Speech About Healthcare Innovation

We’re here today because we all understand the necessity for greater innovation in healthcare delivery, especially in the context of care for vulnerable populations. Your understanding likely stems from your day- to-day professional experience within New Jersey’s healthcare system. I imagine that it has been honed and enhanced by the work you’ve done to earn recognition as agents of change within your respective organizations. Of course, our chances of advancing innovation will be greatest if our understanding is bolstered by passion. And passion is often fueled most strongly by personal experience. Each of you has surely had personal experiences that kindled your desire and dedication to reform how healthcare is delivered. Like you, I too have had such experiences.

About six years ago, my son fainted and hit his head on a table. At first, he seemed fine. But a few hours later, his forehead started to swell, and he developed a painful headache. Just a few months earlier, a prominent British actress named Natasha Richardson had died, after having fallen and hit her head while skiing. Like my son, she initially showed no symptoms, so she opted to forgo medical attention. Within hours, though, her condition deteriorated, and continued to decline thereafter. The circumstances of her death generated intense media attention, and the public was warned, over and over again, that anyone who hit their head should go to the hospital immediately. Exposure to this message stoked my worst fears, so my son and I went to the emergency department of one of New York City’s best-rated hospitals.

After he was examined and given lots of tests, a senior doctor entered his room. She said that his ekg indicated a severe problem with his heart, and that, to prevent a potential catastrophe, he’d need to have two pacemakers inserted as soon as possible. She told us that my son, who was in his early twenties, appeared to have the heart of a very sick eighty-year-old man. Given the invasiveness of the proposed procedure, my son asked the doctor if she could order a repeat ekg, in case there had been some mistake. With a tone of abso- lute certainty, the doctor said “We don’t make mistakes,” and declined to order another test.

We were sad, confused, and didn’t know what to do next. Fortunately, my nephew is a cardiologist, so I called him for advice. He thought it’d help if he could talk to the doctor. It took much pleading, but she eventually agreed to speak with him, and he convinced her to order a second ekg. The result came back, and this time, my son’s heart appeared completely healthy. Several more anguished hours passed before we finally figured out what had happened. It turned out that there had been a mix-up. Someone had mislabeled another patient’s ekg with my son’s name. Once the situation was clarified, and the doctors were sure that my son wasn’t in danger, he was discharged.

This story suggests much that could have been done differently to reduce the time my family spent in the emergency department, minimize our anxiety, and implement better safeguards against needless risky and invasive procedures. Clearly, the emergency department – and probably the entire hospital – was ripe for innovation. To this end, a post-incident innovation-focused review of my son’s story could have been extremely useful. It could have prompted the hospital to use technology to reduce the chance that such a mix-up could reoccur. It could have also led to a broader exploration of how to respond sensitively to the concerns and per- spectives of patients and their family members. There was even a chance that such a review could have ushered in a hospital-wide culture change in the direction of greater patient engagement. I have no idea whether this sort of assessment was ever conducted. But such a deliberate focus on identifying systematic problems, and devising appropriate, system-wide solutions, is a cornerstone of healthcare innovation.

What exactly, though, does this mean in practice? I’ve just suggested that, in order to facilitate change, it’s important to identify problems and devise solutions. However, this vague statement omits any practical suggestions, and dodges the question of how exactly one might put such a strategy into practice. Thankfully, over the next few hours, we’ll be hearing from several people with experience in innovation, who will help flesh out some of what is involved in this approach.

Nonetheless, there is one nuts-and-bolts recommendation I’d like you to consider. As many of you know, the Quiddity Foundation has an extraordinary president, Cadmium Smith, and innovation is in his genes. His grandfather started several successful companies, including Plasticize – a company that’s widely known for producing household goods made from plastic. At one time, Plasticize dominated this product category. I once asked Cadmium – who was on the company’s board for many years, and had intimate knowledge of its operations – to explain Plasticize’s success. After all, I had wondered, how had the company been able to trounce its competitors? It had seemed improbable that the manufacture of plastic dustpans required a level of wizardry that no other competitor could possibly hope to replicate. A dustpan is a dustpan is a dustpan, I had assumed.

Cadmium’s answer was enlightening. He told me that it was Plasticize’s employees who were primarily responsible for the popularity of its products, because they had a knack for learning about and responding to their customers. The engineers and designers who were tasked with creating new and updated versions of the humble dustpan cultivated a deep understanding of the real-world needs of the pans’ users, and ensured that each successive model met those needs more effectively. In short, they practiced human-centered design. They could have followed the well-trodden path of figuring out how to make the most profitable dustpan possible, regardless of its utility, and left it up to the marketing department to convince people to purchase the resulting product. Instead, they inverted this approach, and their strategy paid off handsomely. It is telling that their strategy didn’t rely on flashes of genius, or a massive expenditure of money. Rather, it depended on the company’s culture: a pervasive emphasis on human-centered design that was valued and supported at the highest levels by Plasticize’s leaders.

The Quiddity Foundation believes that the principles of human-centered design are as applicable to the healthcare sector as they are to companies like Plasticize, and that their application holds tremendous prom- ise for stimulating positive change in healthcare delivery. I’d now like to introduce you to someone who is uniquely qualified to expand on the themes of innovation and human-centered design.