OPTIMIZING SKILL SETS, PROCESSES AND TECHNOLOGY TO BOOST THE EFFECTIVENESS OF HEALTHCARE DELIVERY TO CUSTOMERSCase studies, Concepts, and Debatable Ideas
Kenny OngCNI Holdings Berhad
www.myCNI.com.my www.OOBEY.com
Summary:
Long-term
Objectives
Strategies
Enablers
Resources
Also known as L.O.S.E.R.
www.myCNI.com.my www.OOBEY.com
Summary: Today’s presentation
1. Solution Model
2. Strategy
3. Resources
www.myCNI.com.my www.OOBEY.com
Issues and Obstacles
1. Increasing costs1. Staff2. ‘Cover cost’ overbooking
2. Public-sector burden3. Shortage of specialist
Doctors1. Geriatrics (2%)
4. Less time per patient5. Population Growth6. Disparity and
Maldistribution7. Untested, risky new
Technology
8. Safety of patients1. Medical errors2. Hospital infections3. Medical fraud4. Malpractice
9. IT: Privacy and Confidentiality
10.Episodic Care -> On-going care
11.Communicable Disease -> Non-communicable disease
12.Rich and Poor segments
www.myCNI.com.my www.OOBEY.com
Issues and Obstacles
13.Unregulated private sector
14.Variations in Quality and Performance
15.Cultural and language barriers
16.Access17.H/C workforce instability18.Black Market19.Fail to enforce
Regulations20.Expensive insurance
premiums
21.Lack of coordination22.Poor customer service23.Short on personnel and
medication24.Long waiting time25.Access to self-care
resources26.Absence of clear
admission/referral policies
27.No standard protocols for different levels of H/C
28.Over-focused on Profit
www.myCNI.com.my www.OOBEY.com
Income Groups
Urban, Affluent
Middle Class
Poor,Rural
Expensive, cutting edge, private funds
Government priority, high subsidy, rural stations, cheap
No money for high-end, no access to low-end
www.myCNI.com.my www.OOBEY.com
Our Role?
Healthcare Industry
Customers, Patients
Main Healthcare Providers
Delivery
Request
Request
Service
Request
Service
www.myCNI.com.my www.OOBEY.com
What is the Business Model?
USP
Market Discipline
Profit Model
www.myCNI.com.my www.OOBEY.com
What is the Healthcare Model?
USP
Market Discipline
FundingModel
www.myCNI.com.my www.OOBEY.com
Intro: Market Discipline
• Mamak stall
www.myCNI.com.my www.OOBEY.com
Intro: Market Discipline
"They are the most innovative"
"Constantly renewing and creative"
"Always on the leading edge"
"A great deal!"
Excellent/attractive price
Minimal acquisition cost and hassle
Lowest overall cost of ownership
"A no-hassles firm"
Convenience and speed
Reliable product and service
"Exactly what I need"
Customized products
Personalized communications
"They're very responsive"
Preferential service and flexibility
Recommends what I need
"I'm very loyal to them"
Helps us to be a success
Product Leadership
OperationalExcellence
CustomerIntimacy
www.myCNI.com.my www.OOBEY.com
Operational Excellence(low cost producer)
Ref: The Discipline of Market Leaders, Michael Treacy & Fred Wiersema; 1995
Product Leadership(best product)
Customer Intimacy(best total solution)
Intro: Disciplines
www.myCNI.com.my www.OOBEY.com
Summary: Today’s presentation
1. Solution Model
2. Strategy
3. Resources
Done
www.myCNI.com.my www.OOBEY.com
What is the End Objective?
“…in the past 18 months, we have heard that profit is more important than revenue,
quality is more important that profit, people are more important than profit,
customers are more important than our people, big customers are more important than small customers, and that growth is the key to our success. No wonder our
performance is inconsistent"CEO, Anonymous
www.myCNI.com.my www.OOBEY.com
What is the End Objective?
In the old days of HR…• Average training hours per staff• % of staff attending training• # of training programs• % of training programs conducted• Training needs analysis conducted• Competency models developed• Training budget as % of payroll
What’s wrong with this picture?www.myCNI.com.my www.OOBEY.com
What is the End Objective?
Moral of the story…
1. Innovation:– Business models– Products– Services
2. Market Leadership
3. Competitive differentiation
End Objective?www.myCNI.com.my www.OOBEY.com
“What is the moral of the story?”
www.myCNI.com.my www.OOBEY.com
What then are the End Objectives?
