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

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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

Is Your CEO Serious About Innovation?

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I used to think that if I just yakked long and loud enough, I could convince CEOs to embrace transformational innovation.

It took me 25 years as a road warrior consultant, author, and accidental government bureaucrat to realize that proselytizing doesn’t work. If leaders don’t want to change, all the consulting jargon and fancy PowerPoints in the world won’t convince them to.

In those situations, no matter what lofty rhetoric the CEO uses in public or at company retreats about “creating an innovation culture” and encouraging everyone to think outside of the box, the best result you can hope for are incremental innovations to improve the performance of today’s business model. You never get transformational new business models — and you always get frustrated if you were hoping for bolder change. If you want transformational innovation, you have to find leaders who want transformational change and are receptive to organizing differently for tweaks than for transformation. After learning this lesson the hard way over many years, I no longer try to convince CEOs who don’t want to change and instead try to find those CEO’s who do.

Here’s my list of 10 questions you can ask a CEO to tell if they are really serious about transformational innovation:

  1. Do you agree transformational innovation goes beyond breakthrough products to include business model innovation — entirely new ways to create, deliver and capture value?
  2. Will your employees tell me that failure is a career-limiting move, or that the company celebrates experimentation?
  3. How much time do you spend strengthening and protecting the current business model, versus designing the next one?
  4. Do you have clear and discrete objectives for both incremental and transformational innovation? Do you organize differently for each?
  5. Does your organization invest in R&D for new business models as it does for new products, services, and technologies?
  6. Are you prepared to have your organization disrupt itself? How do you see that playing out?
  7. Do internal ideas and projects that threaten to cannibalize the current business model get squashed — or nurtured?
  8. Do you have a process for allocating resources for transformational innovation projects that lie outside of the control of business units?
  9. Do executives with responsibility for exploring transformational business models report to you, or to another line executive responsible for today’s business?
  10. Are you willing to create a sandbox to explore transformational business models? Would you carve out a part of your current business/market to serve as an ongoing real-world innovation lab?

A few words of advice about using these questions in the real world: tread lightly, since no CEO likes to be put on the spot and drilled with a laundry list of questions. Pick a few of the ten to put into your own words to help you discern whether the company you work for or are thinking about working for (or with), has a leader who shares your appetite for transformational innovation. Better to know what kind of environment you’re going into in advance than to learn painful lessons later.