Making Innovation an Integral Part of Healthcare Leadership

Sri Bharadwaj, vice president of digital innovation and applications at Franciscan Health, is part of a new wave of healthcare executives focused on advancing a culture of virtual (and value-based) care

With virtual health becoming a mainstay in the healthcare landscape, more health systems are including innovation in their leadership structure. The management of new tools and technologies, as well as new strategies that aim to improve clinical care and fine-tune clinician workloads, often now falls to the chief innovation officer, the chief technology innovation officer, or the vice president of digital innovation.

Sri Bharadwaj leads that charge at Franciscan Health, a 12-hospital, 400-site health system based in Indiana. As vice president of digital innovation and applications since February of 2020, he’s been guiding the health system through an intense period of change, precipitated by the pandemic, along with what he says is the journey to value-based care.

“Central to this is change management,” he says. “It’s a critical component of how we operate, and how we will become a virtual hospital of the future.”

The operative word there is ‘change,’ and it’s a key component of the role that Bharadwaj and others like him play in transitioning healthcare to value-based care. He notes that among the biggest challenges to a health system’s acceptance of change is “relationship barriers,” or a reluctance within the organization to embrace new strategies.

“We have to rethink the status quo,” he says. COVID-19 “created an urgency to change and gave us a good look at what we have to do from now on to succeed, and we all have to play a part.”

It’s not an easy role. Just a few years ago, a Health Affairs study looked at the “relatively new” phenomena of the chief innovation officer, and concluded that they often face pushback from upper-level management in fostering innovation.

“If the goal of the chief innovation officer role is to truly catalyze transformation into new business models, organizations will need to be more ambitious in developing innovation structures, providing access to key stakeholders, and resourcing appropriately,” the report concluded.

And in a 2018 survey conducted by Kevin Schulman, a professor of medicine at the Clinical Excellence Research Center at Stanford University, and several colleagues from the Harvard Business School, roughly one-fifth of the health systems surveyed don’t have a chief innovation officer or appropriate position. With the rest, the position is seen as a strategic role, but often there’s a disconnect between appointing someone to the role and making an impact.

“The innovation literature has a growing focus on the role of organizational structure as a key enabling approach for organizations to consider, particularly for business transformation,” Schulman and his colleagues wrote. “Yet, in our study, only 20% of respondents reported that innovation included a novel organizational form. This result stands in contrast to an aspiration for transformative innovation in organizations, such as a shift to value-based payment models in health care. This result may limit the impact of these innovation efforts: ‘When innovators stop short of business model innovation, hoping that a new technology will achieve transformative results without a corresponding disruptive business model and without embedding it in a new disruptive value network or ecosystem, fundamental change rarely occurs.’ ”

Those challenges aside, the chief innovation officer role is gaining attention in healthcare circles. Chief innovation officers even have their own professional group. In 2018, the Healthcare Innovators Professional Society (HIPS) launched, with 36 executives from some of the most forward-thinking health systems in the country.

“I believed that the pace of innovation could go faster if these executives had access to a non-competitive network of peers with whom they could informally share thoughts and ideas, and work collectively to create solutions,” Toby Hamilton, MD, the group’s founder and executive director said in interview with HealthLeaders.

Sri Bharadwaj, vice president of digital innovation and applications at Franciscan Health. Photo courtesy Franciscan Health.

Bharadwaj says executives like him are starting to prove their value, in part, because COVID-19 emphasized the importance of telehealth and digital health innovation. Those health systems with innovation officers already in place were able to adapt to virtual care more easily at a time when that may have been all that stood between a hospital and complete chaos or closure, while others struggled to embrace not only the technology but the management structure behind it.

As we move beyond the pandemic, health system leaders are now focused on a future that combines virtual and in-person care in a hybrid platform, using new technologies and strategies that focus on remote data capture and care management.

“We’re affecting the entire continuum of care,” Bharadwaj says. “And we need to look around us and see how other industries are doing this. They’re all moving to a digital model.”

He says this digital transformation in healthcare is fueled in part by the shift to consumer-focused care. As consumers gain more control of their healthcare, including deciding how and where they access care, they’re putting pressure on care providers to offer options, such as telehealth visits and digital access to healthcare records, resources, and scheduling. If care providers aren’t willing to make changes, there’s a fast-growing network of new care providers, from retail clinics to telehealth vendors, willing to meet consumers' requests.

A health system’s innovation leader creates an atmosphere by which those changes can be made, Bharadwaj says. It starts with collaboration, in the form of discussions between management, clinicians, and others within the healthcare settings that identify gaps in care or barriers to effective care delivery. How those challenges can be addressed is not only with new technology but with strategies that  consider cost, workflow management, and patient engagement. Innovation won’t succeed unless there’s proof in hand that it makes healthcare better.

And that’s where data comes into play.

“Data is the cornerstone to care,” Bharadwaj says. “That’s one of the things we’ve struggled with in the hospital system. We now have the ability to capture so much data, both inside and outside the [hospital], but how do we use it meaningfully?”

How a health system collects and uses data may be the key to whether an innovative new program like remote patient monitoring (RPM) catches on and becomes sustainable and scalable. Bharadwaj says that the data coming into the hospital can be used to paint a more complete and accurate picture of the patient, offering not only more opportunities for improved care management but new insights into preventive health and wellness that affect long-term patient engagement and outcomes.

“In the end, we’re not talking about a patient, but about a person,” he says.

Bharadwaj says the health system of the future won’t be confined to a hospital, clinic, or doctor’s office; he cites recent research by Gartner that predicts at least 40% of a hospital’s business will shift to the home by 2025.

In that landscape, a health system must lay the groundwork for more RPM programs, even the more ambitious hospital at home concept that sees some intensive care services shifted to the home, and it must have a strategy in place for vetting mHealth apps and other digital therapeutics prescribed by doctors, and wearables and telehealth services preferred by consumers.

“The hospital of the future will be high-acuity,” he says. “We have to be ready for this, and we have to make sure the home is ready as well. By 2025 or 2030, the patient will have the technology at home to accept virtual care, and we have to be ready to provide it.”