Update From the Field: National Association of Community Health Centers April 2019

The Business Innovation Factory (BIF) team just recently visited Castle Family Health Center in Atwater, California and Lawndale Christian Health Center in Chicago, Illinois where we conducted interviews with the health centers’ leaders, staff, and patients. Our work with the National Association of Community Health Centers (NACHC) is focused on creating more opportunities for transformation within their network. As we began to analyze and synthesize our findings, a few emerging curiosities came to the surface:

How do you create the conditions where people are able to advocate for their own health and wellness – both physical and mental?

What practices, processes, and mindsets are central to creating a culture of trust in a health center?

How are community health centers uniquely situated to be transformative players in the changing landscape of healthcare?  Beyond providing health care services, what roles do community health centers play in their ecosystem?

Throughout our travels to Florida, California, and Illinois we had rich discussions with patients that offered insights into their perspectives around these questions. Combined with over 14 years and 70 BIF projects seeking to understand customer (patient, student, and citizen) experience particularly in underserved communities we have a solid design foundation to explore opportunities with NACHC to accelerate patient-centered transformation in the communities it’s Members serve.

 

Prioritizing Personal Health, Wellness, and Self Advocacy

 

When individuals have the mindsets, time, resources, and/or support to invest in themselves, they can better advocate and have greater ownership over their healthcare and wellbeing experience beyond their visit to the doctor’s office. Patients will be better agents of their own health and wellbeing when their life experiences are understood in a full context. Health and wellness start by unleashing patient agency to take advantage of the right knowledge, tools, expertise, and resources when and where patients need them.

A patient from Castle Family Health Center explained,  “An important decision for me is to take care of myself because I was always worried about other people, what they were feeling, and making them happy….but getting to the point where I had allowed myself to be a little selfish, and take the time for me, that was a big decision. ”

The healthcare system today relies on the expertise of the doctor to provide knowledge or tell a patient what they need to change to improve their health and assumes people will take this advice and act on it. People need to feel empowered and enabled to make these changes in the face of other life stressors, and feel supported by their doctor. Providing the opportunities for patients to be engaged in their healthcare journey, rather than passively being told what they need to do by a doctor, will enable patients to actively sustain the steps towards improved health and wellness.

 

Cultivating a Culture of Trust

 

Individuals make important decisions based on the people, places, and information that they trust, which can lead to positive, negative, or neutral health and wellness outcomes in their life. When patients feel that both the staff and doctors truly listen and understand them, it helps build their trust and relationship with the health center they are utilizing. A patient at Castle Family Health Center described, “Right here is where my entire self-care comes from… They listen to what I’m feeling, you know?” This patient has entrusted the health center to help her on a path to taking better care of herself due to the positive experience she has had over time.

When trust is developed, patients are more open and comfortable sharing their experiences and problems, allowing health centers to better help them in reaching their health and wellness goals. In this day and age, there are many different options of providers and services available to individuals that it can be difficult to know who to trust. When health care centers are able to meet the needs of individuals and value them as more than patient X of the day, this moves from a transactional experience to one based on relationships.

This was demonstrated when another patient from Castle Family Health Center explained,  “They were kind. They were caring, attentive, and quick. If I came early, they called the doctor to see if there were any slots open or if someone didn’t show….I had two appointments today, and I checked in and they communicated with me and made me feel like I wasn’t just going to be brushed aside until my appointment time.”

Overcoming barriers of distrust within healthcare institutions requires creating a culture of trust where patients know their care is personalized for their life, resulting in a healthcare journey that has their best interests at heart.

 

Reflecting Community Values and Catalyzing Patients’ Narratives

 

People want to share their stories and contribute their knowledge and passion to their wider community. As noted before, the healthcare experience is often a one-way transfer of information, knowledge, and values. However, we heard from patients that it is just as important that they are able to see their values and knowledge reflected in the health center. They noted that generosity and collective support kept them engaged in spaces both in the health center and beyond.

A patient at Lawndale Christian Health Center shared that values of the health center help her have trust in the staff and services provided. Those values also made her more likely to share her story with members of her community and support them in living healthier lives.  

She shared: “If a testimony was ever required of me I’ll be sure to make some space for it to make people aware that this [depression and other mental health struggles] is a real thing and that there’s help out there and there is proper medication for this… Whenever you guys want to call me to initiate a conversation for me to express my own story, to share with others I’ll make time for it for sure.”

A patient from Bond Community Health Center shared a story where he saw himself reflected in the community. “Today a lady came in and she didn’t have her copayment. Another lady sitting in the waiting room walked up and said ‘I will pay her copayment. If she has any problems I’ll pay it for her.’ These are the people who touch you. She said the copay was $25 and she only had $20. And I looked at the receptionist and she already knew that I had it, but before I could reach to get the five dollars the other lady came up and said ‘I’ll do it.’ So you know, it’s people like me that are here with open hearts and they will do for others. So I feel really comfortable with the people here.”

When patients see a health center emulating the same values and beliefs that they adhere to, it creates a sense of trust and commitment as they are aligned together through a common purpose. Health centers have an opportunity to lift up patients’ narratives and create pathways for patients to become core to their recruitment, retention, and reform efforts.

As we continue our exploration, we look forward to more storytelling and actionable insights from the field to put patient experience at the core of our design and innovation process.

 

Read Part 1: Emerging Insights from the Leadership Perspective

Are you ready to transform healthcare? Email us at hello@bif.is


Update From the Field: National Association of Community Health Centers March 2019

Last week, the BIF team visited Bond Community Health Center in Tallahassee, Florida and Eau Claire Cooperative Health in Columbia, South Carolina to conduct interviews with leaders, staff, and patients as we continue our work with the National Association of Community Health Centers (NACHC). BIF and NACHC leadership are joining forces to explore the questions:

How might we shift our lens to uncover innovation opportunities that will transform how we serve patients?

