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AMA Update
Fostering collaboration and public health innovation with Scott Dulchavsky, MD
Sep 19, 2023
Featured topic and speakers
How the Henry Ford Innovation Institute works and helps Henry Ford Health stay ahead of the curve. Scott Dulchavsky, MD, CEO of the Henry Ford Innovation Institute, offers a behind-the-scenes look at the institute, discusses some of its most successful products, and shares how it brings together individuals from across Henry Ford and the world to solve problems in health care. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Scott Dulchavsky, MD, CEO, Henry Ford Innovation Institute
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Innovation—it's at the heart of health care. And today, we're talking about the unique approach that Henry Ford Health has taken with its Innovation Institute. Joining us to discuss is the CEO of the institute, Dr. Scott Dulchavsky in Detroit. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Dulchavsky, thanks so much for being here today.
Dr. Dulchavsky: It's a delight to be here and talk with you.
Unger: Well, I had the pleasure of touring the Innovation Institute with you recently. So excited to dive into our discussion. I found it really, really inspiring. Why don't we just start, for background for the audience, by giving them a little bit explanation about what the Henry Ford Innovation Institute is?
Dr. Dulchavsky: Well, Todd, innovation is everybody's business. And it may not just be curing cancer or having the best artificial intelligence tool. We all have to innovate to survive. And I think that everybody in our lives has to do some MacGyverism, some clever way to do things better, faster, cheaper. And delivering health care is no exception to that.
Unger: Well, you told a really great story when we were there about why it was so important that you started the Innovation Institute. And you laid out three reasons for why it was so important to change the way that it was being done before. Can you talk about those?
Dr. Dulchavsky: Yeah. The first thing is everybody has an innovative spirit. We have 30-some thousand employees and everybody has a different job here, and my hope is that they all think about ways, not just to do it individually, but to do it collectively, if they come up with a clever solution. How do you memorialize that, and how do you pass that on to your colleagues so they can benefit from that?
And that helps you at the local level. But how do you scale that? And how do you get value from that? And unfortunately, two decades ago, here at Henry Ford, innovation, while we knew it was important, there was no structure for that to occur. It was somebody's third job in things like that.
And I'll give you an unfortunate example with a company very familiar to most of us in health care that makes surgical robots. So we had a very innovative surgeon here that took the robot that was originally designed primarily to do heart surgery and it wasn't the best tool for that, and he modified the techniques and technologies to be able to do a prostatectomy, which—so now that's how most prostatectomies are done, so he revolutionized that field.
Doctors are, by nature, sharers of information. And so that information was obviously very much accepted by that company. And now that robot is sold to do that, but we got no value in that other than it's a great process and a procedure. And the company got all the value. So now today, should we want one of those robots, we get in line like everybody else and we pay retail for those.
And there is probably a better way that we could have co-developed and partnered that that Henry Ford itself would have gotten some value from that amazing development discovery.
Unger: So getting the value there, how about just in terms of who's participating? You mentioned 30,000 people working in the system. How do you get more people involved in innovation and getting it done in a productive way?
Dr. Dulchavsky: So how do you get a housekeeper to think of themselves as an innovator? It's pretty easy in some of the very clever proceduralists or trying to develop a novel catheter, maybe a cancer researcher is trying to do gene therapy to cure a deadly disease. But how do you get everybody to go, boy. We're part of this apparatus that values innovation. You have to make it easy for them. And then you have to reward that behavior. And that reward doesn't necessarily to be financial, it can be in that.
But it often can just be recognition and development of that. And we didn't invent that concept. We're Henry Ford. And we're automotively initially started. And many of the car companies now have ways that line workers, if they come up with a better process, they derive some value from that.
And so I think part of it is making it easy for those people to see, is there value in this? Is it novel? Maybe it's patentable. Maybe it's commercializable and maybe it's extensible beyond the health system. Those are all really important, but having the right structures in place that everybody knows it's not Dulchavsky's Innovation Institute, it's ours.
And so how does everybody go, I want to play in that health care arena? One of the best comments I ever heard about our Innovation Institute was from a nurse who came in and was struggling with how to get a complex patient out of bed that has all kinds of stuff hanging out in a big patient. And that takes five people, at least, and it's tough work.
