“We ordered 40 sheets of four-by-eight cardboard,” explains Brian Bechard, a Technical Fellow at Medtronic. “Everything we wanted in the space was put together in cardboard first, before we created CAD drawings and then the physical environment.”
To create a new space for prototyping the future of healthcare experiences at home and in hospitals, why not start out with a cardboard prototype?
The Applied Innovation Lab opened its doors in September 2015, with a goal of helping Medtronic evolve from being simply a maker of medical devices like pacemakers and stents to one that is thinking more broadly about improving health and patient outcomes. In the two years since it opened, there has hardly been a quiet moment at the lab — and there has been so much demand from different groups in the company that Bechard and the rest of the team at the lab have had to create screening criteria for what they will work on.
The seven-person team that operates out of the lab sits under Medtronic Chief Information Officer Michael Hedges. Team members have backgrounds in design thinking, business strategy, engineering, and clinical research, explains Scott Mark, a former Director of Healthcare Innovation at the company.
Explaining the motivation behind creating the lab, Mark says that in the years since Omar Ishrak became CEO of Medtronic in 2011, “we’ve increased our focus on patient outcomes. Omar has focused us on understanding economic value in what we do, and in being more of a solutions-oriented company, not just a medical device company.” Mark says that creating a place to practice human-centered design would be a way to help Medtronic’s various businesses move in that new solution-oriented direction.
“It put a really heavy onus on us, from the beginning, to deliver what the business units would see as meaningful value,” explains Mark. “We didn’t want to just be a space, or to just be workshop facilitators, providing a transient opportunity for people to think differently. We wanted to build up a robust internal consulting capability, with hard deliverables as an output, so that teams could bring something back and continue working on it in their business.”
A centerpiece of the 2,200-square foot space is a 360-degree video projection screen that drops from the ceiling. The team often goes out and uses GoPro cameras to gather from different healthcare environments — like a hypertension clinic in Ghana, or an emergency room in Los Angeles — which allows the lab to immerse people in what feels like a realistic patient experience. “It’s very different from putting on virtual reality goggles,” says Bechard. “You can ask questions, and have it be social. You’re there with 10 of your peers, and you’re all looking at the same thing.”
The innovation team that created the lab knew they didn’t want to create a showcase for cutting-edge technology or a “tour stop,” in Bechard’s words. “This is a working space, a team space. There’s always activity in it, and things up on the whiteboard – pictures, or itineraries for upcoming visits in the field.”
Much of the work that happens in the lab is less about creating prototypes of new medical devices or new apps for doctors, but rather experience design and solution design. One example involves helping medical professionals manage patients with hypertension and heart failure in emerging markets – using tablets, mobile phones, and in-person interactions. Storyboards are a commonly-used tool for mapping out the patient journey, and his or her interactions with the healthcare system.
“Everything we build at the lab is a sacrificial concept,” explains Bechard. “There are going to be flaws and things that aren’t right. What we’re doing is looking for a reaction – someone who says, ‘it needs to be more of this, or less of that.’ We want to have honest dialogue. But the idea is that we don’t spend months and hundreds of thousands of dollars developing a beautiful prototype that looks like it is commercially-ready.” Instead, the Applied Innovation Lab aims for “crude and rapid prototypes.”
Initially, the lab worked on a roughly equal mix of its own projects and projects for different business units around Medtronic. But in its two years of existence, the balance has shifted dramatically. “Today, only about 10 percent of our time is devoted to our internal projects,” Bechard says. The other 90 percent involve collaboration with a business unit team, which can often involve insurance companies, technology vendors, and other outside partners
Some teams may be resident in the lab for two months or more to flesh out a concept and gather data from the market; others might come in for a more focused day-and-a-half session.
“There are times when we’re helping a team get over a specific hurdle – like doing some de-risking on a specific project – and we may plan in advance to get the background material, do some up-front field work, and just jam on it for a short amount of time,” Bechard says.
The lab crew also holds regular “office hours,” when teams from around the company can drop by, and get advice or recommendations on projects. “That’s one way to distribute our impact around the organization,” Bechard says.
It’s key, he adds, that the lab works closely with business units and “speaks the language of the business,” he adds, “so that our credibility is built up over time. They are focused on keeping the engine running – and we’re trying to provide value in ways that may not have been explored before.”
There isn’t an insular attitude at the lab of “let’s do something and then throw it over the wall to the business,” Bechard says.
As the lab has begun getting involved in projects outside of the US, it has also expanded its team to include seven “extended team members” in regions like Asia-Pacific and Europe. So in addition to a weekly team meeting in Mounds View, Minneapolis, where the lab is based, “we’ve just begun to do a monthly call with the extended team members, highlighting specific projects in places like Singapore and China,” Bechard says. Knitting together a geographically-distributed innovation group, he adds, “doesn’t happen by itself; you have to be deliberate about it.”
As an example of how the lab is working with constituencies around Medtronic, and around the world, Bechard brings up a project that started with the company’s minimally-invasive therapies group, based in Boulder, Colo. “They came to us to think through market readiness for a new patient monitoring solution, and they needed a first launch site or testbed,” Bechard says. “This was a solution that was potentially disruptive to our current mature markets, and so they told us that they wanted to look at emerging markets.” Two they wanted to examine were India and China. Bechard was the project leader at the lab, “and we had extended team members in Shanghai,” he says, “and the main business sponsor in Boulder. The group that was local to the Chinese market let us go into the field and talk to anesthesiologists – walk into the NICUs and PACUs [neonatal intensive care units and post-anesthesia care units] to better understand the jobs to be done and the needs there. Just understanding the complexity of [how procurement happens in China] was very valuable. For example, it can be easier to buy capital equipment in china, versus trying to sell a piece of software.”
At any given time, the lab tends to be juggling between 30 and 40 different projects. But since it opened in 2015, a queue of more than 50 other projects has built up, all vetted by the team as “a good match for our capabilities,” Bechard says. And there are plenty of other people among Medtronic’s 90,000 employees eager to spend time there. “Demand has definitely increased,” Bechard says.
So the lab has been honing its criteria around what kinds of projects it chooses to work on. “We always emphasize that we want to be involved very early — at Phase 0 or Phase 1, helping to develop the challenge statement and getting everyone pointed in the same direction,” Bechard says. Projects need to be relevant to the lab crew’s expertise and skill set. “We are also trying to focus on funded and supported projects within businesses,” he explains, as opposed to pet projects of a single employee or “science fair”-type explorations.
Bechard and his colleagues know they’re only two years into a long journey.
“We talk all the time about putting the patient or end-user at the center of our process, and developing empathy and understanding of how they work, and their needs,” he says. But in doing anything new, he says, “you’ve got to be mindful of the corporate culture. We can be very qualitative at times, and it can be very quantitative, and market research driven. So we’re chipping away at this piece by piece. It takes time to turn the ship, to develop trust, and to bring in new mindsets.”