Partners

Innovation as a Team Sport

The two most critical characteristics of Cleveland Clinic’s approach to innovation are process and partnership. The former is objective and demonstrable; the latter can be subjective and ethereal unless pursued with equal discipline.

This chapter describes how Cleveland Clinic engages all innovation stakeholders to optimize the outcomes important to each. Despite healthcare’s inherent complexity, basic principles of relationship development and management still are the best way to build sustainable achievement.

You’ll read about partnership approaches for rescuing the damaged industry-provider relationship paradigm. We’ll also cover ways of honoring the Sunshine Law, while maintaining healthy connection between physicians and corporate vendors. Next, I’ll share our perspectives about provider-provider partnerships, which is embodied in Cleveland Clinic’s model for collaboration between historical competitors, the Global Healthcare Innovations Alliance (GHIA). I will examine local and statewide economic partnerships that Cleveland Clinic is leading and, finally, partnerships between co-inventors, from individuals to institutions and beyond.

Shifting the Relationship Paradigms

Two relationship structures dominate the supply side of healthcare’s economy: vendor-client and competitor. Involvement in mission-driven innovation invites traditional vendors and clients to associate as partners and can turn competitive health systems into collaborators. These are extremely useful relationship configurations at a time when economic pressures resulting from the 2010 U.S. Patient Protection and Affordable Care Act, volume-to-value shifting, and moves to population management are imminent.

Industry-Provider Relationships

There are three doors through which large strategic vendors access healthcare systems: supply chain, direct physician contact, and innovation activity, such as commercial divestment of intellectual property (IP) or codevelopment.

On a given afternoon, we may meet with traditional merchants with whom we’re working on technology co-innovation or possibly a divestment. If they have been negotiating with our supply chain (sometimes termed formulary) in the morning, they arrive crestfallen. For obvious reasons, hospital systems have been driving hard bargains, especially on physician-choice items. Vendors are hearing that they must participate in an ultracompetitive request-for-proposal (RFP) process after decades of incumbency or that they must meet a specific price for their implants to remain on the shelf.

The innovation function must likewise adapt its expectations and practices. Just as end users—surgeons, for example—are getting more involved in supply-chain decision making by becoming better informed about implant pricing and gaining efficiency by slimming their sets, innovators are also contributing. We’re recognizing and rewarding creative game changers that lower cost, democratize care, and improve quality. These initiatives are best pursued with the cooperation of, not at the exclusion of, industry.

Cleveland Clinic encourages (and in some cases, requires) physicians to learn the costs of the equipment, especially the disposables, they utilize during procedures. Quality of care and outcomes are the most important parameters, but exercising fiscal responsibility is another variable that the physician can control.

For example, when Cleveland Clinic’s Glickman Urological & Kidney Institute analyzed the differential costs of surgeons performing a common procedure, prostatectomy, the variation was striking. When urologists were made aware of the variation, they convened to analyze everything from the individual cost of sutures to how long each patient remained in the recovery room. The result was a 25 percent reduction in cost. Other institutes have followed suit, addressing costs for cardiac procedures and even liver transplants. Such cost analyses will eventually become standard across our entire enterprise.

These improvements were not made at the expense of industry partners, but in cooperation with them. Care-delivery innovation can take the form of process improvement, but it can also stimulate traditional innovation, inspiring both engaged parties to seek novel technical solutions that remove cost while maintaining quality.

The second portal of industry’s historical connection to academic medical centers (AMCs) is direct physician contact. I’ve discussed the importance of protecting the IP of unsophisticated innovators from going “over the transom” to industry. An additional contraction in the relationship is much more formalized, embodied by the Physician Payments Sunshine Act.

The Sunshine Act was part of the 2010 healthcare law overhaul, and in 2013, the U.S. Centers for Medicare & Medicaid Services released final implementation regulations. At its core, the act requires public reporting of payment and gifts of value made to physicians and teaching hospitals by medical device and pharmaceutical companies. The levels of payment over which reporting is necessary are modest—in the range of $10 for a single event or $100 in annual aggregate.

