1. © 2014 Healthcare Information and Management Systems Society
Abstract
Across today’s healthcare continuum there is a need for simple frameworks to drive
innovation. The Innovation Pathways Workgroup surveyed a community of healthcare
stakeholders who answered questions related to eight key factors of innovation and
whether or not these were impacted by the adoption of specific process management
methods at their healthcare facilities. These key factors, as developed by the Innovation
Pathways Workgroup, include common organizational elements that define the
innovation potential of an organization.
Analysis of the survey results shows that the use of process management methods is
strongly related to the success of innovation within organizations; more specifically,
when process management methods are not used to pursue innovation, almost all of
the eight key factors of innovation were negatively impacted.
Introduction
New models of care, new clinical measures, and new innovative ideas have emerged
over the past few years as the entire healthcare industry transforms itself from a
volume-driven model to a value-driven one. There are many factors however that affect
an organization’s ability to innovate.
For example, predictability is one of the many challenges in healthcare. No one knows
when a disaster will strike or when emergency rooms and hospitals will or will not be
full. Often it is forgotten that the healthcare industry needs to be managed as a business
that takes care of patients instead of the reverse. Innovation is key to healthcare
organizations’ futures; they must be agile and receptive to change to remain competitive
in the industry, and the factors that contribute to success lie deep within the
organization.
Innovation can be a disruptive force in organizations and as a result, innovations vary in
their degree of adoption. What are the elements in healthcare that drive success or
failure? Does a formal process methodology ensure success? Are there key factors
involved? What activities translate to actions? What actions then lead to changes in
organizational behavior?
Innovation Pathways
Do process management methods affect
innovation within organizations?
Presented by the HIMSS Innovation Pathways Workgroup

2. © 2014 Healthcare Information and Management Systems Society
So how does an organization formalize the innovation process? First, we will examine
the components of innovation, from strategic planning to culture. These components, or
factors, serve as ‘paths’ to innovative performance within an organization. The more
successful an organization is in implementing these factors within its business practice,
the more likely it is to have an environment that promotes innovation. However,
innovation as a process requires consistency around how it is pursued within the
organization. Secondly, we will explore process management techniques to evaluate
their relationship to the innovative ability of organizations. More specifically, we will
explore how process management techniques impact each of the factors of innovation
and how these factors relate to the overall innovative ability of organizations.
Eight Factors of Innovation
Innovation is enabled through many factors
but no single factor will catalyze change if it
is siloed in the organization. Vijay
Govindarajan, co-author of Reverse
Innovation says, “silos hold something
important and make it hard to get at” which
negatively impacts the ability for innovation
to occur throughout the organization.1
The Innovation Pathways Workgroup
developed the eight factors shown in Figure
1 to illustrate various elements that can
enable innovation within the organization.
There is not one factor that is more important
than another and ideally they all work in
concert with each other. Organizations that
can support and coalesce these factors in
their innovation approach will be better
positioned to innovate across operations,
processes, services, products, and markets:
Blend Cultures – Include the organization’s larger community and ensure that
institutional leaders are engaged and supportive of the proposed innovative strategies.
Use People with IT – Do not create an over reliance on people or on technology; use
both resources in concert.
Create Roadmaps – Develop a plan for the functions required to innovate and
encourage effective communication between functional experts for strategic clarity.
Collaborate and Listen – Listen for ideas that will potentially solve a problem or
present an opportunity to collaborate with stakeholders and galvanize your network.
1 Govindarajan, Vijay. The First Two Steps Toward Breaking Down Silos in Your Organization. Harvard
Business Review Blog Network. Published: August 9, 2011. http://blogs.hbr.org/2011/08/the-first-two-
steps-toward-breaking-down-silos/.
Figure 1 – Innovation Pathways Factors of Innovation

