Health care innovation hubs: A catalyst for technology adoption across federal health
Can applying human-centered design principles in an innovation incubator be the key to a technological revolution?
Tim Small
Laura Baker
Alison Muckle Egizi
Ipshita Sinha
Paige Leiser
Joe VerValin
Many successful technological breakthroughs are less about helping people and companies do new things and more about enabling them to do familiar things better, faster, and more securely. Often, the key is eliminating friction in an onerous process. Remember how many steps it took—not so long ago—to deposit a check into a bank account and the subsequent time it took for the money to become available. Mobile banking dramatically streamlined these processes. According to Forbes, as of 2022, 78% of Americans surveyed prefer digital over traditional banking, providing financial institutions the opportunity to boost customer satisfaction and loyalty.1
The health care space has long struggled with similar challenges related to efficiency, speed, and security, with hopes that technology will solve many of the problems. Clinicians are looking for new technologies to help make their work easier.2 It’s also likely that clinicians will expect emerging tech to meet their patients’ needs while patients seek a health care experience free from complications or disruptions.3 And all stakeholders—clinicians, patients, and administrators—need new technology to be reliable and secure.
Just as banking apps shifted the playing field for fintech, artificial intelligence–based technologies could revolutionize health care delivery. Predicting patient outcomes through machine learning, virtual health assistants, remote patient-monitoring tools, wearables, and other technological advancements can help clinicians deliver better health care services.4 But the revolution—one that the industry could have to help boost efficiency, effectiveness, and coverage—hinges on clinicians and their patients being able to adopt such technologies.
Federal health leaders can play a role in this transformation through federally sponsored innovation hubs focused not just on fast-tracking innovation but also on accelerating adoption. These hubs can serve as a platform for testing and advancing health care technologies that can transform both clinician and patient experiences. Using a human-centered design approach, federal health leaders can revolutionize innovation hubs, going beyond tech development and deployment to create a system that learns from care providers and designs for their tasks and environments.
With a focus on the real-world needs and challenges faced by clinicians (doctors, nurses, allied health professionals, pharmacists, and other health care providers), innovation hubs can create solutions that meet clinicians where they are and ultimately address the needs of their patients, too, helping to promote greater adoption and catalyze the tech revolution.
Innovation hubs have a history of accelerating innovation and are well-suited to a federal health environment
As early as 1998, Michael E. Porter, a professor emeritus at Harvard Business School, defined business clusters as the “geographic concentrations of a critical mass of interconnected companies and institutions in a particular field” in a Harvard Business Review article.5 This definition has now been broadened in the field to recognize not only the physical closeness of organizations but also the dynamic interactions and evolutionary processes that contribute to the collective growth and innovation of a cluster.6 For decades, Silicon Valley has been touted as a gold standard for innovation hubs, allowing participants to innovate in fail-safe environments.7 By fostering collaboration among academia, industry, and government, it has been able to create synergies that can accelerate the development and commercialization of new technologies. Noteworthy achievements include the commercializing routers that formed the backbone of the internet and the establishment of the modern semiconductor industry.8
Innovation hubs are incubators designed to catalyze the development and adoption of cutting-edge health care technologies.9 Key features of innovation hubs include:
- Focused expertise: Involves skilled professionals and people possessing deep domain-specific knowledge
- Collaborative environment: Fosters partnerships and networks between academia, industry, government, and nonprofits to share knowledge and codevelop solutions.
- Advanced infrastructure: Equipped with state-of-the-art technology and tools necessary for research, development, and testing.
- Regulatory and compliance support: Provides capabilities to conduct clinical trials and other necessary testing while also understanding how to comply with health care regulations and standards.
In health care, innovation hubs can help accelerate technology adoption by providing a controlled environment to test and refine new technologies before they are rolled out on a larger scale.
Agencies like the Veterans Health Administration (VHA) and the Department of Health and Human Services (HHS) are already frontrunners in prioritizing cutting-edge technology solutions to improve patient care through efforts like the VHA Innovation Ecosystem (figure 1). Building on such initiatives, innovation hubs can be used to test and scale technologies across the network of Veterans Affairs hospitals, Military Health System facilities, and HHS services, saving time and resources.
