When it comes to fostering innovation, most academic medical centers, medical schools, and health systems use the “pull” approach: they open technology transfer offices, hire staff, create industry relationships, and then wait for physicians, investigators, trainees (students, residents, and fellows), and other health care providers to initiate contact, submit new inventions, or navigate the typically opaque path of medical innovation and discovery.
That approach works for only the most self-directed, enterprising innovators, largely ignoring the majority of an institution’s health care professionals.
There’s a better way: pushing fundamental health innovation knowledge, skill sets, opportunities, and ground-level support to every health care professional who enters an institution’s doors.
That’s the route I and several colleagues have taken for Mass General Brigham, a large Boston-based health care organization, overseen by its innovation office. Though most of our efforts are less than 5 years old, we are already seeing results: portfolios of new companies, patented technologies, publications, and a subtle but notable shift from excellent clinicians and researchers to excellent clinician- and researcher-innovators.
Why bother? Health care innovation saves lives: New diagnostic methods, therapeutics, devices, and methods are an engine for keeping people healthy, treating their illnesses, improving their quality of life, and preventing them from dying prematurely. Medical schools and health care institutions must do everything in their power to sustain innovation, keep it running, and democratize the process.
Play the long game
Institutional innovation in a scalable manner is anything but quick. It requires a long-term vision from executive leaders to invest in and sustain initiatives to increase the innovator pool over years, generally starting from scratch.
A generous estimate of the number of bona-fide innovators at Mass General Brigham is 0.5% of the total workforce. These are physicians, researchers, clinicians, and others who have invented new products that have successfully been commercialized, generally, but not always, used in patient care or in clinical trials with substantive investors. The proportion of prospective innovators — those who may be nibbling at a new idea or who may have submitted or received a patent or created a prototype or marketable product without substantive commercialization success is about 5%.
A strategic long-term vision might be to double the pool of prospective innovators from 5% to 10% with a corresponding, but not necessarily equivalent, increase in the proportion of bona-fide innovators. Just a 0.1% absolute increase in bona fide innovators would predict a 20% increase in innovation output according to our metrics, translating to better patient care and high-value licenses for the health system. In short, a little investment in foundational development can go a long way in absolute output.
My colleagues and I have explored the educational deficiencies underlying key barriers that prevent health care professionals from developing as innovators. Our research has shown that the knowledge of traditional innovation domains — patent process, commercialization, idea translation, prototyping, digital and device basics, artificial intelligence, and more — is universally poor.
What’s more, as our team described in a recent report in Nature Biotechnology, most health care trainees do not initially consider themselves to be innovators. Their biggest barriers to innovation are limited time and energy (43%), lack of physical resources (35%), and lack of expertise (31%). The most beneficial tools cited were dedicated time for research and innovation (61%), financial support via grants and startup funding (49%), and partnership with mentors (47%). Internal research shows that approximately 50% of our workforce would like to develop an idea they have for a new product — in other words, innovate.
There are ways to bridge this gap.
An important step forward is for organizations to provide required — not elective — innovation education. These core curricula would be augmented by the pull approach of providing additional asynchronous innovation and entrepreneurship programs and mentorship opportunities such as grants and venture funding, patent and development support, networking opportunities at innovation conferences, and more.
Support for such health-improving effects could come from the organizations that accredit medical schools, like the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Neither currently lists innovation as a core competency. While that shouldn’t signal a rebuke of health care innovation by these bodies, it also doesn’t engender an explicit focus on and respect for innovation in medical school and residency programs.
A case study of innovation push
To radically change the landscape for medical innovation, Mass General Brigham established the Medically Engineered Solutions in Healthcare (MESH) Incubator in 2016.
The first step was to develop and stand up an integrated, hospital-based core curriculum called MESH Core. Originally at Massachusetts General Hospital’s Department of Radiology, this intensive, hands-on, one-week rotation guides residents, fellows, attending physicians, and clinicians at all levels through the fundamentals of the patent process, commercialization, corporate development, artificial intelligence, prototyping, 3D-printing, entrepreneurship, venture funding, and much more. For this program, we obtained protected time for trainees to participate. Just as they rotate through the ICU, for example, they now rotate through the innovation service. The message to trainees is clear: Innovating is as important as clinical practice.
Peer-reviewed results showed a significant increase in all aspects of the fundamental domains of innovation. Mass General Brigham Innovation led the expansion and deployment of MESH Core using a novel inventor-built online platform across the entire health system of more than 80 affiliates, serving as its official innovation education certificate course with more than 1,400 prospective and successful innovators in every specialty now enrolled as “students.” It provides an exclusive networking platform to connect junior and seasoned innovators alike for mentorship and guidance. The MESH Core is also taught at international medical conferences.
Additional follow-on pull programs have resulted in numerous new inventor disclosures and inquiries to the innovation office, new companies, patents, publications, and products used in patient care. RadTranslate, for example, is an artificial-intelligence-powered medical translation app that provides verbal, out loud, point-of-care exam and procedure instructions — such as performing a chest X-ray or giving a Covid-19 vaccine injection — in numerous languages so patients can understand what is happening and how to best work with their health care professionals. The app is now being used daily in urgent care and emergency departments across the system, with positive effects on patient care.
Diversity in innovation is not optional
Diversity in innovators, in ideas, and in development will ultimately help provide more equitable care to patients. Highlighted by disparities in disease incidence during the Covid-19 pandemic, as well as its impact, inequities in health care were — and continue to be — brought to the forefront.
Innovation programs everywhere must recruit, educate, and fund women and those from underrepresented groups who understand inequalities on the most visceral level — by living them. People with real and lived experience in disparities must be among the leaders who are envisioning and executing innovations to benefit all populations. Structured programs, such as one led by a colleague of mine, Diana Schwartzstein, can help close this gap.
A rising tide lifts all boats
Institutions such as Mass General Brigham and schools like Harvard Medical School are blessed with resources that many others don’t have. But that shouldn’t stop other institutions from aiming to make innovation a core part of what they do.
Various innovation interest groups may exist at a given medical school or hospital. The common thread for the most successful groups is having one or more inspiring leaders who walk the walk: bona-fide innovators with solid credentials such as patents licensed to industry and generating real revenue or in clinical trials, or revenue-generating companies with exits and concrete investment returns.
The pool of M.D.s and Ph.D.s with this background is small, and they are often overlooked. That’s why institutions must incentivize and recruit these successful innovators to serve in executive leadership positions, not only to efficiently engage the pipeline and advise the C-suite but also to provide direct mentorship to trainees, faculty, and health care providers who wish to follow their footsteps.
Institutions can augment their internal leadership pool via recruitment of successful entrepreneurs-in-residence, one of a number of strategies that Mass General Brigham Innovation employed to advise its institution’s senior leaders in commercialization efforts.
Innovation is now core-required knowledge in medicine. Long-term, mandated innovation education needs to be integrated into medical schools and residencies the same way pathophysiology, medical ethics, and other core knowledge is required today.
Marc Succi is a radiologist at Massachusetts General Hospital, inventor, the Clinician-in-Residence at Mass General Brigham Innovation, founder and executive director of the Mass General Brigham Medically Engineered Solutions in Healthcare Incubator, faculty at Harvard Medical School, and CEO of 2 Minute Medicine, Inc.