Our final visit on the trip was to the Mayo Innovation Center in Rochester, MN. I had been aware of the Mayo Clinic Innovation work since starting the work with User-centred Healthcare Design in 2008 (ish) and so it was a bit of a seminal moment for me to find myself looking up at the hallowed clinic. We were walked through the atrium and up to the Innovation Centre by Linda Cooper. It brings home just how integrated the unit centre is that through the double doors at one end you are in rheumatology… We were greeted by fresh coffee and donuts and more importantly by Douglas Wood, M.D. Doug talked us through the history of the centre and described the route from idea to the 63 staff across two sites that the centre comprises of now. For me, some of the most powerful aspects of the journey were how the work of the centre talks directly to the stated strategic goals of the organisation. Some six years ago the Mayo clinic added ‘innovation’ to it’s core values. This gave a clear role and purpose for the innovation centre to respond to and a sense of legitimacy to work differently. The centre is a core resource for any and all of the 36,000 members of staff on site (in Rochester). The team who created the centre were based in the department of medicine and, at the time, were looking around for interesting ways to improve the way they delivered care. They identified the global design firm IDEO in 2002, and worked with them to understand the role human centred design might play in healthcare innovation. That relationship with designers has remained core to the centre’s activity with 14 designers being on the payroll currently. The IDEO collaboration led to the SPARC Innovation Programme and the first physical space was established where staff could prototype and design healthcare in the same environment in which healthcare was delivered. By 2006 they had undertaken enough projects to demonstrate a sufficient return on investment to their colleagues and the board. Doug cited being able to demonstrate the effect to key opinion leaders (surgeons: hard to impress but once on side, powerful advocates). The form of evidence was varied, from costs savings through to patient and staff experience, and also ‘the Buzz’ generated from working differently and using design. The centre’s approach is very recognisably design led. Think Big, Start Small and Move Fast, and the design methods are human centred with a clear focus on prototyping and making. They deliver their activity across 4 platforms develop and refined over the last few years to allow strategic focus, with the voice of the patient at the centre. There is a model of open collaboration with local and strategic collaborations. There is specifically an annual CODE award ($50k) to support innovative awards, winners not only get cash but access to the Innovation centre staff. Multi disciplinarity is at the core of the practice of how the Centre delivers innovation. Each team has a project-manager, a designer, an IT innovation persona and the clinical lead. For me it is the inclusion of the IT innovator that is so telling in the range of projects that the centre can address. IT is an enabler rather than a limiting factor for the centre. An experience so far removed from my experience to be truly revolutionary! Strategically having the living lab environment, companies approach Mayo to try out new tech and products near to patients (e.g. Delos living). Mayo also partners other initiatives like the rock health consortium, a group specifically looking to use technological innovation in health through supporting start-ups. The centre also can act as a placement for students of different disciplines, design, IT, economics. This happens at different levels, secondment to project or specific Doctoral programmes supported by academic partners. Alongside this learning environment CFI staff can undertake and complete a recognised curriculum and gain a certificate in innovation. Doug described a current ‘spin off’ project with Arizona state University (the biggest in the States) looking at improving retention and QoL of the students. They are using the model developed to improve the wellbeing of Mayo’s employees, and using their user/human centred approaches, coming up with tools to support the student wellbeing services to identify students at risk of stress and helping with life planning.
Joe and I were particularly interested in how the centre justifies its existence in terms of what metrics are highlighted. Doug described the potentially useful concept of ‘lives touched’ but also the sobering thought that every project must also clearly work to sustain the financial performance of the Mayo clinic.
Alison Mathews design researcher, took us through her presentation on design in health. It was great to see the very human centred approach and she asked really interesting questions about how as designers we know where we are creating value in complex health systems, and described the U Penn model of Innovation Centres. One being to remove obstacles to innovation (a Centre for Innovation) , the other to deliver innovation (a Centre of Innovation) leading to the idea that there are centres ‘of’ and centres ‘for’ innovation.
For me an interesting question and one I still am not sure about is how and when the Centre engages with the rest of the Clinic.
The presentation described a range of modes of engagement but I wasn’t sure what the end looks like for the centre, is it around the ideas or is it to support the implementation into routine practice. Hopefully Alison can comment on this.
Paul T Nordlund gave a Tour de Force presentation around the IT support and plans that, at times, was over my non SCRUM, non Agile development head. What I was struck by was the descriptions of not only what was planned but what is in place now around the IT infrastructure to support exemplary patient care and to support continuous innovation and positive change. From Mayo apps. (to support bariatric care and Asthma), to systems of internal communication where you can see where the physician is and what they are doing to allow ‘micro-consults’ between professionals when the system alerts them their colleague is not with a patient.
Paul is right at the cutting edge of IT and was keen to share with us the future of tech and how it could and would apply to healthcare. His predictions around the future direction of health It were inspiring, but what I was struck by was that in the clinic there was no sense of IT being about servicing the old version of windows on someones clockwork PC, but imagining a future where the newest aspects of commercial IT are bent to the needs of patients and professionals…Part of the remit of Paul and his team was to continuously explore the very latest tech being developed making it clear that often, their own role was not about developing new tech but about finding ways of taking off-the-shelf cutting edge tech from elsewhere and re-purposing; adapting it to fit the needs of the Mayo Clinic, its staff and patients.
We had asked so many questions that we were running a bit behind so only had a couple of minutes to talk through the presentation we had planned to deliver, but I think we got to give a flavour of the particular slant on creative practice and design that we have delivered through projects over the last 6 years.
The Centre for Innovation has the enviable position of being viewed as another central function in the hospital, alongside service improvement or audit. This gives it a legitimacy that allows the innovative stuff to happen in a safe environment. The exec support and the leadership believe in the mission of the centre and are constantly looking to innovate themselves alongside the professionals and patients they support. The range of metrics to demonstrate impact is carefully selected to play to the strengths of the approach, but everyone knows the clinics mission and everyone acts towards that mission. Not wanting to go on (and in no way diminishing the impact of the other aspects of the team) the IT core team support is extraordinary and innovative in its own right. I wonder if the Centre knows how novel this is from an NHS perspective.
Joe and I came away buzzing with ideas for collaboration, further visits and with a sense that this model, if in someway recreated in the UK would embed the infrastructure to support innovation within an organisation that we have been looking for. It does also show the level of commitment required for such a venture to succeed, but demonstrates the potential return on investment that might be delivered.