In 1916, Massachusetts General Hospital opened one of the nation’s first dedicated cardiac units.
Nearly a century later, in 2014, cardiologist Eric Isselbacher created the Healthcare Transformation Lab at MGH, which aims to explore new ideas in healthcare delivery with a team of engineers, entrepreneurs, and clinicians.
Isselbacher raised philanthropic funding to support the new lab, according to HTL’s managing director, Julia Jackson. That funding source, she explains, gives the lab’s staff the ability to test and deploy the kinds of projects that might be hard to do with traditional departmental budgets in a large research hospital like MGH.
While the original team focused on cardiology and heart health, they’ve grown to other specialties based on the projects and challenges that “have come to them” from throughout MGH, according to Jackson.
The team is now made of five dedicated full-time employees, as well as MGH affiliates, interns, and externs. While the group was originally staffed predominantly by MGH professionals, Jackson says they have shifted to hiring mostly external employees with diverse skill sets.
“We leverage talent and time from many places. It has really evolved,” Jackson explains. “For our project management team, we have people in consulting, social work, videography, and gaming. We’re looking to bring these complementary skill sets to work with clinicians and clinical teams in order to experiment and come up with the right solutions.”
The Three Pillars
The HTL’s structure is built upon three pillars, Jackson explains: collaborative innovation, digital health, and validation research.
HTL’s major programs and contests including Co.Create, the EtherDomeChallenge, and the HTL Fellowship — fall within collaborative innovation, or the “wide-end of the funnel,” she says. With these programs, Jackson says the team sources ideas, recruits innovators, and identifies how their projects tie into the strategic priorities of MGH.
Within the digital health arena, Jackson notes that “pretty much 100 percent of what we work on in our current portfolio is technology-related. How do we better leverage data? How do we get smarter about the healthcare system?”
And everything the lab does eventually leads to validated research. “We’re an academic medical center,” Jackson says. “Whenever we give a grant or do a project on something, we really do try to measure it and understand the ‘So what?’ Is it having an impact? Should it be scaled? How and where do we share what we’re working on?”
As an example of the funnel process, Jackson noted an ongoing contest that was facilitated by HTL for the hospital’s Department of Surgery in 2018. “We’ve had 127 ideas submitted. We’ll open it up to crowd voting and expert judging, then we’ll award grants,” she says. Then, “we’ll go into project implementation in the digital health realm. Hopefully some of those grantees will want to study their project as well. Hence, they’ll land in the validation research phase.”
Working with Startups
Along with contests and grants internal to MGH, HTL collaborates with the broader healthcare community through external innovation programs.
Its Co.Create program, a challenge competition targeted to student-led startups, began in partnership with the Massachusetts Institute of Technology with a goal to help academics grow their ideas after they’d sketched them out as part of a hackathon. With Co.Create, HTL offers innovators sustained funding and access to clinical environments while they build up their product.
The program also offers advice from doctors and nurses to help participants validate their product and determine how it will fit into actual daily workflows. “They’ve created something cool and new, with a device or a sensor, but is anyone going to use it?” Jackson says.
While Co.Create was launched with a focus on student solutions, the Ether Dome Challenge, launched in collaboration with Harvard University, allows startups to pitch their solutions for a given problem. (The Ether Dome is an operating theater at Mass General in which anesthesia was used for the first time during surgery, in 1846)
Through its work with the Boston-based accelerator program Pulse@MassChallenge, HTL was introduced to a startup called Medumo in 2017. They had built a text-messaging system that sends patients preparation tips in the days leading up to a medical procedure. Since then, lab team has helped Medumo pilot test and implement its service within MGH’s gastroenterology (GI) division.
“One of the things that’s really hard for big hospitals and business system is creating incentives that encourage GI [employees] to share their innovation and results. As an independent division, they may not have all that much incentive to do that,” Jackson says.”
With Medumo,” she reflects, “we captured the story, the results, and now we’re systematically working to scale that. We got about a dozen other divisions who are interested in the tool.”
“We joke with [Medumo] and other teams that a lot of the things that are transformative for healthcare are not necessarily innovative. The world’s been text messaging for a while. Healthcare just catching up,” Jackson says.
“Text messaging is a gray area in medicine. [Medumo] had to know what could be in the text message, and how many pieces of information could be in the text to constitute HiPAA (Health Insurance Portability and Accountability Act) compliance.” She adds, “Healthcare takes a fairly conservative approach, especially at large institutions in terms of how quickly and readily we adopt seemingly simple things.”
The Importance of ‘Boots on the Ground’
As the HTL continues to grow, the team has also learned how to invest in more than just “shiny new things,” says Jackson.
The team invests their advice, time, and other resources on startups with a strong team, as well as internal projects that they can learn from.
“We feel really confident that projects will go well, or that at least we’ll learn something valuable about it—even if it’s a total failure,” she says.
One big learning from the lab’s first few years of existence, Jackson, adds, is the importance of having “boots on the ground.” Those boots belong to executive champions, sponsors, or clinical supporters in various departments of MGH.
“Just having the idea is one piece,” she says, “but implementing the idea is the hardest part.”