Healthcare Delivery Organization (HDO) Innovation Lifecycle Ontology (ILO) - HDO-ILO

The following section covers the Innovation Lifecycle Topics identified by Medigy that must be addressed by innovation practitioners to get things done to innovate efficiently. These topics form an integral part of the ontology and the Innovation Lifecycle community of practice (ILCoP) on Medigy. By integrating these topics in the innovation ontology and gaining insights from articles discussed in the ILCoP, innovation practitioners at HDOs can accelerate innovation and overcome barriers to innovation adoption.

Innovation Problem Definition

“If I were given one hour to save the planet, I would spend 59 minutes defining the problem and one minute resolving it”- Albert Einstein.

A Problem Definition, or Innovation Challenge ¹ as it is called in many cases, is a problem that an innovator or HDO may solve to either:

• Grow their brand visibility and survive the competitive market, or
• Resolve a dire problem within the organization to help stakeholders get their jobs done smoothly and efficiently to achieve patient care goals, or
• To address a social challenge in healthcare that’s been begging for attention.

Defining a problem², in the right manner helps find the right solution. Similar to a mission statement for an organization, the problem definition helps keep everyone focused on the same goal. Writing a Problem Statement can help innovation centers get ideas, but doing it right is a real game-changer to get the most relevant ideas into your innovation funnel.

The following steps could be adopted to define the problem statement ³:

1. First define the perspective of the problem, whether it is (a) Need based: Patient focussed or Provider focussed ⁴ (b) Market based.

2. Define the area the problem exists in (a) Product (b) Service (c) Organizational structure (d) Business model.

3. Try answering the following questions to define the problem in depth ²:

• Customers. Who is affected by the problem? What problem do they have? How will the solutions affect them?
• Transformation process. What processes does the problem affect? How will a solution change the process?
• Market view. What is the big picture, and how does the problem affect it? What effect will a solution have?
• Environmental constraints. Are there any constraints of time, money & resources? How can you innovate within them?

These 6 keys to writing an effective problem statement by John Hopkins Medicine should be an ideal template to follow for HDOs and innovators to define their problem statements before diving into the innovation processes.

Innovation Expectations

Deploying innovations requires practitioners drawing out, and documenting the expectations and goals of audiences in a disciplined and result-oriented manner. Exceeding the end users’ expectations remains a major goal for healthcare innovators. Regardless, many innovation projects fail due to following a systems-requirements approach. Instead of an intended-results approach. The Innovation Expectations area focuses on the key factors that guide innovators in leading stakeholders to accurately pinpoint and document patients’ and other stakeholders’ actual expectations, instead of guessing their needs ⁵. The Innovation Expectations topics should drive the collective critical inquiry on different goal-setting frameworks like Objectives and Key Results (OKR). Systematic and framework-based content enables innovation practitioners to track all expectations objectively, staying on top of them throughout the innovation process.

Innovation Discovery

Once adequate documentation of innovation expectations takes place, the ILCoP provides assistance unlocking the insights into solutions and techniques needed to meet those expectations. Medigy’s IL CoP topics and subtopics navigation, organic content creation, offerings listings, and automatic references, offer the right tools to drive innovation discovery.

Innovation Intelligence and Evaluation

Proper evaluation of healthcare innovations involves assessing intended use, as it relates to achieved objective outcome. This topic helps measure your innovation efforts through quantitative and qualitative evaluations. Here you will find innovation evaluation content that helps lead you to the best suitable choice that addresses your unique circumstances.

Innovation Pilots and Early Adoption

According to an interview by Dr. Roxie Mooney on The #HCBiz show 95% of innovations that are brought to market fail to reach an adequate level of customer adoption or financial ROI. It is thus imperative that innovators take necessary steps to dramatically increase their chances of being in the other 5%. Why do you need an early adopter strategy that focuses on the specific needs, goals, and desires of the customer? How to avoid pilot purgatory? The benefits of being strategic with your go-to-market timing (i.e., don’t rush to market; do rush to customer feedback). How to co-create with your clients without building a product that works only for them? When to convert your early-adopter messaging to mainstream messaging (i.e., social proof, trustworthy, reliable, ROI, etc.)?

These are some of the questions that the ILCoP and the ontology framework will make the HDO innovation practitioners ponder on, to scale their innovations efficiently.

Innovation Decision Support

Once implementation of the innovation evaluation process occurs, the next step is decision support. Here, the decision whether to procure, and scale the innovation happens, using decision support tools. This topic will focus on the various tools and technologies that will help you with making a comprehensive evaluation to arrive at the best decisions.