And so she came down to an ideation session. At Innovation, we had all kinds of folks involved in that multidisciplinary. And at the end of the day, they came up with this unique walker that now we have commercialized. And that allows one person to do that easier. And she said at the end of that, not that she may or may not get some money from that, but she said, this has been the best day I've ever had at work.
And I think it was twofold. One was, we empathize, well, wow. That's tough. We empathize with your struggles. And secondly, we're here to help. And that help actually is extensible beyond Henry Ford, is just a wonderful bonus.
Unger: Wow. What a great story. And you provide then really the infrastructure to do the things you went through really fast, which is like, is that a novel idea? Is it something we can patent? How would we build a model of what that might look like? So you have the infrastructure to do that in the Innovation Institute to turn those needs, like you just outlined, into something real that can be commercialized.
And again, I think you've taken this idea beyond the Henry Ford community and out into the rest of the community in Detroit. And you have a great story about that—about a surgical gown that you have on display. Tell us a little bit more about that.
Dr. Dulchavsky: Yeah we got a lot of press about that. This was a shock to me. I thought it was a little bit of a silly idea, but they thankfully proved me wrong. So I'm a big proponent of getting dissimilar people together to share potential solutions to a problem. So in Detroit here, we have the College of Creative Studies. And it's one of the handful of similar ones. There's been one SCAD in South Carolina, there's FIT in New York. LA has one in their College of Creative Studies.
And there are a lot of art-type stuff and design-centered thinking. And so we had some of their students. And we just embedded them here. And with no agenda. So just have a look at how we do things and come up with some solutions. And I thought they'd be focused on wellness or what color paint you'd do a room or how you'd make a lounge or something like that.
And they were intrigued by the current hospital gowns. And they saw patients walking around like everywhere in our country with their butts hanging out. And they look and they said, "You got to be kidding me. This is the best you can do?" And so we said, "Well, that's the way we've always done it. And we're used to it and patients, they don't like it but they tolerate it."
And so they started iterating on what would be the ideal of hospital gown? And so what are the parameters? So it's got to fulfill the functional. It's got to do what—it's got to cover you, it's got to be accessible, it's got to fight infections, it's got to be laudable and things like that. But how can we give you dignity in this? How can we give you a pocket for God's sakes? How can we make it that patients actually want to wear this darn thing?
And so 17 iterations later and lots of inputs from patients, they came up with this gown. And it had lapels on it, because they thought that that was important for a dignity. It had a pocket. It had access for us doctor types and that. And we worked through how it's X-rayable and how you can launder these darn things with 1,000 others and stuff like that.
And we had a local manufacturer Carhartt, ran our first production of those. And then we said, well, maybe we should try them. And so we did a failed trial in our patients because as we went to the wards and you were selected to have standard patient gown or the fancy one, in that there were near riots on the floor in that. So we had to stop the trial for safety reasons, because there was nobody signing up for plan A on that one. So we thought—we didn't get a paper out of that. But we certainly got an answer and a solution.
So subsequently, we don't make gowns here. We use them. And so we have now passed on the licensing of that to Medline and so you can buy these things. So I think that that was—and I thought, that's a good thing to do. And maybe it'll make our patients comfortable, but it was like wildly successful. So I'm thankful they proved me wrong.
Unger: What a great example, again, of innovation and improving the patient experience and kind of out of left field on that one. So we talked about getting value for the system for the contribution that you're making to innovations like this. Expanding the number of people involved and supporting them with the infrastructure to turn an idea into an innovation.
And then finally, I think one of the other things that you pointed out was really, looking at an enterprise approach, because you've got all sorts of people working on maybe the same thing just in different places that don't have the view that you do. Tell us a little bit more about that.
Dr. Dulchavsky: Yeah. Well, I'm going to go even broader than—I'll answer your question then I'll go even broader than that. I'm a firm proponent of do the right thing. And so sometimes that right thing is going to cost you money to do. And you should do it. Sometimes, like this gown, it may be commercially successful. And that's a bonus. That shouldn't be your primary driver on this.
