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Ask the Experts: Is Innovating Within an Academic Medical Center Really Possible?

Sachin Jain


Sachin Jain, MD, MBA, is the Chief Medical Officer at CareMore Health Systems. He was previously the Chief Medical and Information and Innovation Officer at Merck.

Is innovation even possible inside an academic medical center, or should innovators move into the private sector?

When I was a medical student, I felt marginalized because my interests extended beyond learning medicine and into health policy and management. Today, you can’t walk through the medical school quad or teaching hospitals without bumping into someone with a big idea about changing healthcare. We have hackathons and accelerators teeming with enthusiasts launching new ventures.

And yet, I worry. I worry that when I walk through most hospitals, clinics and health systems around the country, the change feels small, marginal and unambitious. I worry that the loud noise made by words like “innovation,” “transformation” and “strategy” might be obscuring the more powerful murmurs of intransigence that still dominate our health care system. I worry that the work of changing health care is being led too much by people who have too much to loose if they truly enabled that change. I worry that underneath the smoke of “health care innovation,” there is no real fire – but instead individuals motivated less by real change than profit or worse, recognition. I worry that “pilot” is code for “sorry, I can’t say yes, but I’m too polite to say no.”

I worry that rather than this being the single most important moment in the evolution of our country’s health care system, it will be remembered as a missed opportunity. I worry that we are living in an “innovation bubble.” And that worry extends from academic medical centers to the private sector.

Why is innovating in academic medicine so difficult? Why do we keep pushing to make it happen?

The undeniable truth is that there is now a clear bifurcation in health care. There is a “change layer,” the cloud in which visionary ideas about transforming health care resides. But there is also a “reality layer,” the place where most care is delivered. Both are necessary, but there’s little mixing between the public and private sectors.

So while there is a booming healthcare innovation industry, a new startup being created every day, a new app being launched every minute, the actual work of delivering care or the experience of receiving care is changing very little. In fact, many elements of the change layer – startup companies, innovation centers – are structured to isolate and “incubate” change.

The most charitable view is that new models of care and new ways of taking care of patients must be isolated and supported separately from the rest of an unmoving enterprise. That view says that innovative solutions and models are too disruptive, and so they must be protected.  Over time, with patience, great new innovations that arise from the change layer will find their way into the reality layer.

But there is another, more cynical view, that in other cases, many elements of the change layer have been created and supported by the incumbents to deliberately kick the can down the road. It says that those who occupy the change layer are content to float above the hard work of changing crusty old operations in favor of innovation conferences and startup ventures. And much of what is continuously described as “new” is really window-dressing on the same old stuff.

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Jenni Whalen

Jenni Whalen

    Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.

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