggest mistake players in the healthcare industry are making when it comes to innovation?
TG: They fail to recognize that innovation is not an ethereal wind that blows through their organization to bring a "eureka" moment to the few smart creatives that happen to capture it. On the contrary, innovation is a discipline to be practiced. It's process-oriented and metrics-driven. Ever since we helped to pioneer the contemporary concept of innovation more than two decades ago, we have continually sharpened our focus on the mechanisms to solicit, develop, divest and deploy innovation.
We developed multivariable scoring instruments to discern both clinical/technical merit and market feasibility. We are continually validating these tools to make sure that they reflect the current landscape.
Furthermore, we solicit advisory expertise at every step of the process: first peer review to judge whether the idea is truly novel and achievable, then input from the investment community and industry to determine if it can attract capital, can be made at scale and will be viable in the market.
There are other gaps that must be bridged when implementing and operating a successful innovation function. These include the knowledge gap that exists when innovation is not understood or accepted and the capital gap with which we all struggle, in the funding of organic-stage ideas.
However, in today's environment, where almost all CEOs list innovation as one of their top priorities, the biggest mistake is in not treating it with the same gravitas as their other core competencies. Innovation can make a huge difference as a nonclinical revenue generator, a recruitment and reward tool and a way to move the needle of patient preference — and it should be practiced, recognized and nurtured as such.
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