The Heart of Healthcare Innovation

[00:00:00] Jared: Hello everybody. And welcome back to the medDesign podcast. This episode, we're incredibly excited to host Todd Dunn, a powerhouse figure in healthcare innovation and strategy as a recognized 2023 modern healthcare top innovation award recipient.

Todd has been pivotal in driving forward the integration of consumer patient driven strategies across the healthcare landscape. Todd has pioneered the development and deployment of systems that not only foster innovation, but assure it is deeply embedded within the organizational fabric. His approach to innovation is not just about creating new solutions, but transforming entire healthcare systems to be more empathetic, effective, and aligned with the needs of those they serve.

Todd has advocated for a model where innovation is democratized and empathy serves as a core pillar of development and transformation. His work challenges us to rethink our approach to healthcare innovation, making it more inclusive, impactful, and inherently human. As we delve into Todd's journey, insights, and strategies that he's built, we're excited to uncover the valuable lessons on the power of empathetic innovation and the critical role that it plays in the future of healthcare.

So let's get started. Welcome, Todd Dunn. We're very happy to have you today. Thank you.

[00:01:07] Todd: Thank you, Jared and Ty. Let's go. I look forward to the dialogue. I was honored when you reached out and I, these are always great conversations. So thanks a lot guys.

[00:01:17] Jared: Thank you so much. And yeah, just getting started. So, you're somebody that's really made their stamp on the world of innovation throughout their career.

And I guess how would you define innovation and what does it really mean to you at this point in your career? Does it mean to compete against luck? And maybe they're throwing you a bone on that one.

[00:01:34] Todd: Jeff Bezos has one of my favorite ways to think about it is he said only the person consuming it can really define if it's innovative or not.

And when he said that, it made me start thinking about the distinction of something innovative as an adjective versus innovation as a verb. And so I don't think it's almost hard to give myself a title of innovation if the consumer gets to define it. And so I like to think about innovation as a verb.

And when you mentioned competing against luck, Clay Christensen and his co authors Karen and Taddy and David were kind enough to let me participate in the book and I have a story there. The thing I enjoyed most about that was framing the verb of innovation through the eyes of the consumer. And, the jobs theory that's spoken so eloquently about in that book frames up the world and the theory and really what a theory I think is in simple southern terms is just admitting you don't know, but you have a construct through which you learn.

And so the jobs theory, people make a progress on functional, social, and emotional dimensions, but because we have a theory, we admit we don't know. The parallel to medicine that I've always loved and keep beating the drum on, germ theory is why you have vaccinations a theory. It's not theoretical. It's a theory that produced something amazing.

You have the cell theory that helped us understand how the body works and is really a big foundation of medicine. So the thing I like about Innovation as a verb is that it's an activity that we harness to go learn more about consumers and the progress that they're making and then we design to that so that's my point of view on are you competing against luck if you are it just implies that you are not harnessing some of the greatest tools and brains in the world and i've just always believed that you don't have to be brilliant to be a great innovator.

You just have to be wise enough to use a system to harness to learn the right problems and struggles to solve for through the lens of the consumer in the company.

[00:03:59] Jared: Yeah. And I'm curious also of is competing or, this were you always systems based when you think about innovation? Was there a point in your career where you had a different thesis and took you to where you are now or you were always this way?

[00:04:13] Todd: That's man, frankly, that's a beautiful question. We could go back a long time ago. I grew up in family businesses. And so we never took lightly this notion of losing because it was your livelihood. And so I was always, we always were quite rigorous. My dad was and how we thought about what we did. But where it really hit me, Jared, was I have an MBA in supply chain management.

It's a system. And then I went to work for Cisco systems where we built a system called the e hub, which gave us global insight and data around the global supply chain for Cisco and all of its partners. And so I was fortunate very early in my career to understand the power of a system. And when it hit me about.

With innovation, we built software when I worked for McKesson, I worked in the Horizon Clinical Division, and this guy named Jared Lormond, hello Jared if you listen to this, he was the CIO of Opelousas General Hospital, he said Todd, y'all come down here, and you sell me software, And that demos really beautifully, but then you make my life hell because what you build is not what our doctors and nurses want to use.

And so that one, it offended me, not in a bad way, but I thought that this isn't right. We can't do this. This is not innovative if they hate it. And I wasn't even in an innovation role yet, but I thought, what is it that we're missing that we're building stuff that people don't like because the engineers are amazing.

Not there. And so I've always thought systems wise because I just tried to figure out what's causing this to be so messed up. It just bothered me.

[00:05:55] Ty: I've been just fascinated by the confluence of systems thinking and innovation, because you're right.

Good innovation should be systematic. There's a book simple complexity by William Donaldson, where I don't know if you've run across that yet.

[00:06:10] Todd: I've heard of, I've heard it's a wonderful book. I should put it on my list. Thanks for reminding me.

[00:06:14] Ty: Yeah, the first chapter, it just hits you with all of these big concepts.

And then he spends the rest of the book unpacking it for you. It's really good. But there's so much about that, that as far as thinking of each innovation aspect as a like almost like a Mobius strip where it's orientable within the organization where it has to relate up the organization out the organization and thinking about it in those terms we're just talking about with jobs to be done is like you've got the outside of the organization and also like looking up and making sure it's aligned with the overall vision, because it does have to make sense for the organization as well.

So it's, you can't just isolate one factor of it. So I was just curious, like how you're applying systems thinking to innovation process and as you've encountered it too.

[00:06:57] Todd: That's a great question. I'll go back to when I first started with Atrium, which was a really interesting time in the world, February of 2020.

