Improvisation in medicine is not a recent development – in 1816, Dr. René Laënnec invented what would become the stethoscope from a paper cylinder. Today, medical makers throughout the country are making things to help solve problems and deliver personalized care for patients. Examples include:
• a toy gun that buzzes when your IV bag is empty;
• an asthma nebulizer made from a few parts you can buy at any hardware store;
• a new kind of bandage that helps reduce the number of infections in babies with neonatal omphalocele;
• a diagnostic test for Ebola that’s easy to administer and gives accurate results in only 30 minutes, created by a high school student;
• a child’s insulin monitor so that it sends real-time updates to his father’s smartphone
As some health care organizations transition from fee-for-service to value based care, community hospitals and leading academic medical centers alike are reaching into the non-traditional set of tools and ideas to foster new behaviors and prepare their teams for a more creative, collaborate care delivery co-created with the patients at the center. Many of the characteristics associated with making translate into the day-to-day problem solving that care teams typically do: design thinking, creative problem solving, agility, collaboration, rapid iteration and feedback, etc.
In our experience, an increasing number of organizations are experimenting with making initiatives while very few are capturing making’s full potential. Those who do, follow a somewhat similar path. Here are a few thoughts on what these organizations have in common.
First and foremost, they tend to go beyond the physical space and the lone 3D printer in the supply closet. Instead, they set-up an organization-wide making program and allow their leaders to access resources to stand up : 1) an infrastructure and a safe environment to enable making and experimentation, 2) trainings and resources that embed new skills and thinking into everyday care delivery decisions, and 3) data capture and use cases, efficiently connecting across maker communities within the organization and external maker communities to help scale successful initiatives, share knowledge and improve patient outcomes.
In the past few years, we have seen a wide proliferation of making. More than 1 million people worldwide attended MakerFaires in 2015 and over 200 hacker spaces exist around the U.S. Medical making has grown from technology crash carts, developed by the MakerNurse initiative, that hold simple tools and materials to help get nurses’ creative juices flowing to full dedicated maker spaces like those developed by MakerHealth. The physical and virtual infrastructure is a key first step that enables makers to access tools, materials, knowledge and a like-minded community to develop solutions for their patients.
Understanding the usage of maker environments and the virtual knowledge exchange, can help link medical making it to performance metrics and patients outcomes. This is the true untapped potential of medical making in health care that can turn the one-off “innovation pet project” into a coordinated program that empowers and defines the future of medical professionals.
Building a maker space is the first step that the majority of organizations today take, but it is rarely sufficient if not coupled with corresponding training programs, incentive structures, and a culture of making. Embedding a formalized home for making, where training and knowledge-sharing sessions become as routine as daily rounds and filling out claims paperwork, helps spark creativity and encourage ongoing learning to build a climate of making, and potentially reshape the culture in one organization.
In our Global Human Capital Trends research 89 percent of companies tell us their culture is their top priority yet less than 1/3 really know what the “right culture” is for their organization. Time and again we’ve seen that when large organizations go through an era of profound transformation – a merger, shift in business models, new strategy or operational initiative – it is typically the culture that makes or breaks their success.
And as health care organizations seek to find their place in the value-based world of the future while still relying on the established fee-for-service models to deliver quarterly performance targets, culture is an increasingly overlooked yet crucial piece of capability building, retention, patient satisfaction, and ultimately outcomes.
Typically the question of scale is associated with stumbling upon breakthrough discoveries that lead to patent filings or start-up ventures that get spun off or taken public. That mental model of scaling and commercialization, however, is often outdated and misses out on the greatest potential of these programs: 1) diffusion of leading practices born out of the maker programs across the maker community and 2) building an ecosystem of collaborators and partners across the health care ecosystem who contribute knowledge, access, data and resources.
Maker programs that scale effectively are not measured by number of patents filed. In fact, reduced number of surgical interventions, days to discharge, procedure-related hospital re-admissions or even patient satisfaction score are able to effectively capture how well maker solutions are diffused across your organization. To do that, maker programs who are truly transformational connect with existing quality control procedures, clinical protocols and surface maker projects that enhance the practice of medicine rather than becoming an isolated case.
Transforming health care
Creating a robust system to support medical making can be a tremendous undertaking, and may require years of work and experimentation. However, safe experimentation is exactly what health care organizations need to take advantage of new innovative toolsets in this time of transition. Now is the time for established health care organizations to embrace making.