Chip Blaufuss is the Vice President of Strategy and Innovation at HCA Healthcare, the presenting sponsor of Health:Further. Chip heads up innovation at the largest healthcare organization in the country – one of every 20 babies born in the US is born in an HCA facility. So how does such a large company keep new ideas flowing? What happens when a nurse on the floor has an idea for solving a problem? How does leadership vet and test those solutions? Where is the balance between internal and external innovation, where do partnerships in healthcare come in to play? We discuss all of that and more…



Give us some background on HCA Healthcare
By the numbers HCA has 179 hospitals, 119 abulatory surgery centers, and then everything that goes around those in terms of physicians, urgent care, and so forth. We’re in 20 states and about 40 communities within those states. I think some other numbers that I think are good to know is that we have about 250,000 employees, about 40,000 physicians on staff and about 80,000 nurses. And collectively, that group [has] about 28 million patient encounters a year and just short of 9 million of those encounters are E.R. visits. So in the grand scale things were one of the largest providers of healthcare services in the U.S..


What does “Innovation” mean at a huge organization like HCA Healthcare?
[I]t starts with the strategy side of this in terms of how do we want to position ourselves in the communities that we serve, how are we competing for volumes with our competition, but also how do we provide that care and how do we provide it efficiently and most effectively?
[W]here innovation comes in is from those from [our] priorities we identify where there’s opportunities to think about new and original solutions. How we can change healthcare and probably more importantly advance HCA strategy. [And also] have the tools and techniques of a corporate innovation program to develop and test and validate those solutions. And once we get that validation of a new solution we’ll know that it’s ready to scale and incorporate back into the strategy. So there’s a little bit of a cycle: set the strategy, understand where we’re going, understand where we need innovate, develop the solutions, and bring it back around to scale across all of HCA


How do you protect both innovators and their ideas in a large, established organization?
What we’ve discovered over years [in] thinking about innovation and understanding what innovation means at HCA is that we’ve got a vast amount of activity going on in our hospitals. In those surgery centers, all the time nurses and staff and physicians are coming up with ideas, then testing and developing them. And so rather than having a single sandbox or a lab where we develop and test these ideas, how do we provide support out in our markets and our facilities with our employees to take their ideas and get them developed? And it starts with identifying the great ideas and the ones that we think are critical to the strategy of the company and then putting the weight of the company behind them.


Practically speaking, how do you set this up?
One of the vehicles that we have is an online platform that all of our employees – full-time and part-time have access to. It’s called Innovation Link. Any employee you can go in there and share an idea. They can look up ideas that other people have posted. Think of it almost like social networking around innovation. They can see what other people are thinking about, and they can comment, they can like, they can follow and see what’s happening in or around an innovation community. And we track all of the submissions, both for unique original ideas but also thematically what are what are our employees thinking about? What problems are they trying to solve? How do we take the best of multiple peoples perspectives combine those into a solution that we can go test?
And a lot of times it reflects what our leadership is talking about. So they’ll be messaging, “hey here are our priorities here’s what we’re thinking about.” And then our employees get to thinking about, “hey how would I solve that, how would I apply what I experience in my day to day work [to] come up with new solutions.”


How do you vet ideas from external sources/vendors?
[My team is] constantly scanning and understanding what the entrepreneur, startup, venture capital ecosystems are innovating around. What solutions are they developing and starting to offer?
We also rely on our leadership throughout the organization – whether it’s a data scientist here in Nashville or someone in our I.T. organization in one of our markets. They may have come across an interesting vendor. And that’s the kind of pilot we support. “Hey, I’ve got an interesting solution. It’s a vendor from it from a third party. Let’s go. Let’s go try it out. Let’s see what it does it work as it does it does it improve things for HCA.” So we’re keeping track of that. It’s a little chaotic at times in terms of understanding who’s working with who and what pilots will be running, but that’s rather than trying to bottleneck and saying only one group can do it, we’ve got a vast network of leaders who are always looking externally and […] they know to call us and say, “this has worked out, we really think it’s ready to think to scale it across all of HCA.”


You’ve talked a lot about pilot programs. How do you measure those?
When we set off to pilot a solution, whether it’s internally developed or externally developed, that we’re bringing yet we strive to be incredibly deliberate upfront to understand what’s the problem that we’re solving. Can we establish a baseline of performance as well as an expectation that we’re trying to hit and understand how we’re going to measure success so that at the end of that pilot we can look at it and say, “did we learn what we needed to in order to inform decision-making?” We’ve had cases where someone’s tested something and the response back was it was really cool or it worked. And you need more if you’re going to propose then installing it at a hundred and seventy-eight other hospitals. We need a little bit more data to say, “well, how did you change the patient experience or how did you improve care.” So we work with a lot of our innovators too. How would you measure progress?

Everyone else in healthcare is looking for an edge, too. What’s your take on competition vs collaboration?
I think [we] recognize that at times competing for volume is different than trying to improve the quality and efficiency of the care that we’re providing. And so there’s plenty of opportunities to collaborate with other health systems or with payers or with the government to say, “how are we going to improve the care that we provide in our communities.” And that’s not and shouldn’t be I guess from my perspective a competitive dynamic. There’s plenty of opportunity for us to share information, and that sort of has an “all boats rise” effect. And that just makes the health status of our communities better.
On the other side, we are competing. But that’s more about how we position ourselves, our cost status and our contract with payers or employers, the convenience to our consumers. So we compete on that front but there’s plenty of opportunity to collaborate on clinical excellence if you will.


What should a startup or vendor who wants to work with a company like HCA be thinking about?

…Listen to the interview for Chip’s answer.

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