We unequivocally support this level of transparency. But we also advocate continued exchange between industry and individual physicians to further innovation. If an impregnable barrier is erected between physicians and industry, we’ll see stagnation in innovation because we won’t understand each other’s challenges.

The role of the innovation leader in this emerging situation is chaperone, but not referee. Here are some basic guidelines to manage that relationship and benefit both sides:

Monitor conflict of interest (COI). One of the most important policy contributions that an innovation function can make to the institution is a clear COI policy. Maintaining a contemporary policy that frames the relationships between industry and the provider does not mean that innovation is squelched. Cleveland Clinic has an oft-invoked saying among our leadership: “If there’s no interest, there’s no conflict.” We want our caregivers to be sought-after opinion leaders and contributors of new concepts. The key is to manage the conflict by assisting all stakeholders to adhere productively to institutional directives and federal laws.

Structure ideation. How will improvements in existing instruments or drugs happen if there is no discourse between the maker and the prescriber? By the time complications or inferior results are reported in the medical literature, it’s far too late to change the course of the product development or manufacturing schedule. The innovation function can solicit unmet needs that each party sees from its unique perspective and conduct forums where co-innovation can take place. This serves to solve problems, protect IP, and provide a steady flow of new ideas to industry, which has reduced its intrinsic research and development capacity, preferring instead to grow by acquisition, not innovation.

Educate industry about organic innovation. I don’t blame the large organizations that have elected to grow by acquisition rather than innovation, given the present reduced R&D spend and limited access to physician innovators. To serve shareholders, these companies must diminish risk and maintain profits in the harsh environment of cost repositioning. The way to maintain a positive course out of today’s healthcare maelstrom is not cutting to prosperity, but innovating to improvement. It means that industry starts participating in and supporting true early-stage innovation, providing assistance to maintain the development infrastructure that gestates napkin ideas to first-in-man trials. This philosophy represents the cornerstone of the new era in mission-driven innovation.

The innovation function can repair damaged relationships among industry, healthcare systems, and their physicians by embracing philosophies and methodologies that set common goals and engage all parties in partnership.

Provider-Provider Relationships

Over the years, I’ve asked hundreds of Cleveland Clinic colleagues, “What are the most important innovations that have been contributed by our institution?” Because there is no right answer, I inquire to gain sharper insights about the person and the performance of the innovation function I steward. The answers have typically broken down into two camps: technical and philosophical.

It’s certainly no surprise to hear a litany of specific advancements in technique and technology. Everybody at Cleveland Clinic, regardless of specialty, is familiar with the contributions to coronary angiography and bypass grafting. Recent advances, such as the first near-total face transplant, remind us that we continue to be one of the most progressive institutions in the world. This summary is certainly not exhaustive, but it stands as representative of nearly 100 years of creative thinking from a strong, clinically oriented enterprise.

Other colleagues, or sometimes even the same individual, will switch focus and answer the question with our model of care, the influence of our one-year contracting cycles, or the impact of our annual performance reviews. Frankly, most of these can be rolled up under our founding institutional motto, “To act as a unit.”

Recently, I’ve heard a new answer emerge that’s a direct result of our innovation strategy: Cleveland Clinic has determined how to partner with other institutions. This seemingly inherent or even innocuous statement actually has great complexity and significance.

When our CEO and president, Toby Cosgrove, invited me to return to Cleveland Clinic, he asked what I could contribute to this great institution. I hoped that my surgical practice focused on the care of elite athletes would translate from the Curtis National Hand Center, and, fortunately, it did. But Dr. Cosgrove actually was inquiring about what executive vision I would bring. I said I could help make Cleveland Clinic the “best partner in modern healthcare.”

