Chapter 10: Projects and Next Steps in Building a Culture of Innovation
Files
Description
Ms. Kaul sketches projects she is currently pursuing: how to use technology to expand the MD Anderson network and scale the standard of care optimizing clinical time developing a culture of innovation.
Next, Ms. Kaul gives her view of the launch of EPIC, which she says does not quality as “innovation” as she understands it. She comments on EPIC as a company.
Finally, Ms. Kaul talks about cultural values she hopes to instill at MD Anderson. She talks about a project under development that will help MD Anderson people with innovative ideas present and find support to develop their ideas.
Identifier
KaulR_02_20160425_C10
Publication Date
4-25-2016
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Leadership; Leadership; Definitions, Explanations, Translations; Overview; Building the Institution; MD Anderson Culture; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
T. A. Rosolowski, PhD:
Well, I'm just curious, I mean obviously, you're still finding your feet and learning the complex environment, and making your decisions about how to proceed. But are there some concrete steps that you've been taking, putting together specific projects or initiatives, and can you tell me a bit about what those are looking like, and what their goals would be?
R. Kaul, MBA:
Yeah, I mean, I think I've been able to identify some low hanging fruit in some areas that we can start to think about. Obviously expansion is a priority here at MD Anderson, meaning expanding our network, being able to scale our standard of care to general oncologists across our network, which isn't going to happen with just human intervention, it's going to happen through technology. You can't scale with just human beings. So developing systems that can enable that scalability and expansion, some of that already exists in the market and it might just be partnering with startup companies. There's some development to be done, I think these are all opportunities. And I'm being vague on purpose.
T. A. Rosolowski, PhD:
Sure, I figured. That's fine.
R. Kaul, MBA:
So, I think there's a lot of opportunity that's kind of clear and tangible to help with that. I think it'll help -- I think there are opportunities in helping to optimize our clinical time, reduce the administrative burden on our clinical community. And I think that that's just always welcome wherever you go, whatever regulatory environment you're in. That's sort of regulatory agnostic that you want to reduce your administrative burden where you can. So I think there are opportunities like that to be had. I think there's a lot of kind of cultural components that just --opening up the flood gates for people to start thinking more broadly, engaging more in the entrepreneurial communities, things like that, as well. And starting to establish that culture and starting to open up the doors for kind of ideation.
T. A. Rosolowski, PhD:
What's -- I mean, I hadn't planned to ask this, but it seems logical. What's your view of EPIC and what's been happening with installing that, and how that might dovetail with, or help you, in your own process?
R. Kaul, MBA:
I think implementing an electronic medical record is kind of one of those standard things that everybody has to do. I think it helps with the transactional part of healthcare. Our lessons learned at UPMC is it's not a clinical system, it's a transactional system.
T. A. Rosolowski, PhD:
And by that you mean...?
R. Kaul, MBA:
It helps with the operations of healthcare. How do you drop a -- it helps dropping bills, facilitating orders and documentation, and all of the steps you need to take to bring a patient, you know, register or schedule, get a patient in our door, through our system and out our door, and get paid, right? Not necessarily as effective at helping you determine how to treat a patient, and how to best care for that patient. So I think we'll probably go through the same learning curve other institutions go through, as you go through the thinking it's going to solve all your problems, and then realizing what it's good at and what it's not. And I think it's good in a lot of things, but you have to -- with any of these systems, you have to recognize them for what they area.
T. A. Rosolowski, PhD:
What is the tool, make sure you know what the job is designed to do.
R. Kaul, MBA:
Yeah. It's designed to do a certain job, it'll do that job well. Trying to make it do a job that it doesn't do well will leave you dissatisfied.
T. A. Rosolowski, PhD:
Do you think that there are unreasonable expectations about what EPIC can do? I mean, do you get a sense that --
R. Kaul, MBA:
No, I'm not really that engaged with it. So I don't really know what the expectations are. I know what typically happens, not necessarily what's happening here. I think EPIC the company has unrealistic expectations.
T. A. Rosolowski, PhD:
That's another issue.
R. Kaul, MBA:
I think EPIC the company would like to be everything EPIC, and would like you to wait for them to do anything -- their notion of having an innovation group would be contrary to the EPIC philosophy of everything EPIC, because for me, innovation is about not relying on just one company and one vendor, but really, taking the best of what's out there, whether it's been created or not been created. EPIC would say everything needs to be EPIC.
T. A. Rosolowski, PhD:
Well, they certainly have an investment in doing that thing.