1. Level of Population Health
2. Health Inequalities
3. Level of Health System Responsiveness (patient satisfaction)
4. Distribution of Responsiveness within the population (segment satisfaction)
5. Distribution of health system’s financial burden within the population (who pays)
The World Health Report 2000, World Health Organization
www.myCNI.com.my www.OOBEY.com
Expectations and Objectives
1. ↓ cost
2. ↑ access
3. ↑ Quality
4. ↓ Variations in performance
5. ↑ Utilization of resources
6. ↓ Disparity ↑ Equity
7. ↑ Prevention
8. ↓ Overcrowding in urban
9. ↑ Profiting from High-end
10.↑ FDI to ↑ H/C System
11.↑ Meet segment needs
12.↑ Workforce Management
www.myCNI.com.my www.OOBEY.com
Some broad Solutions and Strategies…
1. Patient-centered care
2. Inpatient -> Outpatient
3. High-end care
4. Rural care
5. Public-Private sector collaboration
6. Preventive Healthcare
7. Government subsidy -> Private sector funding
8. Disruptive Innovation (“Just Good Enough”)
www.myCNI.com.my www.OOBEY.com
Side Note: Disruptive Innovation
Per
form
ance
Time
Performance that customers
can absorb or utilizePerformance of present te
chnology driven
by sustaining technological improvements
New Performance trajectory
*The Innovator’s Solution, Clayton M. Christensen
www.myCNI.com.my www.OOBEY.com
Side Note: Disruptive Innovation
• begin in unattractive or overlooked markets• high-quality, affordable alternatives• more convenient• less centralized locations• increasingly lower prices• for less complicated cases• less specialized training to deliver
Also known as ‘Downwards Innovation’
*The Innovator’s Solution, Clayton M. Christensen
www.myCNI.com.my www.OOBEY.com
Side Note: Disruptive Innovation
Examples of Disruptive Innovation in serving the “Under-served” markets:
1. Angioplasty
2. LASIK
3. Home Pregnancy Kit
4. MinuteClinic - diagnoses < 20 conditions
5. Sonosite – portable ultrasound machine
6. Quantum Dot – self diagnosis of complicated conditions such as prostate cancer
*The Innovator’s Solution, Clayton M. Christensen
www.myCNI.com.my www.OOBEY.com
Side Note: Disruptive Innovation
Abi
lity
to D
iagn
ose
and
Tre
at
General Hospital Inpatient
*Will Disruptive Innovations Transform Healthcare, 19 August 2001, John W. Kenagy, MD
Specialty Hospital Inpatient
MD Outpatient
Non MD O
utpatient
Alternative Care
www.myCNI.com.my www.OOBEY.com
Healthcare Objectives
Strategy
Customer
Who do we define as our customer? How do we create value for our customer?
How do we enable ourselves to grow and change, meeting ongoing customer needs
Employee Learning and Growth
Internal Process
To satisfy customers while
meeting budgetary
constraints, at what business
processes must we excel?
Financial
How do we add value for customers
while controlling costs?
Main Healthcare BSC
www.myCNI.com.my www.OOBEY.com
Financial
“To satisfy our stakeholders, what Financial objectives must we accomplish?”
Internal Process
“To satisfy our customers, in which internal business processes must we excel?"
Customer
“Who are our target customers?
What is our value proposition?”
Learning & Growth
“What capabilities and tools do our employees require to help them execute our strategy?