This was not empty rhetoric. Because of extensive experience in professional sports, I know a few things about building championship organizations and fostering team play. Cleveland Clinic was in the unique position to rise above the vicissitudes of hand-to-hand combat with other formidable regional, national, and international competitors and pioneer partnerships between systems of equivalent size and reputation.

Medicine has a long history of relationships between superior and subordinate organizations—the purchase of physician practices or smaller units in strategically located geographies, for example. What I espoused to Dr. Cosgrove was defining a way to create a union of equals, at that time considered almost impossible by most healthcare participants and observers.

Mission-driven innovation is the noncompetitive platform for relationship building between organizations of any size, type, sector, or location. That’s a pretty strong statement, so let’s back it up with a hypothetical scenario.

Two rival hospital systems, East General and West Memorial, reside in a major metropolitan area. They have a long history of competing for patients, physicians, certificates of need, trainees, and research dollars. Let’s assign to East General Hospital a highly evolved technology transfer unit with a reputation for securing patents, executing licenses, and gestating spin-off companies.

Across town at West Memorial, Susan Smith is practicing and innovating at an institution that has not invested in developing an infrastructure for IP commercialization. Dr. Smith is a busy clinician, but she maintains capability and commitment to identifying unmet needs and forwarding solutions. Innovation hasn’t been consistently described as part of West Memorial’s DNA. Dr. Smith is unaware of her institution’s inventor policies, should they even exist, or mechanisms by which ideas can be protected and developed.

The choices for her “napkin ideas” are limited. In frustration, she could file or discard the scribblings that might have led to a disruptive solution to a pressing problem. Or she could share her idea with a vendor, and it will make the all-too-frequent lateral migration to industry without any level of protection or participation by the inventor.

The net result of Dr. Smith’s game-changing innovation is that, at best, her hospital can buy it from a vendor in a year or two and get it into her hands to help patients. At worst, nothing happens. No patients will be helped, Dr. Smith is not rewarded, and her hospital gets no funds to further its innovation capability.

Ironically, even East General comes out a loser, as no regional jobs are created by the economic development potential of her concept. If East General and West Memorial could set aside their rivalry when it comes to innovation and collaborate, it becomes a brand-new story.

Let’s paint a new picture, now with an alliance between East and West to allow access to state-of-the-art innovation support. Patients’ lives are improved and extended by the breakthrough technology or drug Dr. Smith developed. Appropriately, she is financially rewarded, incentivizing additional innovative thinking or possibly investment in growing the technology of others. According to prenegotiated revenue distribution arrangements, both institutions (the inventor’s home base and the organization entrusted to develop the technology) benefit. Lastly, jobs are created in the region. If so much advantage can be created when experienced innovation experts assist under-resourced inventors, why would organizations choose myopically to maintain their identities as competitors?

Cleveland Clinic invested millions of dollars and countless hours in developing a core competency in commercial development of IP. We determined that in the area of innovation, partnership outweighed partisanship. So we founded the GHIA, a collaborative network of healthcare systems, academic institutions, and corporate partners from around the world, creating opportunities that benefit patients everywhere through scalable technology development and commercialization.

Realizing Provider Partnership Potential: The Founding of the Global Healthcare Innovations Alliance

Several factors converged to stimulate the foundation of the GHIA, including maturing capability, market demand, and the power of personal connections. But there was also a bit of serendipity.

The invitation for me to return to Cleveland Clinic was unanticipated. My family was very comfortable in Baltimore. MedStar Health was evolving into the largest care-delivery system in the mid-Atlantic. In addition to being chief of the national hand center, I led a systemwide sports medicine entity, MedStar SportsHealth, through which we cared for the Baltimore Ravens, Washington Nationals, and many of the colleges and high schools in the region. In addition, we had launched the Arnold Palmer SportsHealth Center.

