Elsevier

Healthcare

Volume 2, Issue 1, March 2014, Pages 9-13
Healthcare

The Leading Edge
Accelerating change: Fostering innovation in healthcare delivery at academic medical centers

https://doi.org/10.1016/j.hjdsi.2013.12.001Get rights and content

Abstract

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician–innovator career track coupled with innovation training programs.

Section snippets

Background

We are at the beginning of an unprecedented era for innovation in healthcare delivery in the US due to the convergence of payment reform and the proliferation of technology. Policy advances at the federal and state level are catalyzing the shift from volume to value-based reimbursement and creating the best opportunity in recent history for quality-driven innovations such as patient-centered medical homes to have successful business models.1, 2 At the same time, ubiquitous access to the

Incubator programs at academic medical centers in the US

An innovation incubator at an AMC is a program that cultivates the rapid transformation of ideas into value-generating products or services that benefit patients, providers, and/or payers. Incubators at AMCs have their roots in the original business incubators dating back to the 1950s.9 Since then, business incubation has grown substantially to include over 1100 incubators in the US and approximately 7000 incubators around the world.10 With the recent proliferation of software development and

Creating and running a new incubator at an academic medical center

The key resources for incubators at AMCs are the frontline insights of their clinicians,13 combined with the wealth of available clinical data to add granularity to the problems clinicians observe. However, most AMCs lack training programs in innovation methodology, so the clinicians are unprepared to take advantage of their insights and fail to efficiently produce solutions to these problems. We propose the following adaptation of prior best practice guidelines for incubation programs as a

A clinician–innovator career track

Essential to the success of an incubator program are the clinicians to fuel innovation. However, AMCs have a poor track record of helping clinicians advance their academic careers outside of grant-funded research, so it would be difficult to convince clinicians to devote extra energy to an incubator project unless it could also promote their career. To recognize the contribution of successful innovation to the healthcare system, AMCs should create a CI career track. The measure of success

Clinical innovation training

The maturation of CIs within the incubator system would be bolstered by rigorous innovation skills training that complements traditional medical and specialty training. Training in innovation requires exposure to entrepreneurial practices that are currently foreign to academic medicine. One of the foundational innovation practices is Lean Startup Thinking (LST). Lean Startup Thinking is a management process that aims to create a minimal viable product (MVP), which is an intervention with the

Future challenges and conclusion

There are important challenges to be overcome for an AMC to build successful incubators and innovation training programs. The most pressing issues include development of a consistent but flexible protocol for mitigating conflicts of interest, safeguarding against projects that marginalize patients with lower socioeconomic status, and creating a culture that accepts delivery system innovation as an equally laudable pursuit as clinical research.

These challenges bring up questions about how

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Dr. Ostrovsky is a resident in the Boston Combined Residency Program in Pediatrics. He is also the CEO and co-founder of Care at Hand.

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