How to use “tweakovation” to accelerate innovation.

I am on the launch team for the new book from Doc Related available on Amazon starting December 6th.


If you’re not already a subscriber to Doc Related, it’s a weekly comic strip written by Peter Valenzuela MD. The strip pokes fun at all the unnecessary complexity in the US healthcare system that drives many physicians crazy.


The book left me wondering whether we’ve taken two steps forward as an industry and one step back. Many of the issues that existed prior to the race to digitize healthcare still exist. If you consider the toll on physicians, we may have even compounded the problems.


Internal process improvement is hard work and in my opinion, even harder than startup because you have the headwinds of change to deal with. Startups can work around the resistance as many health tech startups have done. The problem is that they create more fragmentation and complexity for those trying to manage the system and navigate it.


I highly recommend reading the book for details. Now let me explain the term “tweakovation” and why it might give you some additional ideas of how to execute on the recommendations from the book.

Four ideas to help you innovate faster

1/ Develop a “tweakovation” culture


A colleague shared information about JUCCCE, founded by Peggy Liu who is leading the CleanTech initiatives for China. The term “tweakovation” came from one of her Ted talks. If you’re not familiar with her initiatives, it’s worth your time to watch her talk.


“Tweakovation” is similar to continuous process improvement but the term helps to reframe change from something complex and scary that people resist to something small, digestible and ongoing. It caught my attention because I often talk about foundational problems.

As you might infer, the foundation encompasses everything that supports existing operations and much of it is legacy processes and technology. Workarounds often mask the problems until a strategic initiative is planned. Unfortunately, the problems derail the strategic plan.


Adopting a “tweakovation” culture could prevent the foundational erosion that many healthcare organizations experience and make the organization more resilient as the industry evolves.

2/ Create a compelling vision


China’s ability to scale quickly is impressive. It has to make you wonder what they are doing right to get that kind of commitment from people. Reportedly, the secret is a compelling vision that inspires people to work hard for something better.


Now let’s think about the triple aim for a minute. It’s not a vision but rather a mantra that leaves many stakeholders wondering “what’s in it for me”. The lack of alignment in payment, care and incentives prevents us from realizing something better for all. That’s why Medicare for All keeps surfacing in political debates.


Ask yourself, what is the healthcare moonshot? Simply put all stakeholders should be delivering on a system that helps all people live healthier, longer and independent.

How organizations contribute to the vision will differ. The guiding principles of the triple aim can help flush out the details of your strategic plans.

3/ Know your limits


Without getting into the intellectual property issues, we can probably all agree that China is good at recognizing their limits and inviting experts to help with radical innovation. Reportedly, it’s another reason why they are able to innovate and scale so quickly. 


Healthcare leaders should be aware that it is hard for people to ask for and accept help because help is often thought of as a sign of weakness or incompetence. Some healthcare organizations perform better than others in part, because the leaders have routinely invested in the development of their people.


The skillset to run the ongoing operations of a business is different than the skillset needed to generate innovative ideas and transform the business. That’s why healthcare organizations should start by mastering “tweakovation” and getting the organization comfortable with inviting other companies and consultants in to facilitate more rapid transformation.

4/ Structure to scale out quickly


China uses economic zones for experimentation. Within the zone, they accept failure as part of the innovation process and celebrate the wins by scaling them out to the whole country. The level of standardization achieved allows them to turn on a dime.


The healthcare industry has long resisted standardization which makes innovating and scaling harder on everyone involved. Standardizing processes as part of the “tweakovation” competency should be one of the key requirements for more radical innovation and transformation.

Zones [ie. departments, units, centers, regions] that achieve a high level of standardization should be used to develop, test and help scale out new technologies to transform the organization.