I had recently been approached by MedStar’s president and CEO, Kenneth A. Samet, about helping to develop a commercialization and corporate venturing entity to be called MedStar Institute for Innovation (MI2). While I didn’t stay at MedStar to commence the innovation initiative, my 2010 return to Cleveland to lead Cleveland Clinic Innovations (CCI) allowed me to continue my involvement with MI2.

CCI + MI2 = Start of the GHIA

I knew CCI had enjoyed great success since I departed in 2000. My question was, “How could Cleveland Clinic grow CCI and extend the reach of mission-driven innovation?”

The number of disclosures per year—the currency of innovation on any campus—had leveled off at about 300. This number is astronomical and reflects the extraordinary talent and creativity of Cleveland Clinic colleagues, but the growth curve was nonetheless flat. Unless the staff was expanded by hiring a few prolific innovators or annexing hundreds of creative colleagues in some form of system aggregation, the number of disclosures would likely remain at that level.

Shortly after my homecoming, our team got to work determining whether the CCI process was stable, sustainable, scalable, and transferable. The first two qualifiers are internal checkpoints, while the latter two relate directly to why we founded the GHIA. Stability and sustainability are the basic substrates of a world-class innovation infrastructure. Scalability and transferability define the potential to grow innovation partnership.

Cleveland Clinic was the ideal laboratory for developing an innovation function, owing to the model under which we’re all similarly contracted, the high-volume and high-complexity pathologies we treat, and the clinical entrepreneurialism that has pervaded since its inception. Many organizations want what we have: a culture of innovation and a commercialization function that attracts and retains talent, expands creative identity, and generates nonclinical revenue.

But how do you efficiently build and operate an innovation engine in today’s environment of austerity? We all recognize that innovation can be nonlinear, at times inefficient and fraught with failure. The nature of innovation collides with the economic realities facing our healthcare leaders, but they also realize the necessity for it as an identity, revenue, recruitment, and patient-care advantage.

The question facing today’s hospital system C-suite is not whether innovation should be part of the portfolio, but is the process of joining the innovation fraternity a “buy” or a “build”? Without belaboring the costs of building an innovation entity from scratch, it is hard—rewarding, but hard work. Aside from variables reflected on the balance sheet, the valuable commodity consumed in abundance is time. Top executives dislike delay about as much as ambiguity, and the assembly of a commercialization platform is beset with both.

It would be disingenuous to discourage anyone from chasing this noble pursuit. However, we’d be guilty of withholding a key nugget of advice if we didn’t present the contemporary alternative to a homegrown innovation entity—partnering with a going concern.

You’ve guessed the outcome of the CCI and MI2 story. Because of extraordinary cultural alignment, compelling complementary capabilities, recognition of economies of scale, and the catalytic influence of the personal relationships, we launched the GHIA on January 11, 2011—1.11.11 for all you binary thinkers.

There are those who may think this was easy because our physical separation largely precludes us from competing for patients. No large-scale initiative between healthcare systems is preordained. It takes commitment and trust. These traits were plentiful in Cleveland Clinic’s inaugural innovation partnership with MedStar and have remained as we’ve grown the global alliance. Much of the credit goes to the two CEOs, Toby Cosgrove and Ken Samet, and the tireless champion of innovation at MedStar, physician Mark Smith.

Any alliance is characterized by detailed structures for rights, transactions, governance, and performance standards. The specifics are confidential, but the generalities are relevant. You identify best individual processes and seek to develop best combined practices. You continuously leverage resources and relationships that are unique to the members because of region or are attracted by your collective scale.

We Complete the “Innovation Triangle” and Then Double It

Through a combination of strategic outreach and fielding of inquiries from CEOs around the country who quickly learned of our model, we’ve rapidly grown the GHIA. The “innovation triangle” was completed within a year of the MedStar transaction when Northwell Health (formerly North Shore-LIJ Health System) joined us. Again, the personal and professional cohesiveness between Dr. Cosgrove and Northwell Health president and CEO Michael J. Dowling played a part. Having an innovation evangelist like Kevin J. Tracey, a talented neurosurgeon and world-class researcher who runs the Feinstein Institute for Medical Research, facilitated the alliance.

