Every health system leader has unprecedented executive management challenges facing their organization in the wake of the pandemic. And they highlighted, more significantly, the innovation that needs to be done in the healthcare system. In this episode, we sit down with not just one but two experts in the innovation space. We learn from Ben Look, the Director of the Innovation Hub at Trinity Health (Hq Michigan), and Mike Morin, a serial entrepreneur and co-owner of Seamless Ventures. Together, they dive deep into how innovation can rescue healthcare in a way that is not only great for the patients but also for those in the care team. Ben shares their human-centered design at Innovation Hub while Mike tells us about their Seamless model, both giving us a great understanding of the importance of innovation, especially in unprecedented times.
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Can Innovation Rescue Healthcare? With Ben Look And Mike Morin
Thank you for joining us on the show brought to you by the Baldridge Foundation with our strategic partner sponsoring us, ABOUT Healthcare. Speaking of ABOUT Healthcare, I have my good friend and colleague, Ben Sawyer, with us.
It’s great to be on. I am looking forward to this conversation about innovation.
We’ve been talking about this for a long time. I’m glad we can finally do it. I am super excited because I have two very dear friends that have agreed to talk with us. I have loved working with these guys in my previous life in my healthcare career. That’s one of the things that I hated to let go of. I keep begging these guys, “If you guys are doing anything fun or interesting, keep me posted. If I can help you, let me do that.”
Let me do a brief introduction of our guests. It’s hard to make it brief because these guys have done so much interesting stuff. One of our guests is named Ben Look. We have Ben Sawyer and we have Ben Look. Ben Look and I worked together when we were at Trinity Health and had a fun project. We created this innovation hub that I’m sure Ben will talk about a little bit. It started out being for one hospital and then two hospitals, and then the whole state of Michigan, and then the whole country for Trinity Health. That in and of itself was a great journey.
It was a blast working with you, Ben. You gave me the opportunity to come up with ideas and run them by you. You say, “I can do that,” and you did. You did so much. We got Ben out of consulting and hired him at Trinity Health. He did process improvement and project management. He did so much until we rescued him out of that, got him off the road, and got him stuck in Grand Rapids to do some fun stuff.
Through that is how I met Mike Morin. Our paths have crossed before and since that time in a bunch of other ways. Mike Morin has also been a consultant. He also has been a serial entrepreneur. He’s on many boards. He has worked across 13, 14 or 15 industries in this innovation space. He was one of the Founders and President before Seamless, it was Start Garden. Hopefully, you’ll talk a little bit about Start Garden. It is a way to help entrepreneurs get started, take their ideas, and make them into a business. Seamless is fascinating because we connected through healthcare there. Mike, thank you so much for being willing to be on and for all that you’re doing to keep life interesting.
One other thing that I do want to mention about Mike is that in all of that other stuff that he is doing, he finds time for a very important ministry. He inherited a ministry to community development from his father in Guatemala. I don’t know that we’ll have time to talk about that, but that’s such a cool thing. I’m proud of you.
This topic is about innovation. I gave it a subtitle or a title, Can Innovation Rescue Healthcare? First of all, I don’t know if any of you gentlemen want to talk about whether healthcare needs rescuing. I don’t think it’s a long conversation. We probably all agree that we’ve lost our way a little bit. Is innovation the answer? I don’t know who wants to start out, but that’s an important question. What can innovation do to help rescue healthcare?
Roger, maybe I’ll take that first and then bounce it to Mike and Ben. For our audience, there are a number of you that came to our Virtual Executive Roundtable on December 9th. We talked about the Kaufman Hall Flash Report and saw the upside-down numbers, the great difficulty post-pandemic, and post-CARES Act funding that health systems have been having with the environment of a lot of non-traditional competitors coming into the space. It’s a refocusing and doubling down.
We talked about the waterfront on that. In other words, how do you approach that? How do you create efficiencies? How do you focus on digital front doors? How do you optimize throughput? We talked some about innovation, but we didn’t get into it with the depth that I’m liking what we’re doing here now.
Roger, to your point, I also had the privilege of going up and seeing what Ben and his team were doing in the innovation hub. It was impressive. They particularly showed us a project that they were doing with a primary care office that was super innovative. I also had a chance to talk with Mike beforehand. The audience is going to love what they hear in terms of this new perspective on when you go after innovation, what does it look like? It is great to have you guys on.
Ben Look, you can talk a little bit about that project. How did we go from a general space for a health system to do innovation? Why did you choose this patient-focused or patient-centered primary care model?
