How the Digestive Disease Innovations Program Empowers Caregivers to Be Ambassadors for Innovation

Over the past couple of years, the digestive technology landscape has changed dramatically with the rapid expansion of artificial intelligence, machine learning, surgical and endoscopic innovations and so much more.

As an innovative organization, Cleveland Clinic strives to identify and make improvements where possible. The Digestive Disease Institute Innovations Program was created as a resource for caregivers to provide structure and guidance. The program encourages caregivers to bring their ideas to Cleveland Clinic Innovations and provides guidance for developing those ideas further.

In early 2022, Matthew Kroh, MD, was appointed as Vice Chair of Innovation and Technology in Cleveland Clinic’s Digestive Disease Institute (DDI), and as part of that role, he oversees the Digestive Disease Institute Innovations Council. He works closely with the Institute’s clinicians and researchers to develop novel devices, clinical services and programs and identify promising external innovations that can be tested and deployed at Cleveland Clinic.

Dr. Kroh recently sat down with Consult QD to provide an update on some of the initiatives and achievements since the inception of the Digestive Disease Institute Innovations Program.

Q. Can you give a brief overview of the philosophy of the program and why it was created?

A. The Digestive Disease Institute Innovations Program is designed to identify new ideas and programs that can be implemented to improve care delivery to our patients. Naturally, a lot of our work has been in device development, such as new tools for the operating room or the endoscopy suite, but we've tried to take a broad view of what innovation means.

In addition to developing new tools for performing procedures, we look at educational programs, processes, application of new technologies like artificial intelligence and machine learning to data sets to improve patient outcomes. At the end of the day, we want to be a conduit for caregivers to interact with Cleveland Clinic Innovations and to be more involved in innovations overall.

Q. How are potential ideas evaluated and explored?

A. Our Innovation Council meets quarterly. It's made up of about 30 caregivers across the entire Digestive Disease Institute. So, this includes caregivers from Northeast Ohio, Abu Dhabi, London and Florida, and we discuss various programs and projects.

As far as the ideation to creation process, there are several different pathways. People who've worked with us before and have experience with the process might just come to us with their invention disclosure form — an application for intellectual property development — and that’s really all the help they want.

But many people have never done that. Those caregivers may contact us and just want to have an introductory conversation about an idea that they've had. They've seen something in their workplace that could be better and want to find out more. We’ll walk them through the process and help answer any questions.

Q. How do you see your role as the Director of the Innovations Program for the Digestive Disease Institute? Has it evolved since your appointment?

A. Initially, we needed a leader to help develop structure for guiding our innovation and to establish some deliverables for what that means within a clinical institute. Now, I'm mainly a facilitator to inform our caregivers about the opportunities, existing innovations and available resources. With these ideas and innovations, there isn’t a one-size-fits-all approach that we can take. Sometimes what’s most helpful for one caregiver isn’t necessarily what another caregiver needs. This could be something simple like referring someone with an idea to our Cleveland Clinic Innovations team or connecting them to a company or another team that's doing similar work to facilitate interactions. But they might be looking for a more hands-on approach, and we try to help guide caregivers at every step along the way.

Q. Is there anything that you’re particularly excited about that has come out of the program and has helped foster technology and innovation?

A. There are several. One of our major successes so far has been the Emerging GI and Surgery Technology Forum, which has been held twice. It's a virtual meeting, consisting of a series of round table discussions on cutting-edge topics in innovation. We discuss the application of new technologies like robotics and laparoscopic surgery and endoscopy, but also topics like artificial intelligence, digital surgical solutions, image capture and quality improvement. Hundreds of participants representing more than 50 countries have been involved with this.

We’ve also developed an app — the MyBari app — that's now a piece of our Epic EHR system that allows better education of patients around the pre- and immediate post-op bariatric surgery pathway. We know that treating obesity requires chronic intervention and durable surgery. This app allows us to identify patients who are doing well and those who may need additional counseling or medical intervention, and it improves their connectedness to our program.

Another great example came from our department’s quality team. Working with the biomedical engineering team at Cleveland Clinic Innovations and our partners there, we came up with several different solutions to improve feeding tubes for patients. These included 3D printing of caps that are protective of these devices and can also help prevent inadvertent filling of feeding tubes with medication. It's a great example of innovation being applied to a quality initiative that directly impacts patient care.

Q: Beyond the Innovations Program, are there any developments within the GI specialty that intrigue you?

A: I think the application of AI and machine learning algorithms will change how surgical and endoscopic care is delivered and how we care for patients. Even in its infancy stage, AI is providing us with a better understanding of how to deliver quality care for our patients. Machine learning algorithms can better identify predictive factors in patients and their risk profiles.

The other area that I'm excited about is the digital surgery space. AI algorithms are being used to map out the steps of an operation and look at quality improvements. They can identify and evaluate variability amongst surgeons and endoscopists and use advanced imaging to identify structures and other important information to make operations safer and more efficient.

The next step is determining how we can use these tools to get even better in our roles. I think the answer to that question will change the entire landscape of healthcare, especially procedural healthcare, in the next five years.

Q. The Innovations Program also created a fellowship specifically centered around innovation. What prompted the creation of that program?

A. This was something that came completely out of the Innovations Program. Having built this program in Innovations, we recognized that there’s a passion among caregivers to innovate. However, there was very little structure and didactics available for how to do it on the physician side.

We created this Innovation fellowship in conjunction with Cleveland Clinic Innovations with great support from Lerner College of Medicine, to give didactic education and a core curriculum to trainees who are interested in a career in innovations. That includes physicians, but also biomedical engineers and other career pathways to understand what innovation in healthcare looks like, within the clinical context of the Digestive Disease Institute. We expect that our first cohort will enroll by the end of 2024, and we want to build that program based on the needs identified within our Innovation group.

We want the program’s participants to focus on a particular area so that they have a deliverable in the end, but ultimately, they will come away with an understanding of what it means to develop an idea, understand the development process, intellectual property securement, technology transfer and, ideally, patent securement.

Q: Any advice for current caregivers with innovative ideas?

A: I think that we're all innovators. It's a core value of working at the Cleveland Clinic, and we're always trying to do better and serve our patients in the best and most efficient way possible. This is an exciting time when it comes to innovation in medicine.

Classically, when we hear the word ‘innovation’ in conversations about medicine, I think our minds automatically go to big, sweeping changes like developing new devices for the operating room or endoscopy. But our program is focused on identifying areas of improvement and implementing solutions in all aspects of care —patient experience, research, education and technical care delivery. Innovation doesn’t just mean drastic change; innovation is simply a pathway towards improvement. That could certainly be a new device, but sometimes tweaks and changes around the periphery can be just as impactful.

I want to ensure our caregivers know that the DDI Innovations Program is a resource to help them implement their great ideas into better patient care and that no idea is too small. That's the role I see for our Innovation Program in the Digestive Institute, and hopefully, it can serve as a model for the entire Cleveland Clinic Enterprise.