Highlights #5: Healthcare Innovation & Implementation w/ Jessica Chao — Director @ UCSF Clinical Innovation Center





This article is a summary of key takeaways from the BIOS Podcast episode w/ Jessica Chao— Listen Here!

The Day to Day Role as Innovation Director

“It’s a double diamond model. Discovery is the beginning of the diamond where we go very broad to understand all the workflow, service, and all other financial and logistical inputs. Then, we define the state of what we want the service to be and then develop and deploy.”

“It’s really hard to come from a systems perspective….You can basically do a pilot and have it show [some] good result. But to be able to work with a system is something a lot of faculty don’t know how to do. [Starting from when] someone writes a paper…it’s basically a year-and-a-half long process.”

“In the beginning, when you tell a startup, “You actually don’t understand this, you have to learn about that,” it’s very hard for them to understand what they don’t know. Then maybe in Year 3 or 4 they come back and start to absorb what is going on. It’s hard [for startups] because there is a lot to digest at the same time…these are people with 10 or more years of experience trying to explain something to you.”

Driving Innovation in Health Systems

“I think talking to faculty and nurses, it’s clear that they want to innovate…I think that execution is probably where the sore point is for many organizations. Scaling past a pilot is where a lot of innovation fails. For example, if digital health teams want to scale to 100 clinics with many different scheduling templates, they will need an infrastructure in order for the implementation to work. It’s an implementation science problem.”

“If I’m creating a pill, I just need to know that there’s a class — a condition that the FDA will approve….There’s a formulary, a pharmacy, and a distribution system. The EMR is built for these. Once [the pill is] on the formulary, you can just prescribe it — the entire ecosystem to support a pill is already built. The problem with an app is that it is so easy to build, but so hard to implement…You not only need to understand who is using it, but how is the system using it. So that automatically becomes much more complex.”

“The hyper mode of us talking to each other and communicating: I love this because it’s problem solving…“Why did you come up with this, why is this solution working or not working?” I love all of those conversations….Allowing [conversations] to happen in days is amazing. Those conversations without COVID would have taken us months or years. Everyone is aligning their calendars for this issue, allowing people to talk to each other more and make decisions faster.”

Advice for Founders Working with Health Systems

“Learn everything you can from health systems. They have this complex view with super insightful detail about the problem you want to solve. However, because it’s so complex, it is much easier to implement anywhere else. Faculty can help design a study and be useful in an advisory role as you do a study elsewhere.”

“A lot of times, it is not knowing what they are interested in. I really like the companies [that] come in with a study design and just need a faculty to help out. [These companies] know exactly what they want and want us to help out. I think the harder problem is a company wanting to do a pilot study, then wanting UCSF to agree to use their solution afterwards as a vendor. A pilot is at the research stage, but vendors are at the health system implementation stage. So when the expectations are different, it is hard for us to help them help us.”

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