If the definition of insanity is “doing the same thing over and over again and expecting different results,” as we’ve often heard, then the opposite of insanity is innovation. At least, that’s the philosophy at Geisinger, where innovation is viewed as a “fundamentally different approach to solving a problem” that’s tied to quantifiable outcomes, says Karen Murphy.
In this interview, she talks about the “data-driven” approach that was used to create the recently-launched Steele Institute, what the organization hopes to achieve, and what she learned by traveling across the country speaking with thought leaders. Murphy also discusses how organizations (both large and small) can create a culture of innovation, her passion for public health, and her journey from ICU nurse to CEO to State Secretary of Health.
- Steele Institute’s 4 verticals: health, care delivery transformation, value & environmental health
- Geisinger’s Fresh Food Farmacy
- IT as an “enabling strategy”
- “Intensive intervention” for opioid-addicted moms
- Feeding data into a unified architectural database – “All of our work is data-driven”
- Coming to Geisinger – “I wanted to focus on elements of public health.”
- “If you’ve seen one innovation institute, you’ve seen one.”
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We’re going to look at innovative, fundamentally different approaches to caring for patients in a way that improves health, care delivery, and patient experience, while lowering cost.
We view innovation as a fundamentally different approach to solving a problem that has quantifiable outcomes. All of our work is centered on trying to solve some of the biggest problems we have at Geisinger, as well as throughout the industry.
I also wanted to gain perspective from these thought leaders by asking, ‘if you had a blank sheet of paper and you were starting, how would you approach it? What do you think the biggest problems are?’ It was very, very beneficial.
The goal — the true north, really — is to design and develop innovations that aren’t just effective at solving a problem at Geisinger, but can be generalized across the industry.
Gamble: Thanks again for taking some time to speak with us, we really appreciate it. To start off, can you give an overview of your role as chief innovation officer at Geisinger and some of the key initiatives you’re focused on now?
Murphy: Sure, and thanks again for having me. I joined Geisinger in September and was tasked with operationalizing the Steele Institute for Health Innovation. We’ve spent the last nine months surveying the landscape. As you know, Geisinger is well-recognized for innovation — there’s innovation happening all over the system. But we felt this presented a way to expand our efforts while also focusing them.
The way it’s structured, we’ll be working in four verticals, the first being health. Under this vertical is the Fresh Food Farmacy, which is designed to address type 2 diabetes by providing healthy food for families, and offering cooking lessons and classes on healthy eating. We’ve already seen a significant decrease in hemoglobin A1cs and obesity through this initiative. It’s an innovative approach to focusing on social determinants of health. Also under that vertical is the organization’s effort to address the opioid crisis, which we will lead.
Our second vertical is care delivery transformation. We’re going to look at innovative, fundamentally different approaches to caring for patients in a way that improves health, care delivery, and patient experience, while lowering cost.
Third is value. Under that vertical, we’ll have an applied behavioral economics unit where we look at ways to change incentives, both of providers and patients. We’ll also be looking at new payment models.
The fourth vertical is environmental health. Geisinger has a very strong research arm in environmental health, and so we’re going to evaluate ways to address environmental factors like air quality that result in adverse health outcomes.
Across all of those verticals will be the enabling strategies — information technology, virtual care, artificial intelligence, and machine learning — that will help us achieve our goals.
Gamble: Really interesting. Now, when you talk about innovation, there are different ways of looking at it — it’s not just about new tools and gadgets. What does it mean to you?
Murphy: At Geisinger, we’ve created our own definition. We view innovation as a fundamentally different approach to solving a problem that has quantifiable outcomes. All of our work is centered on trying to solve some of the biggest problems we have at Geisinger, as well as throughout the industry. The Fresh Food Farmacy is a perfect example of that.
Gamble: It is. You mentioned the opioid crisis as another area of focus. What are some of things Geisinger is doing on that front?
