Service Driven Innovation in Healthcare

This month's edition of Harvard Business Review features an article on service driven innovation at Kaiser Permanente. Kaiser is well known in the healthcare industry as a leader in applying IT to improve quality of care and producing better business results. The organization routinely outspends its peers on IT as a percent of revenue and has always rejected the fee for service model that is often blamed for excessive healthcare costs across the industry.
What struck me as interesting about this article is that innovation initiatives are typically associated with expensive, top down endeavors aimed at producing new product categories. The approach at Kaiser is different in that the focus on service driven processes means that innovation can be done rapidly and economically. One example that is cited examines the process that nurses follow to exchange information between shifts. The status quo process took 45 minutes or more and delayed the arriving nurses first contact with their patients. This not only wasted time, but also often resulted in inaccurate information exchange, as well as unhappy patients. After analyzing the process and engaging the nursing teams, a simple breakthrough was identified that called for information exchange to take place with the patient's at bedside rather than at the nurse's station. This new process, coupled with supporting software to compile information in standard format throughout the nursing shift, led to much improved quality, staff satisfaction and increased quality of care.
To ensure that the service innovation process takes hold throughout the KP organization every project includes a "change package". The package consists of a concise set of guidebooks describing the innovation, the process by which it was developed, the benefits for staff and patients and the metrics used to evaluate performance over time. Several versions of the package are targeted at line of business leaders, project managers and frontline staff.
I think this process of service driven innovation can be applied successfully in the information security domain. Incident response is one area that comes to mind. The process calls for coordination with many groups within the organization and the quality of results are driven as much by the thoroughness of the process preparation as the technical methods employed. Another area calling for process innovation is application security. The risk to the organization is acute, but often IT and information security teams get bogged down in reacting to the latest vulnerabilities rather than following a process to reduce risk and liability to the business.

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