By the Innovations Exchange Team
“The center approaches its work with a 'think big, start small and move fast'
philosophy.”
Innovations Exchange: Why did Mayo Clinic create the
Center for Innovation ?
Spurrier: Mayo Clinic launched the center
in 2008 to transform the delivery and experience of health care. The
transformation is rethinking what we know about the health care system and
looking for opportunities for disruption and improvement. We
also think a lot about health and well-being at the individual, community, and
population level. Our goal is to deliver health care in ways that are
accessible, affordable, and sustainable.
How does the center
foster a culture of innovation?
We think of the center as a
“giant incubator” where we nurture new ideas, and enable them to grow, mature,
and evolve until they are ready for patients. We create multidisciplinary teams
to think differently about challenges and help bring innovative ideas to life.
These teams have project managers, design professionals, and specialists from a
wide variety of disciplines, including information technology, health care,
education, human factors engineering, and communication.
Because
environments matter, we recently moved into a new facility that feels more like
Silicon Valley than Mayo Clinic with a lot of open space for multidisciplinary
teams to collaborate on projects. It also houses the Design Research Studio
where researchers and designers come together to observe patients, interview
families, conduct traditional consumer research, and visualize, model,
prototype, and test possible health care delivery solutions.
We also
developed an outpatient “living laboratory” to study how health care is
experienced and delivered to patients. The lab is a clinical environment where
providers can experiment with health care delivery methods, prototypes, and
processes to discover new insights and address problems.
We also created
and support the Healthy Aging and Independent Living Lab. Through a
collaboration with the Robert and Arlene Kogod Center on Aging and Charter House, the center supports "aging in place," helping seniors
remain at home, healthy, and independent. The approximately 5,000-square-foot
lab is a place for discussion groups, workshops, observations, and other
research activities. There are two mockup apartments for in-lab experiments
simulating a typical home experience that can be recorded with digital
technology.
What is the center’s approach to solving health care
problems?
We connect people through internal and external
partnerships, use design thinking, a creative, problem-solving approach to
improving the consumer experience, and enable competency to flourish. This
methodology called Connect, Design and Enable (CoDE) is a competitive funding
mechanism that supports innovative ideas across Mayo by giving them access to
our methods, team member’s expertise, and help with
implementation.
Another popular concept at Mayo is co-creation—it’s very
important to us that we connect with the users of the new care model or process
of care as well as those delivering it. We also are deeply committed to
human-centered design thinking, to understand the user’s needs and involve them
in the design and testing of new practice models. For example, patients
participate in the outpatient lab and we go to a senior's home to understand
more about aging in place. We use qualitative methods including ethnography and
focus groups to generate insights throughout the process.
We also form
strategic collaborations and partnerships with academia and health care and
technology companies to leverage and accelerate our work. Partnering with
universities enables us to access their talent. For example, a graduate MHA
student at the University of Minnesota wanted to develop a mobile application
for adolescents with asthma. Our programmers wrote the code and Verizon provided
the smartphones that we tested. The application will enable adolescents to watch
videos and connect to their care team for monitoring and treatment.
We
also recently formed a consortium to support the “aging in place” initiative.
Consortium members including Best Buy, General Mills and the Good Samaritan
Society, pay membership fees and in return they receive benefits such as access
to Mayo’s clinical expertise in aging. By sharing expertise and resources,
seniors benefit. Best Buy, for example, is thinking about how they can use the
Geek Squad in the home, Good Samaritan has nursing homes in 240 communities, and
General Mills, a Minnesota company, does amazing work with food, nutrition, and
wellness.
Finally, we are also responsible for growing the culture and
competency of innovation across Mayo Clinic. We want to connect with everyone
across the organization so they have innovative tools to think differently about
the challenges they are facing. We try to connect the organization with partners
who are trying to design new ways of innovation.
How do you
decide which problems to address in health care delivery?
We
think about what is the smallest number of big ideas we can address that aligns
with our strategic mission and what is going in health care and other
industries. We express these ideas through four care delivery platforms to give
our work focus: "Future works" allows us to think about things that we don’t
fully understand yet; Community Health Transformation and Care at a Distance
challenges us to take the knowledge of 3,700 physicians and scientists at Mayo
and deliver that knowledge in new ways to patients in their communities rather
than in the doctor’s office. Finally, Practice Redesign recognizes that the
current outpatient practice model is unsustainable. That platform is very
disruptive in that everything is on the table for review—how we interact with
patients, the team composition, flow of patient care, and how technology enables
and support processes of care.
Each platform has a portfolio of projects.
Similar to an investment portfolio, some projects have a short-term return and
others are more complex and have longer returns. Some projects have a financial
return and others have more of a societal impact. We aim to strike an overall
balance in what we try to accomplish for the organization. Each platform has a
multidisciplinary team, internal and external collaborators, and a diverse
portfolio of projects supported by a solid business model.
What
goals and implementation targets have you established for your priority
platforms?
- Practice Redesign: The goal is to reduce outpatient costs
for Mayo Clinic by 30 percent while improving the patient experience and
maintaining and enhancing quality outcomes.
