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Three years ago, Sean O'Neill, PharmD, then the medication safety officer at Children's Hospital of Philadelphia (CHOP), was frustrated that his team could not easily transfer drug libraries from old smart-infusion pumps to new pumps. He also wanted to leverage the data captured by the pumps to identify potentially unsafe medication practices. O'Neill thought creating new smart-pump software would address these problems.
So in 2013, O'Neill submitted a two-paragraph description of his idea to a contest at CHOP designed to seek innovative ideas from employees. Although O'Neill's idea did not win the contest, it did give him an opportunity to meet with leaders in CHOP's Office of Entrepreneurship and Innovation. They connected him with an outside team of software developers who built a rough version of the platform. O'Neill then tested the prototype software around the country, seeking input from potential users.
In 2016, leaders at CHOP spun off the new software company, Bainbridge Health, located in Philadelphia. The company's data analytics platform for smart pumps is already available on the market, and the library-management capability is in development.
"Most clinicians don't have business and entrepreneurship expertise, so it is incredibly important that they work with entrepreneurs or business experts to push ideas forward," says O'Neill, now the full-time chief clinical officer at Bainbridge Health. "A lot of our success has been due to the fact that we brought in the appropriate leadership from the business side and the technology side."
Bainbridge Health is just one example of how leaders at CHOP have fostered a culture of entrepreneurship and built innovative collaborations inside and outside their organization.
One of CHOP's earlier innovation success stories was the spin-off of Spark Therapeutics, a publicly traded gene therapy company founded in 2013. The company was built on more than 20 years of research at CHOP into the genetic treatment of diseases such as hemophilia.
"It dawned on us after Spark: What else were people working on that we might not be aware of?" says Patrick FitzGerald, CHOP's vice president for entrepreneurship and innovation. The desire to be more proactive in identifying good ideas from within spurred the creation of his role and the Office of Entrepreneurship and Innovation, which focuses on incubating new ideas that improve patient outcomes, reduce healthcare costs, and address chronic disease.
In addition to FitzGerald, who also teaches at the Wharton School of the University of Pennsylvania, the office's team includes an administrative director, a project coordinator, a medical device liaison, and a scientific and medical adviser. This last role is filled by Flaura Winston, MD, PhD, who also chairs the office's scientific advisory council, which vets new ideas that come from any of CHOP's 11,000 employees.
"Our role is to help incubate an idea [also known as "de-risking"] so we have a course of action for that idea moving forward," says Winston, who has a background in medicine and engineering. After the council helps to assess the potential value of an idea, the Office of Entrepreneurship and Innovation assembles a team of internal and external subject-matter experts to help shepherd the idea through the development process. Council members review each proposed project based on its impact on patients, mission fit, commercial potential, novelty, and whether it represents a critical improvement to the standard of care.
"Once ideas make it through our first pass, they go through a very iterative process of development that one would normally see in a startup incubator," Winston says. "But because this is taking place inside the hospital, we can leverage our extensive access to clinical, scientific, and regulatory expertise to ensure that the final product will be safe and effective."
Innovation at a children's hospital is particularly mission-driven, Winston believes. "We consider return on our mission to be as important as return on investment," she says. "For example, there are projects that may not return a lot of profit, but they are so important for the safety of children or improving accessibility. These are projects we would still pursue."
At CHOP, leaders also tend to view innovation in terms of how it might help not only a child but also a family.
FitzGerald says his office concentrates on four areas of innovation and entrepreneurship.
Creating start-ups. In the past 18 months, CHOP has created three spin-off companies that are not limited to the pediatric realm: Bainbridge Health; Diagnostic Driving, which designs software to promote safety on the road; and Haystack Informatics, a firm focused on protecting the privacy of patient data.
Creating licensable assets (usually devices). "We had three nurses come to us with the exact same idea to develop a better version of what is known as the 'no-no,' a peripheral IV cover," FitzGerald says. CHOP leaders are negotiating with a large medical device company to bring the product to market.
Investigating new business lines for CHOP. When a faculty member wanted to create a mothers' milk bank at CHOP, the Office of Entrepreneurship and Innovation helped her create a business plan and make the new offering a reality. FitzGerald says his team also is looking at expanding virtual reality applications for patients to more easily interact with hospital clinicians.
Exploring vanguard technologies that are on the horizon and outside the traditional scope of medicine. One example is a dermatology application that allows parents to send secure pictures of skin ailments for evaluation by a dermatologist. The app will be launched inside CHOP in early 2017. Leaders also are exploring gamification techniques to monitor how children self-report their recovery after a serious illness or injury, Winston says.
Leaders at CHOP and Bainbridge Health offer the following advice for healthcare organizations looking to build their innovation and entrepreneurship capabilities.
Be transparent when selecting ideas to pursue. The selection process for new ideas at CHOP is agnostic and "for people from all walks of life—nursing, facilities, surgery, and so forth," FitzGerald says. "We don't want politics to be involved, so it is a very open and transparent process. Our scientific advisory council covers a large majority of disciplines at CHOP so that we can ensure ideas come from all areas of the hospital."
Look outside for expertise. "Historically, hospitals have been too insular in their approach to innovation, perhaps to protect intellectual property," FitzGerald says.
CHOP's in-house innovation team includes no software developers, designers, or prototype developers. "We prefer to look outside our walls to help us develop these ideas," FitzGerald says.
Make sure financial and operational leaders are comfortable with the ambiguity of innovation. "We cannot always put innovation into a clear work process," says Winston, who is also a professor of pediatrics at the University of Pennsylvania. Having clear guiding principles and oversight can help, but the innovation process needs to remain flexible, she says.
"The office's incubation process starts with determining the development needs—how we can support the team with a great idea to get to a solution that can improve health. Each idea, each team has a different set of needs. It is highly individualized and requires flexibility. Some teams are researchers who have limited clinical or business expertise but already have a great prototype that needs polishing and a business plan. Others are clinicians who have a clear vision for a clinical problem and how to solve it but may lack research, business, and product development skills and resources."
Seek ideas from nurses and other front-line staff, who often develop workaround solutions to solve problems. "Nurses are some of the most innovative people out there," Winston says. "If a nurse at the bedside sees a problem, he or she fixes it to help their patient. We take this innovation and turn the nurses into makers. We give them the support so they can take that workaround into the commercialization space."
Test an idea with clinicians inside and outside your organization. "Unless you are engaging clinicians in this work, you are never going to know if you're truly addressing an actual problem," O'Neill says. By testing the smart-pump software across the country, O'Neill recognized his product was marketable.
Give clinicians protected time to explore new ideas. CHOP gave O'Neill a six-month leave of absence to test his software idea and bring it to market. "You can't really flesh out these ideas for two hours a day after you have put your kids to bed," O'Neill says. "It is vitally important for organizations to provide protected time for people to innovate. We certainly wouldn't be where we are with Bainbridge now if I had not been given that opportunity."
Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill.
Interviewed for this article:
Sean O'Neill, co-founder and chief clinical officer, Bainbridge Health, Philadelphia.
president for entrepreneurship and innovation, Children’s Hospital of
Winston, MD, PhD,
chair, scientific advisory committee, Children’s Hospital of Philadelphia.
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