Oh, three weeks later, locked down because of COVID. And I had the gift of interviewing 72 or 73 people as part of my onboarding, all virtual, as you can imagine. But I decided to ask a question, Ty, related to your systems question. . Couple of questions actually. One, I asked everyone, if I asked 100 people inside of Atrium leaders what their definition of a business model is, how many different answers would I get?

Every one of them. But one person told me 100, one person told me 102. And Dr. Rose, amazing guy, he said. Some doctor, two doctors are going to force you to take two answers, so you're going to get 102. If the business model is the unit of competition and the vehicle for delivering value to the consumer, but we have a hundred leaders all with different definitions, that's a problem.

It's like the Tower of Babel. And then I asked the following question, I said, but how many of those 100 leaders have heard the term or spoken the term in a meeting in the last 30 days? Every one of them said everybody has. So I thought, oh, okay, this is my opportunity at Atrium because Jay, Will, Michael, oh my gosh, Sally, Elizabeth, all amazing people, all understood the concepts, but we hadn't articulated it in a standard system that we could describe with language tools, methods, measures.

So we got in the room with our mask on. And we had a big whiteboard, longer than my wall, and we wrote this out, we drew it out, all the way from the jobs theory and consumer understanding, what's driving the need to change, all the way to the implementation end of it, and we named it Design for Impact.

Language, tools, and methods all the way across, jobs theory and the tools and methods and how you teach it, and business models from Alex. Alex Osterwalder, the great guy. To that, to all these tools and things, and it's to your point, Ty. If we established it, we could teach it, we could build it as an organizational capability versus this team that's over in a super cool building.

So we set out to do that, and man, it was wonderful, frankly. I was. You look back in life, sometimes you think about the people you get to learn from and work with and the innovation engine team, those people that I just mentioned were amazing, and we put a system together.

[00:09:39] Ty: You took that question of business model and you took it from first principles in that organization.

Because if you've seen one innovation system, you've seen one innovation system. It's a reflection of that culture though, like culture, how a culture innovates is a much, as much a part of that organization's culture as anything else, right? Yeah. It is. And what's interesting, so I had the fortune of meeting Clay Christensen in early 2011.

[00:10:06] Todd: Okay. And I was like, how did you do that? I knew Clay's brother in law. And I called Michael. I said, hey, Michael, give me Clay's email. I want to reach out to him. And he said, okay. And so I reached out to Clay. I worked at GE. And I reached out to Clay. I said, hey, would you I admire you for who you are, for what you've written.

I'd love to meet you. And he said, okay. So he gave me 30 minutes. And Wow. And I know that, wow. Yeah. And I really only had one question for Clay that was on my mind because I was becoming part of the, what eventually became GE FastWorks, the global innovation system. I asked Clay, I said, Clay, Because I called him Dr.

Christian, he's no, call me Clay, I said okay. I said, who's the most innovative company in the world? And what clause did it pick then? Really a two part question. Immediately after my question, he said, Intuit, because they have a repeatable system that's driven by the consumer. Ah, Intuit. And there was my answer, Ty, and Jared's, because then I knew if the oracle of innovation said the reason that the culture is so innovative is because they have a system, then it hit me like, Oh, of course, then we need a system to do this.

And while you could cater it and shape it to your particular organization, if you want to have a culture of innovation, you must have a system, language, tools, methods, and measures. And so that really put me off on a journey. I was in a dual role, ops role, and innovation role at GE, and that's where it really, that conversation really ignited it, because he reminded me of the importance of structure, tools, language, methods that make things work.

And I'm curious of maybe on the opposite end of that. And so like how many healthcare systems would you say, just from what you know, are falling short when it comes to innovation and strategy, like in your eyes and then what are some of the ways that they actually do fall short? I'm sure you go into some of these.

[00:12:07] Jared: Or you talk to some of these leaders and you go, you're really, that's how you guys are running things over there, it's probably astounding.

[00:12:12] Todd: I'd like to shape it this way. And the reason that I want to shape it this way is I don't want any system to think I would ever be critical of them. I want to talk about it more in the gap of where I think the industry is from a provider perspective and where I think it should be.

There are a lot of groups. I'm part of an organization called HIPS, Healthcare Innovators Professional Society. And all 32 of those people are amazing at what they do. They're great innovators. It relates a little bit to the questions you've asked me. I think where the opportunity is to move it from innovation kind of being this team over there, to a system that creates a culture that produces innovation faster, more rapidly, and at scale.

And I actually believe it's part of the natural progression of things. We've been working on this probably about 10 years in healthcare, maybe, like a real innovation system from a provider perspective, but for so long, we thought about it as working with startups. If you think about the energy in 2013, there were 21, 800 startups, I remember reading.

That we knew of and we really put a lot of energy into that but when you step back a startup is really only part of your business model. So I think Jared it's a great question I would never want people to think I'm being critical of them because they're brilliant people in health care brilliant. We just need a scalable system that they can plug into to harness all of their brilliance and their passion that's lacking I will say that's lacking.

There are a few that I think are about to get it really get it. I wish I could call them out, but I can't. But it's a, it's an opportunity for the, to just instantiate language tools and methods about innovation, and which I actually believe is what drives transformation. I think innovation is the verb, transformation is the measurable adjective.

[00:14:05] Jared: And I know you also wrote about strativation, so essentially that's, is that what you're talking about when you talk about the strativation world?

[00:14:11] Todd: No sometimes I think of the dumbest words. And that one I would say is funny. But here is my point on this. For too long, I think that strategy and innovation have been separate, and I don't give two cries if you put them together under the same, in quotes, leader in an organization.

