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Learnings on Key Influencers for modelH

Learnings on Key Influencers for modelH

We just wrapped up our business building block sprint on Key Influencers. It was part of a double header where we also looked at Intermediaries in healthcare business models. In summary, the sprint for Project 1.7 Key Influencers completed 2 main objectives:

  1. Questions to Ask on the Canvas for the Key Influencers Block
  2. How to Identify and Use Healthcare Key Influencers

modelH - 1.7 Key Influencers Summary Baterrii

In healthcare at least, the successful resolution of a JTBD by a Customer Segment, and the full realization of the corresponding Value Proposition, usually requires some form of activity, activity set and/or behavior change by the User.  In modelH, this activity is called Key Behaviors.  Key Behaviors can be positively and negatively stimulated by certain individuals connected to the User – in modelH, these people are called Key Influencers.

This is not to be confused with Intermediaries, which are present in a business model between the Value Proposition and the Customer Segment. Key Influencers affect the User’s understanding and completion of their JTBD, where Intermediaries affect how the Value Proposition is seen and paid for by the Buyer (which may or may not also be your User).

Everyone needs a little help!  There is plenty of science that shows that people make behavior decisions easier, and have better completion rates when they learn and act in unison with others. It is natural to the human condition to be influenced by our peers. Healthcare is no different.

This block looks at how we can best make use of the Key Influencers in our business model. Doctors, family, friends, co-workers – all of these can be informal or formal Influencers.  Companies and organizations should account for and take advantage of this network of Influencers to help ensure their Customer Segments realize the fullness of their Value Proposition.

In particular, given that  Providers of care are so important in the process of influencing Key Behaviors, it would be wise for a company that wants to elicit those Key Behaviors to formally work with the Influencers, thus making them a Key Partner. However, so few companies do this very well, if at all. It really calls into question so many of the existing healthcare business models that exist today.

There is a path from Influencer to Key Partner; starting first with recognizing what Key Behaviors can and should be influenced, and how a company can use Key Influencers systematically for those Key Behaviors.

Our canvas should help practitioners both:

1)     Design business models where a Key Influencers can add value to a JTBD, and

2)     Design business models that transform crucial Key Influencers into Key Partners.

1st – Questions to Ask on the Canvas for the Key Influencers Block

Here are the questions we determined we needed to ask for the Key Influencers Block in our modelH business model canvas for healthcare.

  1. What Key Influencers are required for the Buyer & User to realize the Value Proposition?
  2. What parts of the JTBD do the Key Influencers affect?
  3. How do the Key Influencers communicate with the Buyer & User?
  4. What is required for your Key Influencers to understand your business model?
  5. How can you activate Key Influencers without adding Cost?
  6. How do you turn Key Influencers into Key Partners without adding Cost or Complexity?

modelH Canvas 7 Key Influencer Highlight

2nd – How to Identify and Activate Healthcare Key Influencers

We also had some very detailed thoughts around how to identify and activate the Key Influencers you defined in the canvas questions for the Key Influencers block?

Using the modelH method, we advocate that you actually create the Key Activities based on the Key Behaviors that your User must do to complete their Job-to-be-done (JTBD). The 3 strategies for finding the Key Behaviors are:

  • 1)     Identify the critical behaviors that have cascading impact on the JTBD,
  • 2)     Identify the critical moments when those behaviors must be acted upon, and
  • 3)     Identify sources of positive deviance by looking across the User’s network to find out “who succeeds despite the odds” and “what do they do differently?”

We discuss these strategies in our building block on Key Behaviors.

But as we know, Users can be influenced in their Key Behaviors through others. Influence is the ability to change behavior in others.  An influencer creates motivation in others to change. An influencer can motivate others to replace bad behaviors with better ones however sometimes an influencer can actually promote or reinforce the bad behaviors. In short, an influencer can make things happen. This building block is about helping the User in their JTBD through the use of Key Influencers.

How do you identify your Key Influencers?

This is the “who” part of the equation surrounding Key Influencers in modelH. What sets Key Influencers apart from others is their ability to apply, if not understand and utilize, the theory of behavior change. We talk about how to properly activate the Key Influencers you identify in the next section. The first step is finding them.

Modern behavior science shows that not all influencers are the same. As such, it is critical to find the “right” influencer and use their capacity to produce profound, rapid, and sustainable behavior change in your Users.

