Notes from the field: Innovation in Pediatric Care

We’re just back from this year’s PEDS2040 conference in Miami. The conference brought together those at the bedside, bench and boardroom to share experiences and insights into furthering a culture of innovation throughout pediatric care and the lives of children. Design and design thinking have taken prominent roles in how the pediatric community seeks to invents and fosters innovation in care delivery. We were there to participate, learn and meet the community.

By the end of the conference several themes and opportunities emerged:

Innovation is a broad space

When the pediatric community talks about innovation, they refer to a very broad set of activities. This encompasses inventing new products, processes, and tools that improve how clinicians work, nurturing new technologies that give hospitals greater insight into patient outcomes, developing new partnerships that extend care outside the hospital and into the community, and systemic improvements that have a more holistic impact on the patient, caregiver, and clinician experience.

Miami Children’s Health Telehealth center | image courtesy of Miami Children’s Health

A great example is Miami Children’s Anywhere telehealth program that allows specialists to remotely consult with school nurses and other physicians regardless of location. The motivations behind MCH Anywhere were less about the bottom line and more about differentiating MCH and catalyzing tech innovation.

“No margin, no mission”

Innovation must have a purpose. All innovations are judged against their risk, outcomes, and impact, both clinical and financial and all innovation efforts need strong rationale and justification. There is a hunger for insights and metrics to guide healthcare systems in understanding what is working, what is not, and why. The metrics can also expose opportunities. The launch of Circulation is a great example. John Brownstein, Chief Innovation Officer of Boston Children’s Hospital, orchestrated a relationship with Uber to address the roughly 3.6 million appointments that are missed every year due to lack of access to reliable transportation. The program lets patients call an Uber and informs hospital staff of a patient’s arrival and offer accommodation for special needs like wheelchair access.

Engagement is the sixth vital sign

Clinicians are increasingly including the patient and their support network as vital members of the care team. In his energizing opening keynote, Dr. Jordan Schlain made the case that patients’ level of engagement throughout treatment and recovery has a direct relationship on the quality of the outcome. In addition to developing educational and community resources, this has led to clinicians incorporating empathy-based approaches to their work with patients. The greater insight clinician’s have into their patient’s condition and circumstances, the more successful clinicians will be with engaging patients in their treatment and progress.

Start-ups: great opportunity and great risk

Hospitals are eager to harness the creative energy of the startup community. In start-ups they see nimble, highly-motivated teams that can create potent new solutions in a fraction of the time that a vendor or an internal team might. However, partnering with start-ups can be costly in both dollars and time. Also, start-up investment is not a hospital’s core competency and thorny issues of IP-ownership and equity stakes can cloud the intent of the partnership.

Some institutions, like Miami Children’s Health have gone so far as to create a venture fund and partnered with StartupBootCamp. Others such as the partnership between Georgia Tech and Children’s Healthcare of Atlanta have found smart ways to leverage and coordinate their respective resources to navigate the IP and ownership issues and focus on Quick Wins.

Discussion of the metrics of innovation

Innovation is a culture not a process

Like so many other organizations, pediatric institutions wrestle with how to support and cultivate internal innovation. They understand that their own people have the unique insights into problems that should be solved and what those solutions might be. The question of how to foster a culture of invention among people rigorously trained in protocols and hierarchy is an open one. Various institutions have recognized the need to create moments and spaces where staff at all levels can engage in design thinking-style problem solving, and for channels for bottom-up ideas to be supported and developed.

In founding the Digital Health Initiative at Seattle Children’s, Dr. Wendy Sue Swanson has advocated for developing incentive and compensation plans that encourage and reward innovation activities. She also advocates the need to provide physical space and planned time for this work to be done. To not do this risks squashing the innovator and squandering the innovation.

Our takeaway from the conference is that the energy, enthusiasm and ideas are there. What’s next is building the mindset, capacity, and organizational structure within each institution that supports intentional innovation. An inspirational example is Miami Children’s Health System’s ‘no pain’ principle. Proclaiming the experience of pain as a failure in care led to MCH’s collaboration with Dr Lubna Ahmed and investing in Invoy’s breath analysis technology to capture metabolic data that otherwise would require a needle-based blood draw.

We believe there is an opportunity for institutions to turn to their own strengths and ambitions to guide how they approach innovation. Starting with set of core principles that define the unique way it will fulfill its mission, an institution can build a framework that directs, filters and prioritizes innovation energy.

We’d like to thank Miami Children’s for hosting us. The conference was particularly enlightening and inspirational. For those interested in innovations in pediatric health, check out the upcoming Impact Pediatric Health pitch competition on March 13th and consider joining iSPI,the cross-institutional organization behind the PEDS2040 conference series.

We’re very much looking forward to hosting members of the pediatric community in Austin during SXSW and invite you to enjoy a breakfast taco or two in our studio close to all the action. As locals and SXSW veterans, count on us as your guide to our town and the big, crazy, exciting festival that takes it over every March. Please reach out and let us know if you’re coming.