It doesn't mean they're working together. The reason that I believe those together create transformation is that strategy also needs the exact same rigor that innovation is begging for. I believe that often they look at people like, oh, that person's really strategic. What would make you call them strategic?

They think of these big, fluffy ideas and talk about them. Tell me why you, what's the criteria of someone being strategic? And I think we have to step back from that of trying to make heroes of people who may have strategic brains. And we need systems that harness brains that drive strategies. And so I thought, okay, if you have your strategy right, you look out five, seven years, whatever your horizon is and you're back into today, then you're going to do an assessment of your business model.

And in that assessment, you're going to decide which ones you need to renovate, create, or eliminate to win in the future, driven by what the consumer, you believe the consumer will do. And that's why I called it strativation, is you can't separate them, and it has to be a system that is measurable and guides itself along the way.

What did you believe and how are we tracking to that? And I just. I think there's a great opportunity in the industry to put that rigor together in a better way and that drives transformation in my opinion. Did you see the video that Roger Martin put out? He was talking about strategic planning and how that's an oxymoron.

[00:16:08] Ty: Yeah. Yeah. It, you know what, he's spot on. So I love Roger's work in playing to win Richard Rommel strategy work when good strategy, bad strategy and the crux. He wrote those two. Fantastic books. Mark Johnson, Clay's co founder of InnoCyte, wrote Lead from the Future with Scott Anthony and others. You look at the work that those three incredible leaders, along with Rita McGrath, The End of Competitive Advantage, Seein Around Corners, People who I just admired to the end of the world read what they say.

[00:16:45] Todd: You don't have to be strategic, just flippin' use the system. And and so you don't have to be brilliant. You just have to be wise enough to adopt a system versus try and to make yourself look smart, maybe. I don't know. I've just never considered myself smart. I've just always wanted to be pragmatically wise when it comes to running a company.

And to your point, Ty, they offer great ways to think about it. Roger's video, I would recommend everybody watching that. It's brilliant. And by the way, he has a handbook. You can buy this thing. You can buy a facilitator's guide from Roger Martin on his website for a couple hundred bucks. And I'm amazed at how many systems don't have that rigor.

That's just Todd. Yeah, I've given out his book as part of a innovation leadership team development, and we're all just going to read this book together. And we're going to apply a couple chapters out of this, but just infusing some of these big picture ideas to help get that culture of innovation going.

Yeah, in Rommel's books, I'll tell you, Richard's books are amazing. Pragmatic, hard hitting, no fluff around what strategy really is. And I believe that innovation is in the service of the consumer and strategy as a verb. And that's what drives transformation. That's how I think about it.

[00:18:05] Jared: Also, I guess when I, when you talk about like a, reinvestment innovation effort.

This is one of your big things. The couch and the coins dollars in the dryer. How do you actually implement that at scale across a large organization? But then also what are some of the sort of impacts that you've actually seen by implementing that throughout your career?

[00:18:26] Todd: Oh, man. So here's where this kind of come from.

We've all heard about efficiency innovation. So Clay. Dr. Christensen talked about years ago, you had disruptive efficiency and transformative innovation and he was such a learner, he always continually refined it. When I was at GE, GE arguably maybe was the darling of, in quotes, efficiency innovation under Jack, and it was more about Lean Six Sigma, but I decided to interview 100 people.

I know, because I culturally, I was like, what's going on with this? Why aren't people talking about this? And I asked 100 people, what does efficiency innovation mean to you at GE or to your colleague? 98 people told me layoffs. Oh, yeah. And then I thought. Oh, they're probably right. Historically, they're right.

And so I thought if I, from an innovation perspective, if I help reframe it to what I think it really should be, I thought about what we're really trying to do is find coins in the couch, dollars in the dryer to reinvest into the future. And then I looked at the percentage of people who actually did a Lean or Six Sigma project at GE, and it was waning, right?

Jeff had said, we're not really going to talk about that anymore in the annual reports. But because the bar was so high, to get like a master black belt, you needed to show in writing that you thought you could save a million dollars. And I remember telling my buddy Pat, I was like, Pat, if I thought I could save a million dollars, why would I come to you?

I've already had a lot, if I already knew I could do it, why would I not just do it? And then I thought, ah, we are ignoring the ability to engage people at scale. Peter Sims, wonderful guy, wrote a book called Little Bets, and so I started thinking, how could I do this? And Intuit built a platform to get ideas from their employees.

called Brainstorm. My buddy Roy Rosen was reading, leading that. But it wasn't about give me your good ideas. It was about a structured challenge. Here's the challenge. Here's why it's important. What have you seen in other places? Here's the criteria for judging the ideas to solve the problem, which is the secret sauce.

And here's what we're gonna do next, if we pick your idea. So the way to scale it is to use a platform. The one I really like is one called IdeaWake and use that challenge structure and then you let the teams decide what they want to work on. I'll give you a great one. We did a challenge like this at GE that actually produced one of the commercials for the 2012 Olympics.

4, 000 people participated in it. Beth Comstock led it. We worked with her to write the challenge. Bam! All the way down to one that we ran a couple of years ago. This one will crack you up, man. It's 2022. The team was getting faxed orders from the labs. Okay, this lab distribution team. They were printing out these pieces of paper.

They were then keying it into a spreadsheet and then picking it. Wait a minute, isn't that 2022? And the team hated that. Can you imagine that being your job? Yeah. You're putting out these facts. Really? People don't want to do that. And so they ran a challenge. Emily Perry is her name. She ran the challenge.