How might we collaboratively innovate, going farther together?

How might we continue to promote equality in the healthcare system?

We learned a lot in our four day trip down South, and a few insights emerged as we look toward the next phase of the project.

 

Key Insights we Learned from their Healthcare Leaders:

 

The role of Technology in healthcare systems

When speaking with leadership teams at the sites, we learned that technology is helpful but not the long term solution to fix the healthcare system. According to Donnell Durden, Coordinator of Community Relations and Outreach at Bond Community Health Center:

“All of the technology works, it helps, it helps us amplify our message. But nothing is more important than getting outside, touching the people, shaking hands… reaching out to them; letting them know that we are here for them, we want their business, but more so, we’re here.”

Emerging technologies help deliver value in the real world, but are not at the core of creating healthier communities. Technology can be utilized as a component to support larger system changes that focus on the human experience first. If they’re constrained by today’s business model, technologies will only deliver tweaks, not transformation. It is crucial that we consider technology to be a supplementary aspect of innovation, rather than innovation itself.

 

Medical services are only 20% of the health centers job-to-be-done

Keeping in mind the increased importance of the social determinants of health when considering the actual services needed to successfully run a community health center, medical services only cover about 20% of all patient needs. The remaining patient’s jobs-to-be-done are met through enabling wraparound services like transportation, having access to childcare, caseworkers, insurance specialists, social workers, and nutrition education outreach, among others. While none of these wraparound services are actually separate from a comprehensive care model, often these services are unacknowledged in traditional healthcare experiences. The wraparound enabling services compose the majority of what community health centers do for people, but these services are often non-billable and intangible in healthcare. By adopting a more evolved definition of what health and wellness look like for individuals, we gain a better understanding of service gaps and experiences, realizing that wraparound services provide a more holistic and comprehensive solution to their pain points.

What innovation means to healthcare leaders

When speaking with community health center leadership teams, we gathered that innovation means changing the way care is provided to better serve patients and families, leading to healthier, wholesome outcomes. It also means not accepting the status quo. But what does innovation look like within community health centers? Dr. Robinson, CEO of Bond Community Health Center posed the question:

“When we consider innovation, we need to ask ourselves- Is it a good fit in the community? Does it fit the mission? Is it feasible and sustainable? Can you see passion and excitement among your team and will that lead to lasting partnerships?”

 

Innovation means staying true to your core values while also not allowing the way systems work today to dictate what’s possible for a better future. Eau Claire Cooperative Health Center’s leadership team focuses on how their founder instilled in them the mindset and perspective that there isn’t anything they can’t do. Innovation isn’t easy in this context, but core business models need to change if we strive to continue breaking down the barriers of inequality in healthcare.

 

Looking Forward

Look out for the next update from the field highlighting the patient perspective as we continue to make discoveries in our research with NACHC.

 

For more on our work, visit our case study here: National Association of Community Health Centers Case Study


Healthcare Storytellers to Watch at #BIF2018

This September 13-14, 500 innovation junkies will convene in Providence, Rhode Island to listen to 32 storytellers share their passionate stories about transformation at the annual Business Innovation Factory (BIF) Collaborative Innovation Summit. BIF’s Patient Experience Lab is most excited to listen and learn from these 5 speakers from the healthcare industry:  

Andrew Hessel

Andrew Hessel

Andrew Hessel is the CEO of Humane Genomics Inc., a seed-stage company developing virus-based therapies for cancer, starting with dogs. Andrew is also the co-founder of Genome Project-write, an international scientific effort working to engineer large genomes, including the human genome. He is also a Distinguished Researcher at Autodesk Life Sciences and a faculty member at Singularity University.  Andrew is a reputable speaker helping people understand the biotech industry. He enjoys presenting to groups with government, academic, and commercial backgrounds. Check out Andrew at BIF 2016

Dr. Nneka Jones Tapia

Dr. Nneka Jones Tapia

Dr. Nneka Jones Tapia is the Executive Director of the Cook County Department of Corrections where she oversees mental health strategy. The Cook County Jail, located in Chicago, is home to 2000-2500 inmates suffering from mental illnesses. Nneka focuses her work to slow the rate of mentally ill individuals re-entering the prison system by developing the Mental Health Transition Center to build a system of support for inmates re-entering the community. She became warden of the Cook County Jail in the Spring of 2015, emerging as one of the first clinical psychologists to run a prison, understanding how a large portion of the jail’s population suffers from mental illness. Read more about Dr. Nneka Jones Tapia here.

Darden Smith

Darden Smith

Darden Smith is a singer-songwriter, a founder of a non-profit, an author, and a return BIF Summit speaker. Darden has produced 15 critically-acclaimed albums in his 32-year career. Mental health is often hard to talk about, however, Darden is helping American heroes tell their story, release often invisible pain and forge new connections. His non-profit, SongwritingWith: Soldiers helps soldiers and their families cope with the aftermath of combat by using music as a form of expression. Darden is an accomplished speaker and often shares insight into the lessons he learned as a singer-songwriter, how he re-made himself into a non-profit founder and entrepreneur, and his evolution as an artist. Check out Darden at BIF 10.

Ken Falke

Ken Falke

Ken Falke is a 21-year combat veteran of the US Navy Explosive Ordnance Disposal community and retired as a Master Chief Petty Officer. Ken’s passion for taking care of his fellow vets led him to develop Boulder Crest, America’s first privately funded wellness center that assists combat veterans and their families. Boulder Crest focuses on an alternative approach to treating PTSD and depression. Ken is also an accomplished author and recently released his book, Struggle Well which focuses on post-traumatic growth. Ken is highly respected around the world as an innovative and forwardthinking leader on the subjects of wounded warrior care, military and veteran transition, counterterrorism, military training, and innovative technology development.

