Ethnographic ResearchGlobal Innovation FellowsKelly Jorgensen, Chris Plott, Angela Duffy

Call number: 1-702-894-2305 or domestic at 1-866-794-1439All Dial In Numbers at: http://www.intercall.com/medtronic/gan.htm Conf Code: 9410201709Leader PIN (Katie): 498308

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Major Activities & Steps in the VOC Process

VOBStrategic Plan

Business Goals

VOCCustomer Segments

Customer Workflow

Value Chain Mapping Job Mapping

Identify Pain Points(plan onsite visits)

Ethnographic Research Other Research

Prioritizing NeedsClarify Needs Statement

Affinity Diagram

Hierarchy Diagram

SurveysAnalytical Hierarchy Process

Customer Needs Ratio Prioritized Needs

Defining SuccessQuality Planning Table

Defines how well we need to meet each needs

Competitive assessment

Market RequirementsReady for concept engineering

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Select Market Segment

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Segmentation

Emerging Market Industry Overview

Premium Product• Service• Various Options & Safety Features• Used in Complex Procedures• Private & Large Hospitals

Value Product• Extremely Price Sensitive• Not Defeatured Product• Price Decreased by $17 in Five Years• Public Hospital• High Volume Tender

Value Product

Premium32% More

Projected Five Year

ASP

Target Margin

Required LBM

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Trip Preparation

Hospita

ls

Perfusio

nists

Surgeons

Directo

rs

Purchasin

g Managers

Distrib

utors0

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15

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Interviewees

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Select Team

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• Medtronic Teamo Marketing

o Clinical Specialist

o Engineer(s)

Why

How

What

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Map Value ChainChris Plott

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Job Map Prior to Trip

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Trip Observation Directed by Job Map

Ask Yourself• Valid Step

• Specify what customer is trying to accomplish (e.g. determine patient vital signs)• Invalid Step

• Being done to simply accomplish fundamental goal (e.g. check the monitor)• Why? Why? Why? Why? Why?• Did I notice any of 7 wastes?

• Defects: could anything go wrong? • Overproduction: doing more than needed? • Transportation: unnecessary item movement? • Waiting: delayed by another task? • Inventory:• Motion: unnecessary movement? • Processing: changing or redoing something?

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Ethnographic ResearchAngela Duffy

“The best organizations and the ones that survive economic tsunamis are those with emphatic cultures and managers who are able to step outside themselves and walk in someone else's shoes.” ― Dev Patnaik

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What?

• Observation

• Immersion of Medtronic personnel in the ‘World of the Customer’

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Why?

If I’d have asked my customers what they wanted, they would have told me “A faster horse”.

-Henry Ford

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Select Site

Set Study Objectives

Select Team

On-site, in-context observations of

work Video-tape interactions

Analysis & Co-viewing

Representation of work and

scenarios of use

Co-design concepts and/or prototype with users and

developers

Prototype solutions

Evaluate & Iterate

Open-ended Interview

Create user Videotape Library & Database

- Video records- Transcripts- Mock-ups

Verify findings with users/participants

Identify key issues & opportunities

Photograph what you see

Conceptual ideas embodies in sketches, mock-ups and

simulations

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Interviews & Customer Outcomes Question Guides Included Separately

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Contextual Interviewing

Contextual Interviewing• Interview appts. in advance where possible• Interview users in work environment• Set up allocated space where possible• Prepare Question GUIDES in advance• One visitor to liaise with/interview the user or customer• One visitor to record the interview (photograph /video*/ handwritten)

Tip: Start with informal introductions/questions to put the interviewee at ease e.g. ‘How long have you been in your current role?’

• Make open-ended queries e.g. ‘Please describe your day-to-day activities’• Encourage story-telling

• Ask users to discuss the positive and negative aspects of their day-to-day activities• Ask users to discuss the positive and negative aspects of their interaction with the

product/aspects of the product• Repeat back to the interviewee things they’ve said/done – look for confirmation• Focus on the feelings mentioned and ask for more in-depth explanation e.g. ‘You said your were frustrated by the product, why was that?’ - 5 WHYS

* video-capture is optimal

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Stories Told from the Field

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Data Downloading in the Field

Data Downloading (for each visit)• Download data together as soon as possible after visit (same day is optimal)• Data Downloading & Analysis AS-YOU-GO is extremely important in case