In modelH, we call a person who influences our customers a Key Influencer. A Key Influencer affects our Customer Segment’s (Buyers & Users) Key Behaviors, which drive their ability to complete their JTBD, and thus realize the full value of our business model’s Value Proposition. In short, we are looking to apply influence through others to ensure our customers can use our products in order to receive the best result of our business model. In this effect, we are looking at how to first, identify the Key Influencers and then second, to activate them within our Value Proposition.

Like the method we applied for Intermediaries, we suggest you try to first isolate (identify) the Key Influencers by defining a canvas specific to their business model in relation to your Customer Segment and then re-insert them back into yours based on their Key Activities, Value Proposition and Customer Relationship. We believe that this is a valid approach and can actually lead legacy businesses to rethink how they approach their own intermediaries – and possibly even seek to disrupt them.  Once you identify your Key Activities, you can use the methods described here to activate them.

Furthermore, business models that seek individual health consumers as the Customer Segment will do well to systematically craft their Customer Relationship and Experience.  It is essential to consider the needs of caregivers who influence health-care decisions as well as the actual patients (Users).  Therefore, it is critical to actually create Key Activities for the User and (again depending on the business model) the Key Influencers, Key Partners, and Intermediaries.   Each may/will be different in context as well as subtext for the Buyer/User and the various other persons in their circle of influence.

How do you activate your Key Influencers

This is the “how” part of the equation surrounding Key Influencers in modelH.

Persuasion is the act of using deliberate communication to change the way people think, feel, or behave.  Persuasion in the short term can lead to long-term influence. We advocate for using the Influencer Model[1] to persuade your Key Influencers to influence your Users.

We have to first understand how people adopt behaviors so we can then best activate Key Influencers into the Value Proposition. It is unrealistic in most business models to provide a high touch, one to one service unless you can extract revenue through a premium price point that Buyers are willing to pay for. For those types of business models, direct activation of the User is by far better than through the Key Influencers or Intermediary. But for most healthcare business models, we need to find a means to affect high touch with a much less expensive set of Cost Drivers.

People tend to have friends who are similar to them. They “hang out” with people who share their interests, beliefs, and behavior. In behavior science, this is known as homophily.  Social network research supports this concept, but in an interesting ways.  Scientists have shown that humans are more likely to adopt new health behaviors when engaged in close networks of people they already know well[2].  The research shows that getting people to change ingrained habits requires the reinforcement that comes from the redundancies that occur within a close contact network. Meaning, humans need to hear and see a new idea within their circle of friends, multiple times, before they can commit to adopting that behavior.

Based on recent breakthrough research, insights from behavioral scientists and business leaders, and as outlined in the book Influencer, we believe that persuasion from our Key Influencers can be leveraged by identifying the “high-leverage” Key Behaviors that lead to rapid and profound change. Using the “six sources of influence” model will aid in the design of the corresponding Key Activities for both Users and Key Influencers into our business model.

The Influencer Model organizes influencing strategies into six sources that both motivate and enable people to change through personal, social and structural forces. They are the reasons why humans behave a certain way: personal motivation, personal ability, social motivation, social ability, structural motivation, and structural ability.                      

Here is how we suggest activating your business model’s Key Influencers to help your Users:

  • Source 1 – Personal Motivation. Help your Key Influencers to build personal motivation in your Users by giving them a platform to relay relevant personal experience about the Key Behaviors.
  • Source 2 – Personal Ability. Help your Key Influencers to build personal ability in your Users by giving them deliberate, hands-on practice of applying the Key Behaviors in real-life situations.
  • Source 3 – Social Motivation. Help your Key Influencers to build social motivation in your Users by creating directed informal influence through the network of people they already know well.
  • Source 4 – Social Ability. Help your Key Influencers to build social ability in your Users by giving them the individual support required to enact new behaviors in a team-based approach.
  • Source 5 – Structural Motivation. Help your Key Influencers to build structural motivation in your Users by propagating incentives and rewards through new behaviors.
  • Source 6 – Structural Ability. Help your Key Influencers to build structural ability in your Users by using technology to create cues, reminders, and reports that keep their new behaviors real and present.

