Cultivating Creativity

Sutter Health Chief Design and Innovation Officer Chris Waugh on empathy and the case for innovation under constraint

Back Q&A Dec 4, 2017 By Rich Ehisen

Chris Waugh’s entire corporate career has been about finding a better way to do things. Two years ago, he brought expertise in innovative thinking and problem-solving to local health powerhouse Sutter Health, joining the company as its first chief innovation officer. We sat down with him to discuss his views on bringing out-of-the-box thinking to a company over a century old.

How do you create a culture of innovation?

Cultures of innovation ultimately just mean creative cultures that apply great problem-solving skills that people would want to work in. But change is difficult. … In the case of Sutter, it’s a century old, and you don’t just show up and change it overnight. Our approach has been to celebrate and fan the flames of the parts of the culture we’d love to see more of … But for a culture of creativity, we find what we call micro-climates. Rather than trying to change 55,000 people overnight, which is difficult, let’s find a coalition of the willing, and the microsites where we can create that change, and then fan the flames. We call those hatchery sites.

What makes a good ‘innovation hatchery?’

“Despite popular belief, innovation loves constraint. The right amount of constraint is very liberating.”

The simplest element we look for is having people that are attracted to change. They’re up for it, they’ll disrupt their workflow for it, they want to be a part of it and then, ultimately, other people will emulate those behaviors. I don’t need to change 5,000 physician mindsets immediately, but if there are 50 that want to try something different, those are the groups we’re going to gravitate to.

You speak about the need to increase the speed of innovation, and you look at these things in 90-day chunks. How did you decide on 90 days?

Despite popular belief, innovation loves constraint. The right amount of constraint is very liberating. We can spend too much time and money thinking about something and trying to perfect it only to find out it didn’t do what we thought it was going to do. I’ll give you an example. We have a live pilot in collaboration with Lyft ridesharing services. We knew it would be financially helpful because Lyft costs less than taxis. What we didn’t know is just how efficient it was going to be. The arrival time for a taxi was anywhere from 15-50 minutes. Lyft was consistently 3-5 minutes. That created this predictability and efficiency that was unexpected.

Related: Seek Solutions by Seeking Empathy

Now we could have thought for a year about ways we could use a ridesharing service. But in this case, we said: ‘Let’s do it for 100 patients in 90 days and see what happens.’ Within weeks we were through our 100-patient number because it was so popular. So 90 days is a good timeline to keep your momentum and not get stuck. It allows you to not get trapped in the cycles where you can end up spending a lot of money and socializing it with a lot of people only to find out in the end that it doesn’t work.

Are you ever afraid of moving too fast? Of being in such a hurry to get to a specific result that you make a serious mistake?

I wouldn’t mind being known as the guy in health care that moved too fast. That said, I want to be really clear about something: When we get into the clinical domain [and FDA approval, data security and HIPPA compliance] we can slow out of the 90-day cycle. If we’re evaluating a startup, for instance, we’re asking them as they enter the door, ‘Is your product FDA-approved? Are there other health care systems that have used the thing?’ We’re not talking about playing around with people’s medications or how we’re treating them clinically. But the honest truth is that health innovation moves very slow. The average time from a clinical breakthrough to dissemination across medical communities where that clinical breakthrough is being utilized is about 10 years. That can’t keep happening. We can move faster; we can move more efficiently and ultimately you just have to ask if it is costing American health care too much to move that slowly.

You advocate for bringing in people from outside the health field to ensure greater diversity of thought in the organization. How has this impacted Sutter operations?

I think it is important there is pairing between those with the knowledge, the intelligence and the pedigree of health care with those that haven’t been overly polluted by it yet, so they’ll come in with fresh eyes. The last hire on my team is an accomplished architect from Columbia [University] who also has a design MBA from the California College of the Arts in San Francisco … We paired him with our head of cardiac surgery, and it has been like sparks flying because they look at a problem through such different lenses.

Your experience is in human-centered design, which focuses on creative approaches to problem-solving. What does that mean exactly?

Human-centered design comes down to three primary fundamentals. First is empathy for the context of the opportunity or problem you are trying to solve. Then, creativity applied against that problem, and getting really broad input without being too concerned whether it’s going to work, if it’s cost efficient or if it’s clinically relevant or not. And then ultimately prototyping and putting that result out into the world to see if there is something there. So, empathy for the context, radical creativity to be applied against the problem, and then simply trying the thing you come up with — those three things are human nature, but it’s always surprised me how often we don’t apply them.

You’ve spoken a lot about empathy in what you do. Why is that so important to successful innovation?

Because a lot of companies just run a customer survey and then say ‘this is what they said they want so that’s what we did.’ Empathy gets a layer deeper, not just listening to what people say but to what’s really going on that they might not be saying … People may say they want lunch in the workplace, but that might really mean, ‘I want to be acknowledged because it feels like my whole day is being sucked up and the last thing I need to do is get in the car and go to lunch.’ So it might be about recognition as much as it is about the food. We’re trying to understand what is ultimately going on and what we need to design for … There’s also a big difference between empathy and sympathy. Empathizing literally means doing your best, even if you’ve never been in that context, to put yourself in the shoes of the person you’re ultimately designing for.

Artificial intelligence is already impacting several industries. How does this play into your thinking about how Sutter operates?

I think the short-term problem is the perceived threat — especially by highly-trained clinical staff — that, like most jobs in the world right now, there is some threat of AI taking it over. But health care is slow to change, so health care is not going to make a knee-jerk reaction where AI eliminates the need for radiology or for nurses. What we do see is there are some promising AI technologies that could start to work the edges. Frankly, a lot of times we’re talking about things that people would rather not do anyway.

Take charting late at night: Do we have great AI late at night doing dictation that is not just taking things word-for-word but putting it in the context of a conclusion based on what we’re seeing? Using AI against predictive analytics that would possibly allow a research team to predict heart failure two years in advance? That’s really promising because then the job of the health care system just changed. It becomes, ‘How do we get Joe, who we know is a key target for heart failure two years from now, engaged in his health care?’ So AI would perhaps make health care far more proactive than reactive. That’s the promise of AI for health care. If we have all this data and can predict what is going to happen, we just moved from defense to offense, which in my opinion is really compelling. 

What innovation would you like to see in health care? Tweet us @COMSTOCKSMAG