Emily Levy

Emily Levy is the CEO and founder of Mightywell, a company that aims to “turn sickness into strength”. Her products allow patients to live a more comfortable life by helping them to maintain their dignity, health, and confidence through functional and stylish apparel and accessories. At Mightywell, Emily encourages a strong, digitally-driven community where peers can talk about their experiences and find strength in each other.

 

This year’s BIF Summit will be a welcome place for healthcare innovators and leaders to connect and find inspiration to transform the industry. Are you a healthcare leader who shares BIF’s passion to innovate and transform? Email Will to talk about this year’s Collaborative Innovation Summit

Connect. Inspire. Transform. Register #BIF2018


Voices of the Innovative Learning Network (ILN)

On May 8-10, the Innovative Learning Network (ILN) met in Charlotte, North Carolina to discuss and explore business model innovation in the healthcare industry. I found it amazing to see such a diverse group of innovators – senior leaders, doctors, nurses, and directors of innovation just to name a few. With everyone’s different backgrounds, we were able to tackle the looming question of business model innovation in healthcare from all angles and perspectives in a safe space where thinking outside the box was encouraged.

Business Innovation Factory (BIF) hosted the meeting to lead a 3-day workshop with Atrium Health. The workshop was designed to take the ILNers through our Design Methodology and Playbook for Next Practices and New Business Models process using a case study from our past work with Children’s Health in Dallas. In groups, we started by shifting our lens to understand the pains, gains, and job-to-be-done from the customer’s perspective. Then, we took the customer’s current experience as a foundation for imagining a new customer experience that relieves the customer’s pain points, maximize the gains, and completes the job-to-be-done. Finally, we tested a low fidelity prototype and put it up to the constructive criticism of the other groups.

We met with a few top healthcare trailblazers from a variety of different organizations and backgrounds who aren’t afraid to operate in the ‘scary’ space of business model innovation to ask them a few questions. We asked them about their personal take on innovation, the obstacles they must circumnavigate to innovate within their company, what innovative questions they want to explore in their company, how they prepare for future business models, and how they differentiate between transformational and incremental change.

While healthcare leaders understand the imperative of business model innovation, it is often scary to disrupt a large system that has been in place for years. When the motto of healthcare is “do no harm,” it is hard to be the guinea pig to test out new business models and next practices. Our goal was to help them make the business model innovation process safer and easier to manage.

I found it fascinating how unique, yet similar each person’s response was to these questions. The ILN is such a great catalyst for future business models because it provides a place for members to discuss and explore business model innovation in a safe way. Tim Rawson from ILN said that the event was a meeting, not a conference because in a meeting, things can go wrong. It was clear that everybody, no matter who they were felt confident sharing their perspective and wasn’t afraid of failure, rather they embraced it.

From the ILN In-Person meeting and the interviews, I learned how there is a clear imperative for business model innovation in the healthcare industry. Leaders are ready and willing to make that next step to transform their business models, but they just need a clear path forward. At BIF, we make the step towards next practices transformation safer and easier to manage. It is no question that patient’s values have changed; they want to feel empowered to take control over their health and overall wellness. They want to understand their health in normal terms and have a clear path to achieving their wellness goals. By transforming business models to align with customer values, not only will the customer be happier and healthier, but the business itself will perform better under new metrics of success.

New call-to-action


Changing the Quality of Patient Experiences for Families with Autism

For my first blog post as the new Patient Experience Lab Manager at the Business Innovation Factory, I wanted to talk about something that I am passionate about because it is personal. I want to share a story about Autism awareness month and my little cousin Cole, a 12-year-old boy who was diagnosed with Autism right around his first birthday.

As Cole grew older, I saw the pain and struggle that my family went through on a day to day basis just to trying to live a normal life. To gain a deeper understanding, I called my aunt last night to ask her a few questions. What are the challenges? What needs to be transformed? What is missing from the social aspect of families and family members afflicted with Autism and other disabilities?

businessinnovationfactory.com

 

According to the Centers for Disease Control and Prevention, one in 68 children has Autism Spectrum Disorder, a shocking 30% increase in the last two years. Further, the Associated Press reveals that 8% of all children born in 2018 in America will have a disability, and 10% of children stuck below the poverty line will be born with a disability.  

 

 

After speaking with my aunt, she revealed that there is little to no social support for families with members that have disabilities. When a child has autism, it can be hard for families to do normal things like go out to dinner or meet other families that have similar pain points and struggles. “We often feel isolated and alone,” she revealed. “We just need a place where families can be families.”  This inevitably puts immense pressure on the family – there are not many ways that these families can connect, unwind and relax, to just be human. Virtually no support groups exist for parents, everything is social media driven and parent run. There are not enough support systems for siblings to talk about their sisters and brothers who are different. In terms of overall wellness, there is a huge gap between what parents and siblings need and what is available to them. Mothers and fathers just want a normal life for their family, and siblings can find it hard to fathom why their family is different and are often embarrassed because they think that others don’t understand.

Even though the services available to families with autistic members are often not enough, there are not nearly enough resources present for social support systems. In other words, there are services available to cover the clinical definition of well-being, but that is not enough. There are not enough resources available for families with members that have disabilities to cover the emotional definition of well-being. In past work, we at BIF have identified the key drivers in overall well-being as a balanced outlook, sense of self, a solid support system, connected knowledge, and personal power. From our research, we know that children with medical complexities have extremely high needs and unpredictability, causing moms, dads and family members to live under constant stress.

We have examined the experiences of medically complex kids and identified new opportunities to support the whole family better in ways by connecting moms and families in similar medical situations, relieving unnecessary burdens that fall on parents, adapting homes and hospitals so that they feel more comfortable and familiar, equipping parents with the skills they need to provide for their child, providing parents with opportunities to personally develop, and reducing barriers to social life.  It pains me to see how many elements of complete well-being are missing for families with members that have disabilities.

