The Two Keys to Driving IT Innovation

By Charles Araujo  |  Posted 04-23-2013

The Two Keys to Driving IT Innovation

By Charles Araujo

In 1996, I had the opportunity to be a part of something special. Working for a large, regional health-care provider, I was a member of a team that broke new ground in the then-nascent world of telemedicine. Working hand-in-hand with the director responsible for implementing this new approach to health care, we developed a highly integrated system that was far ahead of its time. Pulling data from a whole host of systems and data repositories, we built a workflow-driven telemedicine application that enabled a nurse to move seamlessly from patient identification, to billing authorization, to the review of a patient’s medical history, to accessing our clinical pathways, to updating medical records and, finally, to automated referrals if further care was required. While much more commonplace today, this system was quite a feat 17 years ago.

Without this telemedicine application, a nurse would have been required to access at least eight different systems, with a different log-in for each system, in order to perform his or her functions. It would have virtually guaranteed that the nurse would be focused on the technology rather than the patient. When we rolled out this new system, our sponsor flat-out told the executive team that it would have been impossible to enter the realm of telemedicine in the way we did without the system we had developed. It was a triumph of innovation. And it enabled us to provide better and faster care to our patients. It felt good to be a part of it, but the question for IT organizations today is whether or not you can create this kind of innovation on a repeatable basis. Can IT organizations create truly innovative cultures?

The Need to Innovate

IT organizations are under an immense amount of pressure today. We are simultaneously called upon to be highly efficient organizations, managing very complex environments that need to deliver reliably and consistently. At the same time, we are asked to create game-changing innovation. Unfortunately, these two challenges are seemingly diametrically opposed to one another. On the one hand, we need rigor, discipline and standardization to create these highly functioning, highly reliable environments. On the other hand, we need creativity, insights and the freedom to explore to create meaningful innovation. As an IT leader, how are you supposed to simultaneously put these two together?

In my book The Quantum Age of IT: Why Everything You Know About IT is About to Change, I identify five skills that every IT professional must possess and develop if he or she are to remain relevant in the next generation of the IT organization. One of those skill areas is innovation and collaboration. I believe the capability to innovate—both personally and organizationally—is nothing short of an imperative. If we do not succeed in creating a culture of innovation within IT organizations, we will continue to erode the trust and confidence of our customers. Executing flawlessly is the ticket to the game, but if you want to actually play ball, you must become a master at innovation.

The challenge is twofold. First, how do you balance these two apparently conflicting demands? Second, how do you take an organization that is focused on operational execution and create innovation without putting that execution at risk? I believe the answer can be found in my experiences with telemedicine and in the two secret keys to innovation that it taught me.

Design Thinking

When we began our telemedicine project, we didn’t have this grand plan to reinvent things. It began, as most IT projects do, with a simple project request. The head of the program didn’t really know what she wanted. She had not worked with IT much in the past—and that’s probably what saved us. She didn’t come to us with a pre-baked set of requirements and workflows. Instead, she came to us with a problem. More specifically, she came to us with a persona—a nurse—and a simple question: How could we most closely simulate the experience of a nurse dealing with a patient in a clinical setting, even though each of them would be at the other end of a phone line?

The Two Keys to Driving IT Innovation

Because the program head came to us with a desired experience, rather than a technological demand, it changed how we approached the situation. We were simply unable to fall back into our technology-focused comfort zone. We could not begin solving the technical issues until we had answered a much more fundamental question: What does the nurse-to-patient experience feel like in the real world? It was only from understanding that perspective that we could begin to emulate it in a telemedicine fashion.

As you can see, this was not some flash of brilliance on our part. We were simply responding to the situation the best we could. Circumstances led us to the path of innovation. But what we unknowingly did has deep academic roots in industrial design principles. The basic formula behind industrial design is to create a harmony between function and form in which the product, the user of that product and the environment in which it is being used have come together to create a positive, enjoyable and effective experience. At its best, industrial design mixes both creative and analytical approaches to create the best possible product. In our case, the product was our nurses, but the process is the same.