Our concept of identifying the Key Activities of our Users to be affected by the Key Influencers can be applied to both good and bad behaviors. Remember, in modelH we seek to drive the Key Behaviors of our Users so they can complete their JTBD. We now know that that Key Behaviors are more easily driven when a User is connected to a body of influencers, and you in turn can leverage that structure for a positive outcome. The same can be said for stopping the negative behaviors that pull a User away from their JTBD. Change how the Key Influencers reinforce those negative behaviors, or convince your User to change their contact patterns. Likewise, while the research shows that immediate social bonds are stronger in regards to affecting behaviors, getting someone and their network of Key Influencers to engage in structured and healthy Key Activities is difficult.

Using Technology with Key Influencers

Activation of Key Influencers in your business model can be expensive and time consuming. This is where technology can play a part. Though we will discuss this in detail during our Platform building block section, it is worth mentioning here in context the enabling of the Key Influencers in your business model.

As in all business models, technology creates a lower cost of performing Key Activities and can be a competitive differentiator. As such, there has been a rush to create online communities and deploy them through traditional employer wellness programs as well as some direct to consumers. These have been improved by extension of the social wellness platform into the mobile arena. This makes sense as smartphone penetration includes greater than 50% for not only all mobile subscribers but all adult Americans as well[3].

Technology has always served to reduce the cost of touch. What used to require a person-to-person connection, can now be automated though technology. Nurse lines and patient calls can be set up as reminders through a smartphone. Technology also reduces the cost of compliance with Externalities. Consider how it has been applied to claims processing and electronic medical records, moving the healthcare industry towards paper-free. Technology can also reduce the prices on high demand items. For example, prices for cosmetic surgery have remained flat or dropped while producing higher outcomes, mainly due to the demand for these procedures (sixfold since the early 1990s), driving these significant technological advances.

Technology can enable, depending on the business model, the Key Influencers, Key Partners, and Intermediaries to drive behavioral change as it helps to move healthcare from out of hospitals and doctors’ offices to wherever patients are. Several studies support that technology has become a significant Channel in healthcare.  But it is really only as good as the Key Influencers, Key Partners, and Intermediaries that they are using to spread information and help health consumers with their JTBD.

The 2012 study, The Pew Internet & American Life Project, found that 85% of all US adults use the Internet. Interestingly however, the 2011 publication of Surprising Decline in Consumers Seeking Health Information[4] by the Center for Studying Health System Change showed in 2010, 50 percent of American adults sought information about a personal health concern, down from 56 percent in 2007.  This may result from the growing use of mobile technology.

In the study Healthcare unwired: New business models delivering care anywhere[5] by PricewaterhouseCoopers LLP, it showed mobile technology holds great promise for keeping people healthy, managing diseases and lowering healthcare costs. In the study, Mobile Health: Uptake by Consumers and Care Providers[6] by Parks Associates finds that consumers are using mobile technology:

  • To access health and wellness information, track personal health conditions, and interact with care professionals and care organizations
  • For motivational factors, satisfaction, and other health-related unmet needs
  • For social networking on health-related purposes
  • On games to improve their overall health and well-being

The 2012 2nd Annual HIMSS Mobile Technology Survey[7] shows a growing percentage of providers adopting mobile health tools into their practice as another means of engaging patients directly in their care.  Mobile technology, or mHealth, is powering business models in chronic disease management, senior care, pregnancy, medication adherence, and medical system efficiency[8].

However, at this stage most of these are still centered on practice enablement as opposed to patient enablement. This is because practice enablement represents the more lucrative revenue source for the business models that drive these technologies to market. But just because these Influencers, Key Partners, and Intermediaries are adapting mobile health, it does not necessarily translate to adoption by Users.  Interestingly, another study[9] estimated that 247 million people downloaded health apps on their mobile phone in 2012. This was close to doubling the rates from 2011.  But here again, just because they are being downloaded (many times for free or at the very low opportunity cost of $.99) are they being used? While there is definitely a growing interest, there is also the growing concern of the Externality that could be placed on this Channel if the FDA decides to view mobile health tools under the terms of a regulated medical device.

While giving health business models a better sense of how to successfully influence the influencers, technology is far from the only answer to activate Key Influencers. But it does seem to be among the best given the constraints and costs of using other methods. The trick is to find out what combination of touch (Customer Relationship), technology (Experience) and method (Channel) make the highest impact on the Key Influencers you have identified for your business model.

