Welcome to our Special Edition Series of the HealthChangers Podcast – Powered by Innovation Force. In this series, Cambia’s Chief Innovation Officer and SVP Mohan Nair sits down with industry leaders and influencers to explore the real stories behind health care innovation and transformation. You’ll hear thought leaders share their motivation for changing the way consumers experience health care and learn about the challenges they’ve faced. And you'll gain practical insights to inform your own health care journey.
Mohan Nair (MN): Welcome to The HealthChangers podcast. Just note, these podcasts are designed for your listening pleasure and learning. They are focused on people that we think can bring out the best in you through the process of using the media of podcasting. And hopefully you see a conversation between myself and others who I think can add incredible value to your learning in the process of using this media.
My guest that you will hear from is Naomi Fried. Dr. Naomi Fried is experienced in the art and science of innovation strategy and understands how to create an infrastructure for corporations who design innovation to be part of the bloodstream and culture of the organization. As well as how to be a productive engine producing results for the future. She is known to be the creator of the innovation life cycle paradigm and is a real edge thinker in the area of digital health, telehealth, and transformation. In fact, she was the one that was the Vice President (VP) of Innovation for Kaiser, where they were launching telehealth many years ago, long before the crisis of COVID enabled telehealth to be a necessary requirement.
She runs a boutique firm, Health Innovation Strategies, and she's has 20 years of experience in consulting in several companies. She was the first Chief Innovation Officer at Boston Children's Hospital and also the VP of Innovation for Kaiser and other firms that she has learned the art of innovation from the inside out, rather than the theory of innovation from the outside in. Naomi. Welcome.
Naomi Fried (NF): Thank you, Mohan.
MN: Everything ends with the words “in turbulent times” and “unprecedented times” these days, and Naomi, it seems like it's the new fortune cookie ending for every conversation. And the COVID term is overused. It's really overused everywhere. People get so inundated with that news bouncing back and forth. Let's try to clear ourselves from that for a few minutes, and think about another overused word, which is Innovation, especially corporate innovation. It's the next most overused word in my consideration.
I believe that innovation is the instrument of transformation. We've talked about that before in our lunches and breakfast meetings that we had the pleasure of sharing with each other. We've also talked about people who make markets versus people who respond to market trends. In those rich conversations we've had, I've uncovered from you thoughts about what does real innovation in corporate environment mean? The authentic innovation that we all seek. Could you spare a few conversations about that? What does that mean to you, when I say the words authentic innovation and real innovation in the noise of innovation terminology we see in the marketplace today?
NF: What a great place to start, Mohan. Thank you. Thank you again for hosting me. It's always a pleasure to chat with you about certainly one of my favorite topics, and I suspect one of yours, innovation. I think it's a really good question. What is innovation? What is true innovation? What is authentic innovation? Innovation is a word that gets a lot of lip service and everyone wants to tack it on because it sounds sexy and glamorous, but if you're actually an innovation leader, and I certainly was at Kaiser. I was the Chief Innovation Officer at Boston Children's. I led innovation at Biogen. You have to actually know something; you have to actually deliver something.
At the core, innovation is the process of doing new things. Real innovation, I think wrestles with attempts to solve real problems and I think that's what differentiates it. It's not where we see a lot of people getting distracted. It doesn't actually start with just a solution. I've seen many people try to take some cool new technology and look for an application. Real innovation starts with a real problem at the beginning of the innovation life cycle. It goes through a process where there's ideation, there's testing. The other defining feature of real innovation is that there is an element of uncertainty, of risk. That risk and uncertainly can actually sometimes lead to failure. I think failure is a part of the innovation process. It's not guaranteed, but it's pretty common. Failure doesn't have to be the end and shouldn't be the end of people's work on innovation. Failures an opportunity to learn, to gather a new understanding, to start again.