Needing to understand the nurse-patient experience, we spent a significant amount of time simply talking to the program head and her nurses about that experience. We spent some time in the hospital observing the real-life version of it. And we began formulating what a workflow might look and feel like that would best emulate the feel of a patient seeing a nurse in a clinical setting. It was industrial design 101—we just didn’t know it. And it formed the basis for how we would eventually create this breakthrough telemedicine application.

But mere design was not enough. We still had some thorny technical issues in front of us. And our answer to those issues is the second secret key to IT innovation.

Systems Thinking

Because we built our workflow model from an experience perspective rather than a technical perspective, we had completely uprooted our typical approach to technical development. We weren’t starting with a set of technical requirements. We were working from an experience-driven workflow. We weren’t talking about infrastructure or applications. We were talking about a nurse, a patient and what information or resources they needed at each step of their interactions.

Our first few meetings with the rest of the technical team were a bit awkward. Not having gone through the process with us, they were expecting us to dole out requirements to each team, just like we had always done. Instead, we were talking about nurses, patients and the nurse-patient experience. We got some very strange looks at first. Eventually, we realized that the ways in which we had previously developed new applications and interfaces wouldn’t work. And we unwittingly stumbled onto the second secret key to innovation: systems thinking.

Because we had arrived at this from an experience perspective, we could not simply translate that back into the technical and application silos from which we typically operated. It just didn’t make sense. So, we instead talked about two simple layers: experiential and enablement. That is, we broke apart the different elements of the experience we were trying to emulate and then looked at what data or information resources would be required to deliver that part of the experience. We were no longer talking about specific applications; we were treating the whole of our technical resources as a system and attempting to figure out how to pull from whatever we had available to create the target experience. Again, we had no idea that what we were exploring had a name, but we were practicing systems thinking.

Systems thinking is a concept made popular by Peter Senge in his book The Fifth Discipline. While Senge’s book covers a lot of ground, its basic premise is that in order to be effective and efficient, we cannot look at things in isolation, but must see everything as part of a highly interconnected system. Only by understanding all aspects of the system and the impacts of changes on one part of the system to its other parts could we effectively manage and improve the delivery of any product or service.

The Two Keys to Driving IT Innovation

Having started with a design-driven approach, we were naturally forced to break free of our typical technical silos and unconsciously adopt the fundamental principles of systems thinking. We stopped focusing on technical domains and looked at things systemically. We formed ad-hoc teams of people from multiple areas to create different aspects of the new interface. The teams formed working groups to ensure the seamless flow between the stages of the workflow. And the program head was involved every step of the way to ensure that we were getting the experience that we needed.

Creating a Culture of Innovation

In the end, we created a breakthrough innovation that enabled our company to leapfrog its competitors in what was a new and emerging medical space. More importantly, our patients loved it. It mixed quality care, friendly nurses and the convenience of being able to get immediate help from home when you needed it. The nurses, who were initially skeptical and wondered aloud if they would even be able to call this nursing, found that they enjoyed it. They could help more people more quickly and deliver quality clinical outcomes.

Unwittingly, we had stumbled upon what I believe are the two secret keys to driving sustainable innovation in an IT organization. By being forced to understand the nurse, the role of nurses, and the experience that needed to exist between them and the patient, we embodied industrial design principles. We were forced to focus on the entire package of form and function. From there, we were unable to simply fall back on our technical silos. By breaking down the silos and looking at our technical and application infrastructure as one system, we embodied systems thinking and created a highly integrated system that emulated the nurse-patient experience.

I wish I could tell you that this approach became our new normal. It didn’t. We did not understand how powerful this approach was and that it was something that could be replicated. But it can. And it must. If you are an IT leader who is ready to take your IT organization to the next level, then innovation is the only way to get there. Design thinking and systems thinking can help you unlock the innovation potential of your organization. Embrace them. Practice them. And then go make the world a little bit better.


About the Author

Charles Araujo is the founder and CEO of The IT Transformation Institute, which is dedicated to helping IT leaders transform their teams into customer-focused, value-driven learning organizations. He is the author of the book The Quantum Age of IT: Why Everything You Know About IT is About to Change, is presently at work on two new books. Araujo is also the creator of DeepRoots, an organizational change methodology designed for IT teams. He frequently speaks and writes on a wide range of subjects related to his vision of the future of IT. You can follow him on Twitter as @charlesaraujo.