Volume 8 no 2
We have a great idea, now what? Using the Canadian Healthcare Lean Canvas for implementing innovation
Mamta Gautam, MD, MBA, and Scott Comber, PhD, MBA
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We have a great idea, now what? Using the Canadian Healthcare Lean Canvas for implementing innovation
Mamta Gautam, MD, MBA, and Scott Comber, PhD, MBA
The Canadian Healthcare Lean Canvas has successfully provided a manageable and actionable innovation framework with which to capture the key aspects of proposed health care innovation projects as used by participants in a physician leadership development program to address large-scale complex issues in health care.
KEY WORDS: innovation, framework, lean canvas, health care, tool, problem-solving
Gautam M, Comber S. We have a great idea, now what? Using the Canadian Healthcare Lean Canvas for implementing innovation. Can J Physician Leadersh 2022;8(2):67-70.
https://doi.org/10.37964/cr24751
A dilemma in Canadian health care innovation occurs when excellent ideas and good science fail to reach the bedside.1 Physician leaders know that innovation can improve patient outcomes; however, it continues to be difficult to enact. Although innovation is often supported in theory, it can be difficult to go from ideation to execution. This requires physician leaders to adopt a new way of thinking, to identify and address a different approach to creating solutions. An innovation framework that helps physicians describe the rationale of how their new idea creates, delivers, and captures value in economic, social, cultural, or other contexts can be of help.
Such frameworks are not usually part of a medical school curriculum, and yet we know that physician leaders need innovation processes and tools to move their ideas to solutions. There is a whole field of implementation science dedicated to this concept.2,3 In this article we present the one-page Canadian Healthcare Lean Canvas, a practical tool that reflects many of the concepts implicit in implementation science and that can be used by physician leaders to outline and implement innovation. Top
The Lean Canvas
The Lean Canvas, in its original iteration, is a one-page business model template that summarizes a proposed solution for a defined problem. It was created by Ash Maurya to assist in deconstructing an idea into its key assumptions and is widely used in business and entrepreneurship.4 It is adapted from Alex Osterwalder’s Business Model Canvas and optimized for lean startups. Similar to a startup, it is quick, easy, effective, and concise. Unlike elaborate business plans, which can take too long to write, are seldom updated, and are almost never fully read by anyone other than the authors, consider the Lean Canvas as a fancier way to sketch out an idea for a project on a napkin over a lunch meeting. Ideally, it should be quick to create, adaptable, and easily read and understood.
Maurya describes four key aspects and benefits of a Lean Canvas.4
Adapting the Lean Canvas for health care
We introduced the participants to the Lean Canvas template as a way to map their innovative ideas. The original Learn Canvas model was geared mostly to for-profit organizations and did not entirely meet the social aspects and culture of health care. We searched the Internet for other versions that were more applicable to social entrepreneurships such as health care.5 We found templates that were better, but still not ideal. Finally, we modified the Lean Canvas to suit the needs of health care specifically and designed the first Canadian Healthcare Lean Canvas (Fig. 1).
Using the Canadian Healthcare Lean Canvas
The Canadian Healthcare Lean Canvas consists of 11 elements, with specific questions posed for each element. It is designed to help you consider and complete each aspect of your idea. First, you are encouraged to take time to reflect, define, and articulate your overall Top
You are then ready to move on to the other boxes.
1. Problem: This is the first and most important box to complete. What specific problems are you trying to solve? List the problems being experienced.
2. Stakeholders: Who do you need to have on your team? For whom are you creating value? Who are your internal and external stakeholders?
3. Unique value proposition: How does this product/
service/process meet the identified needs? How is it better or different than what currently exists?
4. Solution: How do you solve the problem? Define the top three features of the proposed product/service/ process.
5. Success factors: Why do you think this will succeed?
6. Sustainability: What resources (financial, human, support) do you need to sustain this project once it is implemented?
7. Feasibility: What are the major costs (financial and other resources) associated with running this project?
8. Key metrics: How will you know you are successful? Identify key metrics you will measure.
9. Pathways: How will your product/service/process reach your target group? How will they access it?
The Canadian Healthcare Lean Canvas template can be used in various formats depending on the project group. In a small group, each member can have a full page-size copy of the template to write down ideas and thoughts. In larger groups, the template can be drawn on a white board and members can place Post-It notes in each box. The goal is to be flexible and easily adaptable as you move through the process. Once the items in each box are agreed on, details can be written concisely and shared with everyone. Top
The idea is to be messy, flexible, adaptable, and fluid with your thinking. For example, thinking your way through an element in one box can often lead to a change in a previous box. We are often asked by physicians why the boxes are not numbered in logical order. The Canadian Healthcare Lean Canvas follows the structure of the original Lean Canvas which presented the boxes in a similar fashion. It was intentionally designed to stimulate original and innovative thinking by moving away from a linear model of thought.