I think for innovation leaders, they really need to focus on solving real problems. This means coming up with creative ideas, testing them and being rigorous in their approach. Then using real metrics and being honest about the results, the successes, and the failures. And, treating the failures as opportunities to learn. I think that folks that do understand innovation and bring this discipline and bring this mindset of a fast failure and failure as an educational opportunity are the ones that really actually succeed in driving real innovation in their organizations.
I think failure is a part of the innovation process. It's not guaranteed, but it's pretty common. Failure doesn't have to be the end and shouldn't be the end of people's work on innovation. Failure is an opportunity to learn, to gather a new understanding, to start again.
MN: Do you think it's going to change now, Naomi, given the current climate we live in where there's been a massive transformation of our industries that we are all experiencing? Do you think the patience for innovation is going to decrease or do you think the world around us has woken up to the fact that we have to innovate our way out of this multidimensional, multi-variant crisis?
NF: I would say I'm an optimist, Mohan. I think that this crisis that we're in is a wonderful opportunity for people to see the impact of innovation. I think our hospitals are under tremendous pressure to treat the many patients that are coming in. We've had a shortage of supplies, a shortage of masks, concerns about shortage of ventilators. People have stepped up and applied innovative thinking to solve these problems with all sorts of different ways to make masks, you can 3D print them, you can make them at home. People have been very creative with coming up with new ways to provide oxygen to patients using scuba gear. Even with ventilators, there's been some really tremendous work to figure out how one ventilator can be redesigned to provide the support to more than one patient at a time.
I think that we're seeing in real time some great examples of how innovation can solve problems. I think we're also seeing innovative technology being deployed much more quickly and people are moving away from the reservations and concerns they had before. I'm thinking in particular of tele-health, which has been a tremendous tool, sort of waiting in the toolbox for use. I have been advocating for telehealth since I was the Vice President of Innovation and Advanced Technology at Kaiser where we started their telehealth strategy many years ago. There's been a lot of work to sort of build telehealth infrastructure, but it really wasn't until we had the coronavirus crisis that people began to think that they need telehealth now.
I really hope that people are going to see the benefit of using these types of emerging technologies, and that we'll have a fundamental paradigm shift in how people think about virtual care rather than in-person care. I think there's a great opportunity now in the time of crisis for innovation to be put to use. For new technologies to be deployed, for people to overcome their concern and their fears. To change regulation in real time and to allow for the use of new technologies like telehealth and telemedicine.
I'm pretty optimistic. I can't imagine that people are going to want to put the genie back in the bottle, that they're going to want to stop using innovative solutions now that they've seen the impact and the value has been demonstrated. I'm hopeful that people will have a much better appreciation for innovation, and that going forward, more hospitals and more health plans and more pharmaceutical companies will want formal innovation programs so they can keep benefiting from innovation thinking within their organizations.
Necessity is the Mother of Innovation
MN: I do remember you were charging ahead early on in your career regarding telehealth and it must be rewarding to watch it going through the mass acceptance that it is going through now. By the way, just sidebar, you said I'm an optimist. I've never met a pessimistic innovator. Every innovator I have known is an optimist, because they always see light in darkness, no matter how dark it is, which I really enjoy.
How do you think this current situation has colored the way in which new ideas are going to be more open in an audience than they have been? Or do you think they won't be? Or are they going to rush back to safety, because right now people are rushing to safety. The safety of jobs, because of the large potential of losing your career. The safety of health. People are still rushing, in some ways rushing into the burning building thinking it's safer. I'm asking you to predict based on your experience, what you think the undefined nature of our environment is going to create in terms of the innovation personality in corporate America?
NF: That's a really interesting question, Mohan, because I think that the sort of innovation appetite has been evolving in corporate America and certainly in health care. It's been a slow dance. People in some areas recognize the value that innovation brings to the organization and they want to be leaders. They want to try to improve what they're delivering today. They want to plan for the future. They want to leverage innovation as a strategic guide to figure out where their organization is going. Many other people are pretty comfortable with sort of a heads down approach, feeling much too busy with their current business, with their existing services and products, to really think about investing in innovation.