And said, hey, we want to reduce the amount of just manual work that this takes. And oh, by the way, here's the criteria. Has to automate it. Can't cost us any money. And there was another one. They got an idea. They automated it and it saved the team three hours a day. Now think about that. That is a little bit, but if you do that over the course of a year, you're looking at, depending on what your work week is.

500 to 750 hours a year of no longer doing that. And so that's how you do it, Jared. You use a platform, you use a structure, and you let managers do it within the context of their team. You never send out, Hey, give me your great ideas. Nah. What's the great idea for? To solve a challenge or problem. And then you reward the little bets, the coins in the couch, dollars in the dryer, because you can repeat those at scale across a massive company.

And the reason I call it reinvestment innovation, is figure out a way of Let's say you save the company 100 million. Could you get the CFO to say, if we can hard dollar proof, we saved a hundred million, would you reinvest 10 million of it into an innovation fund so that we can keep this going without hurting the P and L, not you or de risk the P and L by funding ourselves, reinvesting into the future.

And that's where that whole concept came from about 10 years ago.

[00:23:31] Jared: Still relevant to this day, I feel like

[00:23:33] Todd: Oh, more relevant than ever, because we still have the most passionate, wonderful people. All of our companies, one of the greatest books just came out called The Friction Project from Bob Sutton and Huggy Rau.

And I, I love Bob. And I don't know him personally yet, but man, his work over the years has been so impactful. But he talks about The Friction Project. So now imagine you can have people construct a challenge around friction, get ideas to resolve it and make their life better every day at work. Like the most engaging thing in the world is a question and all the challenges is a structured question to get ideas to solve problems that they care about.

So it's more relevant and needed now than ever. Frankly.

[00:24:18] Ty: Potential impact that routine performance management, AI tools are coming into play where it's. You can automate a lot of those tasks that like are just the ones that are the soul killing activities that happen with large organizations that like now can find them if you don't have the software.

[00:24:33] Todd: Yeah, exactly. Like you just need a system to surface friction and for so long. I think we see those people as the naysayers. What do you mean, the people who are going to question the way things work, they're going to gripe about it, they're going to complain about it. Yeah. Be grateful for those people and but put a structure in place that says, Hey, if you're identifying friction, here's how we can solve it as a team.

And you get the team together. You agree on the challenge. You got to prioritize this stuff. You agree on the criteria. That's the essence of it. Because if the team, let's say I've done this, you have 10 people in a room and you debate, you say, okay, for the next 15 minutes, we're going to debate the criteria.

Okay. Then at the end Hey, we're all like, we in lock sync on what the criteria ought to be. Yes. Then when you judge the ideas against the criteria, if someone's idea doesn't get picked, you know why it didn't get picked? Because of the criteria. They know why it didn't get picked. You're debating the criteria, not the merit of the idea on its own.

It's the merit of the idea within the context of the criteria, and it just works. Look, man, this works.

[00:25:41] Ty: dramatically reduces the political impact of this decision versus that decision. It becomes more objective, right?

[00:25:47] Todd: People don't become apathetic type. They know why they all agree to the criteria.

It's a way to keep ourselves in check.

[00:25:55] Ty: Yeah, it's also what you just brought up comes to mind is like, having a culture of innovation of the 2nd, order of fact, you have people complaining more. Because they know that complaint goes somewhere and it's not that quiet quitting anymore, but rather they're complaining because they think it'll do some good.

And that this is something we should address.

[00:26:14] Todd: That's beautiful, by the way. If you have a great innovation culture, people are going to complain more. Because you, Amy Edmondson, I think, the way she articulated psychological safety, In her book is amazing. And I think a good construct of a challenge makes it psychologically safe to speak up.

And you're right, Ty. People are going to come, they're going to fuss more about things that they don't like doing. And that's good. Hey, that's good, man. Harness those people. Your company will run better. And what is it? 70 something percent of people don't feel engaged at work. Is it just, I'm not trying to be a master of the obvious, but if you have a challenge structure that's shaped in the form of a question that the team agrees to, sorry, but I actually think engagement is going to go up.

Engagement is like having a pizza party once a year or going to dinner. It's about solving problems together. That's engaging.

[00:27:14] Ty: You run across Jim Collins concept of innovation threshold.

[00:27:18] Todd: I have, I don't remember the details of it. And I'll tell you part of it, Ty. I, man, I don't know how many books I read on the topic.

100. Yeah, maybe I literally, I started doing this back. Steve blank's original book, four steps to the epiphany was one of my first books. And then of course, all of Clay's works and what I have tried to do over the years is continue to learn, but not get distracted by things that I can't explain, meaning I need to translate it.

So the jobs theory, how do I translate the jobs theory? It's look, people are trying to make progress, emotional experiences, social impressions, functional things. All we're trying to do is put a framework in to understand people. The word theory disappears, you're still using it. And Collins, all those guys have written great things, but what I try to do is use that the reading to further clarify a system that I would say is within reach.

It's a design construct. Jay Gerhart and I talk about this a lot. Will Behrman and I spoke about a lot is how do we take these principles of in quotes innovation, make it within reach to something someone can do. Ty, you mentioned all these events. Let's say you did something on Thursday and Friday.

One of our questions, if we ran a workshop, was what will they do Monday when they go back to work? And if they can't do anything with it, we didn't design it within reach. Clarity of language and using all of those books to formulate something that's All right, so maybe two wordy. People want plum jelly.

They don't want a basket of plums. Right? Yep. And so I think the brilliance of a good transformation person or a good innovator is to take a bushel of plums and boil it down to pint of jelly that people can experience.

[00:29:21] Ty: What's a 15 minute takeaway that like, spend a little bit of time here, spend some time reflecting on this.

Go back to your job. Maybe something will spark for you. Okay. Next week, another 15 minutes, right?

