3 Ways Health-Care Leaders Can Encourage Experimentation

By David A. Asch, Kevin B. Mahoney & Roy Rosin

Successful health-care innovation follows the pattern of successful science. It requires laboratories where experimentation is encouraged and can proceed safely so that change seems less fraught. We’ve found that the approaches below can help support this essential kind of experiment:

Delay consensus. Highly specialized expertise, and narrow licensing and credentialing make health-care organizations so matrixed that it seems anyone can say no, and no one can say yes. Risks are easier to take at lower organizational levels where getting input, which is directionally useful, doesn’t turn into requiring consensus, which is often directionless. Health-care innovation requires allowing teams pursuing novel models to get started without all the permissions they will eventually need to scale what works.

Enable exceptions. Guidelines recommended early postpartum visits to manage hypertension among women with preeclampsia. But clinic appointment rates remained low. The suggestion that we try a text-based monitoring system led to concerns that texting is not secure. Changing the request from “Can we text patients?” to “Can we try it, for a limited time, in a limited population?” made it a safer proposition. In health care, even seemingly small exceptions to protocol create outsize concerns about setting new precedents.

Free the data. The opportunities arising because health-care data are increasingly digital sit alongside laments that these opportunities remain out of reach. Processes created by electronic health record vendors and hospital information technology policies aim for scale, reliability, standardization and security. While clinical uses and needs should dictate design and pace, the felt experience in hospitals is often the other way around. For us, success has required creating platforms and extensions that sit between the EHR and clinicians, allowing data manipulation and presentation in new interfaces outside the locked-down systems.

Successful innovation requires experimentation. But health-care change requires we tinker with the health-care system we depend on. To support the people determined to drive change quickly, we need to find ways to bend institutional norms safely.

David A. Asch is director of the Center for Health Care Innovation at the University of Pennsylvania. Kevin B. Mahoney is the CEO of the University of Pennsylvania Health System. Roy Rosin is the chief innovation officer of Penn Medicine at the University of Pennsylvania.


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