But then I think a lot of people don't realize the value that they've done to create their own solutions. And I'll give you two examples. One has to do with our Heart Smart Recipes. I didn't know this. Henry Ford discovered these or developed those. And we use them for our patients here. But then we started to look, wow. That's pretty novel. Should be commercialized. So we packaged that. And now you can buy these darn things in that.
And so we now sell these internationally. So if you go to a hospital in India, more likely than not, there'll be a Heart Smart option on there. They license it for a few rupees in that. And it's the right thing to do in that we make a little bit of a revenue stream on that. Or there's one that was very financially successful with it. I'm proud of that. I'm more proud of what it does is it's called Dromos Specialty Pharma.
And they're some really expensive drugs that we give people. These biologic agents that are used for certain orphan diseases and other things. And that boy, they're tough to manage. They are super expensive. Tens of thousands of dollars for an individual dose. So the pharmacy spent a lot of effort, time and money to figure out a way to manage that really appropriately. And we use that here in that.
But we looked at it and went, wow. There's value beyond Henry Ford for this. And the pharmacy folks just did it to do the right thing for the right patients and for their employees. So we now took that to an external partner and now it's going—I think it's in 50 or 60 health systems now. And that did to help manage these very complicated and costly medicines. So I think that's a wonderful success.
Unger: Again, great examples of innovation and then how to derive value from that and export such great ideas across medicine. So you've gone to all this work to, basically, enable an innovation kind of spirit and enterprise across Henry Ford. Now that you've got those things in place, I'm curious, what is the one barrier that you faced in trying to innovate, even given all of these different ways that you've tried to approach it. And how did you overcome that?
Dr. Dulchavsky: Well, let me tell you. I'll go back to the hospital gown. So part of it is just, I guess, a lack of vision. So I never thought to renovate a gown, it's the way we always do things. We can be sort of slow movers and late adopters in medicine. We're, by nature, appropriately cautious. Fail fast, well, a great mantra in innovation, ain't so good in medicine.
We like tried and true solutions. So I think part of it is just moving cheese of people who are used to doing things in a certain way. But I think having some real successes in that like walker or the gown or some of the other things that we have done that actually make life easier for patients and importantly our staff as well, independent of what the finances are, I think it's really important.
So choosing some early wins in broadcasting those and celebrating people that helped in that success, I'm not that clever guy here. I'm the guy that helps manage things that move through here and maybe help with the structure of that. But having all of these solution makers that are in your health system have a voice and have a format that that voice goes to action, I think, is critically important.
Unger: I love that. Again, such an important thing that you see time and time again is the momentum that comes from wins, and getting more people on board because of that. As you look to the future, are there any areas or technologies that the Innovation Institute is focused on for exploring next?
Dr. Dulchavsky: Well, we're all trying to grapple with artificial intelligence and big data management, and all the potential solutions of that. But I guess I want to focus on our Innovation Institute is not a group of really smart people solving problems. It is a group of people reaching out to an ever-increasing group of even more clever people to try and develop these.
So we don't look just to Henry Ford, we don't look just to the U.S. We look to our planet for solutions. So when we all have these wicked health care problems that we're all trying to get through, we reach globally. So I'm in Israel every month, because their innovation ecosystem is on fire.
And so we've had seven or eight challenges there, looking at everything from workplace violence to preventable infections to a variety of other things. And that, we've done challenges with Google and with Ford Motor Company and Premier and others, trying to get thousands of people to be thinking about how we might solve that.
And then we're the learning laboratory, in a big health care system, of taking these half-baked solutions in that and making them commercially appropriate and able to work in a complex health care system. I think that's the future of getting all of us engaged in these wicked problems that keep all of us up at night as it relates to delivery of health care.
Unger: We've got a lot of problems. So we're counting on you. You've got a lot of work to do. So keep that going. Dr. Dulchavsky, thank you so much for taking the time to tell us about your work. I had so much fun being with the AMA team at Henry Ford and seeing the work that you're doing. Keep it up. That wraps up today's episode. We'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
