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Fostering Innovation in the UNC Health Care System

October 12, 2017
by David Raths
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Q&A with Carol Lewis, associate director of the Center for Health Innovation

As associate director of the Center for Health Innovation, Carol Lewis directs innovation efforts across the University of North Carolina School of Medicine and UNC Health Care System. She also is one of the conference chairs for the upcoming Health IT Summit in Raleigh, N.C. Healthcare Informatics recently asked her to describe some of her center’s work.

How long has UNC had a Center for Health Innovation? Were you involved in its setup?

Lewis: The center has been around a little over five years. We started some work on innovation projects about two years prior to that, so I have been involved for almost seven years.

Do most innovation centers created by health systems look alike?

The focus of innovation centers varies significantly across organizations. Some centers focus on commercialization opportunities or partnering with external startups. Some are focused on research-oriented discovery and innovation within the research world. Yet another group is focused on improving healthcare operations and delivery, and there are probably some hybrids.


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The advances in and availability of data from disparate sources create new opportunities and frontiers in care coordination for complex patients. These can range from mobile health/Internet of...

Carol Lewis

How would you describe the focus at UNC?

My team is primarily focused on trying to bring disruptive innovation to healthcare delivery, as well as getting involved in translational research. We also sometimes work with external startups.

I read that one of your team’s approaches involve Digital Health Innovation Sprints? Can you describe those?

The Digital Health Innovation Sprint is a new model we created last year to try to engage a broader community in identifying digital health solutions. We have taken the design thinking methodology and built a series of interactive events around it. We have a design day when we do a deep-dive problem discovery workshop; a ‘define’ day, where we work to define solutions, all the way through to a demo day, where teams that have gone through the process can pitch their prototypes and ideas. It is designed to bring in clinicians, administrators and people from the ecosystem such as software developers, hardware experts, designers, and entrepreneurs to think about how to create solutions to solve a real healthcare problem. We bring together a really diverse group of participants in the process.

Do they come to you as teams already formed or do you help people build connections and create teams?

Both. Sometimes a whole team will decide to go through the sprint. We also ensure that early in the process individuals interested in participating have opportunities to form or join teams.

I read that the sprint this year was about medication adherence in patients over 50.

Yes. We partnered with AARP to launch that sprint because we thought that was a great challenge question that would align very well with our digital health focus and AARP’s mission.

Internally, you offer Innovation Pilot Awards to UNC employees. How does that program work?

Any clinician or employee of the UNC Healthcare System or the UNC School of Medicine can apply for up to $50,000 of pilot funding in order to test a novel idea they have and would like to try to see how well it works. We offer those on an annual cycle in a request for proposal process. We usually get about 20 applications a year and we try to fund up to four projects.

What are some of the biggest challenges clinicians with entrepreneurial ideas face when they have a good idea?

Sometimes it is funding. They need money to get initial data or a minimum viable prototype. Sometimes it is a technology challenge. They are clinicians but they may know very little about bringing in new technologies to solve problems. Often we help them partner with technologists or our own computer science department within the university. Sometimes we see legal and regulatory barriers. We had a cardiologist who believed he could improve the diagnosis of aortic stenosis in primary care clinics if he could train them how to use a handheld ultrasound device, but because of the Stark anti-kickback regulations, we had trouble giving the primary care practices the devices in order to participate.

Conversely, what tends to be the hardest thing for large organizations to do in terms of recognizing and adopting innovations? And are there things your organization can do to ease that process?

There is always a tension between current operations and introducing something novel. There are always complexities when you are trying to scale things across an organization the size of UNC. I think that is the role that our center has been very effective playing within the UNC system. Most of the focus of our resources is providing project management support, data and analytics support, strategic direction, guidance and expertise. We are facilitating with other internal teams how to get through that process of moving ideas forward and getting them piloted or scaled. That is where having a dedicated team like ours is so valuable.

What is the most rewarding aspect of your job?

Our internal customers are so appreciative of the assistance we can provide in areas where they are not expert or may struggle to navigate on their own, so that is very rewarding to know we are helping them. More than that, as an organization we are all about  seeking novel and better way to care for our patients. So much of what I am fortunate enough to be involved in does have the potential to significantly impact patient care. It is really rewarding to assist a team in figuring out how to make that care better.




