Innovation, Diffusion of Ideas, and the Medical Home

Early in my medical school education, I heard about the "science to service gap" , i.e. "it takes 13 years for proven medical improvements to become mainstream".  But after 20 years of clinical practice and 17 years of work with informatics, I consider it a truism.

During my medical informatics work, it has become more than a curiosity as to why the science to service gap exists.  About 5 years ago, I discovered a series of books that explain the Diffusion of Innovations by Everett Rogers who was a professor of communications.  It helped me to understand that there is a natural variation, a bell curve of sorts, for how any group adopts innovation.  Since negative news travels fastest, physicians often get a bad rap when it comes to adopting health information technology (HIT) due to the vocal nature of what Rogers called "laggards".  That is a complex topic for posts in the future. I would encourage anyone interested in innovation to read Rogers 2003 5th edition of Diffusion of Innovations as it includes many lessons learned during the 40 year period following his 1st edition in 1962.

I recently re-visited a web site which comprehensively documents the 18 year journey of a medical home practice that was formed in 1995 called SETMA.  The link to the SETMA site is a great example of how diffusion of innovation can happen within an organization with visionary leadership.  I had the pleasure of meeting Larry Holly, MD the founder of SETMA and I would encourage anyone interested in how to create a cultural framework for innovation to read his web site which is beyond comprehensive in its depth and breadth of information shared.

Believe it or not, in 2013, the medical home is still being questioned as a valid approach.  So perhaps the science to service gap for team work, process improvement, and user-centered design in health care is a bit longer than 13 years.  I am encouraged by the work being done in both my local medical community as well as at the national level -- American health care really needs the medical home innovations more than ever.

Sponsorship of Innovation, The Million Skills Project

I recently contributed to a kickstarter campaign -- my first time. I choose to sponsor the Million Skills Project for many reasons.

1. The project takes a progressive approach to education and life long learning. There are so many positive things that cascade from education like leadership development, tolerance for alternative view points, and skills that will position our community for more success.

2. I have an opportunity to participate in this work. As a significant backer, I will participate in the nomination process for the mentors wired into this project.  I hope to leverage my experience with patient safety and medical informatics to the benefit of the larger group.

3. This a local effort that leverages community assets and talent that highlights some of the reasons I choose to live and work in Bloomington, Indiana. This project has the potential to support economic development and foster the creation of new businesses. So I am all for that.

4. It gives me the opportunity to participate with my children and influence their life long learning. When I showed the project to my teenage son today, he thought it was great. In fact, I think he was a bit surprised that his dad would be involved in something that looks this cool.

I will be writing more about sponsorship of innovation in the near future.

Todd Rowland MD