In November 2019, Mass General Brigham (MGB) was the largest recipient of National Institutes of Health funding in the world. The Innovation Office, led by Chief Innovation Officer Chris Coburn, sought to capitalize on that funding – with the goal of commercializing research done at the hospital to generate revenue and improve patient care. But CEO Anne Klibanski and other key stakeholders had a serious concern: although women comprised approximately 40 percent of the medical researchers and physicians at MGB, the percentage of women participating in innovation activities lagged behind.
Harvard Business School associate professor Katie Coffman, Coburn, and MGB’s managing director of administration and strategy Diana Schwartzstein discuss how they worked to identify the main sources of the disparities and find the right strategy to expand and diversify MGB’s community of innovators in the case, “Inclusive Innovation at Mass General Brigham.”
BRIAN KENNY: In 2020, the U.S. granted just over 399,000 patents across all categories. Of those 12.7 percent were filed by women inventors. In biotechnologies individual female inventors represent about six percent of patent applications globally. And those were approved at about half the rate as patents filed by males. All of which means that absent some form of intervention, women inventors won’t reach parity with men until 2070. Today on Cold Call, we’ve invited Professor Katie Coffman to discuss her case entitled, Inclusive Innovation at Mass General Brigham. I’m your host Brian Kenny, and you’re listening to Cold Call on the HBR Presents Network. Professor Katie Coffman uses experimental methods to study individual team and managerial decision-making with a focus on gender stereotypes. And we are thrilled today to have not one but two protagonists on the show with us. We’ll begin with Chris Coburn who is the Chief Innovation Officer from Mass General Brigham and Diana Schwartzstein is the managing director, administration, and strategy, at Mass General Brigham. I want to thank you all for joining us on Cold Call today. It’s great to have you here.
CHRIS COBURN: Thanks Brian.
KATIE COFFMAN: Great to be here.
DIANA SCHWARTZSTEIN: Thanks for having us.
BRIAN KENNY: I will say that we’re distanced by miles and miles actually. So some of us are in studio here and then everybody else is at home. I think this case raises so many important issues. Katie I know you’re going to sort of elevate it above just what happened at Mass General Brigham, but what’s going on there really sets the stage for rich conversation about how and why we need to improve in this area. So let’s just dive right in. Katie let me ask you to start by telling us what’s your cold call to start this case in the classroom.
KATIE COFFMAN: I like to put students in the shoes of Chris, of Diana, of Anne Klibanski, CEO of Mass General Brigham, and ask them to think about, what are the stakes for the organization in getting this right and addressing this issue? And I think there are really high stakes here, and that’s something that jumps out from the case, right? So you can think about direct revenue that comes in from commercialization for the hospital system. But you can also think about just the ideas that we’re missing out on. The potential improvements in clinical care that we could see by sort of more fully sourcing ideas from across this system. And I think it’s really important before diving into sort of how we’re going to address this, to remember why are we addressing this? Why is it important to get this right, beyond just as sort of an interest in making progress towards gender equality, there are a lot of other high stakes reasons to really make progress on this issue and make progress fast.
BRIAN KENNY: How did you hear about this? And I’m interested in, so why you decided to write the case also, but how it relates to the broader themes that you study.
KATIE COFFMAN: This was such a fantastic opportunity and I’ve really had a pleasure working with Chris and Diana and the whole team at the Innovation Office. But I think just over two years ago now, Diana actually reached out to me and said, “Hey, this is something we’re thinking about, not necessarily writing a case, but of trying to understand this issue. Maybe collect some data on what exactly is the representation of women in commercialization processes. And if we see we have a problem here, start thinking about ways that we might address it.” And so we were able to have some early conversations about how they might approach this. And of course, like every HBS professor would, I said, this is a really interesting decision problem. We should write a case about it. And I’m just so grateful that they were such eager participants in bringing this into the classroom as well.
BRIAN KENNY: And I will say since the host is always the last to know, I had no idea that your husband was a faculty member here, Diana. So welcome to the show even doubly, so that’s great.
DIANA SCHWARTZSTEIN: I would just add to that, that knowing that and knowing that we really wanted to get this right, taking sort of a data-driven research-based approach was at the heart of us starting the effort. So that was another reason for the outreach to Katie, just knowing her background and her significant experience in this area.
BRIAN KENNY: Yeah, that’s awesome. And one of the things, I don’t talk about it a lot on the show, but every show is premised on a case and this is just another great example of how the cases are so close to practice. They really emerge out of what’s happening in the workplace. And that’s part of what I think makes them so relevant and compelling. Chris, let me turn to you and just ask you to, maybe you could sort of pull the lens back a little bit and describe healthcare innovation in the U.S. I think people would want to know, who are the players in this landscape?