3. © 2014 Healthcare Information and Management Systems Society
Communicate and Eliminate Barriers – Cross communication is essential to promote
innovation. By stripping virtual or physical barriers to communication, ideas have a
better chance of being realized.
Stress Simplicity – Do not overcomplicate a solution to a problem; keep the following
principle in mind: “When you have two competing theories that make exactly the same
predictions, the simpler one” is better to implement. (Occam’s Razor).2
Recognize and Reward – Recognize or reward the efforts of stakeholders to innovate
even at the smallest levels.
Co-Create Solutions – Appreciate the complexity of attention that innovation requires
and expose the organization to demands from all stakeholders.
Process Management Methods
There are many process management methods applied
today and each provides a unique approach to controlling
processes across an organization or enterprise. However, it
is rare that process management and innovation are seen
as going hand in hand. Rather than complement innovation,
project management is sometimes designed to compete
with it; Markus Lorenz of Boston Consulting Group notes
that “control-minded project managers…chart strongly linear
paths that discourage distractions” eliminating “the agility
and openness needed for new thinking” thus stifling
innovation.3
It is true that over controlling the process of
innovation can have a negative impact on the ability for an
organization to adapt and change but without any control,
many innovative concepts will never reach reality.
Perhaps what is needed is the proper management of what
Lorenz calls “the inevitable uncertainties.”4
By “worry[ing]
less about the schedule and more about ways to reduce risk
– by partnering with outside companies, say, or getting
advance commitments from customers” a project manager
can successfully implement process management methods
that positively impact the organization and its ability to
innovate. 5
So is there a correlation between process
management and innovation? The 10 process management
methods that the Innovation Pathways Workgroup studied in
relation to innovation with organizations are shown in Figure 2.
2
Gibbs, Phil. What is Occam’s Razor. University of California Riverside Math Department. Accessed
January 29, 2014. http://math.ucr.edu/home/baez/physics/General/occam.html
3
Lorenz, Markus. How Good Management Stifles Breakthrough Innovation. Harvard Business Review
Blog Network. Published: October 7, 2013. http://blogs.hbr.org/2013/10/how-good-management-stifles-
breakthrough-innovation/
4
IBID
5
IBID
Plan-Do-
Check-Act
Six-
Sigma/Lean
Agile
Total Quality
Management
Just in Time Kaizen
Hoshin
Planning
Design of
Experiements
Process
Excellence
Poka-Yoke
Figure 2 – Process Methods Studied
in Relation to Innovation
For more information on each process
method you can click on its box. (You will
be directed to a 3
rd
party site.)

4. © 2014 Healthcare Information and Management Systems Society
Organizational Innovation
We define innovation as the process of effecting continual, incremental change within
an organization. Unlike radical, industry-shifting innovation, incremental innovation is
beneficial to the primary organization so that the products and services delivered can be
offered using fewer resources at a higher quality than previously allowed.
Research Hypotheses
Alternate Hypothesis: Process management methods affect innovation within
organizations.
Null Hypothesis: Process management methods do not affect innovation within
organizations.
Data
Data collection was completed over a month period in October of 2013. Members of the
HIMSS Innovation Community and HIMSS Management and Engineering and Process
Improvement Community were surveyed on the process methods they have used within
their organizations to promote innovation. Each respondent answered a series of
questions focused on the eight factors of the Innovation Pathways Info-graphic
regarding the perceived innovation qualities of their organization.
Survey Data Collected
There were 203 unique and completed responses. Demographic information is below:
Table 1 – What process methods have you used to control and promote innovation?
(Multiple Selections Allowed) – 203 Responses
Process Method Count Percent
Plan-Do-Check-Act 103 19.69%
Six Sigma / LEAN 94 17.97%
Agile Management 59 11.28%
Total Quality Management 54 10.33%
Just-in-Time 45 8.60%
Kaizen 49 9.37%
Hoshin Planning 6 1.15%
Poka-Yoke 9 1.72%
Design of Experiments 23 4.40%
Process Excellence 35 6.69%
None 28 5.35%
Other 18 3.44%

5. © 2014 Healthcare Information and Management Systems Society
Table 2 – What sector do you work in? – 203 Responses
Table 3 – What type of organization do you work for? – 199 Responses
Organization Type Count Percent
Ambulatory Setting 16 8.00%
Consulting Firm 21 10.55%
Hospital/Hospital System 113 56.78%
Vendor 27 13.57%
Other (Government, Insurer) 22 11.06%
Table 4 – What is your title? – 191 Responses
Professional Title Categories Count Percent
C-Suite 25 13.08%
Clinical Management 22 11.52%
Information and Management
Systems
109 57.06%
Other 35 18.32%
Table 5 – What is your role
in fostering innovation?
(Multiple Selections Allowed) –
199 Responses
21%
33%
46%
Public Private For-Profit Private Non-Profit

6. © 2014 Healthcare Information and Management Systems Society
Interview Methodology
To understand the stories behind the results of the survey, the Innovation Pathways
Workgroup walked through the survey with a select group of respondents to gain further
context of their answers. Seventy-three (35.96%) respondents volunteered to talk
further about their responses. Nine interviews were conducted anonymously
representing a diverse range of process methods and levels of innovation that the
respondents had experienced.
Results
The results of the survey demonstrate correlations between the process methods used
and the perceived innovation within an organization.
Table 6 – Innovation is a top
priority for my organization
(1-5 scale, 5 = Completely Agree,
1 = Completely Disagree) – 203 Responses
Table 7 – There is dedicated staff
who have innovation as their
primary responsibility.
(1-5 scale, 5 = Completely Agree,
1 = Completely Disagree) – 203 Responses
Table 8 – My organization is
innovative and brings innovative
solutions to primary business
units.
(1-5 scale, 5 = Completely Agree,
1 = Completely Disagree) – 203 Responses