For example, the Baltimore Tech Hub in Maryland is developing predictive health care technologies (figure 1).10 The hub has built its own equitable technology model called “Equitech” to develop tech supporting clinical decision-making, bioethics, personalized medicine, new biologics, and therapeutics.11 Along with this, the hub also seeks to benefit the region by opening up new career pathways for veterans and opportunities for youth from disadvantaged backgrounds and low-income families.12
The innovation hub approach can help produce significant advancements in scientific development (figure 1). But, their impact can be furthered by incorporating human-centered design principles by directly involving clinicians in the design, testing, and scaling of innovations (see “The human-centered design imperative for the technology revolution”).
The human-centered design imperative for the technology revolution
Human-centered design involves placing real people at the center of the technology design and development process.13 This can result in products that are better tailored to user needs and thus can help increase uptake. End-users can be involved throughout the process, and the approach focuses on working to understand and solve the right problems by addressing root causes, not just symptoms.
The design mechanism is iterative and uses systems thinking to make connections across ecosystems, bolstered by multidisciplinary collaboration across diverse teams and real-world observation. Central to this approach is a commitment to empathy for users and participants and a mantra of “no wrong ideas” and “yes, and” rather than “yes, but.” This technique is well-suited for navigating the complexity of health care technology environments.
For example, journey mapping helps visualize the entire patient or clinician experience, which can help identify opportunities to improve health care service processes or experiences.14 Design sprints can be used to prototype and test new ideas quickly so that they meet patient and clinician needs before full-scale development. High-fidelity prototyping involves creating detailed, interactive models of a product to gather precise feedback from users, and ethnographic research allows designers to observe and interact with clinicians in their natural environments, uncovering unmet needs and contextual insights.
All of this can be applied in the proposed health care innovation hub. Such tools have already been deployed by federal health agencies to meet some of their end goals. HHS released a journey map for adolescents using telemental health services at urban school–based sites. The journey map explores influences on access to mental health care, denoting societal factors such as mental health stigma, program activities such as outreach and education, and issues adolescents may face at each step in the care journey, such as mental health literacy and peer support. Program leaders used this information to identify ways the program can better support adolescents at each step in the process to increase access to care, such as using their resources to normalize mental health screening.15
Human-centered design can help improve medical experiences, as seen with Philips’ Ambient Experience, which transforms stressful magnetic resonance imaging scans into more patient-friendly procedures.16 This technology not only reduces the need for repeat scans by improving patient cooperation but also allows patients to personalize their environment, helping boost comfort and reduce anxiety. The impact is notable: Advocate Lutheran General Hospital in Chicago reported a 30% decrease in sedation rates among young children, while Catharina Hospital in Eindhoven, Netherlands, found that 73% of patients felt more at ease during scans.17 Similarly, at the Children’s Hospital for Wales, United Kingdom, 72% of caregivers noted an improved experience in the upgraded Philips suite, demonstrating the benefits of human-centered design in health care.18
The new tech revolution will have to overcome adoption hesitancy
Transforming a sector with technology requires not just capital, time, and talent—all of which are often in short supply in health care today—but also clinician willingness to embrace new technology.19 Providers today may be hesitant to take on new, unproven technology that could divert critical resources and time away from immediate patient care.20
Clinicians have often found that technology adoption can increase the burden rather than alleviate it.21 This was particularly evident following the 2009 America Recovery and Reinvestment Act, which led to the near-universal adoption of electronic health records (EHR) across the nation’s health care system. Despite this widespread implementation, some clinicians were disappointed with the unexpected consequences of the changes (see “Lessons from the past: When change is too hard, by design”).22
They expected measurable gains in safety, quality of care, and patient outcomes while saving time on paperwork.23 But, clinicians reported losing face time with patients and spending around six hours daily on administrative tasks like documentation, order entry, billing and coding, system security, and inbox management, both during and after clinical hours.24 It’s understandable, then, that many clinicians approach new technology with caution.
