Steal This Idea: How Children's Hospital Los Angeles hacked its way to innovation

Healthcare technology often suffers from a "Goldilocks problem." Sometimes solutions are too narrowly focused. Sometimes they are too broad to be effective. At their worst, tech can miss the mark and add to the noise of healthcare delivery.

Omkar Kulkarni, the chief innovation officer at Children's Hospital Los Angeles, set out to change this. "I've seen quite a few early-stage companies building solutions that do not target problems that really exist or are top-of-mind for many executives," he told Becker's in an interview. Inspired by MIT Hacking Medicine, an MIT-based group that hosts "hackathons" to accelerate medical innovation, Mr. Kulkarni decided to flip the script and host a "reverse-pitch" hackathon at CHLA's Innovation Studio. Unlike a traditional hackathon, the reverse-pitch variety starts with the people who would ultimately be the end-users or consumers pitching prompts, or real-world problems, to developers.

"If you're looking to jumpstart the innovation process in your organization, this concept of not just a traditional hackathon, but a reverse-pitch hackathon can be really impactful," he said. "It's an efficient, effective and replicable way of navigating and starting that innovation life cycle."

But Mr. Kulkarni didn't want to stop there. CHLA followed the hackathon with a hands-on, six-month incubator, called the Digital Health Lab, that took the best ideas from concept to creation. The incubator was the "real meat" of the process, according to Mr. Kulkarni. It's how in just six months, CHLA helped develop and ultimately identify not just one or two, but five highly tailored tech solutions to pilot at the health system.

Here's how to steal this idea:

Catalyzing Innovation

It all started with one weekend in April 2019. CHLA invited about 200 developers from Los Angeles' enthusiast community, universities and local networks to hear 47 common issues, or "pitches," faced by clinicians and hospital administrators. It was the first Gamifying Pediatrics Hackathon.

Mr. Kulkarni knew he wanted to lead with a demand-first approach because his past experience with traditional hackathons yielded less than optimal results. The reverse structure enabled a better alignment between problem and solution. "That alignment is really key to making sure that the developers are solving the right problem and not just things that they think are problems, without having validation from people in the industry," he said.

Mr. Kulkarni also wanted to move quickly, to create urgency around the innovation life cycle, which can become drawn out. In just 48 hours, the developers formed 22 teams and created solutions around three core prompts: digital therapeutics, patient and family experience, and clinical education. By the end of the weekend, they pitched their ideas to a panel of judges that included the CMO of CHLA, its chairman of pediatrics, technology designers and developers, venture capitalists, and even the CIO of another health system. The ideas were evaluated not only on their clinical utility, but also their business potential.

"We wanted to make sure that the products that came out of the hackathon were not only solving the problems that were defined at the start, but were also geared toward building an eventual business that was sustainable," Mr. Kulkarni said.

One such idea was targeted at children's lack of engagement with rehab exercises, an issue that can result in poor outcomes or a prolonged treatment period. The developers decided to use virtual reality and gamification techniques to engage patients in the process, putting together an idea for a virtual reality headset with characters from popular television shows. The tool would not only engage patients in their rehab exercises, but also collect biometric data on how well those exercises were being performed. It's an idea Mr. Kulkarni believes will be fun and engaging for patients, and yield strong outcomes.

Ten teams, including the rehab medicine tool, moved on to the incubation stage.

Gamifying development

The incubation stage is where the magic happened, according to Mr. Kulkarni. "What was great about the process is there were a couple of examples where [the idea] iterated over time, not only in the course of the hackathon, but the idea actually iterated in the six-month [incubation] period," he said.

One such idea started as an app to help parents determine if their baby's stool was healthy or unhealthy based on color, texture and consistency. Through mentorship and feedback, that app evolved into a much more expansive tool, powered by artificial intelligence and chatbots, that could help parents find reliable information on a much broader variety of issues.

The teams developed their ideas with the help of more than 50 volunteer mentors, who worked with each team on a weekly basis, providing expertise in product design, venture capital, sales, go-to-market strategy, team building and more. Mentors came from all over, including companies like Google, BCG Digital Ventures and UnitedHealth Group.

"Each of those companies has an interest in supporting the entrepreneurial ecosystem in healthcare, and in giving back to future entrepreneurs," Mr. Kulkarni said.

Teams also received frequent feedback from the most important source — the end users. CHLA hosted what it calls "Gamifying Wednesdays," giving the startups three hours each week to get direct feedback from patients and families on their product. Patients and families were curated based on what the tools aimed to solve. The concept is one that Mr. Kulkarni believes was essential to making the innovation process so successful. For example, through Gamifying Wednesdays, the startup building the virtual reality headset for rehabilitation quickly realized one of the biggest limitations was the headset itself. It limited the types of patients who could use the tool by age, diagnosis and other logistical barriers. It led the team to broaden its prototype, ultimately making a more marketable product.

At the end of the incubation period, CHLA hosted a demo day and selected five startups: Manatee, a voice-enabled behavioral therapy robot; Playing Forward, the immersive game with popular TV characters that helps children improve motor skills; Pulse XR, an app that uses data from MRIs to create a virtual model of a patient's heart; Mila, a game that uses music therapy to help patients remotely train cognitive skills; and CHLA Companion, an augmented reality app for parents and caregivers. These five startups each received a $20,000 grant and are piloting their innovations at CHLA.

What's next?

Mr. Kulkarni plans to make the reverse-pitch hackathon and incubator an annual process. "This is just a great way for the next wave of products that are developed in healthcare to be really value-added and purpose-driven, because they will have started through the words of and through the guidance of people who actually live and breathe the problem," he said.

He also hopes the idea will spread to other children's hospitals and potential partners, who can help innovate at an even bigger scale. "I'm excited to see what the next wave of healthcare products looks like, not only here in pediatrics and Los Angeles, but in every market around the country," he said.

Steal this idea and run with it

Mr. Kulkarni offered a few key words of advice to other health systems who want to follow a similar path to innovation:

1. Start with a specific problem. He advises hospitals start with problems that both executives and front-line staff want to solve and to narrow them down as much as possible.

2. Provide background. Ensure developers have all the information they need at the beginning, not only from executives, but from clinicians and other stakeholders, so they can holistically develop their products.

3. Customize support. Teams working on physical rehab will have different needs than teams working on speech therapy. Mr. Kulkarni advises customizing the mentors and roadmaps at the incubator stage.

4. Be prepared for pleasant surprises. The process is a "living, breathing thing," according to Mr. Kulkarni, and can produce unintended benefits. "It will turn into its own program based on every hospital and its own culture and ecosystem."



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