Doing Different Differently

I was all set to write about bacteriophages, both because I hadn't known much about them until recently and because they represent an approach that doesn't just proliferate the antibiotic arms race.  Then I realized that what appealed to me about them was as an example of attacking mainstream problems with non-mainstream solutions, so I decided to write more generally about how organizations are trying to encourage that.

Because, goodness knows, health care needs a lot more of them.

Let's start with IBM.  Yes, I said IBM.  Believe it or not, Big Blue is trying very hard to reinvent itself as a design company, or at least a company that uses "design thinking" to develop products and services.  They're investing over $100 million in the effort, dropping their ratio of designers to coders from 1:80 to 1:15, according to Wired.

Their design principles emphasize "making users your North Star," using collaborative multidisciplinary teams, "restless reinvention," and a continuous loop of "observe/reflect/make."  I particularly like the restless reinvention principle, with its great reminder that "everything is a prototype" and with its explicit admonition to "solve problems in new ways."

So far, about 10,000 employees have gone through the design bootcamp, and around 100 products have been developed using design thinking.  Those are drops in the bucket for IBM, but the approach is an audacious and, one might say, long overdue attempt for IBM to stay relevant in a millennium in which Apple has reminded companies about the importance of design.

Or take Microsoft.  If there is any doubt that Microsoft is well on its way to doing things differently, look at the Surface Book or Surface Pro, each of which has won rave reviews that might make Apple itself envious.  CEO Satya Nadella has been shaking things up ever since he took over two years ago.

One of Mr. Nadella's key actions was to break up Microsoft's Research group, which historically had been kept separate from the day-to-day action.  Bloomberg reports that Mr. Nadella has insisted that the research teams work hand-in-hand with the product teams to get new ideas into actual products quicker.  They focus less on pure research and more on making an impact on products.

Mr. Nadella has emphasized, "we need to be open to new ideas, and Microsoft Research is where they will come from."  This attitude led to Skype Translator becoming an actual product within three months of Mr. Nadella learning about the underlying research, a time frame that was previously unthinkable for Microsoft.

It ain't Bill Gates' Microsoft.

Venture capitalist Anshu Storm has a theory -- "stack fallacy" -- that he believes explains why so many big companies fail to innovate.  The theory posits that many companies suffer from the "mistaken belief that it is trivial to build the layer above yours."

He cites how Apple has built great devices but also has missed on simple apps, or IBM's classic blindspot about letting Microsoft own the OS layer that ran their PCs.  Then there is Google with its efforts to expand into social networks (Google+, anyone?).

Mr. Storm explains that "we (over) value what we know," which can lead to a lack of understanding about end users' needs.  In his view, "Product management is the art of knowing what to build."  The trouble is that too many companies focus on the how and not enough on the "why."

Christopher Mims, writing about Mr. Storm's theory, says that they key to avoiding stack fallacy "is figuring out how to have true, firsthand empathy for the needs of the customer for whatever product you’re trying to build next."  That sounds logical, even obvious, but evidently is hard to actually do well.

For example, think about hospitals.  They're trying hard to position themselves as patient-centered health systems, but no one who has been in a hospital can believe that hospitals see patients as the customer.  Hospital gowns?  Waking patients up in the middle of the night to take vitals?  Corridors upon winding corridors?

Sadly, I could go on, and not just about hospitals, but the point should be clear.

The customers hospitals cater to are physicians, who bring them patients and thus revenue.  That's not to say that the people working in hospitals don't care about patients, but the processes, procedures, and design clearly aren't about putting patients first.  You can't just proclaim you are "patient-centered."

Still, Tom Graham, M.D., the former Chief Innovation Officer at The Cleveland Clinics, thinks health systems and academic research centers will be the "logical crucibles" of innovation in health care.  He emphasizes the importance of collaboration, which hits health systems' and academic research centers' sweet spot, since they already have "interdependent communities with nuclei of creative thought."  His new book, Innovation the Cleveland Clinic Way: Powering Transformation by Putting Ideas to Work, details his thoughts.

I worry that putting a bunch of smart health care people together may generate more innovation, but that the resulting innovation may look like, well, more health care ideas.  That's not what we need.

We need the health care experience to be less like health care and more like things we actually like.  Nick de la Mare suggests that hospitals (and schools) "should be more like theme parks," and that designers should be aiming for "magical experiences."  As he asks, why shouldn't health care settings be the "happiest places on earth?"

That's the attitude we need to be taking as we try to innovate; it's not just doing more, but really rethinking the overall consumer experience.  I was particularly struck by Mr. de la Mare's caution:

The trick is to deploy technology strategically and sparingly, since new tools tend to introduce unintended complexities....A hospital patient may feel similarly overwhelmed by impersonal and bureaucratic processes that seem to serve the health care provider at their expense. Just because we have the technology to do something, doesn’t mean we should.

I especially love that last sentence.

There is cool innovation going on within health care.  David Chase, for example, raves about how Zoom+ (which I've written about before) has revamped the ER experience, and there is no shortage of other health care companies hoping to be disruptive (e.g., Becker's list of 30).  These may not reinvent the consumer experience, but at least they may improve it.

There is plenty of incremental innovation going on, and health care sure can use it, but I continue to be on the lookout for breath-taking innovation -- innovations that surprise, excite, and delight.