© 2013 Chris Trimble Presented by: Chris Trimble Adjunct Professor Dartmouth College Leading Innovation in Health Care Delivery © 2015: Chris Trimble.

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Presentation transcript:

© 2013 Chris Trimble Presented by: Chris Trimble Adjunct Professor Dartmouth College Leading Innovation in Health Care Delivery © 2015: Chris Trimble. These slides may be freely distributed, with this copyright notice, so long as the format remains unchanged. I receive royalties from sales of the above-pictured book. I have no other conflicts of interest to report.

© 2015 Chris Trimble

Who invited this guy?

© 2015 Chris Trimble 4 Agenda The Cheap and Curative Pill Bright and Shiny New Objects The Prescription The Happiest Physicians

© 2015 Chris Trimble 5 The Cheap and Curative Pill

© 2015 Chris Trimble Cost Outcomes A Cheap and Curative Pill 1940

© 2015 Chris Trimble Cost Outcomes Innovation in Aggregate 1940

© 2015 Chris Trimble Cost Outcomes Biosciences-Driven Innovations

© 2015 Chris Trimble Cost Outcomes Biosciences Driven Innovation Cost Constraint The Cost Wall What Now?

© 2015 Chris Trimble Cost Outcomes Biosciences Driven Innovation Cost Constraint A Second Kind of Innovation Innovation in Health Care Delivery

© 2015 Chris Trimble 11 Bright and Shiny New Objects

© 2015 Chris Trimble 12

© 2013 Chris Trimble Innovation is a two-part challenge: IDEAS EXECUTION

© 2013 Chris Trimble The EXECUTION challenge: Underestimated Underinvested

© 2015 Chris Trimble 15 An Exception to the Rule IDEASEXECUTION Biosciences Driven Innovation REALLY HARD HARD Innovation in Health Care Delivery REALLY EASY HARD

© 2015 Chris Trimble 16 Innovation in Health Care Delivery Four Categories, Four Simple Ideas 1.Standardization 2.Coordination 3.Prevention 4.Improved Medical Decisions

© 2015 Chris Trimble A Simple Innovation Map Where is the Opportunity? Large Small InnovationImprovement

© 2013 Chris Trimble Physics of Innovation R tot = R ops + R inn

© 2015 Chris Trimble 19 The Critical Resource: TIME People Fraction of Time 10% 80% 90% 70% 60% 40% 50% 30% 20% 100% Ongoing Operations 0% 10% 20% 30%40% 50% 60%70% 80% 90% 100%

© 2015 Chris Trimble 20 Part Time Contributions from All People Fraction of Time 10% 80% 90% 70% 60% 40% 50% 30% 20% 100% Ongoing Operations 0% 10% 20% 30%40% 50% 60%70% 80% 90% 100% Innovation

© 2013 Chris Trimble The Fundamental Limitation Project Size

© 2015 Chris Trimble 22 Full Time Contribution from a Few People Fraction of Time 10% 80% 90% 70% 60% 40% 50% 30% 20% 100% Ongoing Operations 0% 10% 20% 30%40% 50% 60%70% 80% 90% 100% Innovation

© 2015 Chris Trimble 23 Innovation with Full Timers Bigger Projects Resources are More Reliably Available Ability to Practice Clean Slate Team Design (Without Breaking Anything)

© 2015 Chris Trimble 24 This Approach Does Not Enable Clean Slate Team Design People Fraction of Time 10% 80% 90% 70% 60% 40% 50% 30% 20% 100% Ongoing Operations 0% 10% 20% 30%40% 50% 60%70% 80% 90% 100% Innovation

© 2015 Chris Trimble Large Small All, Part Time A Few, Full Time A Simple Innovation Map Where is the Opportunity?

© 2013 Chris Trimble A “Lab” or “Innovation Center” May Not Be the Answer

© 2013 Chris Trimble Team Redesign … …lies at the very core of innovation in health care delivery.

© 2013 Chris Trimble Team Based Medicine Step One: Build New Teams From Scratch

© 2015 Chris Trimble A Simple Innovation Map Where is the Opportunity? Large Small Bright, Shiny, and New Comfort Zone

© 2015 Chris Trimble 30 The Prescription

© 2015 Chris Trimble 31 Primary Children’s Hospital (Salt Lake City) 1. The Population Children with Complex Medical Conditions. 2. The Intervention Heavyweight Primary Care. More care planning, care coordination, and close contact with families. 3. Results Outcomes up. Costs down >10%. Patients more satisfied.

© 2015 Chris Trimble 32 The Prescription: 1.Accelerate the transition to value-based payments. 2.Make more bets on full time teams.

© 2013 Chris Trimble The Happiest Physicians

© 2015 Chris Trimble 34 Physician Innovators 1.Choose a Patient Population 2.Understand the Needs of the Population 3.Design and Build Teams From Scratch 4.Invent Operating Routines From Scratch 5.Measure Costs and Outcomes

© 2013 Chris Trimble Greater Autonomy Plus Greater Accountability

© 2013 Chris Trimble Questions

© 2015 Chris Trimble 37 Team Design Innovation in Established Organizations PARTNER- SHIP Dedicated Team Shared Staff

© 2013 Chris Trimble

© 2015 Chris Trimble

© 2013 Chris Trimble Presented by: Chris Trimble Adjunct Professor Dartmouth College Leading Innovation in Health Care Delivery © 2015: Chris Trimble. These slides may be freely distributed, with this copyright notice, so long as the format remains unchanged. I receive royalties from sales of the above-pictured book. I have no other conflicts of interest to report.