To keep goals and expectations in check for UCHealth's innovation team, Richard Zane, MD, reminds them of Amara's law: "People will overestimate the importance of technology in the short term and underestimate it in the long term."
As such, according to Dr. Zane, the Aurora, Colo.-based health system's chief innovation officer, technology may not even be the most important aspect of healthcare innovation. Change management and the actual implementation of new ideas, he explained to Becker's Hospital Review, can pose more challenges and, ultimately, have a far greater impact on care delivery and clinical workflows.
Perhaps the most important part of his job, then, is instilling in his team and their partners a mindset that is receptive to both change and failure. "The important part is that we make sure that [the failures] are small and that we learn from those failures and know that just because we've had a failure, it doesn't mean we're going to pivot and completely abandon the direction that we're going in," he said.
Here, Dr. Zane explains how he prioritizes that "mindset of innovation" and how UCHealth is harnessing that mindset to transform how care is delivered to its nearly 2 million patients.
Editor's note: Responses have been lightly edited for length and clarity.
Question: What does innovation look like at UCHealth?
Dr. Richard Zane: We work very pragmatically and ethnographically; we're trying to identify frontline problems that affect healthcare. What we do not do, specifically, is start companies for the sake of starting companies. We look at solving problems that we need to solve, and we identify outside partners to build those solutions. When we do that, we build them with the assumption that if something is a problem for us, it's a problem for the 4,000 other hospitals or 1,000 other healthcare systems in the United States.
We do this by using our large integrated healthcare system as a learning validation laboratory for the solutions. We work with our outside partners to build the solutions and very rapidly iterate, ideate, deploy and scale. That's how we function.
From a topical area, we tend to focus on intelligence. That's a pretty broad category, but when we say intelligence, we mean helping providers, administrators and executives make better decisions. It might also be called clinical decision support or prescriptive analytics or AI — we work across that entire spectrum.
Q: What are some of your goals and priorities as chief innovation officer?
RZ: One of our biggest focuses is on the concept of surveillance: what it means and how it integrates within traditional types of care delivery models. By surveillance, we mean being able to monitor a very large population base, whether that's just inpatients or both inpatients and outpatients, and being able to intervene before someone develops an acute exacerbation of a chronic illness or needs an escalation in care. We've done that by building a very robust virtual presence and being able to have that virtual presence, integrate devices, perform remote surveillance and deploy prescriptive intelligence. We started with inpatient units with sepsis and are now growing it to encompass all patients, and we'll eventually bring it into the home as well.
Q: What are some barriers to that and to other types of healthcare innovation? How do you overcome those obstacles?
RZ: There's always going to be cultural barriers — change management, showing providers and patients that there is a better and different way to be able to do something. Other barriers are also pretty straightforward: It takes money to be able to do these things, and sometimes the technology to do what we would like to do does not yet exist. We've faced and worked through all of those barriers in different avenues.
Q: How so?
RZ: From a technology perspective, we stood up the virtual health center. We've been looking for the right device to be able to do home surveillance; we did an environmental scan, we looked at really everything that exists, and we did not think there was a technology that was deployable, reliable and scalable. So, with a partner, we invested in a company that is going to be able to deliver that, and we've worked with them to get them through the FDA to build the data systems. We're now working on pilots to deploy that technology.
Q: In terms of the financial barrier, not only do you need quite a bit of funding to back innovation initiatives, but you also need your organization's executives on your side to secure that buy-in. How do you address that?
RZ: For one, UCHealth set up an investment fund to be able to do early-stage investments in companies we want to partner with. That's really a function of the treasury of an institution looking for opportunities for investment.
For another, when my team and I move forward with some type of a deployment or initiative, it has a business case. That business case is not just adding expense, it's also providing value; every time we add an expense in one avenue, we're taking it away in another, so that we can be revenue-positive over time.
Q: What is a big mistake you think players in the healthcare industry are making when it comes to healthcare innovation?
RZ: The biggest mistake we've seen over and over again on the tech side is when companies come to healthcare with what they believe is a complete or nearly complete solution to a problem with which they're not necessarily familiar. Healthcare is complicated and it's not intuitive, nor is it similar to other industries. So when you have a technology that you believe solves a problem and you haven't fully understood the problem — and fully understanding a problem in healthcare means understanding the workflows, understanding the people, understanding how the solution is socialized — it's doomed to failure.
Ninety-nine percent of the startups in healthcare fail, and most of them fail because of this lack of ability to navigate healthcare. So what I say to companies that come work with us is to come with us early. There are going to be early failures, but we have to build together. Very rarely will a young company have an out-of-the-box solution that actually works.
Q: Is there any initiative that you'd like to implement or launch but is still out of reach, maybe because the technology or the money or the partners don't exist yet?
RZ: The most important initiative that we're deploying now is the concept of taking care of complex care in the home. We're starting to do that; we have to make sure that the data systems and the technology and the process and the tools are ready, and we're just starting on that journey. This is all about people, process and tools, and we have to make sure that they're all aligned, but some of them are just now being developed and are deployable.
Q: How do you achieve that alignment?
RZ: One of the guiding principles is that you can never make sure that everything is all there and right, which means that it's a bit of a mindset. Part of my job is to get people not just excited about the potential and not just working to build a solution, but to get their heads right around the mindset of innovation, which is that there are going to be just as many failures as there are successes. The important part is that we make sure that they're small and that we learn from those failures and know that just because we've had a failure, it doesn't mean we're going to pivot and completely abandon the direction that we're going in. That's probably one of the single most important things that we do.
Another is just setting expectations the right way in a clinical setting. We will sometimes identify a clinical scenario that has more to do with the opportunity of being successful, meaning we have an enthusiastic early adopter and then we disproportionately resource that early adopter. We celebrate their wins, and then others want to be like that. It's almost as much about the implementation and the change management as it is about the technology — in fact, probably more.
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