Once three of the biggest healthcare systems in the country showed that they could form a consortium to further medical innovation, the proverbial match was thrown into the gasoline shed. The benefits of scale economies, co-innovation, shared insight, and resource supplementation started to fuel growth. Three esteemed partners joined nearly simultaneously in 2012: ProMedica Health System, The Innovation Institute at St. Joseph Health, and University of Notre Dame.

ProMedica may have created more local buzz because it is a $2 billion progressive healthcare system based in Toledo, Ohio, only 120 miles from Cleveland. The scenario of regional rivals described earlier was tested in reality, with the result being enhanced cooperation to serve the citizens of our state and around the world.

The Innovation Institute didn’t just take the GHIA west of the Rocky Mountains; it brought in very progressive thinking about monetizing the core services of large hospital systems and keen financial modeling capabilities.

When Notre Dame joined us, it caused a modicum of confusion for some observers, but it is completely consistent with our model to network culturally aligned organizations with supplementary and complementary capabilities. Notre Dame brought to the GHIA a world-class biomedical engineering program and progressive business and law schools. If our country is to maintain primacy in innovation, all members of the ecosystem must be introduced to the inner workings as early and expertly as possible. Notre Dame’s inclusion also brought to the fore the issue of recognizing and rewarding scholars for participation in advancing ideas that have both scientific and commercial applications.

Commercial Innovators Come on Board

Innovation occurs at the intersection of knowledge domains. We knew that restricting membership to AMCs and research universities would be limiting.

Our prerequisite for corporate partners is that they seek to transform healthcare by leveraging special skills, resources, and relationships. The initial entry was motion-control giant Parker Hannifin Corp. If it moves, Parker’s products control or touch it. The Parker relationship taught the global alliance how to work with organizations that weren’t exactly like us.

One of the links that accelerated the partnership’s success was Parker’s annual Best Mousetrap competition, which showcases evolving projects in many of its manufacturing divisions. Since we’ve engaged in this “beauty contest” of Parker’s coolest technologies, every year 5 to 10 new concepts have been brought to the GHIA. Several promising technologies have been submitted for regulatory approval in the United States and Europe, with commercial launch anticipated by early 2016. Two are devices, an optically clear endoscopic sheath designed to minimize risk of infection during surgery and a side-entry torquing device used to direct intravascular guidewires.

In the ensuing years, we’ve added chemicals and materials leader the Lubrizol Corporation to the GHIA for the unique capabilities in the company’s expanding Life Sciences division, and Cox Enterprises, Inc., a communications and media titan. It was again difficult for some to initially see why a cable company and a hospital system should partner. The Cox forte is connecting people; the company touches one in three Americans every day. We can think of no better partner to help medicine move toward mobile platforms and into the home than one of the world leaders in bringing information to people.

The National Aeronautics and Space Administration (NASA) is our newest GHIA partner. NASA will share priceless insights about novel materials, remote monitoring, fluid and gas handling in harsh environments, and equipment miniaturization. The design challenges faced by NASA are surprisingly similar to those hospitals tackle when equipping an operating room.

These partnerships demonstrate the breadth of mission-driven innovation. Opening the aperture to different perspectives and skills, even those heretofore not considered relevant to healthcare delivery, strengthens our capabilities to serve patients.

Optimizing the Alliance

In every sport, there are both responsibilities and rewards attached to managing the all-star team. Likewise, there are expectations in harnessing the talent and capability residing in the best and brightest specialty practitioners.

The alliance has a North Star: the benefit of patients. All partners seek to develop and deploy best-practice models and collaborate to accelerate the pace and maximize the efficiency of medical innovation to benefit patients.

