Invitees represented a diverse set of leaders including technology start-ups, thought leaders, self-insured employers, hospitals, foundations, post-acute care networks, health plans, and investment banks in Southern and Northern California. These executives came together in intimate roundtable discussions to share their perspectives on the key elements of successful adoption of innovations in health care. There was widespread agreement that there was no one element that was sufficient to achieve successful adoption and there were diverse perspectives among these leaders about which elements were most important.

A framework for innovation adoption is important because over the last five years there has been a rise in new technologies and models for delivering care that aim to improve access, reduce costs, and increase revenue for healthcare providers. Yet our healthcare system continues to face problems concerning our payment and delivery programs that defy clear solutions and hinder widespread adoption of service delivery innovations. We shared a draft framework for adoption, asked for the leaders’ insights, and highlighted the work that Avalere is doing to support cost-of-care conversations.

Out of the vibrant discussion came the following key elements for innovation:

• Leadership: people are capable of establishing objectives and assigning team resources
• Design: innovations address unmet needs and delight the end user
• Implementation: strategies are aligned with incentives and connected to the end users
• Evaluation: constant learning from iteration is a priority
• Sustainability: innovations are implemented with incentives for long-term adoption

The key elements were acknowledged and noted that success in any one of those was contingent upon a culture with three strong features:

• Trust
• Communication
• Empowerment

There was consensus among the executives around the importance of the environment in supporting the testing and spread of effective innovation. It is critical to have a culture where there is trust among the participating parties, communication about why the organization is prioritizing putting resources behind the innovation, and empowerment of the end users to adapt and co-develop its use within their unique environment, the group noted that we need to rebalance incentives so that there is universal alignment of all the stakeholders’ engagement. For example, it was noted that sometimes an innovation is brought in by leadership and viewed by the front line staff as a “pet project” rather than a new model that can improve their work and the lives of their patients. In other situations, technologies are brought into the provider setting with the idea that the provider group is doing a “favor” to the technology company or the designer of the new model. This lack of trust between the innovator and the adopters causes a lack of buy-in or commitment from the staff. Whether it is through co-development or clear alignment of incentives there must be new mechanisms to ensure everyone involved in the adoption’s success is engaged and aligned around the goals.