Proven value
We have used the Canadian Healthcare Lean Canvas for the past two cohorts of the year-long PLDP offered by Doctors Nova Scotia.7 It has been easily introduced to and understood by physician leaders. Although the impact of using this tool has not yet been formally investigated, anecdotally, the template has served program participants well, as they design and complete their action learning challenges and consider and propose solutions to actual challenges in health care in Nova Scotia. Examples of some of these completed projects, which provide recommendations on real-life health care issues, resulting from the use of the Canadian Healthcare Lean Canvas, can be found on the Doctors Nova Scotia website.8 Top
Acknowledgements
We are grateful to Doctors Nova Scotia and its CEO, Nancy MacCready-Williams, for the constant support they have shown as we developed the PLDP, created the Canadian Healthcare Lean Canvas, and shared it with course participants.
References
1.Ilan Y. Why scientists, academic institutions, and investors fail in bringing more products to the bedside: the active compass model for overcoming the innovation paradox. J Transl Med 2021;19:55. https://doi.org/10.1186/s12967-021-02726-4
2.Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol 2015;3(1):32. https://doi.org/10.1186/s40359-015-0089-9
3.Rapport F, Clay-Williams R, Churruca K, Shih P, Hogden A, Braithwaite J. The struggle of translating science into action: foundational concepts of implementation science. J Eval Clin Pract 2018;24(1):117-26. https://doi.org/10.1111/jep.12741
4.Leanstack. n.d. Available: https://leanstack.com/
5.Moskovitz D. The social lean canvas. Dave Moskovitz blog 2020;29 May. Available: https://tinyurl.com/4ankfj5b
6.Blank S. Customer development. Steve Blank blog 2009;1 May. Available: https://tinyurl.com/y7e8xbf6
7.Physician leadership development program. Dartmouth: Doctors Nova Scotia; n.d. Available: https://tinyurl.com/2p9bbax7
8.Cohort 3 action learning projects. Dartmouth: Doctors Nova Scotia; 2021. Available: https://tinyurl.com/33tyfz7a
Authors
Mamta Gautam, MD, MBA, FRCPC, CPE, CCPE, is an Ottawa-based psychiatrist who has been working with physicians since 1990. Among her areas of expertise are physician health and physician leadership.
Scott Comber, PhD, MBA, MA, BEDS, is a university teaching fellow at the Rowe School of Business, Dalhousie University, Halifax. He consults to organizations nationally and internationally in the areas of leadership development and change management.
Correspondence to:
mgautam@rogers.com, scott.comber@dal.ca
This article has been peer reviewed.
We have a great idea, now what? Using the Canadian Healthcare Lean Canvas for implementing innovation
Mamta Gautam, MD, MBA, and Scott Comber, PhD, MBA
The Canadian Healthcare Lean Canvas has successfully provided a manageable and actionable innovation framework with which to capture the key aspects of proposed health care innovation projects as used by participants in a physician leadership development program to address large-scale complex issues in health care.
KEY WORDS: innovation, framework, lean canvas, health care, tool, problem-solving
Gautam M, Comber S. We have a great idea, now what? Using the Canadian Healthcare Lean Canvas for implementing innovation. Can J Physician Leadersh 2022;8(2):67-70.
https://doi.org/10.37964/cr24751
A dilemma in Canadian health care innovation occurs when excellent ideas and good science fail to reach the bedside.1 Physician leaders know that innovation can improve patient outcomes; however, it continues to be difficult to enact. Although innovation is often supported in theory, it can be difficult to go from ideation to execution. This requires physician leaders to adopt a new way of thinking, to identify and address a different approach to creating solutions. An innovation framework that helps physicians describe the rationale of how their new idea creates, delivers, and captures value in economic, social, cultural, or other contexts can be of help.
Such frameworks are not usually part of a medical school curriculum, and yet we know that physician leaders need innovation processes and tools to move their ideas to solutions. There is a whole field of implementation science dedicated to this concept.2,3 In this article we present the one-page Canadian Healthcare Lean Canvas, a practical tool that reflects many of the concepts implicit in implementation science and that can be used by physician leaders to outline and implement innovation. Top
The Lean Canvas
The Lean Canvas, in its original iteration, is a one-page business model template that summarizes a proposed solution for a defined problem. It was created by Ash Maurya to assist in deconstructing an idea into its key assumptions and is widely used in business and entrepreneurship.4 It is adapted from Alex Osterwalder’s Business Model Canvas and optimized for lean startups. Similar to a startup, it is quick, easy, effective, and concise. Unlike elaborate business plans, which can take too long to write, are seldom updated, and are almost never fully read by anyone other than the authors, consider the Lean Canvas as a fancier way to sketch out an idea for a project on a napkin over a lunch meeting. Ideally, it should be quick to create, adaptable, and easily read and understood.
Maurya describes four key aspects and benefits of a Lean Canvas.4
Adapting the Lean Canvas for health care
When we were asked to design and develop a longitudinal physician leadership development program (PLDP) in partnership with Doctors Nova Scotia and CMA Joule, it was agreed that one of the goals would be to help participants develop skills in leading change and innovation in medicine. Within the PLDP, participants are presented with action learning challenges where teams work to propose solutions for current, real challenges facing health care. This provides an opportunity for applied innovation, working and learning as a collaborative team through deliberate practice.
