Two types of innovation – what is the right balance?

Joseph Kvedar

(Reprinted with permission from the cHealth Blog)

I recently coined a phrase while talking to our senior leadership at Partners HealthCare. I told them that we aspire to bring them "innovations they don't yet know they need."  Folks at the center like this, especially those who are primarily focused on innovation. They feel that it defines us as cutting edge. And you know, I would not put forth such an aspirational goal if I did not have evidence we could achieve it.

Let's talk about innovation for a moment. In the early part of the last decade, Microsoft and its hardware partners released a series of products called Tablet PCs. They were trendy for a year or two, but then withered away, to be replaced by newer fads such as Netbooks and the like. Tablet PCs failed because the technology was not really portable  -  they were too heavy to fulfill many of the use cases for slate type devices, and in retrospect, they were poorly designed. 

So in 2009, when Apple was preparing its launch of the iPad, if they had gone to consumers and asked them about their interest in another Tablet PC, chances are they would have gotten a tepid response. In fact, Steve Jobs was quoted as saying they did not do any consumer research for the iPad because, "We don't expect consumers to really know what they want." By envisioning the tablet as a large iPod Touch, Apple revolutionized the concept. They brought us an innovation we did not know we needed.  Another, more mundane example of this is the story of the Post it Note. That product failed in early consumer focus groups because it was viewed as a not-very-sticky glue.

At the Center for Connected Health, we've delivered a few innovations of that type. We started working on telemonitoring for congestive heart failure (CHF) in 2002 (a collaboration with Partners HealthCare at Home) and were met with derision from conventional medicine. Fast-forward to 2012 and that program is now in mainstream use for our high-risk patients with CHF. In 2005, we conceived of a need to streamline home vital sign monitoring for chronic illness. That led to the creation of our Remote Monitoring Data Repository (RMDR) and, more recently, the infrastructure that facilitates the integration of home monitored vital signs into our electronic medical record. Both of these milestones show the value of early-stage innovation, or innovation that Partners "did not yet know they needed."

Looking back on these examples, it's tempting to focus our whole team on this type of innovation. But I don't think that is a good idea. The flip side of the coin is interacting with and listening to customers. People who pay you to do work are a critical part of the innovation feedback loop. History has many stories of people who were far ahead of their time and died destitute. They are praised in the history books but ostracized while on earth.

We have innovation going on in our center that is in response to customer needs. Much of our work in text messaging for reminders and education falls in this category. Programs such as OB Connect were developed in collaboration with both pregnant women and midwifes and continue to thrive in our provider environment. We also have a large Collaborative Media Group that acts as a resource to physicians at our hospitals who wish to engage in more traditional telehealth activities, such as remote consultations and home video visits. Are these efforts as glamorous as innovating out of whole cloth with an eye toward utility 5-7 years out?

That is really not the relevant question. The relevant question for us is how to best be of service to Partners HealthCare System as we move into the exciting new world of provider-payer risk sharing, a care model that is ideally suited for connected health to thrive.

So we must do both the type of innovations that people don't yet know they need and the type that is born from creating products and services that customers ask for and are refined by customer feedback.

The question I'm pondering now is what is the ideal mix of these two strategies.

I'd be delighted to get your thoughts on any of this.

Joseph C. Kvedar, MD is the director of the Center for Connected Health (www.connected-health.org), a division of Partners HealthCare in Boston. Connected Health is focused on developing new methods of delivering quality patient care outside traditional medical settings. This post appeared at The cHealth Blog.