Healthcare Industry BSC
www.myCNI.com.my www.OOBEY.com
Revenue Growth
Base Retention
Share Gain Positioning Adjacent Market
New Business
Operational Excellence
Product Leadership
Customer Intimacy
Competencies Information Systems
Motivation, empowerment,
alignment
Financial
Learning & Growth
Internal Process
Customers
Investment Strategy
Productivity Market Value
Linking BSC to Strategy
www.myCNI.com.my www.OOBEY.com
Operational Excellence(low cost producer)
Ref: The Discipline of Market Leaders, Michael Treacy & Fred Wiersema; 1995
Product Leadership(best product)
Customer Intimacy(best total solution)
Segmentation vs. Solution Model
www.myCNI.com.my www.OOBEY.com
The McPlaybook*
Make it easy to eat• 50% drive-thru• Meals held in one
hand
Make it easy to prepare• High Turnover• Tasks simple to learn
& repeat
Make it quick• “Fast Food”• Tests new products
for Cooking Times
Make what customers want• Prowls market for new
products• Monitored field tests
*Adapted from: Businessweek , Februrary 5th 2007
www.myCNI.com.my www.OOBEY.com
Operational Excellence
• Competitive price
• Error free, reliable
• Fast (on demand)
• Simple
• Responsive
• Consistent information for all
• Transactional
• 'Once and Done'
Operational Excellence
• Competitive price
• Error free, reliable
• Fast (on demand)
• Simple
• Responsive
• Consistent information for all
• Transactional
• 'Once and Done'
Customer Intimacy
• Management by Fact
• Easy to do business with
• Have it your way (customization)
• Market segments of one
• Proactive, flexible
• Relationship and consultative selling
• Cross selling
Customer Intimacy
• Management by Fact
• Easy to do business with
• Have it your way (customization)
• Market segments of one
• Proactive, flexible
• Relationship and consultative selling
• Cross selling
Product Leadership
• New, state of the art products or services
• Risk takers
• Meet volatile customer needs
• Fast concept-to- counter
• Never satisfied - obsolete own and competitors' products
• Learning organization
Product Leadership
• New, state of the art products or services
• Risk takers
• Meet volatile customer needs
• Fast concept-to- counter
• Never satisfied - obsolete own and competitors' products
• Learning organization
Strategy: Value Disciplines
www.myCNI.com.my www.OOBEY.com
Operational Excellence(low cost producer)
Ref: The Discipline of Market Leaders, Michael Treacy & Fred Wiersema; 1995
Product Leadership(best product)
Customer Intimacy(best total solution)
Strategy: Value Disciplines
www.myCNI.com.my www.OOBEY.com
Operational Excellence(low cost producer)
Ref: The Discipline of Market Leaders, Michael Treacy & Fred Wiersema; 1995
Product Leadership(best product)
Customer Intimacy(best total solution)
Strategy: Value Disciplines
www.myCNI.com.my www.OOBEY.com
Sample KPIs for Each Discipline
Operational Excellence
• Price• Selection• Convenience• Zero Defects• Growth
Operational Excellence
• Price• Selection• Convenience• Zero Defects• Growth
Customer Intimacy
• Customer Knowledge
• Solutions Offered• Penetration• Customer Data• Customer-success
focus
Customer Intimacy
• Customer Knowledge
• Solutions Offered• Penetration• Customer Data• Customer-success
focus
Product Leadership
• Marketing• Functionality• # of Successes• # of Failures• Learn from key
users• Interdisciplinary
teams• Pipeline
Product Leadership
• Marketing• Functionality• # of Successes• # of Failures• Learn from key
users• Interdisciplinary
teams• Pipeline
www.myCNI.com.my www.OOBEY.com
Summary: Today’s presentation
1. Business Model
2. Strategy
3. Resources
Done
Done
www.myCNI.com.my www.OOBEY.com
Optimizing Resources to Meet Strategy
www.myCNI.com.my www.OOBEY.com
Alignment: 4-Wheels Service Model
Principles
Model
StrategyStructureResources
Leadership
Person
www.myCNI.com.my www.OOBEY.com
Alignment: Framework
• Equity• Protection of the Poor• Cost-effectiveness• Efficiency
Principles
www.myCNI.com.my www.OOBEY.com
Alignment: Framework
• Org Structure• Job Design• C&B• Policies & procedures• Decision making• Job fit• Management Systems• BSC and KPIs• Decentralized & Empower
Structure
www.myCNI.com.my www.OOBEY.com
Alignement: Framework
• Role modeling• Vision/Mission/Philosophy• Leadership Style• Delegation & Empowerment• C&B, Promotions• Sense of Urgency• Customer focused• Best practices• Bottom line management• Tradeoff between Cost vs. Value
Leadership
www.myCNI.com.my www.OOBEY.com
Great Social Transformations happen when:
1. Public Awareness and Engagement
2. Political Leaders followed rather than led
3. Scientists, Engineers, Religious Leaders, Young People who led the way
www.myCNI.com.my www.OOBEY.com
Alignment: Framework
• Identification and Recruitment• Incentives• Training• Values• Motivation• Competency Analysis• Education/Curriculum
Person
www.myCNI.com.my www.OOBEY.com
Alignment: Framework
Enablers• Technology• Equipment• Materials• Intellectual
Property• Partners• Property
Resources
Funding • Public• Private
www.myCNI.com.my www.OOBEY.com
Operational Excellence
Operational Excellence
Customer Intimacy
