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Learning from Doctors in Practice, Pushing Towards Innovation

April 9, 2013
by Mark Hagland
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Northwestern Memorial’s Lyle Berkowitz, M.D. wears many hats—and sees IT-fueled innovation from many angles

Lyle Berkowitz, M.D. has nearly as many professional titles as he has professional affiliations, involvements, and activities. He has been long-time medical director of IT and innovation for Northwestern Memorial Physicians Group (NMPG); and was also recently named associate chief medical officer of innovation for Northwestern Memorial Hospital, the academic medical center located in downtown Chicago with which the multispecialty NMPG is affiliated. He is also a clinical associate professor of medicine at the Feinberg School of Medicine at Northwestern University, and director of the Szollosi Healthcare Innovation Program. In addition, he recently co-founded and is chairman of healthfinch, a software firm building "doctor happiness tools" which integrate with EMRs to improve office workflow efficiencies.

In addition, late last year, he published a new book, Innovation with Information Technologies in Healthcare, of which he is co-editor. And in his “spare time,” he blogs at The Change Doctor.

Clearly, Lyle Berkowitz is a busy man. But he took time out recently to sit down and speak with HCI Editor-in-Chief Mark Hagland regarding the recent evolution of his thinking around healthcare IT innovation. Below are excerpts from that interview.

With regard to Innovation with Information Technologies in Healthcare, Marion Ball [Marion J. Ball, Ed.D., professor at the Johns Hopkins School of Nursing, and a consultant with the IBM Center for Healthcare Management] approached you about creating a book combining healthcare IT and innovation?

Yes, Marion knew that I was very involved in both the informatics and innovation worlds, and brought this idea to me. I wrestled with the question of whether it should be more about innovation or about IT. As I discussed it with my colleague (and eventual co-editor) Chris McCarthy, who leads the Innovation Learning Network (ILN), it quickly became clear that this book should be a series of stories about innovative uses of HIT.  Furthermore, we needed to tell them in a way that would educate and help readers without being overly dogmatic, and would explain to them that you can readily innovate with the technology you already have now.  So the first third of the book has stories about innovative uses of electronic medical records (EMRs), the second third has stories about innovative uses of telehealth, and the last third covers innovative stories with more advanced technologies.

We started the book by creating a narrative for the imaginary Ramirez family, and we asked each author to consider how their innovation would affect this family.  This was a fun way to ensure similarity of voices among the authors, while also nurturing the individuality of the different authors’ situations and stories.  Most of the innovations [presented within case studies in the book] were pretty well-baked, though a few were still pretty early in their development. But in all cases, there were a lot of lessons that had already been learned. In some cases we even went back in time to get the stories of past innovations which still have relevance today, such as the history of one of the first patient portals. Now it’s not as though patient portals are that new anymore, but we went back to the time and place when patient portals were new, and asked the early pioneers from Partners Healthcare what the conditions were like then and how they figured out what to do.

A key point in all of this is that innovation is not about the technology.  In fact, there is a science and methodology to the art of innovation which we see in numerous ways throughout the book. To help orient readers, in the second chapter we defined many of these innovation methods, and explained how they apply to information technology in healthcare.

Lyle Berkowitz, M.D.

How do most innovations start - is it usually via some sentinel event?

We did ask the authors about this - and each chapter has section explaining how and why an innovation began in the first place.  Often, there was a sentinel event, but there was also a champion for change.  The result would be a change in process, technologies, and/or business models. In some cases, people actually changed state laws which needed to evolve to today's realities!  But the tough part is culturally doing something new, and making sure everyone feels comfortable about it.

Are you perhaps impatient that there’s a lack of deep thinking about some things in the industry right now?


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