[00:29:31] Todd: Yeah. Spot on Ty. You're right. And what can they go do? Can they go spend an hour in an OR and then they can look for functional, social, and emotional friction. And then go drive a challenge or something.

Yes, people do that all the time. They just need a structured way of doing it so it doesn't feel chaotic and scattered.

[00:29:49] Ty: And to trust in a system that if you put this time forward, that it will be applied and useful. I think when the system fails innovation. Then that's when people just give up.

I'm like it's too hard because I've got the whole organization antibodies coming after me because I'm trying to change something that has incumbency that's going to prevent that change from happening.

[00:30:07] Todd: Man, Ty, you're so spot on. What you said, those antibodies? And part of the reason that I believe the antibodies show up is that in the mind of an operator, an innovator is a tax, but an innovator believes they're a 401k.

So you have to have both. And I think the burden is on the innovator to show the operator that the system of innovation is actually there to transform operations in a way that's better for the operators and better for the customers and consumers. And so if you can't explain what you do as a system, like Deming said, you don't know what you're doing.

So the burden is on that. And I believe that eliminates the antibodies. And I would say all of this focus on startups over the years, God bless us. We implemented a bunch of them. But if you don't balance that kind of excitement and the romantic nature of innovation with pragmatic reinvestment innovation, you're going to lose the operators.

And by the way, guess who writes your check? The operators pay for you, right? They're visiting with the patients. They're in the clinics. They're in whatever company you're in. So I think you have to have a system to calm down the antibodies. You have to have some type of a penicillin, and I think it's the system that you can go explain to a CFO.

You can go explain to someone who's managing a P& L. To let them know that you're there to serve them, because inherently innovation is a service activity in service of the consumer, the company and the customer.

[00:31:37] Ty: So Todd, you were a panelist on the NC Biotechnology Center conference that happened last year.

And one of the topics that came up was, I think this was a, I don't know, injunction to all startups out there. If your startup doesn't move the needle on the hospital dashboard, we're watching a lot of different things from a population health standpoint, profitability reimbursement rate that dashboard is if you're not impacting this whatsoever, I'm sorry, you don't have a place here in the hospital.

And I was like, where's that dashboard?

[00:32:09] Todd: Okay, you're surfacing a really important dialogue.

Startups, I, the way I think about it now, causal versus correlated. If I hire your company, your device, will it cause, for instance, CAUTIs to go down, and can I prove it? Will it cause acute kidney injury to go down? Like this company I've been such a big fan of for so long called Acuren Medical. They're attacking acute kidney injury and CAUTI, and they have great results.

So I can prove if I deploy those devices, it will cause those to move. One thing that startups make a mistake of is assuming they know what the systems are measuring. And so I have this concept, concept that my buddy Ben Blanket into it and Roy Rosen taught me called a love metric. Clay calls it a customer benefit metric and competing against luck.

All early stage companies should ask if you purchase this solution, what would you love for it to change? That's the dashboard Ty. And if it's not on the dashboard, then the startup and the health system or the customer, whoever it is, doesn't have to be healthcare, can agree on the measures of success.

Of that product in the collaboration together, and that's where I think startups have to get really comfortable being uncomfortable is finding out what would cause you to kick it out. If it doesn't do X, like what is it that would cause you to kick it out? And then if you can get that agreement very early in the work, let's say you're going to do a pilot, you're going to do a proof of concept rather than death by pilot, what you're doing is really pressing on those key measures and figuring those out.

And then you're saying, if we move those in any way, then we'll go to an enterprise deal, right? So then it's not death by pilot. Those dashboards sometimes might not exist. And here's why startups also teach us things that we didn't know we could do. I'll give you this one right here. I'm on the board of this company.

It's needle free blood draw. You can use this to repurpose an existing catheter that little thing right there goes up through the catheter That is in your arm. And the reason that i'm showing you this is because imagine what is the measure of this? What's the measure? Your measure could be the number of blood draws you did without using a needle.

That's not on a dashboard anywhere. Or reducing the number of sticks that a patient has while they're in the hospital, right? 100%. One stick stays, or you could reduce the number of needles, accidental needle sticks, or paralysis, but there are some measures that aren't traditionally known that start to open our eyes to.

And so maybe Ty my message is living inside of a health system, if you realize how much you don't know, and if you stay curious, a lot of these early stage companies are asking powerful questions about why is it done that way. And if we will have a system for engaging them, we can help each other.

That's the way I think about it. And that dashboard will change as a result of bringing someone in. That's just the inherent nature of innovation. Changes the measures.

[00:35:24] Ty: And I wonder about, and particularly healthcare, where there's so much, I don't know legacy, bureaucratic debt, let's say, that and not to be critical, it's just like there's systems in place, yesterday's solutions are today's problems.

Yeah, that are like, are in would have to go away in order to give time for the measurements that matter to start being recorded because there's an overburden on clinicians now and understaffing on clinicians. And so looking at that overall clinician experience, if you're trying to measure something new, but they don't have bandwidth or capacity to imagine something new because the working conditions are such that it's that just that bureaucratic debt is in place.

[00:36:07] Todd: Yeah, we spoke about over email this notion of empathy. I get concerned often that it's a buzzword. So I maybe if you give me a second, I'll try to explain why that's important. You mentioned in the context, let's say of an or an ICU or wherever someone is, there's friction there. There's friction for them.

They're so tacked out with their jobs and with the stress. If you've ever been in like an open heart surgery or whatever. Man, they're, stress is in the air, but if an innovator will go empathetically immerse themselves in the context, circumstances essentially. Element of innovation and go learn, then while they might not have time to try to fix it, they know what the problem is, but we can't bring them.

