Exclusive: Can innovation officers succeed?

Without standardizing the language that healthcare organizations use for delivering care, analyzing finances and assessing technology, “how in the world can you systematically innovate?” That’s the question Marshall D. Ruffin, Jr., MD, MBA, MPH, chief technology officer of the nonprofit Inova Health System in northern Virginia, poses regarding the increase in chief innovation officers in healthcare.

“You can’t systematically improve anything that you can’t measure,” he said. Without standardized measures, organizations really can’t prove they’ve improved anything. “If you can’t, in a reliable way, measure what that hospital is doing, how do you know they’re doing better?” Without the same measures for such elements as nursing hours and patient outcomes, innovation can’t be rolled out across an enterprise or to another organization.

Healthcare organizations must apply the discipline of clinical research to operations to systematically improve what they do, Ruffin said. “We don’t allow device manufacturers to say ‘use this gizmo and your costs will be reduced by 30 percent.’ We require technology providers, pharmaceutical companies and others making claims to have some systematic way of measuring that we can compare to other methods and technologies.”

Managers don’t think that way, however, he said. “Managers need to understand that they have to apply the same rigor and discipline to innovation in their institutions.” For example, nursing is one of the biggest expenses for healthcare organizations. But, nursing hours and responsibilities must be measured the same way across facilities for an organization to prove it has innovated the way they use nurses and their skills.

“I’m afraid that lots of organizations want a chief innovation officer, but they don’t understand that if you don’t have discipline and standardization, you can’t make valid comparisons.” The person in that role may be able to excite colleagues but “with no scientific rigor, people get tired of it and it fails.”

Inova’s OneInova initiative to centralize and standardize everything across the enterprise, was developed out of an ‘aha moment.’ “We came to the realization that we must standardize everything that we can systematically improve,” Ruffin said.

Standardizing language by all using lexicons such as SNOMED, LOINC and NDC codes sounds “dry and boring but if you don’t do that you can’t compare physical exam findings, lab results and medications reliably.” A lot of discipline goes into that standardization in an ‘common enterprise architecture’ manner, Ruffin acknowledges. That is what allows for innovation, he said. “Just bringing on an innovation officer will lead to failure. It’s a waste of time.”

Most healthcare organizations don’t understand the degree to which standardization is essential, Ruffin said, and that has to change.

“You don’t have to create a chief innovation officer position to have innovation.” If each institution innovates in its own way, no one can learn from each other. “The secret to systemic innovation is standardization,” Ruffin said. “Learning organizations cannot exist without standardized measurement for everything ahead of time and a political structure that recognizes and appreciates that. Then, you break the rule in an orderly way to test to see if you can improve something.”

For more with Ruffin and Inova’s efforts to standardize to drive innovation, check out the February issue of Clinical Innovation + Technology.