CHRIS COBURN: I would start by saying when we talk about healthcare innovation we’re talking about pushing the boundaries forward across the whole spectrum of care. So innovation ties back to the core components of healthcare providers, payers, employers, government. When you think about innovation, the key actors are scientists, physicians, companies, entrepreneurs, and investors. And coming together to gain new insights and act on them, really in every single phase of care, when we talk about healthcare innovation, that’s what we mean.
BRIAN KENNY: People think of hospitals as places where healthcare delivery happens, where doctors are so busy doing their jobs and nurses, that they probably don’t think about it as a place where there’s a lot of research activity going on. But the scope and scale of Mass General Brigham, just as one example, is pretty astounding. Can you talk a little bit about how much of the enterprise is focused on this kind of research and scientific innovation?
CHRIS COBURN: I would say, I’ve been there for going on a decade and just echoing your point, it is stunning to see the breadth and scale of the work that our faculty do. We have over 6,000 Harvard Medical School appointed faculty. They conduct a well over $2 billion a year in research. We are the largest academic research enterprise in the U.S. and maybe that makes us the largest in the world. So the magnitude of that, it is, by those numbers, I think obviously attention getting, but it’s really the outcomes that matter so much. So that community of investigators working whether they’re clinicians themselves, or working with other clinicians, focused on raising the quality of care or the availability of it. And in many instances, the efficiency of it.
BRIAN KENNY: Diana, let me turn to you for a second. Can you talk a little bit about the origins of the Innovation Office? The one that Chris is overseeing now at Mass General, how did that come about?
DIANA SCHWARTZSTEIN: Previously, it was the Research Ventures and Licensing Office, which really was a reactive sort of group that was responsible for the IP that were coming out of the Mass General Brigham hospitals. And they would process the paperwork and help commercialize those inventions. And then when Chris came over from Cleveland Clinic seven years ago, we were in the innovation group, which is a business development arm for Mass General Brigham responsible for commercializing the discoveries and capabilities of the Harvard faculty as Chris just mentioned, so that’s really our key charge.
CHRIS COBURN: I think the antecedents run back decades and decades, and there was a lot of success, but they were grouped in my mind geographically, in the sense of there was one for each of the various hospitals that constitute the core of our system. So I think one big transition was to consolidate that, to focus it, to build it around key technology and clinical areas, and to grow it. Even now at nearly 150 people, I would argue that we could use more capabilities, more staffing, just because the magnitude that the size of the collective research that’s being done is so substantial. But I would say in Boston, at our institutions, and all over the U.S. some of this dates back really to the founding of the very first element, Mass General in 1811. Innovation characterized that from the outset, fundamental insights in things like imaging and sedation that that influence the world occurred at Mass General in that instance. But also, the first kidney transplant that resulted in the Nobel prize at Brigham. So it’s been part of the program and the effort to see that deployed in products that will benefit patients has been ongoing over all that. And in the eighties following the passage of the Bayh–Dole Act, in the closing weeks of the Carter administration, resulted in academic centers, again around the U.S. and interestingly actually around the world, it influenced the model of commercial application in virtually every industrialized country. So the roots go back to that, and there was activity and some of it very effective at our hospitals prior to the time Diana just referenced.
BRIAN KENNY: So was part of the reason that you were brought in, to sort of stitch all of these things together across the network of hospitals?
CHRIS COBURN: I think so. I’d been at the Cleveland Clinic for a long time and I think we had many good outcomes. The chance to come to Mass General Brigham, to Partners Healthcare, in 2013 was just that, to build a new chapter for the system. And to try to draw ever more effectively on the capabilities of the faculty, on the direction of the system. And just going back to the opening point, a lot of this is timing, in terms of the work Katie has done and done with us as well. We have the first ever female CEO for this system and she’s been a trailblazer throughout her career. She was the first full professor appointed in the storied MGH Department of Medicine, first female faculty member, which is stunning, to think that that happened in the recent past for a hospital that was established in 1811. So anyways, it’s the right time and hopefully the right strategy in terms of driving added outcomes.
BRIAN KENNY: Innovation is one of those terms that everybody uses, and it’s a little bit of an ambiguous term, right? And it differs from setting to setting, but I wonder if you could give us some examples of the things that you’re doing at MGB to try and spur innovation across the enterprise and what the challenges are and some of the barriers are that you see in doing that work.
KATIE COFFMAN: Maybe I could talk a bit about what I perceived as some of the barriers coming in as an outsider and then I think it would be great for Diana and Chris to talk about what’s going on the ground as well.
BRIAN KENNY: Awesome.