R. Kaul, MBA:
Exactly. That would be their business model. So I think EPIC does a lot of things really well. EPIC doesn't let you fail. I think they're really good at deploying products, their product, and they won't let you fail, and so I think it's a reasonable choice. Most people make the choice of EPIC, and so I think it'll do what it needs to do. But it's not, it's not really a big -- when I think of innovation, it's not on my mind. You know? Innovation to me is well beyond the medical record. The medical record is sort of standard. Been around a long time.
T. A. Rosolowski, PhD:
What are some of your kind of big goals, dreams? You know, aims for what you would like to do here? I mean, you said it was a great opportunity. Opportunity for what?
R. Kaul, MBA:
I think my perspective on that changes often, because I'm learning what the opportunity will be. And, as I learn about the culture, as I learn about what's possible here, as I learn about the regulatory environment, it changes my perspective on what's possible, on what can be achieved and what should be achieved even, right? Because again, knowledge of the general medical community isn't the same as the knowledge of a cancer center, right? So maybe I'll talk in generic terms. I'd like to make an impact. I'd like to change or influence the culture towards thinking about new ways of solving problems and embracing those new ways, moving faster, being more nimble. Being more value-focused, not doing something just because it seems kind of cool or sexy, but actually doing it because it drives the value proposition, because it's going to make an impact on the institution and make an impact on our patients. So I think it all comes back to how do we drive value for the institution and towards the mission? So maybe that won't change, but how we go about doing that will, through my learning.
T. A. Rosolowski, PhD:
What are some of the communication challenges you see? You know, because I think a lot of people, in what you just outlined is something I don't think a lot of people would understand. But I think when we get into the nitty gritty of how you want to do that as opposed to somebody in clinical operations wants to do that. You know, it might look very different. So how do you communicate how to accomplish this goal, be it innovation as you understand it?
R. Kaul, MBA:
I've started that to some extent. I've started to visit the various groups. You know, now that I've gotten to know people and gotten enough advice, now I've started to kind of visit with the different committees and groups, and start to talk to them about the innovation process. I've mapped out a whole process for how it works, and how to engage. So I have a presentation on engaging and innovation, and how one will engage with us. We're going to be launching a website soon on how to submit an idea and how to go through that process with us.
T. A. Rosolowski, PhD:
Wow. Can you share that presentation with me? I can append it to your interview. You can think about it.
R. Kaul, MBA:
1:25:051. It's sort of an evolving thing.
T. A. Rosolowski, PhD:
That's all right. I mean, I'd like to see it.
R. Kaul, MBA:
It'll change on a month-to-month basis.
T. A. Rosolowski, PhD:
Sure. Sure. All right.
R. Kaul, MBA:
Because I'm also learning how people are responding to it.
T. A. Rosolowski, PhD:
Right. Absolutely.
R. Kaul, MBA:
But yeah, I mean, so here's how you engage, here's what we're going to try to do. You know, so --
T. A. Rosolowski, PhD:
Can you take me through the process? Just, you know, sketchy? Like, so how would I engage with you?
R. Kaul, MBA:
You know, once our website is up and running, you'll come on to it. It's a crowdsourcing system, and you'll either submit to a campaign -- a campaign is something we've already put out there as a scope, so it might be, the campaign we're thinking of launching with is, submit your ideas on how to reduce the administrative burden on our clinical community, right? So you might submit an idea for how one might do that, right? Or you could submit a generic idea that isn't a part of any specific campaign, that's just, I have an idea for something that I've noticed, a problem that needs to be solved. Right? That idea will come to us. Right now it's done ad hoc; people send me an email or I meet with external companies and kind of then I assess whether that company solves any of the problems we have here at MD Anderson. But, eventually it will be more formal through our site, and that way it allows us to track it, and create, like, an audit trail of what we're doing about it, what we think about it, what we've learned, so we can always go back and revisit it. And we can cross-reference different ideas and understand the themes across all of the ideas that are coming in. When they first come in, we look at them, we assess them, we see, we kind of ask your standard questions of, Do other solutions that already exist in the market, because we don't want to reinvent the wheel. Is it simply just making an inter-direction for someone? Do we bring in some potential co-development partners? You know, what is the value proposition, what is the problem that's being solved? How will it impact the institution? Do we have a champion? And what I mean by that is, we need someone who's going to see it through on the clinical or operations side that's going to drive it. Even if it's the best idea in the world, if there's no one to drive it, it will fail, you know. So Is there a market for it? Is this an MD Anderson problem? Or is this a problem for all cancer centers? Or is it a problem for the whole healthcare community, you know what I mean? So starting to think about can it be commercialized? Who would be the right target for that? How big is the market? So we kind of go through a diligence process of different kinds of assessments, whether it be financial diligence, technology diligence, market diligence. And, you know, figure out how we can best serve the person who's submitting the idea and the idea. so if it's not necessarily something we're going to develop, we might introduce them to someone who might be helpful, right, in some of our relationships in the market. Sometimes people submit an idea that's really good in the healthcare industry, but sort of not necessarily MD Anderson-specific, or not a big impact to MD Anderson, but a much bigger impact globally. I might introduce them to an investor. I might introduce them to an accelerator. I might introduce them to a company that already mostly does it, and we could form a relationship with that company to build out their idea. Then we might do diligence on the potential set of companies, right? I mean, assess that and talk through what the deal structure might look like with those companies, if an external party is involved. Or if it's something we're going to develop, then we're going to have to put together a budget and a plan to develop it, and see what that might look like, and how we might get resources to do it, and how we might fund it. So, we kind of put it through that process, assuming that it goes through. Then we'll put together a plan for how do we deploy it, and how do we measure value against it? What is the baseline, and what are we measuring, and what does our case study look like going forward, and then sort of at the end of it, how do we -- what's the business plan? How are we going to commercialize it if it's something that's commercializable, and kind of putting together the business plan, and developing those relationships. So it kind of goes through all -- the kind of full life cycle. If it makes it through, we kind of have stages in the process. Not everything makes it through, obviously.