Efforts to usher in the smart technology revolution should consider the context in which clinicians operate today and what they want new tech to do for them. Meeting clinicians where they are should be a precursor to transforming the health sector’s use of technology.
Lessons from the past: When change is too hard, by design
So why did clinicians spend six hours a day staring at screens when they sought more time with patients? The answer lies in part in the unintended consequences of rushing the implementation of policies aimed at modernizing health care through technology. The push for digital records was meant to create efficiencies, thereby improving the quality of patient care, but it often added to the workload of health care clinicians.25
On the ground, some care providers felt that electronic health records were ill-fitted to their existing clinical workflows.26 Clinicians found themselves spending more time inputting administrative data than caring for patients.27 A 2022 Deloitte survey of US physicians found computer-related activities were among the lowest-valued care provider tasks, and they reported removing computer tasks from their workdays as one of the best ways to improve job satisfaction.28
Some of the major challenges clinicians have experienced since adopting EHRs include:
- Physician dissatisfaction with EHR performance: A 2018 Stanford Medicine Harris Poll of over 500 primary care physicians found nine in 10 want EHRs to be more intuitive and responsive. Only half were satisfied with their EHR performance.29
- Confusing EHR visual displays can lead to medication errors: In various government databases, like the Pennsylvania Patient Safety Authority database, cases were reported where EHRs displayed medication orders at the correct dose, but the dates were mistakenly set to the previous day.30
- Diagnostic errors triggered by confusing, cluttered visual displays: Care providers often have to pass through many boilerplate pages to complete a patient’s record, which makes it challenging to thoroughly document clinical information supporting the diagnosis and treatment plan.31 A study on diagnostic errors linked 2.6% of missed diagnoses to copy-and-paste practices, necessitating unplanned additional care.32
- Clinicians missing red flags due to “alert fatigue”: Nearly one in four medication orders trigger an alert.33 Although these alerts are designed to improve care, clinicians often override them—up to 96% of the time.34
- Taking away from patient-care time: The Harris Poll found that only 8% of the respondents felt that the primary value of EHRs is clinically related.35
The EHR adoption journey in the United States provides important insights into the dynamics of introducing large-scale technology within the health care sector and the criticality of an approach that prioritizes clinician needs.
From evolution to revolution: How human-centered innovation hubs can promote faster adoption of emerging technologies
Federal health leaders may be well positioned to help drive the next technology revolution—and to massively boost the scale. To help usher in a new era of transformative technology, federal health leaders can support clinicians with the resources they need to be successful, working to make changes as frictionless as possible. Federally sponsored innovation hubs using human-centered design thinking can test and promote innovations that facilitate both clinician and patient experience.
To help foster this environment of innovation and collaboration, federal health leaders can consider promoting a human-centered design approach before incentivizing emerging technologies that can meet clinicians where they are.
Considerations when promoting a human-centered design approach to federal health innovation hubs
Create an innovation hub for testing and adapting new technologies, using regional learning collaboratives to spur innovations focused on what matters to clinicians and patients regionally. An innovation hub can play a pivotal role by coordinating usability testing of new technologies and testing and promoting interoperability and equitable integration into the health care system. The focus should be on integrating emerging tech in a way that is evidence-based, unbiased, and minimally disruptive to the patient-provider relationship.
Similar innovation hubs already exist throughout the government to solve public policy problems. An example of this is the Advanced Research Projects Agency for Health model, which embodies a culture of measured risk-taking and rapid innovation. This dedicated funding infrastructure allows researchers to boldly pursue groundbreaking projects, nurturing disruptive ideas from incubation to scale. The program fosters a dynamic environment where experimentation is encouraged, helping to strengthen the potential for developing novel technologies that transcend traditional disease-specific treatments.36
Similarly, the VHA’s Office of Healthcare Innovation and Learning strengthens VHA health care by driving creative solutions and practices, building innovation competencies, integrating simulation with emerging health care technologies, and using clinical training to promote high reliability within the organization.37 VHA Office of Healthcare Innovation and Learning has used a simulation health care training program called Simulation Learning, Evaluation, Assessment, and Research Network to test new technologies such as AI ambient dictation within simulated health care operations.38 It also tests the integration of anesthesia equipment with the VHA’s new EHR in a simulated operating room and adapts clinical workflows utilizing new technology.39 Partnerships with vendors and clinical leaders in this process have incorporated clinician perspectives while promoting adoption, patient safety, staff experience, and patient experience.