7. © 2014 Healthcare Information and Management Systems Society
Correlation Matrix
The correlation matrix below shows the correlations between process methods (x-axis) and
organizational factors of innovation (y-axis). Cells highlighted in green and red show
correlations, positive and negative respectively, with statistical significance at a p-value of
0.05.
Plan-Do-
Check-Act
SixSigma/
LEAN
Agile
Management
TotalQuality
Management
(TQM)
Just-in-Time
Kaizen
Hoshin
Planning
Poka-Yoke
Designof
Experiments
Process
Excellence
None
Innovation is a top priority for my
organization.
-0.01 -0.05 0.18 0.09 0.03 0.02 0..06 -0.03 0.06 0.20 -0.14
There is dedicated staff who have
innovation as their primary
responsibility.
-0.10 0.02 0.22 0.16 0.13 0.07 0.06 0.06 0.12 0.13 -0.15
My organization is innovative and
brings innovative solutions to
primary business units.
-0.04 -0.01 0.17 0.07 -0.00 0.01 -0.00 -0.09 -0.00 0.16 -0.16
There is a process for soliciting
ideas addressing innovation.
-0.02 -0.10 0.10 0.13 -0.01 -0.00 0.07 -0.01 0.10 0.01 -0.17
There is a process for providing
feedback on ideas.
-0.06 -0.07 0.19 0.08 -0.07 0.02 0.08 0.01 0.15 -0.03 -0.17
Ideas on innovation are cataloged
and scored for consideration.
-0.07 -0.14 0.22 0.06 0.05 -0.00 0.13 0.08 0.11 0.05 -0.14
There is a program that
recognizes and rewards ideas on
innovation.
0.05 0.02 0.05 0.14 0.08 0.14 0.01 0.03 0.06 0.13 -0.20
Recognition and rewards are a
primary motivator for innovative
ideas and process generation.
0.03 -.071 0.07 0.19 0.07 0.03 0.05 0.06 0.11 0.09 -0.12
Diversity of ideas is important to
the organization.
0.07 0.03 0.13 0.08 0.07 0.12 0.05 0.02 0.08 0.22 -0.23
Innovation is a focus of the
organizational culture.
-0.04 0.01 0.12 0.10 0.04 0.08 0.01 -0.03 -0.02 0.19 -0.16
The organization is willing to take
innovative risk.
-0.04 -0.11 0.16 0.10 0.05 0.04 0.04 -0.08 0.11 0.15 -0.11
The organization encourage
employees to take innovative risk.
-0.03 -0.10 0.13 0.10 0.04 0.00 0.01 -0.09 0.08 0.06 -0.16
The organization's top innovation
priorities are well defined.
-0.05 -0.02 0.31 0.21 -0.06 0.06 0.05 0.02 0.03 0.13 -0.24
The organization's top innovation
priorities are easily executable.
0.02 -0.00 0.21 0.17 -0.02 0.05 0.08 -0.00 0.13 0.11 -0.23
There is plan and mapped
strategy around innovation.
-0.04 0.00 0.22 0.16 0.06 -0.00 -0.08 -0.04 0.05 0.09 -0.14
Roadmaps and plans are followed
closely and updated as needed.
-0.05 0.01 0.24 0.14 0.05 0.02 -0.07 -0.04 0.04 0.04 -0.14
End users or external
stakeholders are involved in the
innovation process.
0.03 -0.09 0.18 0.04 -0.07 0.11 0.02 0.02 0.09 -0.01 -0.22
There is a balance of labor and
use of data and IT in the
organization.
0.05 -0.01 0.05 0.13 0.02 0.10 0.03 -0.02 -0.03 0.20 -0.18