There is absolutely a job-to-be-done for these families and I am excited to explore the possibilities of working with families with children on the autism spectrum to gain a deeper understanding of their pain points, their needs, and how we can support their overall wellness beyond the few services that are currently available. I hope for a future where children with autism and their families do not feel ostracized. I hope for a future where families are connected and given the tools that they need to thrive so that living a normal, peaceful and happy life isn’t out of the question.

To learn more about the work we are doing in PXL, visit us here.


Pulling the Lever — How Teachers are Deepening Student Learning

Let’s be honest, there are plenty of education buzzwords flying around: deeper learning might just be one you’ve heard. Regardless of whether you use the term “deeper learning” or not, skills like critical thinking, being a good communicator and being able to work effectively on a team are all concepts that you consider important for students to have.

If you’re an educator, you know that group projects, and student exhibitions can be amazing ways to engage students not just recipients of knowledge, but as active participants in their learning. That being said, the intention of this article is to get beyond the buzz; to explore what deeper learning is, it’s importance, and to provide some insight as to how teachers are preparing their students for a world outside of school.

 

Deeper Learning, as defined by the Hewlett Foundation, is a set of six competencies that focus on academic, interpersonal, and intrapersonal skills that we believe students need to have to prepare them as life-long learnings, and good citizens.

These competencies are:

  • Mastery of academic content
  • Critical thinking
  • Communication
  • Collaboration
  • Having a perseverance mindset
  • Self-directed learning

Even if a teacher hasn’t heard the term deeper learning, they are at the least familiar with these skills, or rather competencies.

 

If you were curious as to what deeper learning looked like in practice, you might find all these competencies at play at one of the official deeper learning schools, such as High Tech High in San Diego California, or the Big Picture Learning school Network. Many deeper learning advocates have pointed to these schools as exemplary models for what happens when educators collectively drive to deepen student learning. It comes as little surprise that when a school is given the opportunity to establish a mission around deeper learning, space for experimentation, and financial support, you will see deeper learning happening at multiple levels.

However, there has been less of an understanding as to what is going on in our nation’s public schools, many of which are more traditional in their approach to education. More problematically, an “us vs them” mentality has developed in terms of who is doing deeper learning, and who isn’t — creating more challenges in helping schools do more deeper learning. Our time spent in public high schools had revealed that most, if not all teachers, we’re doing some deeper learning work. It might not be happening every day with all 6 competencies, but we know teachers were looking to build out these skills (often times in between test prep, and coursework they just “needed to get through”). So to shine some light on the experience of public school educators with deeper learning, we went out and spoke to educators.

We interviewed educators from public schools in urban, suburban, and rural districts. We spoke with over 20 teachers, school leaders, and administrators. Our questions focused on pulling out teachers experiences as they implemented deeper learning competencies. We had educators speak to the enabling elements in their school or practice that allowed them to deepen student learning, as well as the barriers that restricted them from doing more or implementing all competencies more consistently. The interviews provided us with a plethora of stories that we were able to bring back to our Student Experience Lab where we dissected and analyzed our findings. After identifying patterns and trends, we were able to identify a model of the six most common barriers and enabler that would hold our findings together. We called this model LEVERS, which is an acronym for the six most common barriers and enablers educators’ faced when deepening student learning.

 

The LEVERS indicate that realities of school leadership, student equity, teacher versatility and experience, and school or education structure, could act as both barriers or enablers. For example, a school with a high turnover of school leadership often inhibits deeper learning in a school, whereas a school leader who supports her teachers and advocates for experimentation will have a profound impact the frequency and effectiveness of deeper learning. We published our findings and high-quality videos of our educator interviews on a web report. You can find it all at levers2learn.com. We encourage you to visit the report, and watch the videos, and share them.

From our initial research, we went back to the educators we had initially interviewed to present the LEVERS to see what resonated, and what could be improved. We also brainstormed what we might do, moving forward, to help push a school to do more deeper learning, more often. We established the Deeper Learning Academy, a cohort of teacher teams from 4 different high schools that would use a design-thinking methodology to help spread deeper learning in their school. Teams met up and came up with some compelling solutions. Some of these projects addressed teachers’ personal commitment to do more deeper learning in their practice, and others would be implemented across the school. Staying true to our methodology, we encouraged teachers to start small, prototype quickly, and build upon their learnings.


So what can you do with the LEVERS? As educators, we know that there is power in knowledge. The LEVERS model can be used and a school-wide self-assessment tool.

Deeper Learning occurs in various settings, though it may take different forms depending on the context of a given school. Understanding this context is half the battle. When teachers and school leaders have a grasp of their school’s Deeper Learning landscape, they have the power to act with intentionality. They can focus their energy on classroom and school-wide initiatives that are feasible within their context, while still having a potential impact on the students. Ultimately, the Levers2Learn framework can help educators and school leaders understand the landscape for potential deeper learning at their schools.

Deeper Learning in a given school is affected by where the school falls along the spectrums of all six Levers. Depending on where schools are, different opportunities and challenges may present themselves. Educators can utilize the LEVERS to form strategies to implement more Deeper Learning that can lead to school-wide change. Likewise, school leaders can use the LEVERS to find opportunities to leverage the ones that are currently helping the school implement Deeper Learning initiatives. In addition, both educators and school leaders can use the LEVERS to create strategies that can address any Levers that may be potential barriers towards Deeper Learning.