A hub can also act as a sandbox for regulations. While regulations targeting technology are part of the American health care system, incorporating new tech into the medical workflow can create tensions between the rules as written and rules as they operate. The innovation hub could monitor the implementation of both new technologies and the rules concerning them, aiming to resolve tensions as they arise. The hub could continually adapt to address broader trends in the industry. New technology development in the past decade has shifted toward consolidation within health systems and more coordination of care across public and private stakeholders. For example, the CDC Technology R&D Team promotes the testing and adoption of innovative solutions to public health challenges through various programs and incentives.40
For innovation hubs to meet the mission of spurring novel technology adoption, they should operate under a framework that emphasizes rapid prototyping, iterative testing, and user feedback integration. This approach can allow for the quick identification of potential improvements and the agile adaptation of technologies to better meet the needs of clinicians and patients. Additionally, strong partnerships with regulatory bodies and alignment with health care policies can be crucial to navigate the complex landscape of health care technology approval and implementation, helping facilitate the seamless integration of new innovations into existing systems and practices.
Case in action: Defense Innovation Unit
The Defense Innovation Hub, which was established in 2015 and still operates today, demonstrates how innovation hubs can accelerate technology adoption within federal agencies. It plays a role in transforming the way the Department of Defense (DOD) acquires technology and innovates in response to rapidly evolving threats and challenges, helping the US maintain a competitive edge in defense technology on the global stage.41 It partners with organizations across the DOD to rapidly prototype and deploy commercial technologies and solutions while prioritizing the speed and scalability of their operations. The team is diverse and includes active personnel, civilians, and contractors working together to accelerate the adoption of technology in the military.42 In fiscal year 2022 alone, the Defense Innovation Unit (DIU) successfully scaled 17 technology solutions to defense and civilian agency end users, resulting in US$1.3 billion of contract award ceiling.43
The DIU is working to facilitate easier engagement for first-time, nontraditional participants and small businesses to engage with the DOD, thereby driving opportunities for economic growth.44 The process begins with a DOD partner identifying a critical challenge faced by the agency. If the challenge is considered actionable, the DIU collaborates with the agency to develop a solicitation for commercial solutions. Shortlisted proposals are then awarded with contracts to prototype the solutions, and the DIU begins planning for the adoption of the technology. Through this effort, the DIU has successfully introduced more than 100 first-time vendors to the DOD, significantly broadening defense collaboration.45
Approaches like that of the DIU play an important role in aligning user needs and technological advancements for sustainable and practical innovations in defense and beyond.
Anchor design, development, and deployment in a human-centered design approach. For a tech revolution to work, we need to revolutionize innovation hubs using human-centered design principles to focus on not just science but also what clinicians are looking for from technology. Broad adoption is vital, and it’s important for leaders to keep in mind the whole range of users. By making clinician-friendly systems, health care organizations can facilitate quicker and more universal adoption of new technologies.
A human-centered design approach focused on making technology more intuitive, iterative, and responsive to care provider needs can help health care organizations achieve universal and rapid adoption of new technologies. Clinicians may resist adopting new systems that degrade existing levels of comfort, security, safety, and quality or that require them to take on new responsibilities that don’t align with provider roles.
