Deb Dahl has worked for Banner Health for 40 years and is currently the organization’s VP of Patient Care Innovation (“the best job in Banner”). Along with her team, she is responsible to review and operationalize innovative solutions for the betterment of the patients she serves.
Deb, good morning. [What is involved in your position?]
I have the opportunity to look for innovation—innovation can be people, process, or technology, and is usually a combination of the three. Then I have to figure out how to fund it and operationalize it, and then hand it off. So, it’s the most challenging and rewarding position you could imagine.
That sounds awesome. Often partnering with a healthcare system can be one of the biggest challenges for the entrepeneur. What is your advice to the entrepreneurs who are trying to solve the problems in healthcare?
One of the keys to success is to find a healthcare organization whose vision of where healthcare is going to be matches yours. [For example] if your passion is reducing waste, find an organization that also has that as their mission. I think of Virginia Mason as an example, [how they’ve] really embraced the lean processing in 6 sigma and all the tools that might be useful in that environment to make more efficient, effective healthcare.
The innovator often has a personal experience leading to the innovation. How does the innovator find the right organization?
[You could say] review the mission statement. But the mission is so broad and mushy that it doesn’t really tell you where you want to go. So you’ll have to dig around a little further to find out where they are spending their time and energy. What is showing up from a public perspective. For example at Banner, digging will show a focus on the Accountable Care Organization Model—changing the delivery model from “sick care” to “well care,” or to be responsible from a financial perspective for the whole care continuum would be an area that we would be very focused on. And the tools and techniques that would lead you to a care continuum delivery model would fit a whole lot of passions.
I know your inbox is full. How do you filter requests when folks are trying to partner with Banner?
My inbox on return from a recent vacation had 949 unread emails. My approach was to scan through and delete everything in the first line that didn’t fit with Banner’s mission, vision, values and strategic initiative. The first sentence matters—a lot. If you get a response from me, being succinct in what you are proposing and what you want from the health care institution is important. Generally, Banner does not fund innovators. So you want to be clear: Here is what I’m thinking about; I’d like to talk to you about the concept and how it fits with the healthcare organization. Hopefully we’ll give you enough information so you can get grants or venture capital or other funding. From that point, we can talk about what resources Banner could provide as part of your build. This could be our clinicians to talk through the idea with you, a test site such as IRB and our patient population and subject experts, etc. If it fits where we are going, what Banner is good at is bringing an innovation to scale.
Talk more about that
As an example, 1 of 200 admissions in the US is to a Banner facility. We have 200 clinics. We have critical access hospitals, heart hospitals, children’s hospitals and big academic centers. We really are a microcosm of how healthcare is delivered in America. Banner can show the business community that the innovation works, and that it can work at scale throughout the US.
I know it’s expensive for Banner to bring innovation to the organization. Does Banner take in-kind ownership with innovators as part of the relationship
Typically Banner asks for the technology to be available at no cost or at a reduced cost, or maybe it’s a combination of we buy the hardware and the innovator provides the software. At times, we have to have conversations related to intellectual property, and those kinds of things. Ultimately it has to be a win for both parties.
I heard a number from another organization that a pilot costs roughly $250,000 for the healthcare system in terms of changing their workflow, lost efficiencies and the like. Is that a number you would say is close?
The number depends on the type of innovation. If the product is already FDA approved, the $250,000 is likely a good number.
You mentioned Banner is focused on managing the care continuum, Do you have some thoughts about current gaps in the market place where an entrepreneur might build solutions
Banner is very good at hospital delivery as well as clinic delivery of care. However, when it comes to whether or not you need to come in for care is more of a challenge. This fits in the “wellness” category. We need tools to help us keep those who are aging well, rather than declining into chronic conditions. However, this is a difficult business case to build. Our approach has been to start applying solutions to the top 5%, the complex chronically ill of the population—which accounts for 15% of the cost in terms of utilization and expense—hoping to move downstream to the next 15 %, the chronically ill, and so on. Then we can move down to the well folks and keep them in that category. But we have to have that seed money and see where we can make a clinical impact.
Can you give examples of a few recent innovations Banner has thought truly added value?
We’ve been working with Philips Medical on a solution for complex chronically ill patients that is a combination of telehealth and predictive analytics. Patients enrolled in the program have five or more chronic conditions that have been very expensive, meaning they’ve had lots of trips to the ER and the in-patient environment. We have had some very good success in this space.
There is an area we have not adopted yet but we’d like to dig into it further. There are a couple of areas where they’ve applied gaming principles and activities to change, for example, diabetic compliance and [to effect other] behavioral changes, how to get people to exercise regularly, eat right, take their medications—to change the way they think about what they are doing and the activities that go with it. So gaming is an area of potential for us [even though] gaming solutions have proven very expensive and complex to build.
We’re running out of time. Any other thoughts
There is enormous opportunity in healthcare to improve what we do, how we do it, and how much it costs to do it. We have got to, as a society, reduce the cost of care, improve outcomes, and improve the patient experience. The triple aim has to be met as we move forward. It would be a shame if we didn’t take this opportunity to do that.
I wholeheartedly agree. We have to change the ways we care for each other. Thanks Deb.