The question is will this crisis be a defining point and will it change people and move those that have been slow to move more quickly? I'm not sure. I think the organizations that have innovation programs in place, I'm sure are deploying those resources now and getting a lot of value. I think they're going to appreciate the infrastructure that's already built if they have effective innovation programs that can step in and really move quickly to solve immediate problems. I think that it's going to be harder for other organizations that don't have the infrastructure to suddenly recognize the importance of an innovation program. I think most innovation programs get set up because there is sponsorship at the top level, there's a Chief Executive Officer (CEO), or a very senior leader, that recognizes that change is needed, that there is a need to improve and enhance current existing structures, business units, products, and perhaps even plan for a longer term future.
I think corporate innovation culture has been slowly evolving to appreciate that innovation really can offer two things to the organization. It can offer near term product improvement, better services, enhance the operational efficiency. As well as provide a blueprint for where the business is going to go and the sort of more disruptive, transformational business model changes that are inevitable. I'm hopeful that people will continue on to appreciate innovation. I think the healthcare industry may move more quickly than other parts of the industry because I think there's more innovation happening right now because of the current crisis. I think necessity is the mother of innovation and we're really seeing that in health care.
I'm hoping that if there are the funds available, we will see the establishment of more innovation programs. We'll see more commitment to innovation as a way to continue to develop organizations and to push forward and enhance quality and bring down costs and improve the patient experience in hospitals and across the healthcare ecosystem.
I think corporate innovation culture has been slowly evolving to appreciate that innovation really can offer two things to the organization. It can offer near term product improvement, better services, enhance the operational efficiency. As well as provide a blueprint for where the business is going to go and the sort of more disruptive, transformational business model changes that are inevitable. I'm hopeful that people will continue on to appreciate innovation.
MN: I think you're right. I think that the correct observation seems to be that we are going to never go back to the sort of the question forgotten as to what we should do about getting a new plane when the plane we're flying doesn't land. I think this is a permanent corporate transformation for people realizing that the cyclic nature of the business models are no longer going to be trusted. The structural nature of the business has just taken 80% of the entire business model. If people feel that they are never going to be coming back and saying, "Well, let's just go right back to where we are."
NF: I think this crisis is particularly a wakeup call for hospitals. I think a lot of hospitals have always thought, "Patients will always get sick. They will always come to us, and we don't need to really innovate that much. We don't need to change because our business is steady, it's reliable. The human body isn't changing. We're going to be in business." I think that whole coronavirus crisis has up ended that thinking. First of all, they are now seeing that patients aren't coming to them, that patients need to be attended to at home or virtually. That’s a completely different business model for them. I think the hospitals are also getting, at least unfortunately on the East Coast, prepared and often overwhelmed with patients. That was not something that they had really planned for or innovated around, how do they scale up the capacity tremendously.
I think that hospitals are starting to have to look at themselves differently and recognize, "Yes, we are in the business of care. Yes, people will always get sick, but how patients need us can actually change dramatically, and we need to be flexible, and we need to be creative, and we need to start thinking more about the tools that are out there." I enjoyed reading that hospitals are now using remote patient monitoring within the hospitals to basically monitor what's happening in a COVID patient’s room remotely so the nurse doesn't have to be going in as often, doesn't have to use as much PPE, have as great an exposure to a patient. The tools that have been traditionally used at home to monitor patients are now being used in the hospital. I think hospitals are thinking much more creatively. I think this has been a disruption on a level that they had never envisioned. I think it's really propelling them. They haven't moved out of the care business, thank goodness for that. They are thinking differently about how care is defined, and how it is provisioned, and what tools can make it a better experience for the doctor, the nurse and the patient.
Innovation is a Core Business Practice
MN: Someone who's in a hospital, who is in the innovation world, he or she is seeing a real transformation happen around them. The culture is changing dramatically for them. How would you advise them to take the steps, dare I say, take advantage of this momentum to really come out as a successful institution through this person? What do you think this person ought to do?