I call it the three C's of design disease conference rooms, conference calls and cube. I think it's absurd to a large degree that we bring people out of the context of where they experience the friction, whether it's emotional, social or functional. and ask them to describe it to us in excruciating enough detail on a call and a room, a cube, to the point that we could design something that delighted them, that they would love, that would hit their love metric.

And so I think the practice has to be and part of the system and expectation is that we go there, spend time in the OR, the ICU, we go to the bus stop, we go to the clinic, and then we will observe the friction. And so I think it's an empathetic stance to go to where people are. And really try to live their world to drive your innovation within context so that they would love it.

And you're right, Ty, they're so busy. And we would also know what we should not design for them. Now, there's always so many assumptions of what people will do and Daniel Kahneman's book, Thinking Fast and Slow, really shapes my thinking on this. System 1 is your habit brain. System 2 is your thinking brain.

The brain doesn't really want to go there very much, so it just makes a habit of everything it experiences in system 2. When we ask someone to tell us what they do, they're telling it out of their habit brain, right? There's no way that you can give us all the excruciating details to build an incredible experience for them.

That's why we've got to go to the context is you can often see when system two kicks in by a facial expression, by a complaint throwing of something, whatever. And I think that's far more empathetic. And it's also happens to de risk innovation because then you're not building so much on assumptions.

You're building on a deep understanding of what's happening in the context of where it's happening.

[00:38:49] Ty: A hundred percent. Yeah. You're going to get so much closer to the truth for observed behavior versus reported behavior.

[00:38:55] Todd: Oh, a hundred percent. Look at what Ikea does with life at home. They go in homes.

Intuit has a program called Follow Me. And so they will go do taxes with you go flip pizzas in your small business That's just what they do sasson gazardi has kept up that history that they started with design for delight many years ago png same thing People don't know but png will come in your house and mop floors and do laundry with you. There's a ag lafley and rom sharon wrote about it really well in game changer back in 2008 And so you think if they're doing that for like dish soap and mops Swiffer. They're doing it for personal business software or tax software for your house.

They're doing it for furniture that you stinkin have to put together by yourself. Don't you think that we have the time to do it in health care? We just argue that we don't. What's the software margin business? 50 60%? Probably gross margins. Healthcare, last year so many systems lost money. So I would argue that we don't have the money or time to not do it.

But the only way to transform is to do things differently than we're doing them today. That's for sure. And it's such a problem rich space in terms of trying to start addressing these and having a system to start addressing that. That's where the juicy problems are.

Oh, man. Yeah. And you discover them by being there. And man, if we had hours, I could tell you these fun stories. But so you'll appreciate this. I had someone asked me one time. I had a startup ask me, you guys have that problem at your health system? I just laughed. I said, there's only one real problem that I think health systems don't have.

And they're like, what's that? And at the time, I think Microsoft was sitting on three or four hundred billion dollars of cash and, those large corporations have that kind of money. They get hit with lawsuits all the time because people think that they'll just settle out. I said the one thing that health systems don't have is a problem of sitting on three or four hundred billion dollars of cash and no debt.

That's the one problem they don't have. To your point, Ty, it is a problem rich environment. The question is do you really understand the problem in context enough and do you understand the business model problem or the business model you have to design to solve the problem. You may be able to solve the problem but it might cost you too much so you're really not solving the problem.

And so you've got it, that's why I think about the jobs theory but also think about the business model because you think about desirability, the consumer, feasibility, the operating model, and then viability, the revenue model, the cost model, you've got to tie all three together for it to really be what it should be.

And without a system of tools, language, methods, you're going to invest in things that were a great idea that you couldn't afford. And so I think it goes back to the system. It's the diagnosis before the prescription type system for innovation. It's the scientific method. It's rigor. It's rigor. It's all it is.

[00:41:51] Ty: Any kind of innovation without empathy, without understanding kind of what's the core problem is malpractice. It's an interesting activity. But it's also why McKinsey said 80 something, 80 something percent of CEOs were not happy with innovation. 6 percent were happy. But almost a hundred percent of them all said that they knew they'd need to innovate to stay competitive.

[00:42:14] Todd: And you read that and wait a minute, they just said they know they have to do it. But then they also said out of the other side of their mouth, That they're not happy with what they're getting and you, okay, then that's the job of the innovator is to put the system in place that helps the C suite have a predictable way that they're going to allocate time and money to renovating, creating, or eliminating business models, all on behalf of delivering value to the consumer, just a system.

Jared, you asked about it earlier. Like it's just a system, you got to scale it too, though, because you got all these people want to be involved without a system is just going to be chaos.

[00:42:52] Jared: And we also talked about, pillars of innovation, empathy being one. And I've heard you talk about curiosity as a pillar of innovation.

And, as on the flip side, we lean towards creativity being one of those as well. But I'm curious of how. Curiosity as one of those pillars of innovation. And also where does creativity's role in all that play as well in your mind?

[00:43:13] Todd: Man, it plays a big role. Okay. So the reason that I say curiosity is you can't go in from a If you go in curiously without empathy, then you can like, Hey, why are they so stupid?

Why did they do this? So I think that's wrong. Empathy will harness the curiosity to a question. So I really think curiosity is embodied in the form of a question. What can I go learn and where can I learn it and with whom in a way that I can innovate for them? I believe, Jer, that's a great question, by the way, and Jeremy Utley writes really eloquently on creativity, that creativity is directed and harnessed by curiosity.

