On innovation and ROI

Recently, I wrote about “Chief Innovation Officer” and I have been thinking about it in the background (and beyond the cursory tweets). Innovation without ROI (Return on Investment) is an expense account without returns. There are two important follow-up questions here: What will we gain with an added “perceived value”? How can we measure the return for an idea that does not exist?

Grants (and everything else) flow from demonstrating added value to the “pool of knowledge” – yet it is fungible. I may write the best blog on the planet, but its value remains limited to those who want to consume it. However, I find its value unlimited, because it allows me an idea space that no other medium can provide by creating what I call “idea-matrices” – a system of interlinking of disparate ideas. I call this an “open-sourcing” of my thought processes (and often research in open before I pen down my long-forms). Nevertheless, the current models to define innovation (mated to ROI) are ill-equipped to answer questions in its entirety.

I believe innovation is investing in “futures potential” – A well understood innovation improves processes incrementally to resemble a “radical overhaul” of how we understand contextual overlays and dynamics of work processes. Disruptive innovations are less common, but have more risks to rewards ratio till it is too late, and even more difficult to “project ROI” on those ideas. For example, radiation modulation was a disruptive idea, but everything else is incremental – VMAT or MRI-LINAC. What is the ROI on these innovations? Less of potential long-term side effects translating to better quality of life? How do we measure the impact of xerostomia to ROI on quality of life? This needs to be understood in context of returning people back to employment and productivity, as cancer rates are rising in the economically productive age group. Yet it is difficult (if not impossible) to measure it, because we lack quantifiable models to extrapolate benefits. Not everyone benefits from modulation, but most do. Likewise, how has digital cab hailing innovated? Uber has been “disruptive”, but it alters market dynamics and economics in nuanced ways to entrench itself as a “monopoly” and effects that we don’t yet understand. (In most countries, it is insurance paying for the “expensive technologies”, but without a proper randomised control trial to generate “evidence”. We are accepting evidence of benefits from physical dose distributions alone!

Beyond the specific business case scenarios, innovation (with a baked in ROI) is an insurance for future profits. The pandemic has forced an eventual rethink of business centres in the healthcare industry – Telemedicine, for example, is almost a perfect example. It was relegated to background, but resurrected when in-patient appointments were staggered (and impacting chronic care management). Most healthcare organisations put a doctor and a patient in front of a screen to “speak to each other” and call it “medicine”. Though, we know what medicine means more than “talking to each other”. Have the hospitals further innovated on this idea?

I invested my time and effort to understand Telegram bots (which didn’t have any utility to my organisation) to display real-time information (it was in 2017-18) . I can update information on the fly (or use automated scripts to keep it fresh) and communicate change to end-users without manual intervention. As an innovative product, it could have been used to push appointments, provide medium for health education, and serve as a branding exercise by proxy. Yet, it was impossible to provide a ROI on future uncertainty. I must admit that even I struggle to place my ideas in context without a formal “sandbox” to put them in perspective.

Innovation in an organisation provides stability and alternate profitable models (if given the context) around moderate risk. Utility of Telegram bots in patient workflows is an innovation, but few understand its broad utility, but instead prefer to reach out to patients through “tried and tested” social media (Facebook/Twitter) and wasting incredible time (and resources) through these approaches. Traditional metrics require an overhaul, and the best ideas to bet on are the ones pushing through the interdependence and breaking down silos. It may upset power hierarchies or understanding “established procedures”, but incremental slow-burn disruption shouldn’t come at the expense of proper communication. We reduce organisational risk by diversifying and creating an idea-bank to utilise technologies as and when they are required. For example, for the next pandemic, there is a possibility that augmented reality may offer a better opportunity than a “zoom-call”.

I’d invest in an idea-bank and steer the organisation to tap into them by regularly adapting the risk mitigation models. What is the ROI on business continuity? A diversification of ideas and an idea-bank increases the probability of success. Amazon, for example, shifts focus away from quarterly results, to out-innovate other companies and thereby ensures its future success. I’d bat for investment in a new frontier, only to find a use case to adapt for working around. For example, I would find incremental value in sharing the best resources to the team to internalise and come up with their perspectives.

Here’s something additonal for the context:

The “future” is “autonomy and “self-driving” cars with incremental improvements in “computer-vision”. It is difficult to fathom this if you were owning a car manufacturing unit. Yet, the moving parts (and dynamics) are in plain sight- 5G, Network Splicing, Edge Computing, cameras, on-demand computing, better algorithms to parse images with on-board processors, changing regulation, renewable energy and shifting consumer preferences for “subscription economy”. If you translate this context to healthcare, investments in AR, bots and “futuristic” technologies will appear as a “waste” now but a start-up will capture the same patient pool that falls in your catchment area by providing incremental value to “patrons”. Will you spend millions in acquisitions and spending more to integrate the start-up (people/processes) or spend thousands now and create an idea-bank and “evolve” endemic processes as the time progresses? Which is a more rational approach to ensure your ROI?

A step away from the current business models of “profitability” to look at the big picture will help you understand innovation as an “insurance” option. As a “Chief Innovation Officer”, it is critical to develop the insurance pool of ideas for product opportunities. The specifics of something unmaterialised are unrealistic. Hence, it requires a certain degree of “vision” (and visibility) in the operational landscape.

Besides, it is critical to identify talent wherever it may be on the planet 🙂

Addendum (from my notes):

Startups competing on story have a big advantage if they are bold because big companies optimize for being safe, and that often means being very boring, but nobody will call them out for it. In contrast, startups can be brave and polarizing on purpose.

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