Like any good innovation, we chose it a little bit by stumbling into it. We found a few passionate leaders who wanted to make a difference in primary care and were fed up with solving small problems that didn’t result in any change in outcome. Part of it was the fact that we had strong leadership where everybody was willing to put a stake in the ground and say, “We are going to change primary care. We’re going to change how we deliver that. It needs to be done in a way that is both great for the patient and is a great experience, but also for the care team.”
What’s ironic about that project is our two goals for that project are one, to find a way to open up and create more primary care for our network because there weren’t enough primary care physicians and providers out there. We also wanted to do it in a way that was joyful for them. We recognized the level of burnout and the lack of resiliency we had in our primary care teams. This was 3 or 4 years before the pandemic started. To answer your question about whether we can rescue healthcare, we’ve been on it for a while. The good thing is we already have learned some things.
That was before we knew what burnout was.
Part of our goal for that project and the research we did was to understand how you return the joy of practice to those caregivers and what’s draining them. You don’t do that through a survey. You do that through deep ethnography and research to understand what’s driving folks. That was a little bit of what was different and why innovation is different from another toolset to do that. We also recognize that you could solve 1 of those 2 problems and make the other one worse. It’d be easy to tell everybody, “If we need to increase access, work harder.” That’s traditionally how we do it in healthcare. We’re going to suck it up for our patients and move forward. That was the guise and why we picked it.
We leveraged a process called human-centered design, which is a similar methodology from a scientific background perspective to any other problem-solving methodology. Its main difference in why it excels and why we chose that particular toolset is that it’s good at untangling hairy problems. It’s also good when it comes to human beings. It treats every human the same. Whether you’re a patient or provider, we value you and the experience we’re trying to create. We went through a huge lift to identify all of the problems and lay out the program.
We got good at problem finding. The first thing we do is find all of the problems as opposed to trying to jump in and solve the first one right in front of us. That helped us isolate which problems we solve, in what order and where we get the biggest bang for our buck. That was the impetus. We tore it down to the studs. We looked at everything within the organization that we possibly could.
The physical space wasn’t even a white box. It was like, “We’ve got to go in and tear everything out, and start over.”
We questioned everything, whether or not you needed a care team or not, whether or not you could move things to digital. This was before anything was digital. We went through the process. We followed it very rigorously. Like any methodology, if you don’t follow the methodology, you tend to lose your way. We stayed focused on that. That’s part of what a lot of the mystification of innovation is.If you don't follow the methodology, you tend to lose your way. Click To Tweet
They think that there are some guys throwing darts at a dart board and there isn’t a process. It’s rigorous. As Ben Sawyer mentioned, we paired that with our lean management system. We made sure that we identified all these innovations, but we had to make them stick. We also wanted to implement a process and a way of thinking, where as we tested some of those experiments, we did it in a rigorous way. It was this merger of human-centered design and lean together. What was so successful about that is we were able to leverage the best aspects of both methods and create this new innovative center. We also implemented a way of thinking that allowed it to be sustainable and allowed us to do the testing as we walked in.
Ben, when I came up and saw what you guys were doing, you had rebuilt the clinic in the lab. You brought patients and staff through. Can you explain a little bit more to the audience about the extensiveness of that process? It was super impressive.
Maybe the workspace that you were working out of at GRid 70 allowed you to do that.
I’m still surprised to this day that more organizations don’t do this. It probably was the biggest risk mitigation strategy we had. Part of the process is to do things purposefully so that you don’t take risks unnecessarily. We had this crazy CEO who said, “Go ahead and try to build this on a floor down in your innovation studio.” Roger here gave me the green light.
I can still remember walking the floor of the building in our space and saying, “If we don’t do it here, it will not be as impactful. It needs to be right next to our innovation design studio.” We rented an entire floor of a building that was 5,000 square feet. We brought in architects and interior designers. We partnered with Herman Miller, one of the larger furniture manufacturers in the country. We brought all the expertise in and built a working prototype of the clinic. It was not just once. We iterated on it dozens of times.
We then brought in patients and providers and flew in folks from all over the country to work through all of it. A great example is we redesigned our clinic office four times, just the manager’s office alone. The patient room itself or the exam room was 23 times because we wanted to get it right. It’s all about incremental iteration. You’ve got to do it in a simulated way. We played ourselves. We played patience and whatever it took to figure it out.
The key here was that the reason it was so important was that you were doing this not for one site, but you were doing it potentially for maybe 400 sites around the country or more with this large system that we’re part of.