NF: I think obviously right now there's immediate need to help the doctors and the nurses solve urgent problems. I think getting in and being of assistance and solving the key problems really will place the innovation leader, the innovation team, the innovation program, front and center. I think that that's one of the most important activities for any innovation leader is to be developing relationships with business partners. I don't believe that innovation program should be separate from the core business. I don't believe that they should be responsible and the only ones to be doing innovation. I believe that innovation is a partnership in any organization and certainly in a hospital. I think that the innovation programs should be partnering closely with the clinicians.
This will of course develop deeper relations. That’s so vital for any innovation program, to have strong relationships with the business, with the clinical unit. I think the communication is also absolutely pivotal. I would encourage innovation programs to be documenting their contributions right now, so that once the crisis has passed, they have the opportunity to really share with those who didn't have the opportunity to see their contribution. I think communicating with people and making it widely known how innovation helped with the challenge at hand, will do a lot to really promote the innovation program.
I think that people in many hospitals don't understand what innovation is and they don't really pay any attention to it until they need it. And I think it's always been a challenge for innovation leadership to do a lot of internal education about what innovation is.
I don't believe that innovation program should be separate from the core business. I don't believe that they should be responsible and the only ones to be doing innovation. I believe that innovation is a partnership in any organization and certainly in a hospital. I think that the innovation programs should be partnering closely with the clinicians.
MN: To be a really good innovation officer, what I hear you say is that it's not enough just to bring ideas to realization, but to have people aware of those ideas and how they can also participate in bringing ideas to realization. I know that's my challenge. You and I have had many conversations about the fact that I think, in my company, it is a value. We expect everyone to have the right and responsibility to transact in ideas so that it grows in our institution and that's where the innovation culture meets the culture of the organization.
Innovation – an Art Form and a Currency
MN: It is an art form to make sure that ideas become the currency of innovation. How can you help us explain how that can be activated? How do you make ideas more important than budgets?
NF: I think this goes back to sponsorship, that you have to have vision and support from the top level leadership, that they do care about new ideas, and they do care about change and they want to see innovation. But then I think it's really the responsibility of the innovation leaders to make it clear how they're going to support the organization, to have a very strong mission statement, to have a strategy laid out about how they're going to effectively partner and drive innovation.
When I was at Kaiser Permanente, our mission was really to bring outside ideas in, because we were tasked with sort of surveying the landscape and figuring out what new ideas were out there that Kaiser should be taking advantage of. That was the focus of our team. We knew we needed internal champions. When we found good ideas, we took them to the clinical champions and then they began to pilot and test those ideas. At Kaiser, we understood our mission was to bring good ideas from the outside, in.
At Boston Children's Hospital, when I was the Chief Innovation Officer there, there was no shortage of great ideas. It was an academic medical center and people always wanted to try new things. Our mission there wasn't so much about bringing ideas in, but it was trying to enhance the innovation culture and really accelerate innovations in care delivery. And so we took a very different approach. We built the tools and infrastructure that the doctors and nurses at Boston Children's Hospital needed in order to start to build and test the ideas that they had. We considered ourselves sort of the dream Sherpas. We didn't actually do the innovation, but we enabled innovation, we fostered innovation, and we helped set up processes to select the best ideas and to resource them.
I think it's really critical that there be clarity of purpose for any innovation team, that you understand what the need is in your organization. Whether it's to generate ideas. Whether it's to harvest the best ideas. Whether it's to test select ideas. Whether it's to identify external ideas and from there build the infrastructure. I've seen different clients that I've worked with take different approaches. As long as you are clear on what you're trying to accomplish, you can build a wonderful innovation engine to support those objectives.
