A growing number of New Jersey hospital systems are challenging the conventions that have restricted healthcare providers from developing innovative methods of delivering care in a quest to improve outcomes and save money in the process.
One example is a simple idea with huge potential: a plastic box and labeling system designed to make insulin use easier and more efficient that could improve care and save one New Jersey hospital roughly $100,000 a year in wasted drug costs.
The product — which is now getting national attention — is the brainchild of nurses and pharmacy professionals at Overlook Medical Center. It’s the first invention to result from an innovation center launched earlier this year by Atlantic Health System, the hospital’s parent network.
More innovation on the way
In the coming months, Hackensack Meridian Health, which operates 13 Garden State hospitals, will announce an agreement with two start-up companies that have developed concepts the healthcare system’s leaders believe will help them provide better care at lower cost. It could also result in new commercial products or services that have a national impact.
These pending deals are the result of an innovation competition Hackensack Meridian developed over the past year, hospital officials said, and grew out of a partnership the system formed with the New Jersey Innovation Institute,(NJII) a subsidiary of the New Jersey Institute of Technology, which assists various key industries, including healthcare.
Hackensack Meridian and NJII teamed up in August to announce the opening of Agile Strategies Lab, an innovation ‘incubator’ designed to bring creative problem solving to New Jersey’s healthcare industry. While many of the nation’s major academic medical centers have created such programs, officials said the lab, housed on NJIT’s Newark campus, is the first of its kind in the Garden State to include a focus on this sector.
“Innovation is important. It’s important to our state and all of our health systems are now embracing the word,” said Thomas Gregorio, NJII’s senior executive director. Hackensack Meridian is a charter member of the lab, he said, and NJII is now negotiating agreements with several other hospital systems.
‘Ringing off the hook’
“We understand not all of these organizations can put up the brick and mortar (to build their own innovation efforts.) But they can use our programs,” he said, adding, “Our phones are ringing off the hook.”
The effort also builds on work in recent years by the Nicholson Foundation, a healthcare philanthropy organization, that has provided $50,000 grants to Garden State healthcare systems to help them test and develop innovations that benefit low-income and other vulnerable populations — not products for commercialization. (Applications for the next round of funding are due December 15.)
Some industries, like technology, have embraced innovation and included infrastructure in their business strategies to support the development and testing of new ideas, Gregorio and others said. But healthcare has traditionally been focused on more immediate concerns — treating patients, including those with urgent and critical needs, and identifying and protecting critical resources. This means changes, even if they are positive, are often hard won.
“Healthcare has been historically behind the curve,” agreed Thomas Bartiromo, NJII’s chief innovation officer. “There is no shortage of problems to solve,” he added, and a need for solutions that are “better in a sustainable way.”
“This (Agile Strategies Lab) program creates the right conditions for the right things to happen,” Bartiromo said. NJII is also working on a state-wide patient index, a database designed to ensure providers across the state can’t confuse two patients with the same name, and assisting providers in embracing value-based care and other federal goals and reforms.
Gregorio and Bartiromo previously worked for what is now RWJ/Barnabas Health, the state’s largest provider network, and said they encountered plenty of nurses and other front-line staff with beneficial protocols scribbled on notes they keep in their pockets, or secret workarounds that can save them critical time or other resources.
“A less progressive organization will look at those workarounds and get frustrated and try and bend them back into conformity,” Gregorio said. “Others will look at it as a chance to innovate.”
Dr. Andrew Pecora, the chief innovation officer for Hackensack Meridian Health, said his network should be counted as a leader when it comes to creative thinking. “We are innovators, that’s our shtick,” he said.
The system — with some 34,000 doctors and other professionals at work in hundreds of sites statewide — provides a wealth of “smart people” and a perfect testing ground for new concepts and products, Pecora noted. “We can be an incredible incubator,” he said. “It shows what a healthcare system can do.”
Pecora said Hackensack Meridian set out about a year ago to solve a large, complex problem: How to improve the value of healthcare for providers, patients and those paying the bills. The organization also set aside $25 million as seed funding for a number of projects over the years to come, he said, and decided to both tap its own expert staff and also see what outside entrepreneurs could bring to the table.
Closing in on concepts
Working with NJII and the “ideation,” or concept development, team in the Agile Strategies Lab, Hackensack Meridian reviewed ideas from nearly three-dozen companies. Concepts ranged from designs for new technology — like clothing that senses body functions or tools to improve communication among staff — to surgical devices, to methods for improving community outreach, he said.
To identify the most likely successes and help refine and develop these ideas, Hackensack Meridian decided to create its own version of the investment TV show “Shark Tank,” Pecora explained. Dubbing it the “Bears Den,” the hospital system drafted clinical experts from its own ranks, patent attorneys, and outside investors to help take these concepts to the next level. The pool was whittled down to eight ideas, and then four; now two finalists remain. (Leaders are withholding any additional details until they announce the news.)
At Atlantic Health Systems, a network of six hospitals with nearly 20,000 doctors and other professionals, leaders created their own internal innovation incubator termed Atlantic Health Advancements, or AHa! The program is designed to help develop and test concepts submitted by staff and private-sector entrepreneurs, and it will share a portion of certain proceeds with employees involved in the process.
The first outcome, announced this fall, is the ISSI Box, or Insulin Safety Secure Initiative, a plastic box the size of a large pencil case that has specially designed slots to hold multiple insulin vials. The box, which is stocked and provided to nurses at the start of each shift, gives caregivers quick access to different kinds of the drug in a way that makes it easy to dispense and cuts down on loss and waste — a problem calculated to cost $130 billion nationwide for insulin alone.
Joe Wilkins, senior VP and chief transformation officer for Atlantic Health, said the network is “keenly aware” of the need to find and quickly implement changes to improve care. “The people who understand this best are those who are on the front lines of care each day and night—our physicians, nurses and employees, and the ISSI Box is a perfect example of that,” Wilkins said. “AHa! is a formalized way to collect their ideas, test them, and further hone them into tangible solutions to improve practice and outcomes.”