The whole goal was to make the mistakes once and then get them right so that you didn’t make the mistake every time you built a new office. About three-quarters of the design was transferred across the country to all the offices. It eventually became the standard. The other part that we ran into through our research was that oftentimes, change in the primary care setting was limited by the physical space in a lot of cases. We wanted to figure out where adaptability made sense.
We didn’t want to build a clinic that was 100% adaptable for everything because some things, you don’t change. A great example is how many people have a height-adjusted desk and never change the height. It’s great that you paid for it, but some people don’t use it. We wanted to build adaptability where it made sense and figure that out. That was part of our test bed partly too. It’s to be able to build smaller spaces that cost less. We were spending a lot of money and knew that we continue to deploy a lot of capital. Getting it right the first time was important.
Ben, for the audience, what were your baseline metrics on the two-prong human design process you were doing? What was the outcome from a metric standpoint, and practically speaking, the outcome from both the patient experience and the provider experience? That was remarkable.
We had a couple of throughput metrics that we used. Part of this was to change fundamentally how you created access. Our main look was at panel size. We wanted to take a primary care physician and then wrap a team around them creating a care team model, and then be able to grow the panel without adding a lot of additional physicians. Those were leads, MAs, whatever it took. We also had RNs and pharmacists. We were able to grow our panel size pretty significantly.
COVID mucks with some of the metrics but in general, we were able to carry a panel size almost double what a standard provider would carry, and do so while maintaining or improving the overall care quality. All the traditional triple aim metrics were a part of that. We also wanted to make sure from a satisfaction perspective that we were meeting those.
We measured satisfaction on a more regular basis other than the traditional once-a-year employee satisfaction survey. We saw big increases across the board in that as well. Those were our two main drivers. The clinic was still part of a medical group. We looked at everything from financials to quality to gaps in care. It was the whole gamut.
Didn’t that clinic become the most sought-after clinic by the patients in that area? Wasn’t that an unanticipated but happened outcome?
Yeah. That illustrates a great unintended consequence of human behavior and innovation. We built this brand new clinic that had things that patients wanted, and caregivers wanted to work there. It became a very sought-after process. Right before the pandemic, we were a little worried that we were growing too fast. What it also did was other members of the system who didn’t have that wanted it. There was also this human nature of being a little bit resistant to it.
What we also found through that process is we had to protect the clinicians who were in that office from the rest of the organization. There was a bit of I don’t know if jealousy is the right word, but when you’re doing innovation work in a large organization, the people doing the work need to be protected. We did spend a lot of time sheltering them from some of it, but it was highly sought after. We had people fly in from all over the country who wanted to see it and then take those learnings back to their organization. It was pretty impressive.
I would also say it was the fastest clinic to recover right after COVID shut everything down because we built all this adaptability into it. We converted it pretty quickly into a COVID clinic. Later, it became our leading vaccination location too. We converted it into a vaccination space too. That was a proud moment. We built the whole clinic to reverse its workflow completely if we needed to. We couldn’t exactly explain why we did it, but we knew that we needed to be able to handle that. Sure enough, when COVID hit, having that flow reversal turned it into a vaccination clinic. We were able to vaccinate a huge number of patients and our own colleagues, which was a pretty proud moment for us to be able to do that.
It says something too about human nature and physicians because it’s hard to find somebody to raise their hand and say, “I’ll be the executive sponsor.” We did have two physicians that were fantastic, Fred Ralston and Dr. Mary Klein. They were great. A lot of their colleagues said, “I don’t want anything to do with it,” until it got done and they say, “I want that.” It’s the same thing when we started a concierge practice. Nobody wanted to do it until it was done, and then everybody wanted it. Thank you, Ben. I’m going to turn to Mike. Talk about the intersection here between Ben Look and what he was doing and what you were doing, Mike. Did it occur right around the time of Seamless or was it before that?
It was after the beginning of Seamless. We had worked with some different healthcare partners. With the Seamless model, there’s only one from each industry so that everybody could be fully transparent.
Let’s maybe back up a second. I’m sorry, Mike. Let’s talk about what is Seamless. You were the founder of that. What was it? What gave rise to it?
You alluded to it a little bit. We started about twelve years ago, building a startup ecosystem in Grand Rapids, Michigan, a highly average town across America, and what it looks like to build a startup ecosystem in a place that’s not Silicon Valley or MIT. In a lot of cities, were doing that. One of the things we discovered that we had here that was a tremendous asset is we have this disproportionate number of global enterprise headquarters in Grand Rapids, Michigan that represents a diversity of industries. The top three office furniture manufacturers are here. There are a lot of automotive companies here. Companies like BISSELL, Whirlpool, and names that people recognize but don’t know where they are exist in Grand Rapids, Michigan.
