Thursday, May 13, 2010

Storytelling and Innovation

I am fortunate to be part of the Innovation Learning Network (ILN) which "brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation. Its purpose is to foster discussion on the methods of Design Thinking and application of innovation / diffusion, ignite the transfer of ideas, and provide opportunities for inter-organizational collaboration." Some other members include Kaiser, Partners Healthcare, the VA system, UPMC and the Ascension Health System.

We meet twice a year for "in person" meetings where we learn formal innovation techniques, brainstorm on how they can be applied at our institutions, and share stories of successes (and failures - since the nature of innovation requires some failures!). Our most recent meeting was last week and was in Chicago - it was primarily hosted by a fantastic innovation and design consultancy called gravitytank (and the Szollosi Healthcare Innovation Program helped to co-host since it was in our home town!). As usual, my friend and fellow blogger Dr. Ted Eytan has already written this up a bit - check his ILN report out and you might also be able to see a picture of me about to be adorned with a leopard robe...

The theme for this meeting was "Storytelling" - particularly around how can stories help one develop or spread innovative ideas. I took away a couple of major learning's:

Stories are a very powerful communication tool - humans are innately and culturally programmed to hear and understand stories. It is much easier and better to explain a problem or solution in the context of a story than as a bunch of numbers and statistics. What would you rather hear as a prelude to a decision to open up a new medical office in a certain area of town: "Bob and Jane were 25 years old when they met at Margie's Candy store, fell in love, bought a house in the new section of Lakeview, and then had a son named Bobby Jr. and later a daughter named Scarlett", or "The average age of marriage in Lakeview is 27 and the majority of couples have two children". Think about how much of the story of Bob and Jane you already filled in with your own mental images (the look and smell of the candy store, the kids playing in the house…) and how much you are already interested in their lives vs. how little you care about the stats.

There is an art and a science to creating stories. First, define your Hero, the Villain, the Weapon (the tool which the hero uses to defeat the villain), and the Treasure that is received. Consider adding in a Mentor, a Companion (an important partner), some sidekicks (humorous extra characters). Next, set up your plot to mirror some of the typical archetype stories that people are used to hearing… almost all stories have a Hero overcoming a Villain to get to the treasure, but more specific stories each have their own subtleties, such as "Rags to Riches" (think Aladdin), "Overcoming the Monster" (think Jaws) and "A Quest" (think Indiana Jones). Finally, always make sure to humanize any data and keep things interesting by doing things like proposing puzzles, using props and interacting with your audience.

Storyboarding is an excellent tool for brainstorming. Draw picture panels of the current state, put them up for everyone to see, and then step back and think about how else it could be done. Draw new panels and put them up, mix and match.. and create a whole new story. We broke into groups and looked at the problem of getting thru the airport - some groups looked at this from the eyes of a single mother with two children, others from the eyes of a busy consultant, others from the eyes of an aging couple. Within 30 minutes, the amount of great ideas was staggering - from "Family tickets" (one ticket for the adult and kids) to "amusement-like rides" through security, to pat downs with cooking-like gloves which smelled of warm cookies (hey - no holds barred on innovating!).

There are a ton of books on how to more effectively use stories; one of my favorites is Squirrel, Inc. Others include Made to Stick and The Seven Basic Plots: Why We Tell Stories.


  1. Personally, I have found storytelling and storyboarding to be quite a useful technique to get my point across, especially when introduced to users early in the design process during idea generation. One thing that I've learned is that, while brainstorming early and often is great, even more productive is getting frequent iterations of high-fidelity mockups in front of key decision-makers. Ideas can get stale or forgotten, so prototyping those that are more valuable to the team or organization can help bring the idea from the drawing board to reality.

    One book that is on my to-read list that may illuminate the power of storytelling in medicine is Kathryn's Montgomery Hunter's "Doctor's Stories: the Narrative Structure of Medical Knowledge." She writes about storytelling from the perspective of a humanities professor teaching ethics classes at a medical school.

    Non-clinicians like me trying to understand what drives medical decision-making find her writing invaluable. (As you may know, I'm a medical informatics graduate student.) I've also been reading Hunter's "How Doctors Think." It's fascinating reading which explains that how medicine has been portrayed in history and literature can affect the way it is practiced today.

  2. Dr. Berkowitz:

    Reading your blog and seeing you as an influencer in the HIT evolution, I want to make you aware (or at least MORE aware) of a particular aspect of HIT development and that is the use of ontological engineering in that process.

    It's a complex "story" that I hope you'll find of interest and become more familiar with.

    It is increasingly accepted that ontologies are valuable for data mapping that correlates data from disparate sources. Data disparity is endemic to (for example) EMR/EHR due to different systems storing the same data differently.

    But finding a company that understands and uses ontologies is not easy.

    I am aware of a company that has made a significant break-thru with respect to ontological engineering and disease control that is worth note.

    It's a small privately held SaaS development company based in Colorado that has developed and deployed an ontologically-based, GIS integrated disease management decision support system in Africa to fight malaria. This is a significant system that was funded by the global combatants of this disease and the system can be rapidly customized for deployment to other disease environments…especially if you are talking about vector-borne disease.

    The company, TerraFrame TerraFrame is interested in leveraging its technology to fight global diseases or other problems requiring better decision support systems and is happy to entertain creative conversations to that effect.

    For more information please contact Ray Hutchins at