 

Although we do not feel like all LEVERS must be turned to the “on” position for a school to do deeper learning, having an understanding of what might presenting challenges to educators provides a great opportunity to work to break down some of the barriers. For example, we found that in one school many educators did not feel comfortable experimenting with new techniques and methods (limited versatility). The group of teachers we were working with decided that providing a low-stakes, safe way for teachers to try out deeper learning projects was a great way to help them feel included. Further, encouraging those teachers to look for the deeper learning they were already doing helped alleviate some of the “us vs them” mentality as to who was doing deeper learning and who was not.

So where do we go from here? Having gotten to work with the teacher teams has provided us with some great insight for how the LEVERS can be used, as well as how teachers can take a proactive approach towards the spread of deeper learning in their school. In the coming school year, we will be providing additional videos to the levers2learn website to help ground the conversation in how teachers are taking action. The videos, along with our analysis of the teacher teams’ experiences working towards implementing more deeper learning in their classrooms and schools, can be found at leverstolearn.com.


The Kids’ Table

Do you remember being stuck at the kids’ table for Thanksgiving dinner growing up? I do. There were always too many of us to all sit around one dinner table, so we had a secondary table off to the side, sometimes even in a separate room, to which the younger generation was relegated. I remember asking every year if I would be able to sit with the grownups. The conversation at their table ranged from sports to politics to family gossip, and whatever the topic it was always more animated and intense. I know why now: it’s because adults love to talk, debate, and argue about the sorry state of the world and how it should get better. But what an irony: those of us with the biggest stake in the future-our youth-were not at the table hearing or contributing to the conversation. Back then, all I understood was that the main table was where the action seemed to be, and I wanted in.

These days, I do get to sit at some main tables, but I try to stay mindful of whose voices aren’t being heard there-particularly when they are young and presumed not to have anything to add. I feel this most acutely in the debates around education reform. We keep kids off to the side while the adults talk and talk and talk about how to improve student experience and outcomes. And there’s another similarity to Thanksgiving meals: a lot of loud conversation and not much action! The talk at the grownup table never stops, yet year after year the education system in the US continues to atrophy and our students fall further behind the global curve. Every 29 seconds in America another student gives up on school, adding up to nearly a million high school dropouts a year.

What if we put students at the center of the education transformation conversation? Could we get past our suspicion that they would make ignorant or irresponsible suggestions, and tap into what they know better than any of us: what works for them as learners? If we engaged kids in the problems facing schools, and gave them access to design tools, they might imagine a learning experience they would be more likely to engage in and commit to. What if we didn’t stick our youth at the kid’s table?

The notion of bringing kids into the conversation about what serves them best is beginning to take hold in various quarters. Ellen Galinsky did it in the midst of a cultural debate on whether children were better or worse off when their mothers entered the workforce. The audacious approach of her study became the title of her book Ask The Children. Architects who design the places where kids spend their time are doing more asking, too. Check out, for instance, these photos of the Erika-Mann Grundschule II in Amsterdam. “The school’s recently revamped environment is amazing, perhaps not surprisingly as it was designed by the kids themselves”

Here at the Business Innovation Factory (BIF), our Student Experience Lab has a growing portfolio of projects guided by a simple and powerful question, What if we trusted and enabled students to design their own education future? A future that learners were personally excited about and committed to. The big ‘aha’ from over twelve years of facilitating education design studios at BIF is the imperative to enable student agency. We must put students in the driver’s seat and view our role, the role of adults, as catalysts.

In a representative education design studio at BIF we invited 40 students aged 12–22 who traveled to BIF in Providence from all corners of Rhode Island’s public education system to explore and demonstrate the power of student agency. Right at the start of the day, it was announced that there would be a kids’ table, but guess who was relegated to it? The adults in the room-leaving the students at the main tables to drive the conversation while we listened.

Sure enough, just like at the Thanksgivings of my childhood, all the action was at the main table. As a room full of engaged youth began filling flip charts and flip cameras with idea after idea for improving their student experience, we adults were blown away by their purpose and passion. First of all, note that this design studio took place on a Saturday: these forty students were giving up half of a precious weekend to think and talk about school and how to improve it. And their energy level remained high for the entire day.

The first insight that hit us like a two-by-four between the eyes is that students don’t hate school. These students made it clear right away that they see the value of school, and given the opportunity to design their dream student experience, not one of the student groups in the room argued for throwing out the traditional school model completely. They embraced the importance of a strong core curriculum, but their ideas suggested how hungry they are for the freedom to follow their unique curiosities, and learn skills in the context of subjects that already fascinate them. They also had things to tell us about the importance of learning relationships, and how schools could provide more mentors and role models.

They also told us a few things about how it felt to be at the kids’ table. They were aware that no one had ever asked them before what they thought, and that when they did speak up in their various ways, they were not heard. One student remarked, “I come to school to be heard, so shouldn’t you listen?”

I’m certain we only scratched the surface of what young people can contribute to the education reform conversation that day. More broadly, think of all the areas where adults are monopolizing a conversation in which youth have the largest stake. We should recognize that young people seek purpose and want to impact their surroundings, including school but not limited to it.

For me, that means I should listen to and involve youth more in designing any future I have a hand in, but they will inherit. At my family’s Thanksgiving this week, there won’t be a kids’ table. Happy Thanksgiving


What’s Your From…To Story?

A fellow pharmacy school graduate and colleague from early in my career, George Zorich, is writing a book advocating for pharmacy schools to integrate entrepreneurship education into their standard curriculum. A section of the book will contain stories of pharmacy school graduates who leveraged their education in surprising ways, catalyzing non-traditional and interesting career paths. George asked me to share my story. I’m honored to be asked and I found it invaluable to reflect on my own convoluted career path. Are you doing what you originally set out to do in college? If you’re like most people you’ve had to reinvent yourself multiple times over your career. The world of work is changing faster than ever. What’s your from….to story? Here’s mine.