• Knowledge Gaps Remain• Important/Unexpected New Information is Gained• Re-direction Required

Materials Required:• Large sheets of paper e.g. A3 / Scrapbook• Post-its

Creation of a Story-board: For Each Simulation/Interview:• Record interviewee name at the top of blank sheet of A3 paper (1 sheet of paper per interviewee) (Write down any ‘quirks’ pertaining to the interviewer – a reminder to you of their personality/attitude)• Discuss observations (seen & heard) together• Swap stories• Note all observations deemed important and write each on a Post-it: one observation per post-it• Group Post-its under themes where possible e.g. cost/price, safety • (scrapbook can be used in the field to store post-its in order – swap to poster board back @ base)• When photos are printed stick relevant photos onto the board• Take photos of the Story-boards • Maintain the story boards for group communication and brainstorming

• Markers• Pens

Data Review – Video Example

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Left hand used to pull off seal tab

Seal tab pulled off towards the body

Thumb stuck into box to break seal

Box still cannot be opened with seal tab removed

Finding ‘start’ corner routinely difficult

‘To me that’s ages trying to open that’ (pouch) ‘This is the thing I was telling

you about’ (gripping of start corner)

Severe bending of wrists to “pass-off” product to physician

Old packaging opened easily

Severe bending of wrists to ensure sterility during “pass-off”

Affinity Mapping

Getting hold of “start corner” difficult

User 3(Older)

Use of thumb into the box to break seal

Ages looking for corner to open

Adjustment of hands to enable fast/easy “pass-off”

‘They (hooped product) do get stuck’

User 1(Novice)

User 2(Experienced)

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Left hand used to pull off seal tab

Seal tab pulled off towards the body

Thumb stuck into box to break seal

Box still cannot be opened with seal tab removed

Finding ‘start’ corner routinely difficult

‘To me that’s ages trying to open that’ (pouch) ‘This is the thing I was telling

you about’ (gripping of start corner)

Severe bending of wrists to “pass-off” product to physician

Old packaging opened easily

Severe bending of wrists to ensure sterility during “pass-off”

Getting hold of “start corner” difficult

Pass-off

Use of thumb into the box to break seal

Ages looking for corner to open

Adjustment of hands to enable fast/easy “pass-off”

‘They (hooped product) do get stuck’

Start CornerTime (Speed)

Sterility/Pass-off

Seal Intuition

(Habitual)

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Affinity Mapping

| MDT Confidential 27

Curr

ent b

ehav

iors

Jo

bs to

be

done

• Performs 400+ Procedures/Year• Proud of Off CPB Procedure• Accepting Gov’t Patient to Increase

Volume• Concerned about Profitability• Views Oxygenator as Commodity

SurgeonProfit Driven Product Selection

• Approves or Removes Device• Drive Patient Volume• Minimize Cost of Procedure• Ensure Best Outcome for Price

• Lack of knowledge of current best practices

• Interested in education• May provide opinion but takes

direction from surgeon• Adheres to budget

PerfusionistBasic Knowledge of Perfusion Technique

• Quickly construct circuit for crash on cases

• Select device based on patient’s ability to pay

• Record products used for billing• Utilize resources available

Example: Typical Customer Profiles & Unmet Needs

Distributer Margins Gains On Other Products

• Pay Medtronic within 90 days• Monitor and maintain hospital

inventory• Sponsor customer to attend medical

conferences

• Frustrated by delayed payment; 150 day average

• Focused on market share• Increases Medtronic reach

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Example: Hospital LandscapeOwnership & Location Packages & Insurance Government Scheme

• 40% of India Below Poverty Line (BPL)• BPL Scheme Introduced to Select States 3-4 Yrs. ago• $1787 for Screening, Surgery & Follow Up• Complications Are Hospital Expense• Predicted $1300• Nationwide in 2014 with Election Year; Rapid Product Growth

Ownership• 50% Private, 50% Public• 70% Oxygenators Sold to Public• Rapid Private Growth

Location• Significant Growth in Tier II Cities• 40% Tier I Patients Live Elsewhere

Packages• Out of Pocket Patients

• Deposit Required Prior to Surgery

• Three Price Packages• 50% Select Low• 30% Select Middle• 20% Select High

• Room Amenities & Devices Used Vary By PackageInsurance• 30% Insured; Growing Quickly• Reimbursement Unclear

Create Job Map to Organize Observation

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Use Job Map to Develop Customer Needs

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