Innovation Procurement

An efficient innovation procurement process is as important as making the right buying decision. In essence, “what do I want to buy?” The objective of this section is to help you reach the best deal in the record time. The complex process of procuring new technology, especially in a large organization, can quickly spiral out of control. By sharing the industry’s best procurement practices, along with the most common mistakes and problems, you are a step ahead. Applying this practical knowledge will hasten your steps to snagging the most lucrative deal out there. Innovation Diffusion, Adoption, and Implementation.

This section focuses on the three core processes of any innovation diffusion:

• Presentation of the innovation to your organization.
• Acceptance by the decision-makers.
• Integration of the innovation into the existing culture.

Dixon-Woods et al., (2021) ¹ discusses various aspects of diffusion that innovators frequently overlook and how to overcome them. For example, at times some innovations with unproven value diffuse rapidly while those that could potentially deliver benefits to patients have a slow uptake. This topic in the ILCoP will improve your understanding of innovation diffusion. As a result, you will be able to achieve structured and accelerated diffusion in your healthcare organization.

Innovation Termination

This topic derives lessons from the mistakes of others. The content under this topic revolves around the phasing out of healthcare innovations. You will find case studies from previous unsuccessful healthcare innovation projects. Avoiding repeating these mistakes will allow you to improve the chances of your success and keep you safe from the survivorship bias.

Here are the two specific agendas that this section covers:

• Failure of innovation at diffusion stage – How an oversight by a health facility can lead to failure of widespread adoption, and how to avoid such mistakes.

• Difference between Failure, Exit, and Retirement of technologies ³.– We will talk about all the concepts related to phasing out innovations and break down the meaning of each idea. You will get to know the difference between concepts like Innovation, Novation, Replacement, Failure, Exit, and Retirement of healthcare innovations. Armed with this knowledge, you will have insight into aim innovation’s life-cycle, when it is at the tail end, and how to proceed.

Innovation Careers

This section serves as the career mentor of healthcare innovation professionals. Here we share informative content that dispels common myths around the topic of innovation lifecycle careers and explain evolving roles and responsibilities of Chief Information Officers (CIOs) at hospitals. We also provide specialized career guidance and the latest trends – with a laser-sharp focus on the healthcare innovation context.

Innovation Connectors

Another term for an innovation that is widely applicable across multiple sectors, is a horizontal solution. On the other hand, a vertical solution refers to an innovation that mainly works within a single industry, like healthcare. Most endogenous growth literature explains that the vertical innovation process consists of the introduction of a better quality version of the existing products, while horizontal innovation process consists of the creation of totally new product lines ². During the COVID-19 pandemic, some Electronic Health Record providers expanded their platforms to include HIPAA/HITECH compliant and secure video conferencing, for telehealth. This example showcases a vertical solution. Yet a popularly known option, Zoom Technologies’ webinar used across multiple industries, without need for specialized privacy, as required in healthcare, would qualify as a horizontal solution. The Innovation Connectors subject area caters to unmodified horizontal solutions. This can be applicable, helpful, and potentially even more disruptive than healthcare-specific vertical solutions. The unobvious ‘Innovation Connectors’ have a potential to significantly disrupt the healthcare ecosystem and affect certain healthcare practices. This section focuses on various how-to-guides for innovation practitioners to connect the dots by uncovering relevant horizontal innovations to address healthcare vertical problems. This cross-pollination creates a collision space which opens into unexpected innovation to solve healthcare problems ⁴

Return on Innovation

Seeing good returns remains the goal of any business. Healthcare innovation is no exception. This topic is dedicated to understanding the profitability of a certain innovation for the business and users of that innovation. While embracing the financial value of healthcare innovations as a starting point, it cannot function alone. Other great questions in consideration include: “Is this innovation financially viable?”, “What is the ROI on this one?”⁶, “How long will it take to break even?”, among others. AMA also has a Telehealth framework for practices which is worth considering. This concept of ROI will allow innovation professionals and decision-makers to use a language that is often more defensible, even in healthcare – the language of profits and returns.

