Innovation's moral quandary: When am I obligated to reinvent the wheel?

Healthcare has a lot of problems, and oh, if only problem-solving were simple.

When we talk about creating solutions to problems in healthcare, the 'how' is becoming just as important has the 'what.' Often, the question is a helpful one. But recently, the answer to 'how' dissolves automatically, and sometimes meaninglessly, into everyone's favorite buzzwords: disruption and innovation.

Let me make one thing clear: Innovation is crucial. Leave anything in an echo-chamber of ideas for long enough, and all hope for progressive movement is over. However, the overwhelming desire to throw the baby out with the bathwater seems to have overtaken the healthcare industry.

Not all problems are in need of an innovative fix.

Take low handwashing compliance. People can (and do) write books on this simple, but common problem.

You're the head of infection control at a major, resource-rich health system, and it comes to your attention that providers just aren't remembering to wash their hands. You had previously considered this problem and already have a reminder program in place, but it's clearly insufficient. Do you a) consult with similar providers and adopt a preexisting program that has proven results at another institution, or b) scrap your current program and build one from scratch?

The answer isn't always clear. Maybe you know of another system with stellar handwashing statistics, and you recognize the possibility of adoption and customization. Or perhaps, as director of the infection control program at your resource-rich system, you feel an obligation to create an even better program or technology — one that collects data by itself, for instance. Surely this would be an improvement upon simple handwashing compliance success.

What would you do? What should you do?

Answers to these two questions tend to differ, as explored in a recent article Harvard Business Review entitled "Health Care Needs Less Innovation and More Imitation." The authors argue that while innovation is fashionable, imitation, too, should be recognized as a legitimate form of problem solving.

In the article, the authors describe the semi-satirical organization, the International Institute for Innovation. "We want to establish an annual prize for the highest impact implementation of an idea explicitly created by someone else. We want to take the shame out of stealing from others, shake off the conceit of Not Invented Here, and embrace the sincerest form of flattery by learning how to imitate approaches known to work," they write. Now there's a mission statement you don't hear often.

One facet of the innovation process rarely discussed externally is that of resource allocation. If your health system has a finite number of dollars and man-hours to spend on problem-solving, where should those resources go? To the quick, certain fix that is likely cheaper in both regards? Or to the slower, uncertain fix that could consume more resources but have a broader impact in the long run?

What are you obligated to do to protect your patients, advance your brand and uphold your total progress as an institution?

What can you afford to do?

What does your mission assure the public that you will do?

From a bird's-eye view, it seems like healthcare organizations face two broad categories of inefficiency.

The first is having the wrong tool for the job at hand. The second is having the right tool but needing a higher level of performance. For the first, it's possible innovation isn't the most elegant solution.

This is not to say innovation should be reserved for project systems that already work but could use an upgrade. Sometimes, systems are developed incorrectly, are poor fits or are simply outdated, and a quick fix isn't an option. Indeed, innovating a solution can bypass more traditional avenues to progress that otherwise might be crossed more methodically — and more slowly — even though the innovation takes longer than swapping in a quick, though legitimate, fix.

So, should you innovate or imitate? The answer very much depends on your institution, resources, market and ethics. The question requires careful consideration, and it's important to look at the risk-reward process. When you consider your resources and your ability to contribute to progress in the healthcare system, do you need a radio-frequency tracking, specialty-sorting, mobile widget for hand hygiene compliance? Or do you need to give your providers a straightforward reminder? Will you spend more resources on developing technology on the cutting-edge? Or will you choose to allocate more resources to "simpler" problems?

It seems healthcare will rely largely on innovation to cope with the impending, systemic incentive-flip it's about to experience, but perhaps default problem-solving methods should focus less often on "disruptive" plans and reconsider inside-the-box tools and tried-and-true strategies. Before rushing to innovate, consider: A little more of the same could be just what the doctor ordered.

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