Innovation in health care is certainly not new, but we've never seen the level of interest, activity and buzz that now characterizes the health policy reseach community's engagement with the topic. Meanwhile, policymakers, providers, and insurers are similarly embracing the belief that the solution to the health care system's various woes may lie in that system's near-total reinvention.
The engine of this new mindset is the Affordable Care Act, which elevated health reform to a top national priority at the same time it created a new center on innovation within the Centers for Medicare and Medicaid Services. In the last year,
The new buzzword of the U.S. health services research community is "innovation" -- in technology, administrative procedures, payment systems, treatment methodologies, clinical cultural norms and nearly every other aspect of the patient-provider continuum.
that center stoked interest by pouring nearly $1 billion into 107 "Health Care Innovation Award" projects. Elsewhere:
The Agency for Healthcare Research and Quality (AHRQ) has developed an online "Health Care Innovations Exchange" that catalogues and analyzes a wide array of evidence-based interventions. It has categorized 759 innovations thus far, as well as 20 "Innovation Attempts" that failed -- which may say more about the publication bias toward positive results rather than the success rate of innovations.
Meanwhile, many academic medical centers are taking their cues from the business world and appointing "Chief Innovation Officers," forming innovation centers, and even running "innovation tournaments" to stimulate and catalyze new ideas to improve health care. The LDI Health Economist recently conducted a roundtable discussion with one such group at the University of Pennsylvania.
The buzz is not confined to academic journals. A quick search of Amazon.com reveals that more new books have been published with the keywords health and innovation in the last five years than in all the years before that.
Is innovation simply the latest buzz word in health services research, or does it have more staying power as a concept for the field? The academic literature can serve as a mirror into the longer-term dynamics of words and concepts as they drift in and sometimes out of fashion. We used ISI's Web of Science database to calculate the number of articles with the subject "Health + Innovation(s)", and compared that to the number of articles on "managed care" (another buzz word in the past) and "malpractice" (a longstanding issue seemingly without buzz) over the past 20 years. The trends look like this:
We can see that interest in "managed care" spiked rapidly in the 1990s, and fell almost as rapidly in the subsequent decade. Was it a fad, or a failed conceptual model? The data do not tell us. But it should give us pause about what lies ahead for innovation as a concept, given that we are in a similar, though not as steep, period of growing interest. And then there is malpractice, in which interest remains at a relatively steady state in the literature. Should we interpret its flatline status as stagnation around the issue, or a stubborn resistance to faddish interventions? The data do not tell us that either, but we might surmise that interest might be piqued by some innovative thinking in the area.
Other centers of activity and sources of information in the burgeoning health care innovation field include:
Federal Government
The Center for Medicare and Medicaid Innovation is a new center that identifies, develops, supports, and evaluates innovative models of payment and care service delivery for Medicare, Medicaid and CHIP beneficiaries.
The Agency for Healthcare Research and Quality (AHRQ) has developed an online "Health Care Innovations Exchange" that catalogues and analyzes a wide array of evidence-based interventions.
States
The Maryland Department of Health and Mental Hygiene (DHMH) Innovation website serves as a clearinghouse for innovations in health care in Maryland. Its goal is to highlight successful efforts to reform the delivery and financing of health care and spread them across the state to achieve maximum impact.
Universities
Stanford's Graduate School of Business' Program in Healthcare Innovation promotes research on the innovations that can make healthcare more sustainable and trains a
Innovation has become a major focus of academic researchers.
new generation of leaders to conceive and implement transformative healthcare ideas.
Emory's Health Innovation Project is an interactive network among Emory, Georgia Tech, Morehouse and five other organizations that provides information, resources, and community connectivity to support and enhance innovation in healthcare research, education, and service.
University of California's Center for Health Quality and Innovation promotes innovations at UC medical center campuses and hospitals to improve quality, access and value in the delivery of health care. It distributed more than $3.4 million in grants in 2012 to fund nine projects across UC campuses.
The University of Pennsylvania's Penn Medicine Center for Innovation launched this year to identify, test and develop various sorts of innovations throughout the institution's $4.3 billion-a-year network of regional health care facilities.
UCLA Institute for Innovation in Health fosters innovation to transform the delivery of care within the UCLA Health System and in regional, national and global partnerships.
to transform the experience and delivery of health care for patients at the Mayo Clinic.
Kaiser Permanente's Garfield Innovation Center provides a living laboratory of mocked-up clinical environments where new ways of delivering health care can be tested.
Group Health Cooperative's MacColl Center for Health Care Innovation builds bridges between the worlds of research and health care delivery to improve care in outpatient settings.
The Henry Ford Innovation Institute serves as both a physical and virtual resource for inventors and innovators at the Henry Ford Health System.
The VA has launched a new health services research and development Center of Innovation initiative (COIN), which will fund multiple centers across the VA Health System.
Coursera
Duke University produces an interdisciplinary course, Healthcare Innovation and Entrepreneurship, that
focuses on sustainable innovation, introducing entrepreneurial students to the realities of problem identification and solution design within the complex world of healthcare.
Topic Guide
The University of Pennsylvania'a Leonard Davis Institute of Health Economics has created an online Topic Guide to Health Care Innovation that lists many sources of information, including recent video seminars on the subject.
The Foundation for Healthcare Innovation has launched a new peer-reviewed academic journal in healthcare innovation and is developing an innovation community of key leaders and organizations.
The Center for Care Innovations is funded by a number of California-based foundations to identify and support innovations to improve California's health care safety net.
