According to the CDC, 133 million Americans are affected by chronic disease, accounting for more than 70% of all deaths. Reports by The Trust for America’s Health and the Commonwealth Commission suggest community-based programs targeting chronic disease could reduce disease burden and save $306 billion over 10 years. Technological advances such as mobile technologies make this feasible, yet health expenditures and innovation in the US remain focused on hospital-based care resulting in high costs and poor outcomes.
The challenges to health innovation are numerous. The health field is deeply technical requiring many years of training to master clinical knowledge. The field is highly regulated from drug and device development to data protection. There is tremendous aversion to risk given concerns for patient safety. There is an inherently conservative culture with an emphasis on incremental innovation. Payers and users are often different with disparate demands. The misaligned incentives result in greater emphasis on hospital-based innovation.
In light of these challenges, Health for America, with support from the Vodafone America’s Foundation created a fresh approach in the form of a fellowship program that connects recent college graduates with physicians, community leaders and entrepreneurs and empowers them to create innovative, sustainable solutions for chronic disease.
This framework reflects a fusion of the opportunities that my cofounder, Kapil, and I saw. Kapil is a cardiologist who had built an innovative heart failure program at Johns Hopkins using techniques like lean startup and design thinking. As a Robert Bosch Fellow, I knew first hand the power of the fellowship model to provide young leaders with invaluable practical experiences.
We hypothesized that the framework that emerged from combining these concepts would have benefits at three levels:
- 1. Improve patient outcomes through novel solutions for chronic disease
- 2. Increase innovation capacity in the health system
- 3. Provide youth with invaluable practical experiences in health innovation, thereby shaping the health care leaders of tomorrow
We tested this concept in a summer program a few months ago. Three fellows worked with communities in five cities around the country over a period of eight weeks to develop solutions for childhood asthma, the commonest chronic disease in childhood. Some of the highlights included conference (Health Data Palooza, MedCity Engage and Southland), meetings with startups, insurance companies and asthma practices in Louisville , a workshop at IDEO on childhood asthma, visits to Oakland and DC Children’shospitals, a Lean Startup Machine workshop in New York and meetings with congressmen and senators.
The result? The fellows helped put together a hackathon-style design challenge called #GamifyAsthma to create a game around asthma that was won by a team of ten year old girls who beat adults in the competition. The fellows also developed a conceptual framework for a novel device to improve medication delivery in asthmatics as well as a comprehensive thirty-page white paper. In the process, the fellows grew personally and professionally, developing a deep passion for health innovation. In addition, the health institutions they worked with were influenced by these novel techniques. Inspired by this success, Health for America is now working to launch a year-long program in 2014.
The potential of fellows to spur innovation and change is not unique to Health for America or healthcare. In fact, it has shown success in another highly regulated industry: government. Two programs come to mind. Code for America is a program that harnesses fellows for innovation in cities while the Presidential Innovation Fellows program works at a federal level. The successes of these initiatives suggests that the fellowship model could have tremendous impact in other fields. It should be seriously considered as a vehicle to spur social innovation.
Post script: Given our passion for fellowship programs, it seems only fitting that Kapil was selected as a 2013-14 White House Fellow.