We were partnering heavily with those organizations and realized that both sides of the equation had a little bit of a problem. While startups were trying to figure out how to scale and how to gain traction, enterprises were also a few years into what they would call open innovation. They were starting to look externally for innovations. They were all doing that on their own.
Because Grand Rapids has a social fabric that facilitates a lot of collaboration, we had this notion that we could probably do this better together than we could separately. We were all looking at the same emerging tech stacks but evaluating them from different angles. Now it’s been around for ten years. That turns out to be true. A group of experts from multiple industries evaluating a series of emerging technologies or business models can learn a lot from each other, can save costs, and add efficacy to that model.
It was this particular project that piqued our interest in having the Trinity team be a part of Seamless because they had so much discipline in the practice. They understood the practice of innovation. We’d talk about startup petting zoos, which are very common in enterprises where you got a bunch of shiny objects floating around that make executives feel good, and all that stuff but nothing ever happens. The Trinity process was structured with intentionality to get those things over the wall and into the system.
When I hear that story of what Ben and the team did, it makes me want to loop back to your original comment on whether innovation will rescue healthcare. One role that we didn’t get to mention is for the last ten years, I’ve also been a part of an early-stage venture fund. I’m very close to the venture capital community. My answer to that would be innovation is going to transform healthcare in the same way it did retail, transportation and everything. It’s just a question of timing. The participants get to choose what their role is going to be in that.
Often time, from my perspective, the incumbents somehow think they’re the toll gate that gets to determine whether innovation is going to happen or not. What I’ve told every one of our Seamless partners is, “I know the default answer. The default answer is you go away and something replaces you,” because that’s what’s happened for the last 150 years in America. Most organizations will not have the nerve, foresight or insight to embark on those types of things, especially when they challenge business models. Incremental stuff is okay, but once you start playing with the process, business model, revenue stream, and how that’s earned, it gets hard for incumbents to get there.
They love what they’ve done. They say, “This has to be right.” What we see is a lot of people getting disrupted out of business rather than being disrupted into innovating themselves or changing their whole business model.
I would add to that a little bit, Roger. Not only do they think that it is right, but they also operate in highly competitive landscapes that have forced them to optimize everything about that organization around that model. You’ve hired people. What we would say is not only do well-run enterprises do a good job at doing what they do, but they do a good job of ignoring or killing anything that doesn’t do what they do. You’ve hired a bunch of people to optimize a process and think that all of a sudden, going around and talking about innovation is going to take people who are personally wired as optimizers to become these diverse innovators.
I would say that goes all the way up into the C-Suite because most of the people, and I’m not just talking about healthcare, in every organization have started in the financial or operations. Since that’s the season the industry was in, most of the people in your C-Suite have been promoted through that channel. They didn’t come from innovation. They didn’t come from entrepreneurship or launching new businesses. They always talk about how there are peacetime leaders and wartime leaders. You’ve got a lot of peacetime leaders in a season of war.
That’s why it comes all the way back. That’s all the more reason that the innovative primary care was so amazing. It’s an organization that didn’t have to choose. It was able to leverage all of the knowledge and insights that they had, which is the disadvantage that people coming into it from outside don’t have to be able to leverage that history as an advantage as opposed to it becoming something encumbered or something new coming to be.
Maybe we could talk about Seamless a little bit more. I attended a few of the sessions. Let’s name names. You’ve talked about BISSELL, a floor care company. We had Whirlpool appliances and consumer goods. We had Blue Cross Blue Shield there, which is an insurer.
We had Priority Health, Spectrum Health, Spectrum Health, Meijer, Amway, and Gentex, a large French auto manufacturer. There’s been quite a few over the years.
It was speed dating a little bit. You had a portion that was speed dating. Tell our audience what Seamless sourced these ideas with and these companies, and what happened to some of these things.
There were two components to Seamless. One is looking inward into the enterprises and understanding what the future looks like for them, and what they think the future of their industry looks like. It is harvesting insights and future stacks and then taking that from multiple industries. We would map that into a series of themes that we saw.