It's a great question, and if you ask a great question, Beth Comstock used to say at GE, Imagine if. . , that's a question and it just ignites people who are creative. And so I'm probably just leaving off one of the most critical words. I think you're right. Empathy, curiosity and creativity are the three big pillars because we get creative in how to solve problems when we ask the fundamental right question based in an empathetic understanding in the context of where people are struggling.

So yeah, spot on man. I just, for some reason, I just left it off. I don't know why.

You have to do it. You've got to be creative. If not, you're just recreating what you're doing today.

[00:44:34] Jared: No, it was just fascinating because, we, I was just thinking about it at the scale that you work at does creativity have a role in all of that? It feels yeah.

[00:44:43] Todd: What would you do to solve the problem?

That opens up creativity. Yeah. And so there's this kind of, there's a, there's an interesting construct. I talk about painstorming, back to Ty, your point, just spit it out there. Tell me all the pains that we're experiencing. Tell me all the friction that we're experiencing as a team. And we shape that. We can shape that into a belief statement or an assumption or something about the consumer in context.

But then this is when the creativity piece comes in. The brainstorming and painstorming are brothers and sisters, right? You got to have them together, because if not, if you don't prioritize the pain, then what are you brainstorming to do anyway? But on activity that leads to nowhere and it really creates apathy.

And so I think, Jared, and I love the framing of the question because you're teaching me by asking me, painstorm, brainstorm. And I think brainstorming. Unfettered brainstorming driven by great questions wakes up creativity, and I think one of the most rewarding things for people in the world is to know that you encourage them to creatively make the world a better place, right?

And I think that's what innovation is about. I think it's why people love going to work is to creatively solve problems.

[00:45:59] Ty: Yeah, it's one of the most fulfilling activities we get to participate in.

[00:46:02] Todd: Yeah, but it takes a system, by the way, because I think if you just say, Hey, we're going to have a pizza day, and we're going to get real creative, and we're going to brainstorm in a room, all these really cool ideas on the wall, and then you walk out in that room is where ideas went to die.

Not a problem. It's different, right? You focus the creativity, say, what could we possibly do to reduce X or to increase Y? And is that the pain we're going to agree to solve for? And not the team's yep, we're all in. And then we say, okay. Now, let's put some criteria over here of what a good idea would look like.

Because you really have to tell people what a good idea would look like, because then they know what a bad idea would look like, because it didn't fit the criteria. And then, go crazy. Go creative. And man, people will come up with the most amazing ideas. They'll, ideas will collide and they'll shape and they'll help each other.

But if you have a system, you can win. But if you just do it haphazardly, people are going to be like, yeah, that was really cool, dude, but it never went anywhere and it's because you didn't painstorm and prioritize the way you're supposed to in the beginning to really harness people's passions. And frankly, I think it's disrespectful to bring people in a room, tell them you care about what they think and never do anything with it.

Man, that's not right. It's almost Steve Blank would call that innovation theater.

[00:47:26] Jared: Oh, Ty knows all about the innovation theater.

[00:47:29] Ty: We talk about that. Yep.

[00:47:31] Todd: But that's innovation theater, right? You're just going to go be creative or brainstorm to say you're innovative. If it doesn't positively impact a consumer in a way the consumer says it's innovative, it's innovation theater.

Yeah, I use the analogy that a good ideation session is like Thanksgiving dinner. Getting down to enjoy a nice meal and sit down means that there's a whole lot of work that's happened prior to Thanksgiving dinner to get ready for it. Otherwise, you're just doing like bologna sandwiches.

You know what, Ty, I love the analogy because it's nutritious to the soul of an employee and it's nutritious to the soul of the culture in a corporation to have all the prep time.

Hey, what are we going to cook? How are we going to cook it? Where are we going to buy it? Like how are we prioritizing how we're spending time in the kitchen? And Oh, and then you do it. And so I think you're right, man. It's great. Innovation is nutritious to the soul of people and to the soul of a corporation.

But if you don't have a plan, if you don't have the ingredients, the recipes,

[00:48:38] Ty: McDonald's for the day.

[00:48:39] Todd: Yeah, it's McDonald's for a day. Yeah. You guys have been around the stump on this. You guys ask. Amazingly good questions. This is cool. Thank you. Thank you.

[00:48:53] Jared: This is the Ty show today. He's on a roll.

[00:48:55] Ty: We, we've been learning from you. This has been so much.

[00:48:57] Todd: Yeah. Oh man. We just, I think we're just all in this to help each other too. Yep.

[00:49:01] Jared: Ain't the truth. Ain't the truth. And yeah, you've been very gracious with your time today. Really. Thank you. But also before we let you go, I'm just curious. So what's going on in Todd Dunn's world, you've accomplished so much.

You just have, taken back now after this whole, experience that you've just had with your previous employer and no, you've got a book that you're working on and just what's going on over there.

[00:49:21] Todd: I am working on a book that I'm going to title The Innovator's Journey, and it goes back to what ignited me to change from a career being a guy with an MBA in supply chain and ops to trying to bring that operational structure and rigor to innovation.

I'm planning what I'm going to do next. Talking to a few organizations, I still have such an itch to scratch. Back to our earlier topic about truly scaling an innovation system that's repeatable throughout an entire healthcare system. One, because I think we need it. I never have a podcast.

Wendy and I'll be married 30 years in December. So it's really cool. It's great. Congratulations. What's up with me? My oldest son, Oliver is in the brewers organization. He's going to be a triple a ball player for them starting in Nashville. And I think he'll make it to the bigs. Emma's in med school down in Tampa.

