BY KIM BELLARD
One of my favorite movies is The princess Bride. Among the many great quotes is one from Inigo Montoya, who gets frustrated when the evil Vizzini keeps using “inconceivable” to describe events that were clearly happening in reality. “You keep using that word,” Iñigo finally says. “I don’t think it means what you think it means.”
So it is for most of us with the word “innovation,” especially in health care.
What got me thinking about this is an opinion piece by Alex Amouyel: Innovation doesn’t mean what you think it means. Ms. Amouyel is the executive director of Solve, an MIT initiative whose mission is to “drive innovation to solve global challenges.” It sees itself as “a marketplace for social impact innovation.”
In her article, Ms. Amouyel points out that traditional definitions of innovation focus on the use of novelty to create wealth. She doesn’t dispute that view, as long as “wealth” includes the less traditional “community wealth,” which includes “widely shared economic prosperity, racial equity, and ecological sustainability.” She suspects that innovators like Jeff Bezos or Elon Musk don’t adhere to that view of innovation.
Ms. Amouyel’s take is: “For me, innovation is about solving problems. And if innovation is about solving problems, what problems are you solving and who is out to solve them is key.” She points to the multiplicity and difficulty of the global and community-level issues we face, urging: “What is most urgent is that we focus on the issues that affect the most neglected among us.”
For example, in health care, which of our many problems are we trying to solve, for which populations, with whose help? Does innovation increase the wealth of the community, or just the wealth of some people? Will it improve the health of the most destitute among us?
She is particularly interested in proximal leadership in problem solving, quoting Jackson, Kania and Montgomery: “Being a proximal leader is much more than being exposed to or studying a group of people and their struggles to overcome adversity. It’s about being part of that group or being meaningfully guided by the input, ideas, agendas, and assets of that group.”
Therein lies the problem. Whether it’s global warming, poverty, or America’s dysfunctional healthcare system:
The problem today is that too often we are not recognizing and therefore not investing in upcoming innovators working in underserved communities, which means their innovations may never reach the depth and scale needed for change. systemic
Those seeking innovation (investors, corporations, foundations, corporations, or governments) rely on closed or top-down approaches to find innovators. This relies on innovators being part of existing networks in particular geographies, going to the right schools, or being introduced through the right person to an investor or foundation program officer. We need to open doors both literally and figuratively to meet nearby innovators where they are, taking co-creation and bottom-up approaches that allow access to those working in and with the most underserved communities.
I can’t speak to how well that applies to other big issues, but I do recognize that it’s a problem in health care, particularly in the US, they’re mostly focused on making things a little bit easier for people. middle/upper class with moderate health problems. It doesn’t exactly get to the heart of the biggest health problems facing our nation, or the biggest problems in our health care system. Not really throwing the doors wide open to the thousands, maybe millions, of upcoming innovators whose lives are at stake.
For example, if you’re a hospital and frontline nurses aren’t helping lead your innovation efforts, you’re probably focusing on the wrong things. If you’re a digital health company, a pharmaceutical company, or a medical device company, and patients play an advisory role at best, admit it: you really do it for the money.
Solve, for example, brings together Challenges that recruit “social entrepreneurs who use technology to solve today’s most pressing problems.” He has supported some 228 Solver teams over the years, including one focused on the economics of care and another on equitable health systems. Current open challenges include how to measure performance improvement in primary care and another on how to improve the quality of life of people with rare diseases.
Solve just held Solve at MIT 2022. Two quotes from the abstract caught my eye:
- Azra Akšamija: “When we work with fragile communities, we always have the best intentions, but the best intentions do not always lead to the best solutions.”
- Hanna Hala: “Charity asks: what’s going on, how can I help? Justice asks: why is it happening, how can I change it?
Look, I’ve been a longtime advocate of electronic health records. I am totally in favor of more digital health solutions. I am grateful for the kind of advances in drug development that made finding and producing COVID-19 vaccines so fast. I have been a beneficiary of improvements in surgical techniques and devices. I am fascinated with AI, 3D printing, virtual reality, augmented reality, the metaverse, and robotics in healthcare. All of that, and more, counts as “innovation,” as we normally define it in health care, but I have to ask: are these the best solutions for fragile communities? Do they help bring more justice in our health care and in our society?
I don’t think so either.
If we’re going to be true innovators in health, we need to start by realizing that we’re spending our $4 trillion pretty stupidly, and that much of the innovation will make already rich people and organizations even richer. We would focus on the fact that most of our health problems start with too much poverty, with too many people lacking adequate income, housing, food, and education. We would be angry if people who provide practical care, including nurses, nursing home workers, and home care aides, are paid so little relative to their immense contributions.
Addressing those kinds of things, taking on those kinds of challenges, so you can call yourself an innovator. Until then, I would have to agree with Ms. Amouyel: Innovation doesn’t mean what you think it means.
Kim is a former e-marketing executive at a major Blues scheme, editor of the late and lamented Tincture.io, and now a regular contributor to THCB.