What it means to be a healthcare system "is being completely reinvented,” said Richard Roth, who runs San Francisco-based Dignity Health's strategic innovation efforts.
While this may sound like hyperbole, new payment models are forcing healthcare systems to transform the way they work across a range of new priorities: population health, telemedicine, precision medicine, data analytics, consumerism and provider integration to name a few.
Large metropolitan hospitals to rural regional systems say they go through hundreds of proposals from startup companies to help meet these objectives since few systems have in-house expertise in all of these areas.
Little wonder that many health systems find themselves taking on too many transformation projects with outside vendors that get stuck in the pilot phase and never reach scale. Figuring out how to test and scale innovation is critical in this environment as is shedding pilots that don't work and learning from those experiences.
Dignity Healthcare, which is the largest system in California and the fifth largest in the country, uses what it calls the “run, run, jump” process to bring promising technology to scale and discard less promising innovation.
The name comes from children's swim lessons, where kids run from one mat to the next and then jump into the pool. In the case of Dignity, the “run, run” refers to two sets of pilots and “jump” refers to deployment through the entire system. The process is designed to promote early stage companies with promising technology.
“It allows us to jump into new technology in a safe and secure way,” said Roth, adding that it makes the process less daunting.
The first pilot determines if the basic premise or concept actually works. In this phase the innovation is often tested in a hospitable or favorable environment. Micro-metrics, like physician or patient experience and engagement, are used to access the pilot's impact. Big-ticket items, like admission reductions, are set-aside at this stage.
The second pilot mixes things up. That could mean testing the innovation with a different demographic, fee structure and without a project champion.
“A higher bar must be met before we roll it out to the entire system,” he said. In some cases Dignity will invest in the company. Since 2012, 15 companies have been brought to scale using the “run, run, jump.” The hospital currently has five ongoing pilots.
Augmedix jumps in