And Ross is a minor league guy with the twins. When you ask what keeps me busy baseball season's on. And I watch a lot of baseball games. I watched over 200 last year. And Em and I talked every single day. And she teaches me a lot about medicine and the other thing that keeps me busy, I like to take care of myself and stay healthy, but I love to learn, Jared.

I'm reading all the time. I had a wonderful dialogue yesterday with a former HCA executive. Her name is Sandra Morgan. She just took the time to teach me, and I'm doing a lot of listening and learning so that the next thing I do is shaped well for the company that I joined and for me and then two other things.

I'm doing a lot of work. I'm so passionate about acute kidney injury. This is when you're, it's an inpatient diagnosis happens every 6. 5 seconds in this country. Yeah, like stroke happens every 40 seconds and today kidney is understood all manually, right? Company called Akron medical has digitized the kidney and it automates urine flow so that the nurse doesn't have to pick up the tube doesn't have to write down how much you're in all that stuff and it protects the kidneys and I've been really passionate on this kidney journey for three years believe it or not and I have spent an enormous amount of time in the last couple of months trying to raise awareness around.

Taking the burden to Ty's point off of clinicians of manually managing the kidney and urine flow and inner abdominal pressure. And so that's really kept me busy. It's fun to have an inch wide and a mile deep on a topic after being, maybe an inch deep in a mile wide on so many. So that's keeping me busy.

What's keeping y'all busy?

[00:52:06] Jared: Yeah, maybe that's a good question for Ty right there.

[00:52:08] Ty: Yeah, we're we've we're, I'm over here at Venture Connect have, we're a council entrepreneur development, which is a two day event, which is we're seeing a couple of our clients pitching today. So they're startup clients in the life sciences space and so that's.

So there's Couplet Care, which is postnatal infant bassinet. We've been working on for seven years, maybe. And so it's reaching commercialization status this summer, which I think they're expecting to be shipping product this time next year, it'll be delivering in hospitals. So really cool.

It's been a long journey. It's been a labor of love to help support this group and get it going. Any number of different other kind of topics we work with as a design consultancy. Anyway, we've got a number of different irons in the fire and just, it keeps us busy. So out of trouble and off the streets,

[00:52:53] Todd: keep it going and Ty.

I'd be really curious. if the bassinet team knows what the love metric is for the context. What would nurses love about it? Parents love about it. What would the system love about it? And see if they can be one of the pioneers in changing or adding to typical corporate dashboards, a love metric dashboard about their product.

And that really creates loyalty Ty. It creates word of mouth. And I think it's one of those things that will help an early stage company really grow because they could go back at the end of 30, 90, 180 days and show the organization that they're delivering to the love metric and it just keeps refining their product and their business model and.

Delivers value to the world. So I'd be really curious. I want to follow your journey with that one. That was really interesting

[00:53:42] Ty: Yeah, they're starting a year long clinical study at johns hopkins and those love metrics are like Yeah, reduced, calls to the nursing reduced non medical calls to the nursing station reduced infant drops

[00:53:53] Todd: Okay, so can we two minutes?

Here's one for you. There's an old thing about the five y's Yep in fbi chris voss wrote about this a little bit and never split the difference, but they found an FBI interrogation. If you ask people why it put them in their lizard brain or Dukes up immediately, if you ask them what. So if they say, what would be good about reduced calls to the nursing station?

So that's the top level measure, but what would be good about it? You may get down to the fact that they will have time to eat lunch. And the love metric would be taking time to eat a nutritious lunch. Keep the nursing call thing there. If you can go to, and then they say I would I would just like to have time to eat lunch.

What would be nice about eating lunch? And then someone may say, I get to reconnect with other nurses and learn. And then you say what would be nice about that? And at some point you'll stop asking what, two or three more times, what would be good about that? What would be your measure of that?

Then it goes even deeper into the research about what the customer benefit is. And you called it out earlier, which made me think about the unstated though, what would be good about that question gets to the unstated eventually. Cause you're basically a researcher around the love metric would be The Hopkins, what a great, yeah, one there.

[00:55:25] Ty: Yeah, exactly. And the team that's been assembled around this, we actually have a couple of podcasts planned in the future to start really unpacking Couplet Care. And it's, one, it's a device, but two, it's an entire standard of care. As far as postpartum. Care immediate, like in those critical moments, like immediately postpartum.

So it's it's a really cool topic. We're hoping to unpack this over the next couple episodes.

[00:55:47] Todd: This is why we innovate. Yeah, that's right. That right there is like encapsulated of their entire dialogue. They're going to make a difference for babies, moms, clinical people and the world. That's.

That's what wakes us up. That's empathetic, curious, and creative work. And it matters.

[00:56:08] Ty: And it's fulfilling, and you know that it's going to make a difference for people. And you see these stories happen, and you know what? If we had gotten to market faster, then we could have changed outcomes here. We, we have that kind of moral imperative to do this, because we know it'll make a difference.

[00:56:21] Todd: 100%. You guys are awesome, man. Thanks for having me on. This is so much fun. Yeah. So we gotta figure out you're in LA, so that's a little bit harder, but you gotta figure out how to get to lunch somewhere, maybe in the middle of the country or a conference or something this year. And just keep up the dialogue.

I'd be honored to Break bread with you guys. It'd be such a pleasure.

[00:56:41] Ty: Absolutely. It would

[00:56:42] Jared: be completely honored.

[00:56:44] Todd: Let's go. Hey, thanks a lot for the dialogue guys. You're amazing.

[00:56:48] Jared: Thank you so much. Thank you so much. Thank you for joining us. Thank you for joining us. Everybody today as well.

[00:56:52] Todd: Thank you. Yeah.

Thanks for reaching out, man. See you later. We'll see you Todd. Thank you.

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