Editor's note: This story is part of an occasional series in which people talk about their jobs in the Catholic health ministry. We invite readers to recommend themselves or colleagues for stories that will show the diversity of jobs, skills and people that make the ministry vibrant. To do so, send an email to firstname.lastname@example.org with "At Work" in the subject line.
By KATHLEEN NELSON
Rich Roth knows "innovation" is an expansive term, one open to many definitions. So, as senior vice president and chief strategic innovation officer for CommonSpirit Health, Roth has a crisp, elevator speech that encapsulates his team's approach to innovation.
"This type of innovation is looking three to five years into the future to see what we think health care will be like, then to pull that future forward," he says.
Rich Roth and his 14-year-old daughter, Lia, enjoy a vacation hike in Montana. Roth, the senior vice president and chief strategic innovation officer for CommonSpirit Health, considers work-life balance essential to his productivity and well-being.
Roth and his team of six lead the system's effort to create, test and scale three to five services, programs, partnerships or technologies a year that can reduce costs, improve quality and increase access to services. When their work is most successful, they share the results so other health systems and partners benefit as well.
Laying the groundwork
After earning a master's degree in health administration in 2004, Roth earned a fellowship with Catholic Healthcare West, which rebranded as Dignity Health in 2012 and aligned with CHI to form CommonSpirit in 2019. "I was stapling board packets and running to the copier," he says. He was assigned a project focused on scaling community assets to address poor housing, unsafe streets, substandard education and a lack of job opportunities that keep people trapped in poverty and contribute to poor health and shorter life spans.
"We were looking at how to apply analytical discipline to community benefit" by making investments aimed at improving social determinants of health, he says.
The assessment tool and subsequent research he guided in partnership with IBM Watson Health revealed that residents of communities with the greatest barriers to health care achieved higher assessment scores and were twice as likely to be hospitalized for such conditions as asthma, pneumonia or congestive heart failure as were residents of communities with the lowest scores for barriers to health care.
Catholic Healthcare West shared the tool, the Community Need Index, with almost 50 health systems and community organizations nationwide to identify health disparities, assess need and strategically allocate resources to improve people's lives.
"That got me into innovation," Roth says. "We realized that any employee can come up with an idea that can benefit not just their department or system but health care as a whole."
After committing to this type of innovation, the system decided that rather than set up a separate innovation lab or facility, Roth and his staff would embed their innovation efforts throughout operations. "At the end of the day, the innovation has to benefit the operation and cost benefit returns to their area. You really need to get ownership from operational leaders for the long term. If your goal is sustainability and greater impact, you have to bring people in early and bring them along."
A typical day
Roth starts nearly every morning with a workout and frequently walks to his office in San Francisco, taking a phone meeting along the way. He also sets aside time each day for learning, poring over articles in journals, browsing Twitter and reading innovation blogs from other industries or venture capital websites.
The rest is devoted to meetings — sometimes trouble-shooting, sometimes advancing projects. Some meetings are updates from his team on current projects. At others, he connects with clinical staff or administrative peers on how to move a project forward. Some are problem-solving sessions with financial or legal experts. Others involve reporting to community partners.
He also spends about 25% of his time as co-manager of CommonSpirit's Strategic Investment Fund, which is invested exclusively in companies that partner with the health system to develop products and services. "Often, when we're early in our relationship with companies we also invest in them. We recognize that it's hard to work with early innovations and to scale them," he says.
"In between that, I often have to pick up my kids, and take them to their sporting or club events. I have a regular family life. It's super easy to be consumed. If you don't take care of yourself, you risk everything breaking down."
Among the projects that Roth is most proud of is what he characterizes as the first partnership in the country to produce a digital therapeutic device with GPS tracking. Working with Propeller Health, CommonSpirit developed a sensor that attaches to an asthma inhaler that records where, when and how often the inhaler is used and identifies triggers like air quality and pollen count so that doctors have better data and can prescribe treatment more effectively.
Originally designed for children with asthma, use of the device has expanded to patients with cardio obstructive pulmonary disease, or COPD.
Just as important as the device and its utility is the research structure behind it. The clinical research trial in 2013 was among the first in digital health to include patients from a broad spectrum of geographical and socio-economic diversity. The 490 participants, from 5 to 80 years old, saw a 54% reduction in visits to the emergency department and improved outcomes.
"We managed to prove value, so that someone would pay for it and a clinician would believe in it," Roth says. "The clinical trial was the largest piece of evidence on digital health in the country. It led to the next generation realizing that they had to do clinical research and that it needed to include a cross section of society."
Roth gets excited about the possibilities of differentiating and personalizing care. "I use the 31 flavors analogy," he says. "A lot of times health care scoops a lot of vanilla to their patients and customers. It's safe, but some people like butter brickle or cherry." So, CommonSpirit is exploring the development of alternate pathways to care that meet people where they are, "differentiated models for seniors or women or ethnic groups that would have a different flavor than the standard choice." For example, care for seniors might be more community focused than medically focused. Care for women might be staffed and led by women.
As health care systems continue the shift from hospital-based care to disease prevention and wellness, Roth says, the model of care expands beyond health care "to something much more like the social services ecosystem. Catholic health systems have a leg up because they understand the person as a whole and because of the partnerships that we form with nonprofit entities. I think we have a better shot at caring for people in that model because that's been our mission since the beginning."
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