KATIE COFFMAN: We’ve already heard a bit about the size of this organization, the decentralized nature of the organization in lots of ways at least historically, and you can put yourself as a clinician or even a researcher in that setting. You’ve been trained in some specialty, maybe you have a medical degree, you have a PhD in some field. Now all of a sudden you have this great idea that you think could be really transformative. And yet in some ways it’s like where do I start? I understand the science, but how do I move forward with that? How do I develop that as a potential business idea and commercialize it? Even for the really smart, highly capable people at MGB across all these different areas, you’re not necessarily trained in this. You don’t know how to go about it. It’s maybe not your core responsibility. You’ve got tons of other things on your plate. I think we can all appreciate how busy and stressed a lot of these people are in their day-to-day lives. And you just add this on top of it like, “Oh, and figure out how to bring this to market.” And so I think it’s, in many ways, not surprising that there are people who choose not to pursue that path. And I think one of the challenges then is how do you support them? How do you draw them out? How do you give them the resources? They need money, time, education, to take the kernel of a really promising idea and be able to fully develop it to a place where investors or partners are going to be excited about seeing that idea all the way through.
BRIAN KENNY: Yeah. Katie, I would imagine that you’ve looked at this in other industry settings. Is this a fairly common situation that you see as you look across sectors?
KATIE COFFMAN: I think anytime you have a complex setting like this. There’s so much nuance and idiosyncrasy of any one particular environment, but I think you can see common themes across places. So anytime you have these decisions about sort of whether to pursue a risky path forward, you’ve got to think about, what are the chances I’m actually going to succeed with this? Do I like this idea of taking this risky path? Is it worth sort of the opportunity cost of my time?
BRIAN KENNY: Diana, does that all sound, does that ring true to you?
DIANA SCHWARTZSTEIN: Yes, completely. And I think one of the things we did with Katie, which shows up in the case, is this survey that we sent to the Innovation community, where we asked about the challenges, the roadblocks to participating in innovation. And just like Katie said it’s resources, know how, time, all those things showed up. And what’s cool is we’re really taking those key learnings from this survey and designing programs to help people get the education of the path to commercialization. Why you, why have an entrepreneurial mindset and the programs that we’re designing are direct outcome of the work that we did with Katie through this case. So absolutely rings true and has been incredibly important to our success so far.
BRIAN KENNY: They don’t teach any of this stuff to young scientists, I guess. Now this is not really part of the education process, the formal education process?
CHRIS COBURN: That’s such an interesting point. Society, the economy, values innovation at such a high level and we never teach it: creativity, discovery, application. And so just as Katie and Diana were saying, it’s on us as the institution to create the culture, the environment, provide the resources, that helps these people to advance. And in a sense to provide the insights that allow them to learn how to be innovators.
BRIAN KENNY: We’ve been speaking about this in sort of generalities, but obviously the case talks about inclusive innovation. What does the landscape look like for women innovators at Mass General Brigham?
KATIE COFFMAN: I think that a lot of the barriers we’re talking about are barriers for everyone. And the question is, are there ways in which some of those barriers may bind more tightly for some populations in your community than others? And I think as someone with two young kids myself, we think about those binding constraints of time and scheduling and resources and do I have time to add something to my plate when I’m trying to take care of my core responsibilities. You can imagine that women may be disproportionately likely to have other responsibilities that they’re trying to manage that make taking on these additional tasks even more challenging. We also talked about, it’s only going to be worth it to go through with it if you really feel like it’s going to be successful. And so if you feel like it’s going to be successful, that has a little bit to do with self-confidence, it has a little bit to do with the type of feedback you’re getting from the people around you, a little bit to do with whether you’ve had a mentor who’s been there before and says, “Hey, you could do this too.” And if we think women may be a little bit less plugged into some of those entrepreneurial networks, or maybe even just have a little bit less self-confidence around some of these processes or ideas, you could imagine that that shows up in some of this decision-making as well.
CHRIS COBURN: Worth noting that current skew among innovators and commercializers among our faculty community is four to one, male to female. We have a lot of room for improvement as we try to address the points that Katie and Diana said.
BRIAN KENNY: Are there specific things that you’re doing to sort of get at this gender gap issue?
DIANA SCHWARTZSTEIN: The broader effort, just to call it by name, is the Innovation Community Expansion Initiative. And the idea is to try to grow and diversify the pool of people participating in innovation. And we started with women. As Chris said, and as the case shows, there was the proven gender disparity, so we went after that first to really understand those roadblocks and challenges to getting them to participate. And like I mentioned earlier, now designing some education awareness and other resource materials to try to get at some of those challenges that they shared with us to help overcome. We’re also really doing a great job in trying to partner women innovators with people in our office who can support them and provide them some more information about how to get involved and what they can do. These workshops, as Katie mentioned, we have, with Chris and the other leaders on our team, have a lot of industry contacts. So we pulled together key industry contacts with our key faculty across the MGB system with really trying to focus on diversity and giving people opportunities for more visibility. They’re so busy doing unbelievable work obviously in the clinical community. But then this gives them the opportunity to kind of interact with people across industry. So we’ve been designing these programs really for developing and networking opportunities. And they’ve been a huge success.
