A Prescription for Innovation

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At Mayo's SPARC innovation lab, a project team gathers to brainstorm.

Left to right: The latest working version of a self-service kiosk, a prototype for the patient intake area, glass walls revealing the lab's inner offices and spaces, and a prototype for a doctor's nook.

Dr. Victor Montori, an endocrinologist, brought doctors and patients to SPARC to experiment with a new way of discussing statins, drugs that lower high cholesterol. Too often, he says, patients get overwhelmed with information and let the doctor choose the treatment. Because they didn't decide for themselves, patients tend to abandon the therapy, which puts them back in the doctor's office.

Montori tested a one-page guide that gives an individual's risk of a heart attack, shows how statins affect those odds, and outlines possible side effects. He's still reviewing the data, which suggests better adherence to medication, but he already knows that the personalized guide got patients' attention. "After the fifth or sixth prototype, we started seeing an emotional and physical response," Montori says. "They were moved." He knows this because SPARC's exam rooms are equipped with small cameras that provide rare glimpses into doctor-patient interactions. "We hear all the time about a clinician being empathetic," Montori says. "Now we're watching empathy at work. The eye contact. The listening. We see the whole dance."

In fact, most everyone can see. With the help of office furniture maker Steelcase, Mayo created a highly transparent environment. The glass walls reveal SPARC's inner offices and show support staff working at the front desk; researchers reviewing project videos; and the SPARC team leading workshops in a central space that functions as an informal lounge and meeting room. SPARC removes the mystery found in a typical closed-off clinic.

The space is also highly flexible. Much of the corridor, including the exam rooms, can be reconfigured to accommodate a variety of experiments. Walls, furniture, and computers can be moved like puzzle pieces. "People come expecting to see the finished product," says Armbruster. "But they experience the opposite. They see prototypes in different stages of evolution."

Mayo's physicians both embrace design principles and integrate them with traditional medical research--in effect slipping the doctor's white coat over all-black designer duds. Doctors or managers propose a problem or a question they want to explore, and the SPARC staff assembles a cross-functional team, which gets a crash course on design methodology. By "the second hour, we were out with cameras, notepads, and tape recorders," says Becky Smith, a manager in patient education. Her team discovered that Mayo's main education center was confusing. It was intended for patients and family members to learn more about diagnoses or treatments. But because the space was open--no walls or doors--patients weren't sure if the computers were for them or the Mayo staff. When they did venture online, it was mainly to check email.

"We hear all the time about a clinician being empathetic. Now we're watching empathy at work. The eye contact. The listening. We see the whole dance."

After researching user needs on the Mayo campus, study groups typically reconvene in the SPARC lounge to share observations, ideally in the form of stories: how patients checked in, how they learned about treatment options, and so on. The goal is to explain how and why people behave the way that they do, to uncover the short cuts around a problem. Then the brainstorming begins. Whiteboard walls get papered with sticky notes and possible solutions. Finally, it's on to prototypes.

Smith's patient education group generated a host of ideas: an enticing name for the area--"The Discover Center"; an entrance modeled after an artery of the heart; more interactive computer programs; anatomical models that encourage hands-on learning; and a snack bar devoted to learning about and making healthy food. Management approved one of the upgrades right away, removing a pillar to improve visibility. In the next two months, visits increased 15% over the same period a year earlier.

The innovation program is still finding its feet, but Armbruster can tell it's having an impact. In one sense, it's subtle; he hears from workshop participants who are applying what they learned in SPARC in their day-to-day problem solving. But SPARC experiments are also beginning to have tangible effects on Mayo's patient experience. Take the long lines at check-in. The last thing people want when they're feeling sick or anxious is to stand around waiting. According to the SPARC team's research, 87% of patients using a kiosk would use it again to speed things along. In fact, the latest kiosk prototype actually plugs in and has a fully functioning touch screen. Based on that work, a top-level committee is weighing the addition of kiosks across the Rochester campus.

Already, SPARC's reach is expanding. What began a couple of years ago as an intriguing but modest concept was named one of the Mayo Clinic's top priorities last year. SPARC's full-time staff has grown from two to six. There are a half-dozen projects going on, and the number of workshop participants is 500 and counting. SPARC is catching on, winning traction--and, hopefully, sparking Mayo's next whirl of innovation.

Chuck Salter (csalter@fastcompany.com) is a Fast Company senior writer based in Chicago.

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