My thought process coming out of high school was no more complicated than, I love science and it would be nice if a college diploma resulted in a job! Pharmacy fit the bill. I wasn’t signing up for a career, just looking for a start. I wanted something I could build on without a clue where it might lead. A pharmacy degree from the University of Rhode Island School of Pharmacy in the 1970’s was the perfect prescription. I knew by my sophomore year I wouldn’t spend my career filling prescriptions but I have always valued the foundation I received at URI. While I couldn’t tell you then how I planned to leverage a pharmacy degree I had confidence it would set me up for a successful career. I have been grateful for my pharmacy education every day since.

I went on to launch a career with many twists and turns as an innovation junkie and strategist. I believe there is always a better way. I have dedicated my career and life to enable those around me to make what’s next easier and safer to manage. My career has followed the simple principle of always staying on a steep learning curve. I have always done my best work when I stretch myself to learn and do something new. I never cared about job titles, how many people reported to me, or how much money I made. I knew those things would come if I kept myself on a steep learning curve, always willing to tackle new challenges.

After pharmacy school, I wanted to learn how business and large organizations work and how emerging technologies change markets. I combined my analytical foundation from pharmacy school with an MBA from Rensselaer Polytechnic Institute (RPI) in the Strategic Management of Technology. From there I leveraged both degrees to work in the pharmaceutical industry for, Eli Lilly & Co, first in sales and then in the home office as a marketing manager. I had the incredible opportunity to work on the US introduction of Prozac. It was a young marketing manager’s dream job. I learned the difference between market making and share taking. Most people and organizations are share takers, competing for market share in a defined industry with known competitors. I became obsessed with market makers, people and organizations that redefine markets. My career has been defined by enabling market makers.

From Lilly I became a road warrior consultant first with Arthur D. Little and then as a Senior Partner at what became Accenture. I’m still learning what I learned during those halcyon days traveling around the world working with pharmaceutical and medical products companies, enabling and leading consulting practices and teams focused on innovation. I became interested in the difference between the innovation rhetoric coming out of the CEO suite and the real work being done at mid-levels in most of the companies I consulted with. The rhetoric was about transformation but the reality was more focused on incremental improvements to the way the companies worked at the time. Nothing wrong with tweaks but it seemed to me that a different approach to innovation was needed if transformation is the goal. Institutions are much better at share taking than market making.

I was fortunate to retire at an early age from Accenture, a few years after its IPO, and my wife wasn’t in the market for an innovation strategist at home to advise on household operations. I made the mistake of raising my hand to the new elected Governor in my home state of Rhode Island and the next thing I knew I was working as the number two at the state’s economic development agency. Soon after I joined the agency its Director went back to Wall Street and I found myself leading the agency. I had become an accidental bureaucrat! It completely changed my world- view and approach to innovation. Instead of seeing innovation through the lens of large institutions I learned to see it through the lens of the citizens, students, and patients they served. In developing the state’s economic development strategy I began to see the state as a real-world sandbox to develop transformational models in government, education, and healthcare.

I created the Business Innovation Factory (BIF) at first as a local program in Rhode Island, and when I left state government, to now serve government, healthcare, and education leaders across the country to explore and test next practices and new business models to help make transformation safer and easier to manage. We live in a time that screams for transformation and the best we seem capable of is tweaking what works today. BIF is trying to change that.

I am proud of my pharmacy background and how I’ve been able to combine and recombine what I’ve learned along the way to take on and create new roles that didn’t exist or that I could never imagine when I was in college. The truth is that none of us can predict what we will be doing in the future. All we can do is learn how to confidently reinvent ourselves, building on our capabilities and experiences. Reinvention is the most important life skill in a rapidly changing world. Any college degree or post-secondary credential, including pharmacy, is a wonderful foundation to open up many new career and life paths if we let it.

What’s your from…to story?


Three Things Are Changing: 1) The Market 2) BIF 3) Me

Famous last words; This time it’s different. No really, this time it is. We have arrived at that Malcolm Gladwell tipping point. Well at least I have, and I don’t think I’m alone. Let me make it personal. We each find our own reasons to reach for another gear, to reinvent ourselves, and to do work that matters. My burning platform is comprised of three things that are changing simultaneously: 1) The Market 2) BIF 3) Me. It’s not about me or my three things, it’s about being informed by and engaged in what’s changing around you, being self-aware and intentional about what’s next, getting better faster, and being clear about what’s important and what you value. Whatever your reasons, please hurry up and figure it out, because we need everyone to play, transformation is a team sport and a generative act. It’s go time!

The Market Is Catching On

When I first starting yakking about next practices and new business models at the Business Innovation Factory (BIF), twelve years ago, it was clear that institutions of all kinds were about to face a tsunami of existential threats that would require leaders to focus much more seriously on what’s next, not just new products but also next practices and entirely new business models. We all saw disruption coming. But at the time very few institutional leaders were ready, I’d say 1 out of 10 were. The truth is that BIF wasn’t ready either.

But over the last decade, an increasing number of leaders have figured out that disruption isn’t something to be defended against but an opportunity for the institutions they lead to be proactive, to go from being a share-taker to a market maker. More institutional leaders now recognize that business models don’t last as long as they used to and that their current innovation efforts are at best-producing tweaks. If transformation is the goal, more leaders now know they need a new innovation approach. BIF helps leaders make transformation safer and easier to manage because sometimes tweaks aren’t enough. Today, 3–4 out of 10 institutional leaders are ready and so is BIF. That’s what I call an addressable market!

BIF Is Ready

Over twelve years BIF has been imagining, designing, prototyping and testing the next practices that enable us to help leaders make transformation safer and easier to manage. Our vision and mission haven’t changed although we are always getting better at articulating it. BIF’s mission is to help institutional leaders design, test, and commercialize next practices and new business models. Our vision is to influence systems-level transformation in areas of high social importance focusing on healthcare, education, and public services. We believe that human-centered design, rapid prototyping, and storytelling/engagement are at the heart of any successful transformation process.