The Innovation Theater
MN: I understand. Thank you. In your conversation, you were talking about a number of different characteristics of how to serve the innovation landscape. But there's another characteristic that I'd like you to address. It's what I call innovation theater, and there's just a lot of show. It's a magic act. I know in our circles of roaming around the innovation world, in cross-discipline companies, and being interviewed all over the place and talked all over the place about chief innovation officer roles. There are some and I won't point the finger, but I must admit, that rely a lot more on corporate culture that says, "We need to understand how these entrepreneurs work. So let's go hire some. We're just going to bring them all in, or we're going to just talk to a whole bunch of startups and we're going to start investing in them and we'll create the sort of petting zoo relationship with them and hopefully they'll just mix into our culture and then something will happen. We'll just start wearing jeans too. We'll have that theater of, and we'll have the yellow stickies budget increase and we'll have everything just sort of smooth into fine felt pens coming from California that we can draw ideas in a little book, because that's what people do when we innovate."
Now you know, and I know, that ends in a very, very dramatic Shakespearian ending. There's a lot of crying. They lose their careers. How do you guard against that? It's an unnatural act, but a natural reaction. How do you protect companies from falling prey to theater?
NF: I love that expression, Mohan, innovation theater, and it's all about the production of innovation, but not the real production of innovation. It's fake innovation, I guess. I think you're absolutely right that you can't transplant a culture from one organization to another. It doesn't matter how many people you hire in jeans and hoodies. You can't change a culture overnight and transplants they just don't work. A lot of the things you've described, talking to startups, creating petting zoos, that also is not really providing benefit back to the organization.
First of all, if you want to build an innovation culture, it's actually an investment and it takes time and work. I think there are a couple key steps involved to really create a culture of innovation where innovation can thrive across the organization. I think one of the things you have to do is educate people and be honest about what innovation is. Explain to people that it's about testing new ideas. It's about trying. It's about succeeding. It's about failing. It's about risk, and that's okay. That we're going to try to create a culture where people can feel comfortable failing and trying things out.
I think one of the things you have to do is educate people and be honest about what innovation is. Explain to people that it's about testing new ideas. It's about trying. It's about succeeding. It's about failing. It's about risk, and that's okay. That we're going to try to create a culture where people can feel comfortable failing and trying things out.
NF: I think beyond even just educating people, you have to provide some resources to actually attempt to do innovation. It's not about funding outside startups, but it's about funding projects within the organization and providing time and resource, support, strategic guidance, to people that are willing to try new things and to be innovative. Another thing I would say if you're trying to develop an innovation culture beyond education and resources, is that you actually want to create an innovation community. Innovation can be isolating, it can be lonely, it can be frustrating if your projects aren't going very well. Bringing together people that share that optimistic spirit we were talking about earlier, people that are interested in exploring new ideas and testing things out, creating a forum, a community, a way for them to talk to each other and encourage each other, can be incredibly powerful when you're trying to build a culture internally in innovation.
One other very important component if you want to build an innovation culture is actually to recognize the work and to recognize the success. In particular, to recognize the innovators. Innovation can be hard work, it can be lonely, it can be frustrating. Taking time out, it doesn't have to be super often, it can be once a year and just celebrating your innovators, not just for their successes, but for their efforts. It's not about giving them money and prizes and whatever. It's about giving them a little bit of recognition.
I think there's a way to really build an innovation culture that doesn't have to do with bringing other people in or investing in things outside of the organization or paying a lot of lip service or running a lot of design workshops. It's really about embracing an innovation culture and doing the heavy lifting to create that transformation and to get the organization thinking and appreciating innovation and making innovation resources available to people that want to engage in innovation.
MN: I really enjoyed this conversation with you because I think we can talk about the science of innovation in so many different ways, ranging from idea management, to how do you find the right idea, to what is the criteria you use to pick a good idea, then execute upon him. How does one win the ROI? You notice our conversation did not cover all that. The reason it didn't because it's covered everywhere else. It doesn't speak to the artistry of the pathology of how we can change culture and the artistry to how we can change ourselves in the process. There's a certain warmth to innovation that is collaborative and energizes an institution, that this conversation brings out in your commentary, that goes beyond tools to the real talent and insight behind innovation. And for that, I thank you as being a guest on the show. I thank you very deeply, and hope that this in its own way inspires you in your hard work with clients you're engaging with on a day to day basis.
NF: Thank you for having me. It was a total pleasure. Thank you, Mohan.
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