The Real Innovation Gap: Why Patients Are Still Waiting

Healthcare doesn’t have an innovation problem. It has an implementation problem.

Every year, research labs and academic medical centers produce groundbreaking discoveries: new drugs, devices, and care protocols. Yet for most patients, those breakthroughs remain out of reach. The issue isn’t a lack of ideas, but the “last mile” of translating research into routine care. We celebrate discovery, but too often, we neglect delivery.

Too many pilots never scale. Too much research never leaves the journal page. Meanwhile, patients wait — for doctors to adopt what works, for systems to integrate evidence into practice, for innovation to become reality. Too often, “innovation” is confused with a press release, when real success is measured by lives improved. Health systems — not academia or industry — are best positioned to solve this. Sitting at the intersection of research, clinical care, operations, and community need, we are uniquely placed to turn proven discovery into widespread practice. That gives us both the responsibility and the opportunity to make implementation science a core competency of healthcare delivery.

The Overlooked Role of Health Systems

Academic centers have long led the charge in discovery and trials, supported by robust infrastructure. Yet, much of their research remains siloed from everyday clinical care. Large systems may have the scale to apply implementation science, but even mid-sized and community health systems are quietly leading the way in overcoming the barriers that typically stall progress. Yet implementation science is underutilized — often mistaken for routine quality improvement or relegated to pilots that never spread. To move the field forward, health systems must treat implementation as a strategic imperative. This means investing in infrastructure for systematic adoption, building cross-functional teams to co-design solutions, embedding continuous evaluation into care delivery, and ensuring evidence-based care reaches every patient, not just those in well-resourced zip codes.

Putting Research into Action

At Endeavor Health, our operating model is built to break down silos between research and clinical teams, turning evidence-based practices into routine care for our communities. We focus on outcomes-driven, intervention-based research, designed not just to generate insight but to measurably improve care.

This integrated approach has allowed us to move beyond isolated pilots to systemwide change. One example: we launched an enterprise-wide initiative to reduce unwarranted variation in care, improve outcomes, and eliminate wasteful practices. By identifying inconsistencies in imaging, lab testing, and medication use, we built a governance and execution model empowering clinical, operational, and financial teams to translate insights into standardized protocols.

The impact is real. We have identified $5.4 million in value — reducing unnecessary testing, minimizing redundant procedures, improving care coordination, and enabling more timely discharges. Clinicians have a greater voice in decision-making, are aligned with best practices, and experience relief from burnout by eliminating low-value work. Patients benefit from consistent, evidence-based care systemwide, regardless of where they enter. 

Reducing variation is just one application of implementation science. Another is the integration of emerging technologies into daily workflows. We’ve applied these principles to genomics, creating the largest primary care-embedded clinical genomics program in the U.S.

To date, more than 68,000 patients have enrolled. Primary care providers now partner with patients to build individualized prevention plans based on genetic risk, rather than relying solely on population-based screening guidelines. Equipped with consultations, decision-support tools, and expert access, clinicians can confidently interpret genomic data and act on it. The results can be life-changing: in one family, a genomics test refined a diabetes diagnosis, allowing a child to move away from daily insulin injections. Personalized care became a reality, not a promise.

Rethinking the Research Ecosystem

These examples illustrate the power of implementation science when it is a strategic priority. Even within the constraints of mid-sized systems, structured, interdisciplinary approaches can turn data-driven insights into measurable improvements.

As healthcare evolves, systems that succeed will master the last mile—not just adopting new research and tools, but embedding them into care in ways that are scalable, equitable, and sustainable. That requires a shift in mindset: implementation is not the final step but an ongoing process shaping how care is delivered across the system.

The future of healthcare won’t be defined by who discovers the next breakthrough — it will be defined by who delivers it, reliably, at scale, for every patient. That’s the real test. Innovation doesn’t save lives until we hardwire it into care. If health systems don’t step up to own that last mile, patients will keep waiting.