What’s changed at BIF is that we have gone from conceptual next practices, to actually standing them up, first for ourselves, and then for other motivated institutional leaders in the market. Because we did the hard work of standing up these lynchpin next practices (human-centered design, rapid prototyping, storytelling/engagement) BIF’s business model now delivers on our value proposition: To make transformational change safer and easier to manage. We’re ready.

The Third Thing That Changed Is Me

As the Founder and Chief Catalyst at BIF I have only myself to blame for what BIF has become and how fast it reinvents itself. It’s true that the market for what we’re trying to do is emerging and that our next practices and business model had to be developed generatively but in the end, I too have to change for BIF to work.

Much like for many of you, September 11th was an inflection point, after which I pivoted and became an accidental bureaucrat, working as the leader of my home state’s economic development agency in Rhode Island after successfully avoiding government for my entire career. It changed my life and world-view of the role innovation plays in transforming social systems, industries and communities. I learned to think about innovation, as value delivered to real students, patients and citizens living and working in real communities. I learned to see opportunities through the lens of customer experience. BIF was a result of that inflection point in my life. I’m beyond proud of what Team BIF has accomplished together.

I’ve now reached the next inflection point in my life, precipitated by the 2016 U.S. presidential election result and turning 60 years old a month later! I’m not one to blog about politics, although everyone who hangs with me or follows me on social media knows that the election result has thrown me, and a lot of us, for a loop. On one hand, if you’re an innovation junkie, the election is an interesting case study in disruption but I would argue that history will look back someday on this election as a case study of how not to disrupt. At BIF we know there is a better way to make much-needed transformation safer and easier to manage. It’s time to prove it.

I thought turning 60 was going to be awful but it wasn’t. Sure, I spent a few beautiful days with my bride hiding on an island, but if anything, turning 60 has energized and focused me with a sense of urgency to continue the work of scaling BIF to meet the scale of the societal challenges we now face. It’s work that matters.

The last chromosome in our BIF DNA is; A decade is a terrible thing to waste. I’m not planning on wasting this next one and I hope you aren’t either. Let’s go!


10 Reasons Colleges Fail At Business Model Innovation

Higher education has a business model problem. The business model for U.S. colleges and universities — how they create, deliver, and capture value — hasn’t changed since Harvard, our country’s first college, was founded in 1636. Our higher education system is a national treasure that creates enormous societal value, but its 380-year-old business model fails to deliver affordable access and post-secondary credentials to an increasing percentage of our population.

The American social contract was clear throughout the Industrial Era. While many jobs moved out of reach for those without a college degree, there were still ample opportunities for everyone to earn a good living in order to support a family. The U.S. became an economic powerhouse with a robust and thriving middle class.

Then the rug got pulled out from under the economy. The Industrial Era ended, taking with it most of the career opportunities for those without a college degree or relevant post-secondary credential.

The existing social contract broke and was replaced by a new one, with the expectation that everyone gains some form of post-secondary credential in order to be relevant to the new economy and to earn enough to sustain a good living.

Unfortunately, while societal expectations for higher education changed, its business model hasn’t. As a result, far too many citizens have been left without affordable access to a post-secondary credential that will put them on a pathway to a good living.

When I was an accidental bureaucrat leading a state economic development agency, my friends asked me how, after working in the private sector for so long, I could put up with government’s slow pace. I responded that, after 20 years in the private sector, I was convinced that big corporations didn’t move quickly either.

I also teased my friends in academia that colleges and universities move even more slowly than either big business or government! Higher education has the most intransigent business model on the planet.

Here are 10 reasons why colleges fail at business model innovation:

1. College presidents and boards don’t really want a new business model.

Business model exploration doesn’t happen if senior leadership doesn’t want it to. It takes strong leadership at the top to pedal the bicycle of today’s business model while simultaneously creating the conditions to explore and test new ones. The good news is that a growing number of higher education leaders are starting to get it.

2. Our hands are tied. Accreditation is at stake.

Accreditation is the most common excuse to protect the higher education status quo. But existing accreditation rules and guidelines leave far more room for business model exploration than most leaders will admit or explore. Accreditation has been more about protecting industry incumbents from new business model competition than protecting the interests of students or society. This must change.

3. Classroom learning is king and nothing else matters.

You would think colleges would have figured out by now that most learning happens outside the classroom, but sadly, too many haven’t. You would also think that the ability to access the best information, thinking, and practices from anywhere, any time via the Internet would change the role played by faculty in and out of the classroom. But sadly, it hasn’t.

4. Campus is the center of the universe.

Students want experiential learning opportunities and direct connections to the real-world laboratories of local communities with which to apply their ideas and solutions generatively. Campus bubbles are too confining. The value proposition for residence-based colleges, along with escalating costs, will be challenged by students like never before.

5. Cannibalization is off the table.

I love it when college leaders say, innovate all you want as long as it doesn’t affect current operations. Innovation agendas that only include projects that can be done without impacting the way things work today leave colleges vulnerable to being disrupted by innovators without similar constraints.

6. Not enough connecting with unusual suspects.

Colleges and universities are wonderful places full of diverse people, departments, and disciplines. And yet there is surprisingly little interaction across silos. The same is true off-campus. Too much time is spent interacting with the usual suspects, rather than exploring the opportunities and people at the edges.

7. Do innovators get tenure?

Are young faculty members who try to change how their colleges work and how students learn rewarded with tenure? Seems ironic that tenured faculty who have already been awarded ‘academic freedom’ are often the least innovative when it comes to exploring new learning approaches and models.