CHRIS COBURN: I think it’s spot on. Maybe just to add one of the challenges going back to Katie’s point is self- identification. If you come into an environment that involves a lot of performance measures, and now you’re being asked to envision yourself in a category that you really weren’t that exposed to earlier. And our philosophy here is, the folks that come into our faculty are among the most highly trained and certified and most accomplished people you could hope for. So to take away that resistance and have them see a clearer path, has the chance to really unleash a lot of actual innovation. But it’s these practical things, the things Diana and Katie were describing, that are going to change the environment and change the path.
BRIAN KENNY: I’m sure MGB is not an outlier. I’m sure this problem exists across the industry. Do you see this as an opportunity to help maybe set the table for others so they can start to think about it and see the approach that you’ve taken to it? I don’t know, is that part of the reason that you went along this path?
DIANA SCHWARTZSTEIN: What we’re doing here is trying to increase the number of ideas coming to our office that will have the potential to impact patient care. I mean, if we could do something that then sets the stage for others to do it as well for the ultimate goal of diversifying the pool of people participating in this amazing community—I hope that people replicate that from here.
CHRIS COBURN: I would say two things, one a beautiful thing about the case is most institutions, most innovators, kind of have to find their own way on issues like this. So to the degree that, Katie’s work and HBS is confirming and contextualizing what the issues are, I think it creates the potential to act on it. And that’s the second point. The things we’re doing in general ways, are not that complex. They’re very focused and getting them right, execution is key. So just as an example, I was so impressed when I came to Boston to learn about the Claflin program, which Anne Klibanski had started decades ago at MGH. There’s now a hundred Claflin scholars, including the current head of the CDC. And this is a targeted program providing resources for early career women who are in their childbearing years to just remove the barriers. Whatever those barriers are, to hire another post-doc, to hire daycare, whatever they need. So getting the information out through channels, even this podcast, we would help to other innovators, other institutions to address this need and this untapped potential.
BRIAN KENNY: Doing a case means making yourself vulnerable. So we appreciate that you did that, and others can learn from it. Katie, let me ask you, having written the case, what’s one thing you want our listeners to remember as they think back on this conversation?
KATIE COFFMAN: I think a lot of times these types of issues, gender disparities, big gender disparities in an important space can feel like a really daunting and intractable problem. You care about fixing it and addressing it. And yet in a system like this, that’s so complex and an organization that’s so big. It’s like, “Well, how do we actually go about addressing this?” And I hope what the case illustrates to students and other practitioners is that, yes, it’s not going to be you’re waving a magic wand and it’s done, but there are really concrete steps you could take. And what I love about what they’ve done, they’ve collected data to document the extent of the issue. Data they can come back to and track their progress and say, “Okay, are we moving the needle in a year, in five years, in 10 years?” They’re understanding the contributors to the gap. Not just looking at the gap and say, okay, well, what’s the source of that? We can collect some data from people. We can have conversations with our stakeholders and try and understand what’s going on. And once you understand sort of where the problems are cropping up from, you can take really targeted action, which I think is what they’ve done with this outreach, the education, the workshops. And so I think it’s a way of showing that even big intimidating problems, solutions can reveal themselves when you really start to understand the problem well. And I think that’s really exciting to see.
BRIAN KENNY: The case is, Inclusive Innovation at Mass General Brigham. Katie, Diana, Chris, thank you so much for joining us on Cold Call today.
DIANA SCHWARTZSTEIN: Thank you so much.
KATIE COFFMAN: Thank you.
CHRIS COBURN: Thank you, Brian.
BRIAN KENNY: We are excited to be celebrating the 100-year anniversary of the case method at Harvard Business School. It’s a yearlong celebration, kicking off this month alongside our new academic year. If you want more on the history of the case method, visit our website: www.hbs.edu/casemethod100. Cold Call is a great way to get a taste of the case method, after all each episode features a business case and its faculty author. You might also like our other podcasts: After Hours, Climate Rising, Skydeck, and Managing the Future of Work. Find them on Apple Podcasts or wherever you listen. Thanks again for joining us. I’m your host, Brian Kenny, and you’ve been listening to Cold Call, an official podcast of Harvard Business School, brought to you by the HBR Presents network.