Murphy: It’s a huge area of focus for us. We have more than 40 initiatives going on at Geisinger to address the opioid crisis, ranging all the way from prevention through education, to treatment. We have medication assisted treatment centers, which we’ll be expanding this year, and of course, traditional inpatient treatment. We’re also working on an initiative called Free to be Mom, where we will intervene when a pregnant women is opioid dependent by initiating medication-assisted treatment. We’ll work with behavioral medicine specialists, addiction specialists, social workers, physicians, and nurses to make sure she gets the care she needs, and that will continue for two years following the birth. The hope is that through intensive intervention, we can enhance the probability of the mother staying in recovery.
Gamble: It sounds like a great program. Now, the second vertical is care delivery transformation, which will focus on improving the patient experience. I imagine analytics really comes into play in an area like this.
Murphy: It does. Our analytics unit is going to be housed within the Steele Institute to support and drive all of our work. We have a long history of strong data at Geisinger — we were one of the first to implement Epic. We have a strong data analytics team, and we have more than 60 sources of data going into a unified architectural database. All of our work will be data-driven. As I mentioned before, quantifiable outcomes is one of the tenets of innovation; those outcomes will come from data analytics.
Gamble: Okay. So, the Steele Institute was officially launched earlier this month, which I’m sure is very exciting. What are the next steps?
Murphy: The next step is to establish a work charter for the next 18 months. That includes the innovative payment and delivery models we’re going to test in areas like population health. So we’ll be busy with that over the summer.
Gamble: I imagine quite of a bit of collaboration has to happen within different departments to get these initiatives up and running.
Murphy: Absolutely. Geisinger is an integrated delivery network that has a medical college, 13 hospitals, 35,000 employees, a health plan. The enterprise is very large, and so, in order to plan for the institute, we’ve pulled together representatives from all of those areas and formed a multidisciplinary team to be sure we’re addressing the needs of the entire enterprise. That team will be our governing committee to make sure we’re reaching our goals and we’re disseminating the information and the work we’re doing throughout the enterprise.
Gamble: So it seems like the building blocks were in place, at least to some extent.
Murphy: They were. There was a lot of innovation happening across the enterprise, and so the goal was to pull that into the Institute. There was a lot of great work with data analytics, and a lot of great work with collaborative projects such as developing apps for patients to track pain and monitor their progress and their exercise goals.
Gamble: Coming into this role, where you faced the momentous task of creating an Institute for Innovation — something that hasn’t been done a whole lot, what was your approach?
Murphy: Prior to coming here, I was the Secretary of Health for the state of Pennsylvania, and before that I was with the Center for Medicare and Medicaid Innovation. I knew I wanted to focus on some elements of public health, as well and population health and social determinants. So for the first four months, I spent time taking inventory of all the innovation that was happening across the system.
Secondly, I traveled the country talking to national thought leaders about innovation, and I will say, if you’ve seen one innovation institute, you’ve seen one. They’re all very different. I also wanted to gain perspective from these thought leaders by asking, ‘if you had a blank sheet of paper and you were starting, how would you approach it? What do you think the biggest problems are?’ It was very, very beneficial.
Gamble: Was there anything that stood out to you particularly from those discussions?
Murphy: I came back with a wealth of information. There was one prevailing sentiment — that we have a lot of problems, and we need to be solving those problems as opposed to chasing the shiny nickel. That was one. Another was being focused as we approach and evaluate innovations so that we can fail fast, or we can easily expand. The goal — the true north, really — is to design and develop innovations that aren’t just effective at solving a problem at Geisinger, but can be generalized across the industry.
Gamble: In speaking with innovation thought leaders, did you find that the goals and challenges are similar across different organizations, or are they different?
Murphy: There were commonalities, but there were also areas of distinction. An urban community has very different needs than a rural community, and so the approach in an urban facility is going to be very different than that of a critical access hospital.
There are diverse problems that come with either the area you’re in or the type of healthcare you’re delivering, but there are enough similarities to allow for a deep level of collaboration. Again, if we design innovation in a way that addresses a specific issue and is generalizable across the industry, I definitely think we can come up with some solutions. I’m optimistic.