We introduced the participants to the Lean Canvas template as a way to map their innovative ideas. The original Learn Canvas model was geared mostly to for-profit organizations and did not entirely meet the social aspects and culture of health care. We searched the Internet for other versions that were more applicable to social entrepreneurships such as health care.5 We found templates that were better, but still not ideal. Finally, we modified the Lean Canvas to suit the needs of health care specifically and designed the first Canadian Healthcare Lean Canvas (Fig. 1).
Using the Canadian Healthcare Lean Canvas
The Canadian Healthcare Lean Canvas consists of 11 elements, with specific questions posed for each element. It is designed to help you consider and complete each aspect of your idea. First, you are encouraged to take time to reflect, define, and articulate your overall Top
You are then ready to move on to the other boxes.
1. Problem: This is the first and most important box to complete. What specific problems are you trying to solve? List the problems being experienced.
2. Stakeholders: Who do you need to have on your team? For whom are you creating value? Who are your internal and external stakeholders?
3. Unique value proposition: How does this product/
service/process meet the identified needs? How is it better or different than what currently exists?
4. Solution: How do you solve the problem? Define the top three features of the proposed product/service/ process.
5. Success factors: Why do you think this will succeed?
6. Sustainability: What resources (financial, human, support) do you need to sustain this project once it is implemented?
7. Feasibility: What are the major costs (financial and other resources) associated with running this project?
8. Key metrics: How will you know you are successful? Identify key metrics you will measure.
9. Pathways: How will your product/service/process reach your target group? How will they access it?
The Canadian Healthcare Lean Canvas template can be used in various formats depending on the project group. In a small group, each member can have a full page-size copy of the template to write down ideas and thoughts. In larger groups, the template can be drawn on a white board and members can place Post-It notes in each box. The goal is to be flexible and easily adaptable as you move through the process. Once the items in each box are agreed on, details can be written concisely and shared with everyone. Top
The idea is to be messy, flexible, adaptable, and fluid with your thinking. For example, thinking your way through an element in one box can often lead to a change in a previous box. We are often asked by physicians why the boxes are not numbered in logical order. The Canadian Healthcare Lean Canvas follows the structure of the original Lean Canvas which presented the boxes in a similar fashion. It was intentionally designed to stimulate original and innovative thinking by moving away from a linear model of thought.
Proven value
We have used the Canadian Healthcare Lean Canvas for the past two cohorts of the year-long PLDP offered by Doctors Nova Scotia.7 It has been easily introduced to and understood by physician leaders. Although the impact of using this tool has not yet been formally investigated, anecdotally, the template has served program participants well, as they design and complete their action learning challenges and consider and propose solutions to actual challenges in health care in Nova Scotia. Examples of some of these completed projects, which provide recommendations on real-life health care issues, resulting from the use of the Canadian Healthcare Lean Canvas, can be found on the Doctors Nova Scotia website.8 Top
Acknowledgements
We are grateful to Doctors Nova Scotia and its CEO, Nancy MacCready-Williams, for the constant support they have shown as we developed the PLDP, created the Canadian Healthcare Lean Canvas, and shared it with course participants.
References
1.Ilan Y. Why scientists, academic institutions, and investors fail in bringing more products to the bedside: the active compass model for overcoming the innovation paradox. J Transl Med 2021;19:55. https://doi.org/10.1186/s12967-021-02726-4
2.Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol 2015;3(1):32. https://doi.org/10.1186/s40359-015-0089-9
3.Rapport F, Clay-Williams R, Churruca K, Shih P, Hogden A, Braithwaite J. The struggle of translating science into action: foundational concepts of implementation science. J Eval Clin Pract 2018;24(1):117-26. https://doi.org/10.1111/jep.12741
4.Leanstack. n.d. Available: https://leanstack.com/
5.Moskovitz D. The social lean canvas. Dave Moskovitz blog 2020;29 May. Available: https://tinyurl.com/4ankfj5b
6.Blank S. Customer development. Steve Blank blog 2009;1 May. Available: https://tinyurl.com/y7e8xbf6
7.Physician leadership development program. Dartmouth: Doctors Nova Scotia; n.d. Available: https://tinyurl.com/2p9bbax7
8.Cohort 3 action learning projects. Dartmouth: Doctors Nova Scotia; 2021. Available: https://tinyurl.com/33tyfz7a
Authors
Mamta Gautam, MD, MBA, FRCPC, CPE, CCPE, is an Ottawa-based psychiatrist who has been working with physicians since 1990. Among her areas of expertise are physician health and physician leadership.
Scott Comber, PhD, MBA, MA, BEDS, is a university teaching fellow at the Rowe School of Business, Dalhousie University, Halifax. He consults to organizations nationally and internationally in the areas of leadership development and change management.
Correspondence to:
mgautam@rogers.com, scott.comber@dal.ca
This article has been peer reviewed.