Balancing innovation and regulatory responsibility at Brigham and Women's Hospital

By Jonah Comstock

To run Brigham and Women's Hospitals's Innovation Hub, hospital executives have to balance a blue sky encouragement of ideas with enterprise IT oversight to make sure apps and devices are safe and secure, Brigham and Women's Chief Medical Innovation Officer Dr. Adam Landman said in a presentation at the mHealth and Telehealth World Congress in Boston today.

"What keeps me up at night is, I love all this innovation, but I don’t want to be on the cover of the Boston Globe for 7,000 EHR records being disclosed," he said. "And that is the reality of the world we all live in today."

Landman shared the stage with Lesley Solomon, the Executive Director of the Brigham and Women's Innovation Hub, affectionately referred to as 'iHub'. The two spoke about the processes by which they facilitate internal innovation, as well as offering a few examples of projects. Since iHub launched in 2013, 50 projects have come through, 10 of which are now in pilots, Landman said. iHub also works with Rock Health and others to help validate external projects.

A lot of what the iHub does internally is based on the hackathon model, where developers get together to complete rough prototypes in a day or a weekend. Solomon spoke about how the team goes from department to department in the hospital and holds brainstorms about the problems those departments face and the solutions they can come up with.

"We’ve focused in departments with specific needs or areas within the hospital with specific needs," she said. "We ask them what are your biggest problems? What are you complaining about to your spouse at night? That problem definition session is a way for us to say ‘here are the big high-level problems’ How can we define the problem in a real way for our hospital. Then we bring in outside collaborators, designers, to identify potential solutions. Is there a plug and play solution? Is there a startup that’s already doing this? Or do we need to develop something in-house?"

Landman said that when iHub first launched in 2013, there wasn't much communication between the innovation group and the hospital's IT department.

"We tended to be notified of these projects only when they ran into problems," he said.

So the IT department created a process modeled after the way that Institutional Review Boards for clinical trials. A combination of forms, checklists, and an in-person meeting made sure innovators knew everything they needed to know about HIPAA, FDA, and other safety and privacy concerns before beginning.

"I really wanted to create a process that was a facilitator," Landman said. "To offer tools so they would want to work with us and not see us as a barrier. We wanted to streamline the process, make it fast, make it efficient, but make it easy for them to comply with our hospital requirements and best practices and make sure that their products were safe."

Here's a few particular projects Landman and Solomon mentioned over the course of the talk:

Herald, a personalized protocol system that lets physicians set up "if this, than that" operations within their clinical workflows (for instance, getting a message when a patient's vitals drop out of a certain range). The system, developed at a hackathon with Microsoft and Epic, also includes a feature that lets physicians crowdsource popular protocols from each other.

An app and web platform for digital wayfinding at Brigham and Women's.

An app to help physicians connect to burn surgeons and determine whether their patient needs to be transferred to one of the state's two overtaxed burn centers. The app also includes resources for diagnosing burns.

A Google Glass deployment for situations where a new mother and her baby are both too sick or injured to visit each other. Google Glass would allow the mother to virtually visit with her baby until they're well enough to see each other in person.