This week I attended a conference on Digital Transformation In Health Care. There I met Dr. Glen Geiger of the Ottawa Hospital and heard him talk about one of the most impressive innovation projects I have seen in some time. I was most taken with how this initiative intuitively applied so many of the BM Generation and Customer Development principles.

The problem / job-to-be-done

The Ottawa Hospital has for the most part the standard IT support for delivery of medical care. Computer workstations provide access to patient results at the nursing stations and in physician’s offices. Access to information at the patient bedside required the bedside required the medical team to recopy the results or print them from the computer system in order to carry them. Herein is the core of the innovation.

Solving a problem

The team recognized the potential for a mobile tool to address the medical staff’s job to present information to patients, lab results, imaging reports, and transcribed documents, at the patient’s bedside. The Ottawa Hospital launched an initiative to configure a clinical application to make patient information available on an iPad platform.

Problem solution fit

The iPad itself wasn’t the solution, and there were no existing applications to allow them to address the job effectively. They developed a clinical mobile application to make use of the mobile platform. The application gave them up-to-date patient information, to improve patient care decisions and to better inform and involved the patients. It did this in a way that could be shared at the patient's bed.

Validation

Having designed a solution, they launched a series of pilots to test the application in real-world use. They began with a small cohort of doctors and tested the functionality. Through the process of piloting the application more functionality was identified and added, including a PACS viewer that allows medical images to be displayed. This gives he doctors the ability to show the patients x-rays and other images right at their bedside. Being able to see their own x-rays and other images makes it easier to understand the diagnosis and treatment plan.

During the evolution of the application the team ran into a difficulty with a requirement of administration to have certain controls built in to the information exchange. The team went to the target segment, doctors, and discussed the requirement. It turned out the requirement was not used outside the pilot and was seen as a barrier by the customer segments, so the team refused the control. They put the needs and the customers first, keeping focused on the value proposition and avoiding barriers to adoption.

The pilots were so successful that at the end of their rotation in the pilot, residents who were moving out of the pilot onto other rotations refused to give back their iPads and were the envy of their colleagues.

Scaling and the business case

One of the aspects that intrigued me the most was the recognition of the difference between searching for a business model that worked, and implementing a proven business model. This is a great example of the Steve Blank dichotomy between the discovery-based approach needed for startup innovation and the plan driven approach to scale proven business models. The innovation team developed a business case and strategic plan only when they had proven the success of the initiative, and wanted to move scaling its implementation.

So where are they – the explosion of innovation

The pilot has been extraordinarily successful. It was extended to more than 1500 iPads and that is being expanded to 3000+. Clinicians are lining up to receive their iPads and the applications. There are two levels of security to protect patient information secure the Clinical Mobile Application. Information is transient, with an ability to remotely wipe the information should an iPad be lost. They have added functionality to order imaging and lab tests directly from the patient’s bedside.

More importantly the initiative is driving an environmental change throughout the hospital. The sharing of information through mobile applications has grown into concentric circles around the patient. The inner circle being, of course, the direct treatment and care of the patient. But another circle of information exchange has grown around the services to support that care, e.g. pharmacy and labs, exchanging information through the mobile applications. The third circle of care involves administration. Now information is shared across intake and discharge, as well as housekeeping. Housekeeping staff use iPhones and iPods that inform them when a person has been discharged, and the room that needs to be addressed so another patient can be accepted.

Wow!