I think about in some ways how Trinity used AR and VR as toolsets for doing this. This was part of the process where all of our industries are looking at that as an emerging technology. We build these themes, and then we have scouts all over the world. We have scouts in Asia and Israel that are working on our behalf that have been educated on these themes. They find us interesting in emerging tech. It might be coming out of South Korea or South Dakota. We don’t necessarily know where things are coming from.
We then processed those through our system. We’ve got a database of tens of thousands of startups including commentary from all of our enterprises on where we think it fits in the world of innovation. When we found things that were interesting, we would frame up proof of concept experiments between the enterprises and the startups. Usually, there are multiple enterprises working with a single startup. It is super valuable to the startup because they’re getting multi-industry access in a single engagement. It is beneficial to the enterprises because they’re sharing the learning, the cost, and all of that stuff of running the proof of concept.
Once those proofs of concept are done, we unshackle our enterprises to do what they want. They can invest, which some have done. They can sign sourcing agreements. They can form joint ventures. Seamless was built for enterprises by enterprises. Unlike a lot of other systems that are about getting a lot of energy and traction for the startups or creating a lot of theater, we were driven by driving things that align with those clearly stated objectives of the enterprises moving forward. I will say enterprises, in general, are much better at understanding what the future looks like than they are executing against it. Those insights are unbelievably valuable but oftentimes, they’re able to see and comprehend things that they find difficult to execute without a lot of pain and suffering.
Ben Look, you might want to have a comment on this. Just the intersection, we talked about these social collisions of running into people and being in meetings with them, even cross-industry. With Bissell, Meijer, Trinity, and the insurance companies, the connections were made there, right?
Yes. Ben Look, you can add to this. At one point, we joked that what we were running was a support group for innovators. Ben, maybe you can talk a little bit about how that played out as you were all trying to figure out how to navigate your enterprises.
First, on that topic, working in innovation inside of a large enterprise can be brutal. I hear no more than a telesales person does on a daily basis. I was told no ten times a minute sometimes. Part of it was empathy, knowing that you weren’t the only person who was struggling and who could see the next version of the future. Struggling to get there was helpful for my team, in particular, and me.
The other thing was in healthcare, we tend to look at what each other does. We look at our peers who are doing it well. Best practice is almost a well-used term as innovation in terms of being used a lot but not clearly defined. We looked at what innovation in healthcare looks like. We looked around at what other healthcare organizations were doing in it. They all seemed pretty similar, but then we started interacting with Seamless in some of the other enterprises and look at what other industries were doing around innovation. We started to realize that we were behind.
The other big thing was every industry has been disrupted either currently or in the past. Learning from everybody else in terms of what innovation needs to look like to be successful was probably the most valuable thing that I learned. The other part, and Mike was being humble about this, is the mindset of protecting the startups. It’s that ability to bring all these enterprises together that could do tremendous damage to any startup on a whim, leading them down the thought of, “We’ll gladly buy and triple your revenue. We’ll tell you that for six months until you run out of money and then we’ll say sorry.”Every industry has been disrupted, either currently or in the past. So learning from everybody else what innovation looks like to be successful is the most valuable thing. Click To Tweet
That mindset of not damaging the startup in this process was also something that was imprinted onto the blueprint of how we thought about it. I can’t say enough. I always joke that we are not like any other innovation team in the industry. That in itself was a giant experiment. I don’t know if it was successful, but having other industries was by and far the most eye-opening experience I’ve ever had in my career.
Mike, your attitude and support de-risked this whole proposition. It served to accelerate it but de-risk it at the same time, so thanks for all that. Predictably, we’re out of time. What we’ve done here hopefully whet people’s appetite to find out more about this. We’ll make sure that we allow you to do that and can connect you with Ben and Mike. Thank you so much.
This will be shared many times with our audience members, their uplines, and what have you because you’ve proven that it takes a little courage to be able to do this, and a little risk tolerance to be able to do it as well, but the benefits are tremendous. Furthermore, we’re not looking for benefits. We’re looking for survival. This truly is a way to survive what we’re experiencing and what’s ahead. Thank you so much for being trailblazers and for laying out the path ahead for many others. Thanks for that.
Thanks to our audience. We thank you for investing your time. You have lots of choices. You can tune in to a lot of podcasts and a lot of things. We try to bring to you the most interesting and innovative things that we can find. We get to be a little provocative at times, but we trust that this will be helpful to you and your colleagues. We are so grateful to the Baldridge Foundation for making this show available and to the Baldridge Foundation’s strategic partner, ABOUT Healthcare. That is our sponsor for this show. We couldn’t do it without them. We know you’re going to enjoy it. Thanks so much for being with us.