Chapter 7: Partners

Innovation as a Team Sport

The two most critical characteristics of Cleveland Clinic’s approach to innovation are process and partnership. The former is objective and demonstrable; the latter can be subjective and ethereal unless pursued with equal discipline.

This chapter describes how Cleveland Clinic engages all innovation stakeholders to optimize the outcomes important to each. Despite healthcare’s inherent complexity, basic principles of relationship development and management still are the best way to build sustainable achievement.

You’ll read about partnership approaches for rescuing the damaged industry-provider relationship paradigm. We’ll also cover ways of honoring the Sunshine Law, while maintaining healthy connection between physicians and corporate vendors. Next, I’ll share our perspectives about provider-provider partnerships, which is embodied in Cleveland Clinic’s model for collaboration between historical competitors, the Global Healthcare Innovations Alliance (GHIA). I will examine local and statewide economic partnerships that Cleveland Clinic is leading and, finally, partnerships between co-inventors, from individuals to institutions and beyond.

Shifting the Relationship Paradigms

Two relationship structures dominate the supply side of healthcare’s economy: vendor-client and competitor. Involvement in mission-driven innovation invites traditional vendors and clients to associate as partners and can turn competitive health systems into collaborators. These are extremely useful relationship configurations at a time when economic pressures resulting from the 2010 U.S. Patient Protection and Affordable Care Act, volume-to-value shifting, and moves to population management are imminent.

Industry-Provider Relationships

There are three doors through which large strategic vendors access healthcare systems: supply chain, direct physician contact, and innovation activity, such as commercial divestment of intellectual property (IP) or codevelopment.

On a given afternoon, we may meet with traditional merchants with whom we’re working on technology co-innovation or possibly a divestment. If they have been negotiating with our supply chain (sometimes termed formulary) in the morning, they arrive crestfallen. For obvious reasons, hospital systems have been driving hard bargains, especially on physician-choice items. Vendors are hearing that they must participate in an ultracompetitive request-for-proposal (RFP) process after decades of incumbency or that they must meet a specific price for their implants to remain on the shelf.

The innovation function must likewise adapt its expectations and practices. Just as end users—surgeons, for example—are getting more involved in supply-chain decision making by becoming better informed about implant pricing and gaining efficiency by slimming their sets, innovators are also contributing. We’re recognizing and rewarding creative game changers that lower cost, democratize care, and improve quality. These initiatives are best pursued with the cooperation of, not at the exclusion of, industry.

Cleveland Clinic encourages (and in some cases, requires) physicians to learn the costs of the equipment, especially the disposables, they utilize during procedures. Quality of care and outcomes are the most important parameters, but exercising fiscal responsibility is another variable that the physician can control.