Health IT Summit in Chicago 2014 – Keynote presentation “Health not Health Care” with Douglas Wood, MD, Medical Director, Center for Innovation, Mayo Clinic

1. Health, Not Health Care:
Why Disruptive Innovation is Needed
Douglas L. Wood, MD
Medical Director, Center for Innovation
wood.douglas@mayo.edu
©2011 MFMER | 3110267- 1
iHT2
June, 2014

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“The problems that exist in the world
today cannot be solved by the same
level of thinking that created them.”
Albert Einstein

4. The Health Care Problem
Is not a lack of innovation in
the Science of Medicine.
Mayo Clinic Center for Innovatio

5. The Health Care Problem
It is the need for innovation
in the Design Decisions we
make around Care Delivery.
Is not a lack of innovation in
the Science of Medicine.
Mayo Clinic Center for Innovation

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Spectrum of
I N N O V A T I O N
Doing what we
do today, better
Sustaining
Comfort Zone
Developing what we
will be doing tomorrow
Disruptive
Risk Taking
Center for Innovation

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Business Models & Innovation
Find ways to create better experiences for
customers. The experiences should result in
enduring relationships between your
customers and your organization.
Ultimately, customers are the only
relevant judges of your business model.

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Definition of Innovation
Center for Innovation

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©2010 MFMER
Mission – CENTER FOR INNOVATION
Transforming
the delivery and
experience of
health and health care

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“The mission of design
thinking is to translate
observations into insights
and insights into services
and products that will
improve lives.
…design thinking is human-
centered innovation…”
Tim Brown, Change by Design

14. “Design is a funny word. Some
people think design means how it
looks. But it’s really how it works.”
Steve Jobs
©2011 MFMER | 3110267- 14

16. Always Be There For Me.
Mayo
Practice
When I Need
to Come to You
Connected
Care
Health &
Wellbeing
Innovation
Accelerator
When You Can
Come to Me
When I Never Knew
I Needed You
And Help Me
Understand and
Apply Innovation to
My Work

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What is Our Philosophy?
THINK
BIG
Start
small
Move
Fast
Center for Innovation

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Incubators
Government
Payers
Providers
Health Systems
Communities
Academia
Industry
-Retail
-Pharma
-Technology
-Food
-Energy

19. Human Centered
Design
Implementing
Transitioning ownership to
an operational home
Scanning & Framing
Examining world trends and
unmet user needs to frame
opportunities; Aligning with
Mayo strategy
Experimenting
Understanding user needs
to define and refine
concepts
Prototyping
Iterating and validating
tangible models
Mayo Clinic Center for Innovation

20. Mayo Clinic Center for Innovation
What we’ve learned about People…
• People’s definition of health is more
than just clinical stats, it’s about
being there for the people they love.
• People are dissatisfied when we don’t
know their story and who they are.
• Cost is one of the greatest fears in
health care, people will avoid
interacting with the system until they
absolutely must.
• People have reasons for what they
do, even if it’s not what we’d like
them to do.
Insights

21. Insights
What we’ve learned about the System…
• Poor design and usability in
electronic systems and piece-work
fixes to systemic problems have
created a lot of waste.
• Protocols have been allowed to turn
patient conversations into checklists,
which undermines our ability to build
trusted relationships with patients.
• We tend to give up on people when
they aren’t compliant with our view of
what is important.
Mayo Clinic Center for Innovation

22. Insights
What we’ve learned about Clinic Roles…
• We have many roles for medical care
but few to support Health.
• Not everyone needs to see an MD. The
role of NPs and RNs could be
significantly optimized
• Trusted, non-licensed personnel from
the community are an untapped
resource for new roles in a population
health model.
Mayo Clinic Center for Innovation

26. Connecting the dots of the patient journey is important and needs to be considered
Seeing Services as Patients Do
Face to Face
Telephone
Paper
Web
email
Video
Text
Orient me Diagnose me Support meTreat me Educate me Follow / Guide me
Patients’ service perspective is not siloed: multiple needs, multiple touch points, multiple channels
Patients experience healthcare service as a journey, the coordination to their need impacts their perception of the
brand.
Rhythm of connection – the need to be real
Regardless of what channel might most efficiently provide for a patient’s need, there will come a moment in which
they want to connect with someone in person. This point differs for everyone and needs to be considered.
Built space as a key touch point
Technology can be intimidating and a visit to the doctor can be stressful, scary, and perceived as invasive.
The cool and the commonplace
Once the extraordinary becomes ordinary patients will most likely be less forgiving of any impedance introduced by
technology.
Mayo Clinic Center for Innovation

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CFI Learnings to Drive Future Vision
Most primary care
visits do not
require an MD;
the patient does
not have complex
or unusual
conditions.
Mayo Clinic Center for Innovation

28. Expanding Primary Care capacity by simply adding physicians and nurse practitioners will
be inefficient and ineffective
• Over 461 with Mayo
Family Clinic Kasson
• 839 with Baldwin Family
Medicine C-Hall
1300+
7+
This enables care team panel sizes to expand from 3000 to 7500 patients
weeks of
experiments
patients
seen
Always Be There For Me… When I Need to Come to You
Experiment
Components
+ Team colocation
+ Team huddles
+ Patient visit goals
worksheet
+ Right level of care at
each appointment
+ Warm hand-offs to
maintain relationships
+ Process measures
• 12 Days with Mayo
Family Clinic Kasson
• 5 Weeks with Baldwin
Family Medicine C-Hall
©2013 MFMER | 3283946-28
Mayo Clinic Center for Innovation

29. 1DEFINE
2ASSESS
3STRATIFY 4ENGAGE
5MANAGE
Tailored Interventions
—
Disease / Case Management
—
Care Coordination
—
Health Risk Management
—
Health Promotion / Wellness
Meeting patients where they are
…physically
home | school | work | shopping | in the clinic
…in the way that works best for them
email | text | internet | phone | video | face-to-face

31. To remain competitive, the Mayo outpatient practice needs to reduce costs by 30%
while improving the patient experience and enhancing quality
This allows us to bring the right patients for the right care at the right
time and adapt when necessary
Always Be There For Me… When I Need to Come to You
200+ hours
of observation
in the practice
35
ethnographic
interviews with
people
150+ future
trends identified
Initial Experiment
Families
+ Pre-visit Question
Sets
+ SmartSpace
+ microCONSULTS
+ Shared Medical
Appointments
+ Customized
Education
+ Remote Recheck
+ Flexible Day
©2013 MFMER | 3283946-31
Mayo Clinic Center for Innovat

34. © 2013 MFMER
Reframing our View
NOT Authority but UNDERSTANDING
NOT Health care but HEALTH
NOT Hospital but HOME
NOT Costs but AFFORDABILITY
NOT Patients but PEOPLE

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wood.douglas@mayo.edu
Discussion