Houston Methodist ranked most innovative health system in US — here’s how its leaders define that

Houston Methodist was recently ranked the most innovative health system in America by Fortune, in part for having an “innovation culture.”

But what does that look like in practice?

“We see our 35,000 employees as 35,000 innovators, empowered to raise their voices, challenge assumptions, and bring forward real problems in need of solutions,” said Roberta Schwartz, PhD, executive vice president and chief innovation officer of the eight-hospital system. “Innovation delivers its full value only when it improves care for patients and supports the teams who provide it.

In this Becker’s Q&A, Dr. Schwartz explains Houston Methodist’s “fast-to-succeed, fast-to-fail approach” and digs into some of its successes and failures and the lessons learned.

Question: Product and process innovation were also important metrics in the Fortune rankings. What have you built on those two fronts that has shown results?

Dr. Roberta Schwartz: Our approach to product and process innovation is grounded in speed, accountability, and real-world testing. On the product side, we prioritize solutions that can be piloted quickly in live clinical or operational environments. On the process side, we redesign workflows by testing changes on a small scale before expanding them systemwide. We expect our innovations to deliver a meaningful return on investment, not only financially, but through clear, measurable improvements in quality and patient satisfaction.

For example, the innovative solutions brought to the operating room have improved efficiency while also reducing incidents. Additionally, our work on clinical pathways using remote patient monitoring has helped shorten length of stay and improve the patient experience. This discipline keeps innovation practical, accountable, and centered on outcomes that matter.

Q: What governance structures are needed to ensure innovation succeeds at scale?

RS: Innovation depends on speed, but scaling requires strong governance. At Houston Methodist, we use governance models that support rapid experimentation while maintaining alignment with our quality, safety, security, and risk standards. To ensure clear oversight and defined accountability, our DIOP (digital innovation obsessed people) steering group reviews proposed innovations, while our security, data, and AI governance teams evaluate their impact on patients and systems.

As AI and digital tools continue to evolve, governance must evolve with them. This approach minimizes risk, reduces disruption to workflows, and ensures innovation strengthens patient care rather than introducing new challenges.

Q: How are you leveraging innovative ideas from frontline staff? Can you provide an example?

RS: Front-line teams are often the first to see where workflows break down or where care can be improved. Their insights shape pilots that are tested, measured, and refined through our Center for Innovation using a fast-to-succeed, fast-to-fail approach. Many of these ideas come directly from our clinicians.

For example, our physicians brought forward the concept of using ambient listening in the operating room to reduce documentation burden and help teams stay focused on patient care. Pharmacy staff helped design medication safety maps to strengthen reliability in the pharmacy. Nurses at our Cypress campus are working side by side with Epic to help build nursing ambient solutions that better reflect real clinical workflows. In our ICUs, physicians and staff have contributed to refining algorithms that improve early recognition of patients facing current or emerging health risks.

When thoughtfully integrated into care delivery, these technologies strengthen communication, improve safety, and give clinicians more time at the bedside. Even when a pilot does not move forward, testing it reinforces that innovation belongs to everyone and that learning from the process is valued.

Q: Success is also built upon filtering out what doesn’t work. How do you decide what innovation projects to kill? Can you provide an example?

RS: Innovating responsibly means knowing when to stop. From the start, we set clear expectations for return on investment, not only on financial performance but improvements for staff, or impact on patient care. Projects are evaluated against defined criteria, including early results, scalability, and alignment with system priorities.

If an initiative is not demonstrating value within a reasonable timeframe, often within a year, the Center for Innovation helps teams end it rather than allowing it to consume additional time and resources. That is what fast to fail truly means: failing early, learning quickly, and redirecting energy to ideas with greater potential. In some cases, projects require more time, but that decision is intentional and continuously reassessed.

For example, we piloted an AI solution in the emergency department designed to predict patient surges and prompt earlier disposition decisions. In practice, it disrupted workflows rather than improving them. We learned from the pilot and quickly ended the project. This discipline is essential to sustaining an innovation culture that is focused, accountable, and built to deliver real value over time.

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