8. Great idea, what’s the ROI?

Using traditional financial metrics to compare innovation projects works great for incremental improvements to today’s business model, but is useless for early exploration of possible new business models. We won’t know what is repeatable and scalable until we try new approaches. But we will never try new approaches if we hold them accountable for a predictable financial return while they are still in the exploration phase.

9. They shoot business model innovators, don’t they?

Ever notice what happens to people who want to transform their college’s business model? They are humored for a while until far too many of them get frustrated and leave for conditions more conducive to innovation. We have to celebrate and support business model innovators everywhere, including in colleges.

10. You want to experiment in the real world — are you crazy?

You can’t analyze your way to business model innovation. You have to explore your way there. And you don’t explore in a conference room or with a presentation deck — you explore in the real world. New business model concepts must be imagined, prototyped, and tested in the real world.

Subsidizing the costs of today’s higher education business model can take the sting out of college sticker-shock and debt service loads for some, but isn’t scalable to the size of the problem. Tweaks to current business models aren’t enough.

If our society is going to fulfill the promise of affordable access to the post-secondary credentials necessary to thrive in a 21st century economy, we must enable more higher education leaders to explore and test new business models. Nothing short of a proliferation of new higher education business models will allow us to deliver affordable access to post-secondary credentials under the new social contract.

Too many students and citizens are waiting for us to fix higher education’s business model problem. Let’s get going. email us at hello@bif.is


So Many Corporate Innovation Labs, So Little Innovation

It’s the innovator’s day. CEOs everywhere know that keeping their companies relevant in a rapidly changing world is imperative and that innovation is the solution. Corporate leaders also know their legacies depend on their organization’s ability to reinvent itself.

It’s not going well.

The CEOs I talk with admit privately that they’re getting tired of hearing Uber, Airbnb and Netflix disruption stories. They want their organizations to play more offense. They want to be market-makers, not just share-takers.

In response, CEOs have climbed onto the innovation-lab bandwagon. Corporate innovation labs have sprung up like weeds across industries around the world. Any self-respecting CEO now has a corporate innovation lab!

I have visited many of these innovation labs and spoken with those who’ve been tapped on the shoulder to start and lead them. My overall impression is that, at best, most of these innovation labs will produce only tweaks to today’s business models.

Innovation labs will launch with lofty rhetoric from CEOs about transformation and thinking out-of-the-box. But as soon as line executives and business unit leaders get control of the lab’s agenda, it is destined to produce only tweaks. This shouldn’t be a surprise, because corporate innovation labs are structured, resourced and governed to produce incremental improvements to today’s business models.

Lab projects are prioritized and funded to produce new products, services and tech-enabled capabilities that will improve the performance of today’s business. The projects compete for resources based on financial metrics relevant to the current business model.

There is nothing wrong with that approach — leaders should always improve their current business model to stay competitive. But here’s the rub — today’s corporate innovation labs won’t help a company avoid being ‘netflixed’ or disrupted by an entirely different business model.

My conclusion: Corporate innovation labs aren’t set up in ways that will help companies avoid disruption.

Here’s why.

 

10 Reasons Corporate Innovation Labs Produce Only Tweaks

 

  1. Innovation lab mandates aren’t clear. Incremental versus transformational innovation require very different organizational approaches and support.
  2. CEOs must own the transformational agenda. Instead, they cede authority to line executives who are accountable for the performance of today’s business model.
  3. Innovation labs overemphasize the production of a better mousetrap, as opposed to a better business model.
  4. Potential innovation projects that may cannibalize current business are taken off the table, severely limiting the innovation lab’s scope.
  5. Requiring a financial forecast for an innovation project — before exploring it in the real world — only works for tweaks, never for transformation.
  6. Corporate innovation labs see emerging technologies through the lens of today’s business model, as opposed to a catalyst for an entirely new model.
  7. Corporate innovation labs have difficulty shifting their perspective to see opportunities through the lens of customer experience and jobs-to-be-done.
  8. Corporate venture funds are not innovation labs. They may provide startup capital to entrepreneurs, but withhold the company’s most important assets: scalable capabilities and market access.
  9. Innovation labs aren’t organized as a connected adjacency to the core, a sandbox where capabilities can be combined and recombined, to change how customer value is created, delivered and captured.
  10. Companies lack the talent systems to develop future leaders with experience working both in the core and in the innovation lab.

I think we all know that tweaks are necessary — we should all get better every day. But tweaks aren’t sufficient. If tweaking the way things worked today were enough, life would be so much easier. Sometimes we need transformation, and this is one of those times. In the 21st century, the most important life skill — and corporate capability — is reinvention.

Transformation, disruption and reinvention don’t have to be scare words. We can create the conditions to explore and test entire new business models while we are still pedaling the bicycle of today’s models.

An important mandate for these new innovation labs is to do R&D for new business models, the same way we do R&D today for new products, services and technologies. R&D for new business models is the new strategic imperative. Corporate innovation strategies must create discrete approaches to deliver incremental improvements to today’s models, while also enabling the exploration of entirely new models. Doing so will require more clarity on the objectives of the innovation lab, as well as recognizing that the same structure, approach, resourcing, staffing and governance will not work for both incremental and transformational innovation.

It’s a good thing CEOs are taking innovation seriously. I sense they’re realizing that just setting up an innovation lab and delegating it to line executives isn’t enough, and they’re right. I’m finding more CEOs open to talking about how business model innovation fits into their strategic agendas, and I predict we will begin to see this new imperative better reflected in their organizational approaches to innovation.

Today I stand by my observation: So many corporate innovation labs, so little innovation. Tomorrow I expect we will see more corporate business model sandboxes to make R&D for new business models an ongoing strategic capability.

 

 

Are you ready to start your innovation journey? We’re here to help! email us at hello@bif.is