Enhancing the depth and breadth of healthcare services in communities: insights, innovations, and applications

Regardless of where health reform efforts lead, the major stakeholders of the U.S. health system – patients, providers, payers, employers, communities, and government – will continue to demand greater value. The value concept relates to the quality of benefits and outcomes received for the price that is paid. Essentially, better value emerges with improvements in quality, delivery, access, and patient experience, while reducing or constraining costs. The drive to advance system performance requires a simultaneous push to innovate in order to make improvements that will result in greater value. Efforts, big and small, to develop value-enhancing innovations and demonstrations are observed in the rapid growth of innovation hubs such as the Center for Medicare and Medicaid Innovation, the VA Center for Innovation, and the Center for Healthcare Innovation. These entities attempt to stay ahead of the changing healthcare environment by working “... to discover, develop, test, and spread new models of care delivery ...” [1] that can contribute to more rapid improvements in health system performance and value. An innovation refers to a good, service, practice, idea [2, 3] or technology [4] used for the first time within an organization, irrespective of whether or not it was used before in another industry or setting. An innovation reflects the newness of the practice to a group of people or an organization in terms of solving problems and improving performance, regardless of when the innovation was first established [5]. Generally, the diffusion of innovations into healthcare organizations from non-health settings arise from: 1) collaborations among healthcare executives and local business leaders, 2) newly hired healthcare executives whose experience is from outside the industry, 3) influential other organizations such as the Institute of Medicine, Joint Commission, Institute for Healthcare Improvement,