Clinicians may be more likely to use technology that meets their needs: strengthening human connection and improving care outcomes, quality of care, patient experience, and clinical value.46 They’re looking for systems that make patient data safe, secure, reliable, high-quality, and shareable.47 Clinicians we spoke to prefer a robust accountability framework that not only clarifies governance but also can result in continuous improvement of AI systems, particularly if an AI-aided diagnosis misses a significant risk factor.48 Care providers may also look to augment AI as a reliable support tool for clinicians, focusing on iterative advancements rather than merely assigning blame.49
The federal Office of the National Coordinator for Health Information Technology pushed for the development and adoption of health information technology systems designed with a patient-centered approach. The office was instrumental in promoting the use of EHRs that prioritize patient access and control over their health data, resulting in the nearly ubiquitous use of patient portals today.50 Leaders could apply this same effort toward clinician-centered design.
By making human-centered design a core tenet of innovation hubs, the development of new technology can result in not only technical robustness but also user-friendliness and customization to meet end users’ needs. Moving away from the concept of getting it right the first time, the focus can be more on human-centered design approaches such as heuristic evaluations, usability testing, simulation, and prototyping.51 For instance, a clinical decision support system might be redesigned to simplify its utility based on feedback from clinicians who found the original system too rigid or nonintuitive.52 This redesign could focus on integrating more flexible, context-sensitive guidelines and alerts that directly support the clinical workflow, thereby increasing adherence to leading practices and improving patient outcomes. By actively seeking and incorporating real-world feedback, leaders within these hubs can make health care technology more effective, resulting in better patient outcomes and improved clinician workflows.
Work to mitigate risk by centering empathy in design research. Empathy is at the core of human-centered design, which involves understanding the needs, challenges, and contexts of end users. In health care innovation hubs, this might involve detailed observations, interviews, and shadowing of clinicians to gather insights into their daily experiences and pain points. Identifying potential issues early in the design process can allow for adjustments before costly development errors might occur. This approach can also build a stronger connection between the product and its users, potentially increasing user satisfaction and loyalty.
The Blue Button initiative adopted by the Veterans Affairs (VA) is a prime example of how federal health programs can effectively use empathetic design to help address specific user needs. The VA conducted consultations with veterans, gathering insights into their experiences, frustrations, and needs regarding health record accessibility. Based on these insights, the VA developed the Blue Button patient portal technology, accommodating veterans’ varying levels of tech-savviness and physical abilities and improving overall health management and outcomes.53 One study found that 73% of Blue Button users surveyed noted understanding their own health history as the primary advantage since it consolidates information in one location.54 Additionally, 21% of those users shared their VA health data with non-VA providers, and 87% of external providers found the information to be helpful.55
Evaluate new tech return on investment and identify policy and reimbursement facilitators for widespread adoption. As part of the innovation hub, federal health leaders can encourage objective, transparent, and standards-based evaluation of new technologies. The National Institutes of Health Information Technology Acquisition and Assessment Center uses cost-savings and cost-avoidance metrics to measure the return on investment of new technology procurements.56 Where feasible, pilot testing can assess the return on investment before full-scale deployment through nationwide incentive programs. These smaller, controlled environments provide insights into potential challenges and user acceptance, allowing for necessary adjustments before wider implementation.
Likewise, federal health agencies can lead parallel analysis of required policy and reimbursement changes that need to occur to enable adoption. Adopting flexible contracting methods like Other Transaction Authorities can improve this process by encouraging rather than restricting innovative thinking within the industry. This can result in contractual models that are compatible with the agile development and deployment of new technologies.
Championing health care innovation: The federal catalyst
Technological innovation has the potential to improve health care outcomes—provided clinicians and patients adopt it. That’s where the federal government can make a real difference. From developing life-saving vaccines to its commitment to value-based care, the government has been a fundamental driver of health care innovation—and it can bring the industry together. Through innovation hubs, agencies can play a significant role today, helping accelerate tech adoption by focusing on what matters to clinicians and addressing tech hesitancy head-on.
As new technologies rapidly come online, agencies should put people first as they work to foster innovation. By meeting clinicians where they are in this environment, federal health leaders can catalyze a health care technology revolution that is increasingly necessary. This proactive approach can not only help accelerate the adoption of vital technologies but can also solidify the government’s role as a pivotal player in shaping a future where health care is both cutting-edge and equitable.