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The Modern Healthcare CIO, CMO, and CTO

December 10, 2018
by Lori Williams, Industry Voice, vice president of fulfillment, Gigster
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Disruption in the healthcare space comes primarily from the expansion of data’s role in the industry, and the healthcare C-suite’s familiarity with that expansion will help drive company and industry success

For the healthcare C-suite executive, the industry has never been more complex—nor has it ever contained so much potential. Emerging technologies mixed with political uncertainty has created an environment where incredible amounts of healthcare data are revolutionizing how patient care is handled, but patients remain uncertain about the future of their own health. With better data and the means to draw insights from it, healthcare CIOs, CMOs and CTOs are in a position to help address patients’ uncertainties and make hospitals and clinics more accessible and effective than ever before.

Here’s a look at how the role of the modern healthcare CIO, CMO and CTO is changing:

The Modern Healthcare CIO
The modern healthcare CIO’s role has evolved to become more innovative. No longer a title reserved strictly for engineers and IT professionals, today’s healthcare CIOs are focused on information science instead of simply setting up network infrastructure or providing back-end support. The trend towards a more data-centric role began as hospitals rolled out electronic health records, equipping individuals with better access to healthcare provider data. Through enterprise data warehousing, CIOs are becoming masters of data management, governance and predictive analytics, and passing along the many benefits of those knowledge bases to patients.

The Modern Healthcare CMO
The confusing healthcare landscape makes the role of a healthcare CMO more necessary than ever before. Thanks to ongoing regulatory changes, uncertainty surrounding the Affordable Care Act, and shifting consumer expectations for on-demand services, healthcare CMOs are responsible for helping patients navigate their way through a complex and opaque industry. As patients continue to assume the role of consumers, carrying out comparison shopping as they would for any other industry, CMOs must be adept in crafting a healthcare provider’s brand and messaging.

At the same time, CMOs must also ensure that healthcare providers offer a modern online experience, ensuring websites are mobile-optimized and social media accounts are generating engagement. This also means CMOs need to help move marketing efforts into the 21st century, transitioning away from direct mail or billboards towards digital marketing and CRM tools. Because if they don’t, there are plenty of med tech startups that will promptly eat into their market share.

The Modern Healthcare CTO
Unlike healthcare CTOs of the past who remained siloed off from the rest of the organization, today’s modern healthcare CTO is fully engaged with healthcare providers and their technology stacks, utilizing new software and hardware to improve daily workflows. The CTO is enabling the transition to patient-oriented self-service operations, enabling patients to carry out administrative tasks like scheduling appointments or refilling prescriptions over the internet. Because medical data is often stored in a variety of different sources, it’s critical for the CTO to be able to keep these systems interoperable with one another. For hospitals riddled with legacy software, CTOs should expect to continue employing middleware solutions to bridge the gap between old and new.

Members of the healthcare industry C-suite have the power to transform lives, and the CIO, CMO and CTO have roles that directly affect a provider’s ability to carry out positive change. With better data from the CTO’s tech stack, the CIO can use better analytics to help providers determine the best solutions for their patients, marketed to consumers by the CMO through modern platforms in clear, easy-to-understand language.

Lori Williams currently serves as Gigster’s vice president of fulfillment. Prior to joining Gigster, Lori was the general manager for Appririo.

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What Does Your Magnum Opus Look Like? A Few Operatic Thoughts

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I was given the privilege and pleasure recently of presenting, for the second year in a row, a lecture on Richard Wagner’s “Ring” cycle, as the leading opera company in my city, a world-class opera house, has been putting on, in yearly succession, the four operas of the “Ring of the Nibelung” cycle by German composer Richard Wagner (1813-1883). Last year, the second opera in the tetratology, “Die Walküre,” was performed; this year, the third opera, “Siegfried.” After the concluding opera, “Götterdämmerung,” is performed, the entire cycle will be presented in festival format, always a major cultural event. I spoke on “Siegfried.”

I’ve been fortunate to have seen six complete “Ring” cycles in live opera houses in different cities, and I can tell you, it’s a life-changing experience, as this four-opera work (16 hours of music altogether), sits at the absolute summit of western art. Richard Wagner was a hideous human being himself, but spent numerous years working on something that changed the course of classical music and redefined opera.

What’s more, from the summer of 1848, when Wagner wrote a first sketch of the libretti, or texts, of the operas, until their true compositional completion in 1871, more than 23 years were to pass; and it would be another five years before the tetralogy was fully presented, in a purpose-built new opera house in the Bavarian town of Bayreuth. It was a herculean feat to create the entire text of these four long operas, and compose 16 hours of music that would completely redefine the concept of opera. Indeed, when the crowned heads of Europe, the great living composers, and the 19th-century European intelligentsia and glitterati, gathered at the new Festspielhaus in Bayreuth in 1876, many were so overwhelmed by what they saw and heard, that they were rendered speechless. Even now, 142 years later, first time Ring-goers are overwhelmed by the breadth and sweep, the musical and dramatic audacity, and uniqueness of the “Ring” operas, with their story of gods, giants, dwarves, flying Valkyries, Rhinemaidens, one huge dragon, humans, gold mined from a river, magic swords and spears, and of course, a gold ring whose possessor can control the world and its fate.