- Target: Develop new practice models by 2012 and implement them in
Mayo Clinic’s outpatient practice by the end of 2014.
- Community Health Transformation: The goals are to improve
the population’s health, enhance the patient experience, and reduce per capita
cost of care.
- Target: Pilot a new “triple aim” model in the Mayo Clinic Health
System's Central Region and Employee Community Health practice.
- Care at a Distance: The goal is to develop three
sustainable models that extend specialty care from traditional clinic/hospital
settings.
- Target: Pilot the model in three venues by mid-2012—an underserved
area in the United States, an affiliated practice, and a patient's home.
Can you provide an example of a care delivery
innovation that was scaled up and spread?
We are scaling the
eConsult model we developed for the Care at a Distance platform to connect Mayo
specialists with primary care providers who are in remote locations. Using, the
concept of co-creation, we brought together primary care providers, patients,
and the payer, which was Blue Cross/Blue Shield (BCBS) of Minnesota, to design a
new kind of system. The result was a project that we tested in a remote
community in northern Minnesota that didn’t have advanced technology or
electronic health records. Patients benefited from the eConsults by not having
to fly to Rochester to see Mayo specialists and being diagnosed more quickly so
they can move on with their treatment.
This pilot project informed the
direction for the e-health platform, and we built infrastructure around it. We
now have eConsults defined for 170 medical conditions that resulted from working
with specialists. We’re approaching our 9,000th eConsult and are scaling up this
service across our entire organization. As we build out affiliate practice
network across the country, we plan to offer this as a service to physician
groups in remote locations and keep patients where they are.
In terms of
payment, we use a subscription service, which began with BCBS of Minnesota who
saw the value in this new practice model. We have now spread that service to new
relationships, mainly this affiliated practice network that we are building. We
also have a subscription service relationship with the Alaskan Native Health
Consortium to reimburse us for eConsults for women at high risk of breast
cancer. We also made eConsults free of charge for Mayo's 60,000 employees and
their dependents through our insurance plan at Mayo.
What
infrastructure is needed for the scale-up/spread phase?
We use a
distributive network model in hiring people with the expertise we need. This
helps us grow our ecosystem across Mayo, co-create, and build support for a
project when it's ready to scale. Some projects can be scaled in 4 to 6 months
while others, such as the medical home, community, and redesign, which are more
complex, can take up to 2 years.
The leadership of Mayo is also very
engaged in our work including helping us to craft the Future works platform and
serving on our internal advisory council that includes patients. We also have an
external advisory council with thought leaders in innovation from different
industries.
The center receives funding from the Mayo Clinic where
innovation is now a strategic requirement. Other funding sources include grants
and the aging in place consortium through its membership fees. As we develop new
products and services, there may be opportunities to partner with IT start-up
companies, in which the center would have equity shares.
How do
you disseminate or spread the center’s products across Mayo and
beyond?
We spread the work of our center across Mayo through our
innovation curriculum and toolkit, and through workshops. We package all our
products in creative ways and share them on the Mayo Intranet. For example,
learning about the redesign of the emergency department could lead the urology
department to consider how that will affect the patient experience, efficiency,
productivity, and throughput.
We also have a monthly leadership
newsletter in which we highlight specific innovation deliverables that we have
completed, our strategic partnerships, and all the groups that are coming here.
We also launched a new Webcast speaker series last year, Unexpected
Conversations, which is available to all Mayo employees. We bring in big
thinkers in innovation with different perspectives such as Tim Brown, chief
executive officer of IDEO, who is on our advisory council. IDEO played a big
role in the development of our outpatient lab.
What are some
challenges and lessons learned since the center started in 2008?
We have faced several challenges. For example, the co-creation
model requires that we connect to individuals and teams of individuals at the
beginning of the process so everyone is working through all phases together.
This is a change from creating and testing a model in a laboratory and then
rolling it out for everyone to implement. We also have been challenged by
developing a new care delivery model before the business model is fully
established. We have learned that if we're meeting the needs of the patients,
the business model will evolve.
Another challenge has been to change the
perception that human-centered design thinking is only for design professionals
and to find ways to include others. Design professionals also approach problems
with a more qualitative risk-taking approach than physicians and scientists who
want data to support the need for change. Lastly, we know that radical
collaboration requires us to go outside our organization and tap into that
energy, intelligence, and network to accelerate our approach and
work.
About Barbara Spurrier, MHA
Ms. Spurrier,
Administrative Director of Mayo Clinic’s Center for Innovation, along with
Nicholas LaRusso, MD, the Center’s Medical Director, oversee all aspects of the
center, including strategic partnerships, portfolio operations and execution,
and business development. Ms. Spurrier joined Mayo Clinic in Rochester in 1997
and served as Operations Administrator for many clinical practices. She was
named Vice Chair of the Department of Medicine in 2003 and in 2008, became
Administrative Director of the newly launched Center for
Innovation.
Disclosure Statement: Ms. Spurrier is aware of the
Innovations Exchange requirement to disclose any financial interests, or
business or professional affiliations, relevant to the work described in this
Perspective. No disclosures were reported.
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Last
updated: March 28,
2012.
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