For example, Maryland physical therapists Jodi Maron Barth and Gincy Lockhart Stezar came up with a way to accelerate the rehabilitation of patients suffering from partial facial paralysis resulting from Bell’s palsy, Ramsay Hunt syndrome, Lyme disease, acoustic neuroma, or stroke.

Using only duct tape, cardboard, and mirrors, these co-inventors built prototypes to replicate and produce a symmetrical image of the nonaffected side of the face. They then deployed Hebbian learning theories¹ that had helped amputees improve function. Their paralysis patients demonstrated measurable improvement and elevated self-esteem.

Through their affiliation with GHIA partner MedStar Health, Barth and Stezar leveraged commercialization advice from Stephen Kinsey of CCI. He helped the inventors hire a developer and bring to market the iPad app Face2Face Facial Palsy. Barth and Stezar formed the Center for Facial Recovery™ in 2014 and are now helping patients worldwide.

The app is available in the Apple Store and through ADEO, the GHIA’s e-commerce spin-off that sells digital healthcare products developed by alliance partners directly to hospitals, private-practice physicians, and patients. Along with mobile apps, inventory includes more than a dozen survey tools, playbooks, and software solutions. In addition to Face2Face Facial Palsy, there’s a fall-risk assessment tool for cancer patients and a hearing protection app that monitors ambient noise levels. Cologene, the hereditary-disease-management software, is offered in ADEO as well. Most items are available for immediate download, and ADEO also offers infrastructure and teams to help configure products and services into a client’s workflow.

The GHIA is not a series of bilateral relationships but a network of high-performing institutions that can work independently, as focused subsets, or as a singular juggernaut of creativity. Relationships are governed by equitably constructed joint management agreements. The environment of trust fosters co-innovation.

As the alliance has matured, we see greater opportunities and expressions of strategic innovation. There may be no better prepared think tank for tackling the most complex and pressing problems facing global healthcare than our consortium. Yes, we have plenty of primary initiatives to pursue, but entities like corporations, foundations, and governments can bring their challenges to the GHIA as a one-stop shop for everything from creative solutions to validation.

The formation of our alliance has accelerated development of a distributed competency across all the partner organizations. The organization with more resources or experience in selected domains provides that service or takes the lead. Moreover, we can exercise the additive power of co-innovation, as often we find the lock on one campus meets a key on another.

The most compelling benefit of establishing an association of this type is portfolio building. The direct result of associating institutions of prolific creativity is the opportunity to aggregate the largest collection of IP in healthcare. The benefit is to explore more of a portfolio approach to its management.

As traditional nonprofit institutions continue to struggle in funding research and innovation activities, not only does investigating ways to extract value from IP become relevant and attractive, but novel funding concepts also should be studied. The GHIA has taken on this responsibility, innovating around models to fund the practice of putting ideas to work.

Our consortium has been examining sophisticated financial engineering concepts including the securitization of IP, which could be game changing to the way we support future creative pursuits. It seems only natural that we would extend the spirit of innovation to all aspects of the engagement, including ways to make the pursuit sustainable from an economic perspective.

While alliance partners were approaching this in a more rudimentary fashion by cobbling together funding from the institutions and government to fuel the innovation function, essentially working from a micro basis, Andrew W. Lo of the MIT Sloan School of Management was exploring securitization on the mega level.² He is proposing a multibillion-dollar fund to bring substantial resources to the problems facing early-stage research.

Economic Development Partnership in Our Own Backyard

Cleveland Clinic is the largest employer in the history of northeast Ohio and the largest employer in Cleveland, with more than 43,000 caregivers. The second spot is occupied by University Hospitals Health System at about half that number. Healthcare is the economic driver of our region. CCI has placed community economic development among our priorities. We partnered with the Fairfax Renaissance Development Corporation, a nonprofit whose mission is to strengthen neighborhoods in northeastern Ohio through comprehensive community development, in building a 50,000-square-foot, $23 million incubator. It houses CCI’s offices and is the headquarters of the Global Cardiovascular Innovation Center (GCIC), a collaborative of six Ohio-based AMCs and research universities that is acquiring, incubating, and commercializing technologies. The companies that we have gestated there have created nearly 1,500 jobs in our city.