Even just looking at the third opera, “Siegfried,” Wagner struggled mightily. For one thing, being essentially a grifter and a cad, Wagner borrowed/took money from everyone who would lend/give it, and often had affairs with the wives of the patrons bankrolling his compositional work, leaving his life in constant chaos, as he fled from one city to the next. One such wife, Mathilde Wesendonck, inspired the opera “Tristan und Isolde,” groundbreaking operas that Wagner wrote during a 12-year hiatus in his composition of “Siegfried.” And “Tristan” itself changed the entirety of classical music, its tonality-challenging chromaticism.

Well, no one is expecting anyone to match the unique creativity of Wagner’s “Ring” cycle. But the leaders of U.S. patient care organizations are doing a lot of important things these days, including using formal continuous improvement methodologies to rework core patient care delivery processes in order to transition into value-based healthcare. What’s more, as our Special Report on Leadership outlines, the entire role of the CIO is being rethought now, as the demands for leadership and strategic capabilities are catapulting that role forward; and patient care organizations are beginning to make real headway in advancing equality for women and people of color among the ranks of healthcare IT leaders and managers.

So while no one is expecting anyone to create an operatic tetralogy that will change the face of music, there are plenty of heroic endeavors open to anyone willing to envision the healthcare system of the future. The opportunities are as limitless as the imagination.

Related Insights For: Leadership


Using Performance Management to Scale

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Performance management is so much more than just a year-end performance review
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Performance management and goal setting have always been part of my DNA. It’s like a compass that tells us we are steering the ship in the right direction or gives us a chance to course correct if we wander off track. It’s hard for any organization to determine how they are doing unless there are clear measurable objectives. CIOs and their leaders need monthly, quarterly and annual goals to measure how you and your team are doing against the plan. I also firmly believe they should be S.M.A.R.T. goals: Specific, Measurable, Achievable, Relevant and Time-based.

Once the goals have been established, you need a written plan. I like three-year rolling plans so you can look into the future and describe your vision of what your organization will look like 36 months out. Then you can work back to the second year, and eventually the first year, to give you the framework for what you need to accomplish in the next 12 months. I suggest you do it with your managers. It makes them accountable to the organization since they are involved in the formation of the plan.

Your plan must be a living document to be used frequently during team meetings throughout the year to see how you are performing as a team and individually. This is not a process you invest in to review at year-end to see how you performed. By then it’s too late. It must be reviewed on a consistent basis to make sure everyone is on track. Performance management is so much more than just a year-end performance review. If there are individuals who are not performing against the plan, you can use the plan as a tool to performance manage them to re-engage as an important member of the team. 

I just returned from the Scale-up Conference in Denver and learned so much about taking goal setting and performance management to a whole new level by adopting the "Rockefeller Habits," as written by Verne Harnish. After reading the book, everything changed for me in the way we will be doing our planning, goal setting and performance management forever. It’s so brilliant and easy to understand. Here they are:

Rockefeller Habit #1: The executive team is healthy and aligned

Rockefeller Habit #2: Everyone is aligned with the #1 thing that needs to be accomplished this quarter to move the organization forward

Rockefeller Habit #3: Communication rhythm is established and information moves through the organization accurately and quickly

Rockefeller Habit #4: Every facet of the organization has a person assigned with accountability for ensuring goals are met

Rockefeller Habit #5: Ongoing employee input is collected to identify obstacles and opportunities

Rockefeller Habit #6: Reporting and analysis of customer feedback data is as frequent and accurate as financial data

Rockefeller Habit #7: Core values and purpose are “alive” in the organization

Rockefeller Habit #8: Employees can articulate the key components of the company’s strategy accurately

Rockefeller Habit #9: All employees can answer quantitatively whether they had a good day or week

Rockefeller Habit #10: The company’s plans and performance are visible to everyone

Accountability is no longer hard to measure since the entire plan is visible to everyone throughout the organization. Each part of your team should have key people accountable for every functional part of your organization. No more guessing is required. I’ve read countless books about leadership, performance management and goal setting, as I’ve been an avid student on the subject for decades.

These ten habits, once adopted and measured regularly, can change any organization that wants to grow and scale, and keep everyone accountable along the way.

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