T. A. Rosolowski, PhD:
1:30.09.7 Sure. So the end goal, I mean, obviously with some of these that would be developed largely in-house, it seems like there would be similar kind of benefits, there could be savings to the MD Anderson operations. But then there could also be royalties and an additional income stream.
R. Kaul, MBA:
Sure. Yeah.
T. A. Rosolowski, PhD:
So capitalizing on that to feed what? What would those funds be used for?
R. Kaul, MBA:
I'm trying to figure that out. The funding structure here is different than what I'm used to. I'd like to see it go back to the department that engaged on the idea, but I'm not sure whether that's possible, or how things work administratively here. So that's something that's on my To-Do List to find out.
T. A. Rosolowski, PhD:
Because I know that's a huge issue, I mean, there's -- talk to a number of people, and finding new income streams, obviously, is really key to the institution's health.
R. Kaul, MBA:
But back to what I said earlier about alignment of incentives and things like that, that is, what I'm learning, is a big question. So back at UPMC, everything sort of came back to the institution at large. And, it didn't -- there wasn't as much bookkeeping around departments, it was more kind of institutional. What I'm learning here is there is more kind of departmental bookkeeping, which means I need to sort out, like you said, the flow of funds. So I'd like it to flow to the internal innovators, because I'd like to foster an environment where people are incentivized and motivated to continue to come up with new ideas and engage. So I'd like to use that as the incentive pull. But I'm not sure. I'm sure there are very rigid rules here, so there's probably --I've got to figure that out. My experience tells me there's usually rigid rules, so what I'd like to do and what is reasonable within the context of this organization will be different.
T. A. Rosolowski, PhD:
Yeah.
R. Kaul, MBA:
And so we'll figure it out. See if we can come to a good, good, happy, happy compromise on that.
T. A. Rosolowski, PhD:
Are there any specific ideas you can share at this point? Specific good ideas that have come across your desk? If not, that’s fine.
R. Kaul, MBA:
Yeah, I’d rather not at this stage.
T. A. Rosolowski, PhD:
1:32:41:3 OK. Well, I’ll be really interested to see how all of this evolves. I mean, I think it’s a pretty cool thing to be keeping tabs of just all the good ideas that bubble up and taking them through their diligence process to see which ones can be shepherded through to another life. Yeah, very cool, very cool. I’m pretty much out of questions.
R. Kaul, MBA:
Excellent. (laughter)
T. A. Rosolowski, PhD:
Is anything you want to --
R. Kaul, MBA:
Nope.
T. A. Rosolowski, PhD:
1:33.14.6 -- you want to share at this point? (laughter)
R. Kaul, MBA:
Nope.
T. A. Rosolowski, PhD:
OK. Well, this has been really interesting and I really appreciate you giving me the time.
R. Kaul, MBA:
Thank you. (laughter)
T. A. Rosolowski, PhD:
Well, I will just close this off for today. And I am turning off the recorder at quarter of four, thanks again very much.
Recommended Citation
Kaul, Rebecca MBA and Rosolowski, Tacey A. PhD, "Chapter 10: Projects and Next Steps in Building a Culture of Innovation" (2016). Interview Chapters. 1269.
https://openworks.mdanderson.org/mchv_interviewchapters/1269
Conditions Governing Access
Open