8. © 2014 Healthcare Information and Management Systems Society
Discussion and Conclusions
Innovation is defined by Merriam-Webster as “the act or process of introducing new
ideas, devices, or methods.” Thus, process management is critical to the success of
innovation in many organizations. By isolating ten different process management
methods and eight themes of innovation, we can objectively look at how different
methods will impact innovation within organizations. Most strikingly, we can see the
effects on innovation when process management methods are not used. As shown in
the previous section, when no process management methods are used, innovation fails
or is often not attempted. Therefore, based on the statistically significant correlations,
we can reject out null hypothesis.
Process management techniques are not a silver bullet for innovation but they allow
organizations to support staff in utilizing their full potential, bringing change and new
practices or products to the enterprise. We found that organizations lacking process
management methods had exacerbated their resource and staff constraints. Without a
process to enable innovation, organizations settle into old habits, and in a rapidly
changing industry such as healthcare this can spell disaster for an organization. These
old habits and the over-stretching of resources can discourage employees from
affecting change in their organization. Often a few dedicated employees are left to think
of innovations that can improve organizational performance, even if just for their own
use.
Even with dedicated employees tackling innovation responsibilities, without
organizational support, changes do not become ingrained into everyday operations.
Leadership creates the culture and context in which the organization functions and if
they do not engage and support change at all levels they are doing a disservice to their
organization. As shown in the correlation matrix, organizations that do not use a
process method to manage innovation have negatively impacted their ability to foster
innovation. This occurs at all levels from basic encouragement for employees to having
a structure to solicit and grade ideas. As Andrew Van de Ven, Health Professor of
Organizational Innovation and Change in the Carlson School of Management at the
University of Minnesota, points out, organizations need to understand that “innovation is
not a discrete event but a process for integrating all the essential functions,
organizational units, and resources needed to manage an innovation from beginning to
end.”6
By using process methods, innovation can succeed throughout the organization and the
process of going from concept to results is streamlined to provide a competitive
adaptability to change. As the entire healthcare ecosystem faces the many challenges
ahead, it is imperative that focus be placed on strategically using innovation and
process methodology in tandem. This approach will provide efficiencies and streamlined
solutions that can drive positive outcomes.
6
Van de Ven, Andrew H. Central Problems in the Management of Innovation. Management Science.
Volume 32. USA. 1986. http://www.d.umn.edu/~rdtaylor/p1.pdf.

9. © 2014 Healthcare Information and Management Systems Society
Next Steps
Questions remain as to which process method is the best to create an organizational
environment where innovation flourishes. Through the correlation matrix we can see
that several process management methods had notable positive effects on innovation
within the organizations surveyed but, if implemented, will these process methods
provide the same results across all organizations? This question may be more difficult
to answer than our data suggests. However, in 2014, the Innovation Pathways
Workgroup will begin to develop a toolkit to answer these questions and to enable
stakeholders to recognize innovation challenges within their organization. It is the
Workgroup’s hope that through the toolkit, stakeholders can properly adopt process
management methods to positively affect the innovation factors and process within their
organization.
Acknowledgments
Thanks to the volunteers of the Innovation Committee and Management Engineering
and Process Improvement Committee for providing additional expertise to the
Innovation Pathways Workgroup.
Innovation Pathways Workgroup:
Judi V. Painter, MBA/HMSA, Healthcare Delivery Analyst
David Wierz, MA, Strategic Consultant – Commercial Development, Symphony Health
Solutions
Marguerite Swietlik, MSN, RN-BC, CPNP, CPHIMS, Manager, Clinical Decision
Support, Clinical Application Services, Children’s Hospital Colorado
Laticia Miller, Vice President, Corporate Initiatives, AIM Specialty Health
Peter Dudka, Patient & Physician Services Coordinator, United BioSource Corporation
Maj. Clark Campbell, RN, MSN, Informatics Officer, United States Army Medical
Command Enterprise, United States Army Information Center
References
Govindarajan, Vijay. The First Two Steps Toward Breaking Down Silos in Your
Organization. Harvard Business Review Blog Network. Published: August 9, 2011.
http://blogs.hbr.org/2011/08/the-first-two-steps-toward-breaking-down-silos/.
Gibbs, Phil. What is Occam’s Razor. University of California Riverside Math
Department. Accessed January 29, 2014.
http://math.ucr.edu/home/baez/physics/General/occam.html.
Lorenz, Markus. How Good Management Stifles Breakthrough Innovation. Harvard
Business Review Blog Network. Published: October 7, 2013.
http://blogs.hbr.org/2013/10/how-good-management-stifles-breakthrough-innovation/.

10. © 2014 Healthcare Information and Management Systems Society
Van de Ven, Andrew H. Central Problems in the Management of Innovation.
Management Science. Volume 32. USA. 1986. http://www.d.umn.edu/~rdtaylor/p1.pdf.
Additional Information
For additional information, please contact Ethan Baron, Program Manager, Healthcare
Information Systems (Innovation), HIMSS, at ebaron@himss.org or 703-562-8828.