A compelling economic reality is that the only net new-job creators in our country over the past two decades are new companies less than five years old. Healthcare-related businesses are at the center of this new market. These facts point to the critical role medical-innovation-derived startups play in fueling our growth.

Several companies that provide our nascent entities with services such as prototyping have been attracted to join the incubator. We have a second site just blocks away already staked out for a sister building. Our dream is to dot the periphery of Cleveland Clinic’s campus with these beacons of innovation, then fill in around them with residential, retail, dining, and entertainment destinations.

Extending beyond Cleveland, in 2013, a Cleveland Clinic–led consortium of Ohio AMCs and research universities was awarded one of three National Institutes of Health Centers for Accelerated Innovations grants to improve translation of basic science into commercially viable products that improve patient care and advance public health. Our center includes Case Western Reserve University, Ohio State University, University of Cincinnati, and Cincinnati Children’s Hospital Medical Center in a seven-year program during which time nearly $13 million will be deployed to promote commercialization of discovery science targeting heart, lung, blood, and sleep disorders and diseases.

Partnership Between Inventors

The creative potential of different-size groups and their constitutions is explored through the lens of what we have observed in the two decades of operation of CCI. Because various engagements may require different approaches, there is no-one-size-fits-all answer, but here’s what we’ve seen work and ways innovation output may be enhanced by optimizing the creative team.

Lone wolf. While history is replete with the likes of Archimedes, Leonardo da Vinci, Sir Isaac Newton, and Benjamin Franklin, the single inventor—or lone wolf—model of invention is simply not as prevalent in CCI’s pool of disclosures. Between two-thirds and three-quarters of invention disclosures are submitted by more than one person. Even the times when a single inventor has enjoyed success, there is usually acknowledgment of a close cadre of advisors and facilitators or a team of supporters. The lone wolf model exists and is OK if your name is Einstein, but we don’t count on this being the dominant source of IP flow.

Dynamic duo. We’ve observed a curious phenomenon over the years building and operating an innovation function concerning the potency of two minds melding as one. It’s impossible to say that two can be the magic number, but whether it’s Watson and Crick or Lennon and McCartney, there does seem to be something special about the power of two. My guess is that it may be the optimal way to combine complementarity, parsimony, and dynamic tension. Keeping it to two also doesn’t hurt the other important innovation variable, speed.

Relay race. We have seen organizations and some smaller teams attempt to engage in sequential innovation, whereby a subset of individuals takes a project as far as they can, then passes it off to another group. We believe this model to be ineffective; whether it’s thought to take advantage of specific expertise or minimize biased thinking, we’re just not fans. Most modern innovation infrastructures provide for more interaction, not less, as ideas develop. That isn’t to say that expertise activated at the right time isn’t valuable. We simply advocate for the innovation team to spend as much of the journey together as possible to maximize the outcome, instead of artificially shielding potentially important contributors from key stages of development.

Innovation ecosystem. It should come as no surprise that we would identify the network approach as the highest aspirational level. After first uniting the individual with the institution over its IP estate, and then combining an alliance of high-performing entities, the next step is making the entire machinery of innovation hum by managing it as a single organism. We find ways to simultaneously grow and balance a larger consortium. This pursuit will be enabled by evolving technologies in big data and the realization of the economic and social climate around healthcare. One day, we may wake up and say that we can’t grow the GHIA any bigger, but that would result only from an inability to render service and leadership to all partners according to what they need and deserve.

Innovation can and will happen by almost any partnership permutation imaginable. The more the leadership understands about its dynamics, the better the process and its eventual outcome. Setting the stage for optimal interaction with a variety of partners and deployment of resources at critical times is one of the key challenges and responsibilities of today’s innovation practitioner.