Customer Intimacy
Product Leadership
Product Leadership
Organization, jobs,skills
Management systems
Information and systems
Culture, values,norms
Each Discipline Requires Different Priorities & Resources
www.myCNI.com.my www.OOBEY.com
Operational Excellence
•Central authority, low level of empowerment•High skills at the core of the organization
•Disciplined Teamwork•Process, product- driven•Conformance, 'one size fits all' mindset
• Integrated, low cost transaction systems•The system is the process
•Command and control•Quality management
Operational Excellence
•Central authority, low level of empowerment•High skills at the core of the organization
•Disciplined Teamwork•Process, product- driven•Conformance, 'one size fits all' mindset
• Integrated, low cost transaction systems•The system is the process
•Command and control•Quality management
Organization, jobs, skills
Management systems
Information and systems
Culture, values,norms
Each Discipline Requires Different Priorities & Resources
www.myCNI.com.my www.OOBEY.com
Organization, jobs,skills
Management systems
Information and systems
Culture, values,norms
Product Leadership
•Ad hoc, organic and cellular•High skills abound in loose-knit structures
•Concept, future-driven•Experimentation and 'out of the box' mindset
•Person-to-person communications systems•Technologies enabling cooperation
•Rewarding individuals' innovative capacity•Risk and exposure management•Product Life Cycle profitability
Product Leadership
•Ad hoc, organic and cellular•High skills abound in loose-knit structures
•Concept, future-driven•Experimentation and 'out of the box' mindset
•Person-to-person communications systems•Technologies enabling cooperation
•Rewarding individuals' innovative capacity•Risk and exposure management•Product Life Cycle profitability
Each Discipline Requires Different Priorities & Resources
www.myCNI.com.my www.OOBEY.com
Organization, jobs,skills
Management systems
Information and systems
Culture, values,norms
Customer Intimacy
•Empowerment close to point of customer contact•High skills in the field and front-line
•Customer-driven•Variation and 'have it your way' mindset
•Strong customer databases, linking internal and external information
•Strong analytical tools
•Customer equity measures like life time value•Satisfaction and share management•Focus on ‘Share of Wallet’
Customer Intimacy
•Empowerment close to point of customer contact•High skills in the field and front-line
•Customer-driven•Variation and 'have it your way' mindset
•Strong customer databases, linking internal and external information
•Strong analytical tools
•Customer equity measures like life time value•Satisfaction and share management•Focus on ‘Share of Wallet’
Each Discipline Requires Different Priorities & Resources
www.myCNI.com.my www.OOBEY.com
Alignment: Framework
Principles
Model
StructureResources
Leadership
Person
Strategy
www.myCNI.com.my www.OOBEY.com
Example: Inpatient -> Outpatient for Rural
Ethnic H/C Workforce
↑ Nurses and para-medical staff
Increased competence
Continuing education for staff
Clear referral policies
Reward for performance vs. input
Expand specialist services in periphery
Government funds
Clarity of roles
Ensure protection and value for money
Regulate
Basic facilities in all areas
Technology: robust and withstand electrical fluctuations
Routine maintenance, replacement, renewal
Expand insurance coverage
In-store clinics
www.myCNI.com.my www.OOBEY.com
Example: Patient-centered Healthcare to ↓ Costs
Quality of Patient decision making
Education to change mind-set
Skills to make decisions
Training patients with chronic diseases
Reward providers who push patients
Measures to focus on patient competency
Definition of roles
Tools to make decisions
System to capture patient experiences and consequences
www.myCNI.com.my www.OOBEY.com
Different types of Patients
Self Reliant Need Help
Seek Change
Seek Stability
Searchers Collaborators
Streamliners Delegators
www.myCNI.com.my www.OOBEY.com
End Notes
www.myCNI.com.my www.OOBEY.com
Activity Grid to optimize resources
Increase (↑)What are features/
activities/services to increase?
Create (+)What are features/
activities/services to introduce?
Reduce (↓) What are features/
activities/services to reduce?
Eliminate (-)What are features/
activities/services to eliminate?
www.myCNI.com.my www.OOBEY.com
What’s Next?
Areas in urgent need of research:
1. Health System Delivery
2. Health Promotion
3. Non-communicable Diseases
4. Nutrition
5. T/CM
6. Health Economics
www.myCNI.com.my www.OOBEY.com
Solution to ‘Global’ problems
All it takes are:
1. A Clear Objective
2. An Effective Technology
3. A Clear Implementation Strategy
4. A Source of Financing
Example: Eradication of Small Pox
*Time magazine, March 24 2008, Jeffrey D. Sachs
www.myCNI.com.my www.OOBEY.com
“There is no shortage of examples of how we can attain our goals, only a shortage of will and stamina…”
www.myCNI.com.my www.OOBEY.com
Thank You.
soft copy of slides: www.totallyunrelatedrandomanddebatable.
blogspot.com
Top Related