Innovation is a challenge across the healthcare industry, and especially in pediatrics. Because the specialty is a small part of a much larger industry, some companies like device or drug developers focus their efforts on adults, leaving pediatric innovation in the hands of specialists themselves.
"Most pediatricians have had to be at the front lines of innovation," said Naomi Fried, chief innovation officer at Boston Children's Hospital. "Necessity has been the mother of invention in pediatrics for a long time."
Boston Children's is at the forefront of pediatric health innovation, with initiatives ranging from seed funds for innovators to apps developed in-house for patients and their families to navigate the hospital.
Listening is the first step to any successful innovative strategy, Fried said. For example, doctors and nurses at Boston Children's expressed frustration with department white boards that keep track of patients and surgeries. The information wasn't updated in a timely manner and could only be accessed by standing directly in front of the board. Fried heard their concerns and assembled a team to develop a digital smart board called ALICE (Aggregated Local Information Collected Electronically). ALICE digitally displays information pulled from Boston Children's electronic health record and bed management system in real time. An in-house team developed the bed management and display system software, which is displayed on monitors. The system integrates with four other clinical systems, including the electronic health record.
The idea for ALICE was found through Boston Children's competitive award process, a program for innovators within the hospital who want to develop new clinical technology. When an idea is chosen, the creators are given access to a team of developers who work closely with the creators to do rapid cycle development and proof of concept. The developers will write and support the testing of the pilot projects. Boston Children's also distributes grant money from a seed fund to test and develop product prototypes.
A number of pilot programs are underway to improve the patient and family experience. MyPassport is a mobile app built in-house that helps patients' families navigate the hospitalization process from beginning to end. From the app, families can communicate with doctors, view pictures, names and roles of everyone on their care team, and view test results and the patient's discharge plan. Boston Children's is also in the process of exploring external partnerships and commercialization opportunities, Fried said.
Boston Children's also has an investment in patient care outside of the hospital. It's piloting a text message platform called DisCo (discharge communications) to stay in communication with families after the patient is discharged. The custom-built software sends a text message to the family within 24 hours of the patient leaving the hospital to find out if the family has questions or needs any additional support. The received answers are displayed on a custom-built dashboard.
Taking post-hospital care a step further, Boston Children's piloted a program that sent VGo video conferencing robots home with patients after urological surgery, allowing for virtual follow-up visits. VGo introduced its first robot in 2011. A survey showed that patients felt doctors were more engaged in these virtual visits compared to a control group that wasn't given robots. The hospital also received fewer unscheduled phone calls from the patient than from the control group.
But innovation is just the first step. Overcoming what Fried calls the "operational gap" ("O gap") can be just as challenging as developing new solutions.
"The question is, how do we motivate people to embrace this new idea?" Fried said. "We look to leadership to provide support. It's also important to have convincing data to demonstrate the impact of innovation. We try to get people who are involved in the operationalization into the innovation process early on. That, more than anything, closes the O gap. You want to get them involved in the pilot phase so they know what's coming."