Who's Afraid of Amazon and Google? Not Cleveland Clinic.

Innovation pros weigh in on the success behind their Summit and Clinic, and say welcoming disruption, partnerships, and a new culture will drive change.

Innovators from across the nation are seeking ideas on how to move healthcare forward. With Cleveland Clinic's 2018 Medical Innovation Summit in full swing, those participants will get a healthy infusion of insights from leaders in every aspect of this arena.

Cleveland Clinic Innovations (CCI), which is presenting the event, is a seasoned health system innovation engine. To get a glimpse into the philosophy behind the Summit, as well as what make things tick at the institution that created it, I spoke with Pete O'Neill, CCI executive director, and Will Morris, MD, CCI's senior medical director.

The duo shares compelling perspectives about what moved Cleveland Clinic to the forefront of innovation and how other health systems can propel the industry forward. While emerging technology may offer solutions, they say culture, partnerships, and a new approach to educating health professionals are the forces that will move the needle. They also have some interesting thoughts about the role Google and Amazon could play if they aren't viewed as competition.

Founded in 2000, CCI has issued over 1,450 patents and executed more than 560 licenses on medical devices and techniques. Additionally, it has helped launch 84 companies that have created over 1,250 jobs and raised more than $1 billion in follow-on funding.

Following is an excerpt of my discussion with O'Neill and Morris, edited for clarity and space.

HealthLeaders: This year's Summit is titled, "Disruption: Reimagining Healthcare." I'm interested in your interpretation of that.

Pete O'Neill: Changes in healthcare are inevitable—some small, some large. The cost to deliver healthcare in the United States is not sustainable. [At the same time,] new technologies are becoming available that have the potential to disrupt healthcare. Those two forces are going to lead to changes.

"Reimagining Healthcare" is meant to present a positive outlook on disruption. Some view disruption as unsettling. Cleveland Clinic looks upon disruption and change positively, as an opportunity. We look forward to what's on the other side of these changes—what the future holds for healthcare. That's the context that we want to try to weave throughout the entire Summit and all the work that we do.

HL: What do you see as the most significant innovations or trends that are viable or emerging today that have the greatest potential to change the way health systems operate?

Some of the trends that are pervasive throughout healthcare are things like artificial intelligence, blockchain, and machine learning. We see those becoming reality.

Another trend that is prominent in the work that we do is managing wellness as opposed to treating sickness. That leads to technologies and innovations that allow you to interact with those customers at home more [frequently], which is very disruptive for a place like the Cleveland Clinic that has millions of square feet in beautiful buildings.

The last trend is multiple ways where care is increasingly tailored to the specific patient. Whether that's through genomics or 3-D printing, [tailored patient care is] certainly enabled by new technologies and increasingly powerful computing that is cost effective and affordable, and, to some extent, pervasive. So many people have cellphones; the computing and connectivity power that's in these devices is incredible. It's really enabling some intriguing ways of managing wellness in the future.

HL: How can innovation teams prepare for a new era of competition from the Googles and Amazons of the world who are forcing change from outside the health system?

Will Morris, MD: Google or Amazon are not our competition. At the end of the day, our competitors are still local. New, nontraditional entrants like CVS, payers like Aetna and Humana, and certainly totally nontraditional healthcare verticals like Amazon, Google, and others are entering the field. They're doing it not because [they're thinking], "Hey, we can make a buck;" [they're doing it] because in disruption you look for areas of waste. There are opportunities to improve. We've embraced that. Our internal strategy is not to wait for the chapters to be written. We want to write those chapters.

You can either disrupt or be disrupted. We're not waiting to see what Google and all of them do; we welcome this because it encourages us to move faster. I can't imagine Amazon or Google will become care providers. I think the best outcome is going to be partnerships.

We also need to focus on our core attributes. We want to provide the best clinical care, period. How, then, do we interact in a world where patients are interacting with Amazon and Google? We are very much entrepreneurial and [cognizant] that there may be partnership [opportunities with these entities]. These interesting collaborations are where magic happens.

O'Neill: I think you nailed it, Will. Google and Amazon are not competition at all. I think they're [potential] partners. If Cleveland Clinic doesn't collaborate with partners like that, somebody else will. That collaboration will [then become] our competition.

Morris: If you view everyone as competitors, you're going to close your door and your aperture. Cleveland Clinic Innovations and, frankly, Dr. [Tomislav] Mihaljevic, [CEO and President of Cleveland Clinic,] and all of our caregivers have a very open aperture. You need to listen, learn, and see because that is the best way where we improve and grow together. We're not trying to avoid competition. We're actually just trying to lead and do the right thing.

HL: We've done a number of recent interviews with health system innovation center executives. Collaboration between health systems is one theme that's emerging. What are your thoughts about this?

Morris: The challenges that we face as an institution are ubiquitous. All systems are struggling with how to provide the best clinical care at the highest quality and safety, but at a [reasonable] cost. And clearly, that has not been achieved. There's a lot of friction, and these [issues] are universal.

Cross-collaboration is an opportunity to share and cross-pollinate ideas, visions, and capabilities. While we believe and know that we are the No. 1 hospital in terms of healthcare delivery, and that's our special sauce that's unique to us, the practice of medicine, and the technology, and the analytics are ubiquitous and transcend brands and boundaries. An opportunity exists for us to share, and listen, and learn—and shame on us if we don't. As clinicians we publish, and we share results; we should do those same things around clinical and operational transformation.

HL: What is the biggest challenge that health systems innovators face today and how can it be addressed?

Morris: Focus and prioritization. I think that's where [innovation] gets local and how health systems are differentiated. There's a lot of stuff you can do. Time and resources are fixed, and you really need to be focused on your clear strategic objectives and values, and then have a framework in which you want to achieve it.

HL: What strategy do you think has had the greatest impact on the enduring success of Cleveland Clinic Innovations?

O'Neill: Innovation is part of the fabric of the Cleveland Clinic. The existence of Innovations is a natural manifestation of what has been part of the Cleveland Clinic's culture for 97 years. What we do is leverage the existence of that culture throughout our 55,000 caregivers.

Morris: That's exactly right. Innovation is for everyone. It's very much a cultural north star that is core to our DNA. Our leadership—from the CEO, to the trustees—all the way down to the frontline caregivers who service the rooms, know that if they have an idea, they have a voice.

HL: Changing the way physicians practice medicine is an enormous endeavor, but a necessary component of innovation. What changes are needed in the academic curriculum to create a new generation of physicians who will focus on prevention versus illness?

Morris: I think you just answered your question. Education or awareness starts at the undergraduate level and goes all the way up. We spend time speaking, educating, and engaging with high schoolers who are thinking about entrepreneurship and innovation. We feel like that is the place where we will [find] the next [generation of] thought leaders.

Second, specifically on healthcare, we at Cleveland Clinic recognized early that we need to encourage new ways of practicing medicine. Our new medical campus is a reflection of your hypothesis. It includes two medical schools, both the Cleveland Clinic Lerner College of Medicine and Case Western Reserve School of Medicine [a partnership between the two institutions], a nursing school, a dentistry school, and allied health professionals all physically in one building.

I trained independently, yet the way I practice is a team sport. It is all about teams. The idea is to create an environment where we train and learn together. [The campus] is a new way of emulating the care model. It's not just a physician- or a nurse-centric view; it is a collective view in service of the patient. Creating those experiences [during the educational process] is key to achieving the kind of transformation and open-mindedness that's needed.