Disruptive Innovation: Conversation with Nancy Barrand and Dr. Sanjeev Arora

Jun 25, 2013, 3:43 PM, Posted by

The Robert Wood Johnson Foundation’s Pioneer Portfolio partnered with Changemakers to launch a competition in 2007 that sought out disruptive innovations in health and health care. Influenced by the thinking of Clay Christensen, the competition asked applicants to submit sustainable ideas that have the potential to systemically transform health and health care, and change the world.

In this post, which originally appeared on Ashoka Changemakers, Nancy Barrand, a senior adviser for program development at RWJF, and Dr. Sanjeev Arora, a competition winner and the visionary behind Project ECHO, talk about how — because of the Changemakers competition — Project ECHO captured RWJF’s attention as a disruptive innovation and an example of the type of ideas that Barrand and her colleagues on the Pioneer Portfolio continue to seek today.

Barrand: RWJF President Risa Lavizzo-Mourey had met with Clay Christensen, and a number of us at RWJF were intrigued by Clay’s concept of disruptive innovation, about ideas that would not just improve upon the system, but change it entirely. We were also intrigued by the idea of working with Changemakers and using the collaborative competition model.

The competition judges selected three winners — including Project ECHO — from more than 400 entries, each of which won a small cash prize of $5,000. The Foundation invited the three winners, as well as seven other applicants, to submit proposals for additional funding. This competition had achieved something we had set out to do: bring in new and different ideas.

Arora: As the Changemakers community knows, when you have a social innovation like this, you’re always looking for funding. We had been turned down by RWJF in the past.

Until the competition came along, I honestly didn’t know how to approach them again. I mean, how do you just call somebody and say, “Look, I’m really good and I want to talk to you about you giving me a grant”?

There are thousands of people doing that. The Changemakers competition gave us the entry point we needed.

Barrand: When I hear that someone like Sanjeev wouldn’t just call us on the phone and say, “I have a good idea,” because we wouldn’t respond – I’m dismayed. That’s the whole point of the Foundation being open to new ideas. No one should be afraid to call us with a good idea.

Anyway, although we were excited about Sanjeev’s idea, when his proposal came in, it looked like a standard research project. A number of reviewers immediately pegged it as telemedicine — nothing new.

So we decided to do a site visit — spending a day with Sanjeev and his team in New Mexico — and we were blown away by what we saw. But when we left that day, we told Sanjeev we couldn’t fund his proposal because it was horrible.

We wanted the proposal to reflect his vision for just how far his idea could go, and it did not.

If people send me something, it’s not written in stone. It’s a place to start; it’s a way for us to understand what they’re thinking.

Arora: My vision in my heart is that we want to change the way that health care is delivered all over the world. But when you ask me for a brief proposal about Project ECHO? You don’t know me; you don’t know Project ECHO.

If I tell you I want to change the world, what is your reaction going to be? You’re going to say, “Where’s the evidence this guy can do this?” RWJF decided to spend the time to really understand a complex program in much more detail.

Barrand: What we read on paper is different than what we come away with when we make a site visit. Can we site-visit every proposal that comes in? No.

So then, how do we know which ones we need to site visit, and which ones we don’t? In this case, it was because Project ECHO won the competition.

Sanjeev, you presented your idea from the heart when we finally got out there. An idea doesn’t come to us devoid of a person. With every good idea, there’s an interesting, visionary person behind it, and they need to be looked at together.

Arora: If there is a more robust dialogue between two people — two groups of people — then the opportunity for synergy is much greater than if the only opportunity for communication is a brief proposal. In a proposal, there is no give and take. Our dialogue made it clear that this was a good fit for what the Foundation was trying to achieve.

Barrand: You were sending us the type of proposal that, based on your knowledge of us, was the type of thing we would fund. I think that’s a myth we need to dispel.

We don’t want to tell people to fill out a form and check their boxes so they can look like all the other applicants who are coming to us. Pioneer is listening for something else.

I’d like every proposal to start, “I would like to change the world by…” because that would cause me to read on. So many proposals start with an explanation of the history of the world or a description of the problem. Or the problem is painted so large that the solution can’t possibly even begin to make a dent in it.

You have to put your idea out there, you have to be willing to knock on the door or make the phone call. But — on the Foundation side — we need to be willing to hear them. We need to be willing to listen and work with those proposals.

I’ve heard from some applicants that, if they send us something and we turn them down, they think they can never send something to us again. I recognize that to have someone tell you that your idea isn’t recommended for funding is like being told your idea isn’t good, but that’s not the message that I want people to take away.

It’s more likely that maybe it doesn’t fit with what our funding priorities, maybe it doesn’t compete with the other great ideas that we’re seeing. But that doesn’t mean that that idea can’t be submitted at a later time in some different way, shape, or form. We shouldn’t scare ideas and people away.

This commentary originally appeared on the RWJF Pioneering Ideas blog.