Innovation Leadership

In a care setting, quick diffusion, and localized adoption are more accepted. Nonetheless, widespread adoption has always been a challenge. On this basis, selecting a leadership style that supports Innovation gets the foremost pass. According to Currie & Spyridonidis, 2019, the‘Distributed leadership’ style has more superiority to the ‘Hierarchical leadership’ style in the realm of successful adoption of innovation. Health innovation implementation consists of three major players, ‘Specialist Practitioners/Consultants’, ‘Allied Care Staff’ and the ‘Managerial’ teams ⁷. If a group lacks experience and needs guidance, the ‘Hierarchical’ structure comes into play. In healthcare, knowledge and expertise take precedent, hence practitioners tend to be the most influential leaders in this case. Adopting a ‘Shared’ or ‘Distributed’ style of leadership as a result, has more significance in healthcare. The Shared leadership involves interactions among all levels of leaders (doctors, nurses, managers etc.) that have a role to play in influencing the diffusion and adoption of an innovation at the facility to ultimately get their jobs done. In ‘Hierarchical leadership’, managers are often given an outsized role than practitioners and other stakeholders, as per Charlie Munger’s ‘Authority- Misinfluence Tendency⁸.’ In the top-down approach, many cases exist where people blindly follow their leader’s vision, and may achieve success. On the flip side, sometimes leadership has poor insight, with a weak vision and mission. When such a leader struggles with communicating it to their people, things may end up worse off.

Innovation Evidence Trustworthiness

Using a systematic approach in evaluating the trustworthiness of any innovation remains key to achieving the central goals of patient care and satisfaction. Innovation practitioners at HDOs face persistent issues in accumulating the required knowledge around innovation evaluation. The absence of an evaluation framework can lead to implementation of technologies that make fraudulent claims. This increases the likelihood of risks, and potentially fatal adverse patient outcomes. An evidence-based, peer-reviews-driven approach could be one such framework to evaluate the trustworthiness of innovations to drive the diffusion, without jeopardizing the overall outcome.

Significant research questions to evaluate the credibility of any innovation, will help to make a distinction between fraudulent and genuine ones based on whether the research went through a peer-review approval, lacks evidence and provides biased opinions OR whether the research just considered correlation and lacks causal explanation ⁹.

Innovation Behavioral Science

Stakeholders across the healthcare continuum often believe in technology-driven innovations to achieve patient engagement objectives. In actuality, this is partly true. Technology forms just one part of the innovation adoption equation. Yet, a widely ignored component that the aspect of psychology surfaces. With the evaluation of innovations, both the patients, and the frontline decision makers at HDOs end up largely neglected. This negligence leads to failure in innovation adoption and is a result of ignoring the behavioral science aspect. Reconciliation of psychological tendencies, along with the attention to detail to the technological framework, increases the success rate of adoption for any innovation. From a behavioral science standpoint, trying to influence frontline decision makers into adopting a technology requires two main things. It includes tapping into their needs, and unlocking challenges from their own perspectives. For the successful adoption of any innovation successful, one needs guidance using evidence-driven behavioral science strategies and user centered principles ¹⁰.

Innovation Ethics

This concept here integrates with responsible innovation and further explains the importance of socially ethical innovation in patient care ¹⁰. This topic talks about what innovation practitioners at HDOs could do to solve this issue. By ensuring proper implementation of innovations with societal and ethical values, through the involvement of concerned stakeholders from a very early stage. Medigy’s ILCoP helps innovation practitioners gain at the initial stages, deep and actionable insights of each step involved. Only then can adopt innovation for the desired objective become a concern. Alongside educating the stakeholders on the Innovation Lifecycle, of equal importance is to generate awareness about the adoption of a framework to identify ethically correct innovations that consider effects and potential impacts on patient care and the broader societal values. For instance, AMA ¹¹ provides a comprehensive guideline to practitioners for implementing ethical innovations in accordance with professional responsibilities to advance medical knowledge, improve quality of care, and promote the well-being of individual patients and the larger community. If at all, even by ignorance, any innovation is implemented that could propagate ethical issues, the Hippocratic Oath might lose its relevance. Failure to properly implement Innovation Ethics can shift the focus from patient care and safety to individual interest.

Innovation Recognition

This topic and the related articles in the ILCoP will help the HDOs learn on successful innovation deployments of their peers. Integrating this topic as part of the innovation journey will make HDOs reflect on recognition as a part of the organization culture. Creating an environment of employee recognition empowers everyone in the organization. Team members acknowledge good work and feel appreciated for what they do. Peer-to-peer recognition can play a big role in helping employees feel appreciated for their work.

Medigy’s ILCoP insights and recognition will support these awards showcasing the continuous innovation being made by truly dedicated individuals and teams who are developing solutions for the healthcare challenges with everyone playing a part in driving forward healthcare improvements.