In Conclusion

In conclusion, we advocate that you take time to define the Key Activities that you want you Key Influencers to perform on behalf of your User and your Value Proposition. In this was you can construct your own Key Activities that are required to use the six sources of influence to activate your Key Influencers.

In conclusion, take time to incorporate these approaches into the Key Influencers block in your business model canvas. Regardless of whether your business model is aimed at Patients, Providers, Payers, and or Purveyors, defining the Key Behaviors as well as the Key Influencers will ensure your Customer Segment can complete their JTBD and realize your Value Proposition to its fullest.

 

What is Next?

Next up we are going to look at defining Channels in healthcare business models.

Interested in what we are doing? Step up to the plate an get involved.

 

To your health,

The Team at imagine.GO


[1] Source: Influencer: The New Science of Leading Change, Second Edition, Joseph Grenny, Kerry Patterson, David Maxfield, Ron McMillan, Al Switzler, http://www.amazon.com/Influencer-Science-Leading-Change-ebook/dp/B00BPO7710/ref=sr_1_1

[2] Source: “The Spread of Behavior in an Online Social Network Experiment,” by Damon Centola. Science, 03 September, 2010.

[4] Source: Center for Studying Health System Change, Surprising Decline in Consumers Seeking Health Information http://hschange.org/CONTENT/1260/?

[5] Source: PWC, Healthcare unwired: New business models delivering care anywhere http://www.pwc.com/us/en/health-industries/publications/healthcare-unwired.jhtml

[6] Source: Parks Associates’ Mobile Health: Uptake by Consumers and Care Providers http://www.parksassociates.com/services/mobile-health

[8] Source: How Mobile Devices are Transforming Healthcare, Darrell West

[9] Source: research2guidance Mobile Health Market Report 2013-2017 http://www.research2guidance.com/shop/index.php/mhealth-report-2

Learnings on Intermediaries for modelH

Learnings on Intermediaries for modelH

We just re-wrapped up our business building block sprint on Intermediaries. This is one we previously started and put away until examining Key Influencers. In summary, we completed 2 objectives:

  1. Questions to ask on the canvas for the Intermediaries
  2. Identification and activation of healthcare Intermediaries

modelH - 1.3 Intermediaries Summary Baterrii

1st – Questions to Ask on the Canvas for the Intermediaries Block

We defined the questions that should be added to our business model canvas for helping practitioners define their Intermediaries.

  • How does an Intermediary influence the Buyer?
  • Does the Intermediary act on behalf of the Buyer, the Value Proposition owner, or themselves?
  • What Costs does the Intermediary add to the business model?
  • What Costs does the Intermediary add to the Customer Relationship?
  • What impact does the Intermediary add to the Experience?
  • Can the Intermediary be disintermediated?
  • Is your business model an Intermediary within another business model?
  • If so, can you be disintermediated?

modelH Canvas 3 Intermediary Highlight

2nd – How to Identify and Use Healthcare Intermediaries

We also built assistance for practitioners regarding the identification and use of the Intermediaries that exist in their healthcare business model. We asked how do you identify and activate/disintermediate the Intermediaries you defined in the canvas questions for the Key Influencers block?

Not all intermediaries are bad. In fact, they would not exist if there was not some flaw inherent in the business model already. No one wants to pay more or spend more time than they have to, yet many healthcare business models leave the Buyer and User utterly confused, the Value Proposition unrealized, and the JTBD incomplete.

Most successful business models started as some form of intermediary. Those that are successful now dispute their intermediary origins. The problem lies when the Intermediary becomes locked into a static model and actually works to prevent better models from surfacing. In healthcare, this has lead to run away costs close to 18% of the GDP.

But healthcare is complex, and most Buyers and Users have poor situational fluency. In this way, many great healthcare business models require a helping hand from an Intermediary to make sure a Value Proposition is understood. In these markets, Intermediaries bridge that gap and assist and improve the Customer Relationship, and as such are essential.

Furthermore, healthcare is large, containing distinct markets where only giant players can survive. This creates a natural resistance to change and usually yields profits for the company and a poor Experience for the Customer Segment. In these markets, Intermediaries force the legacy players to act on behalf of the Customer Segment, and as such are essential.

So given all of this, how do you identify and activate Intermediaries when they are needed and good, and disintermediate them when they are not?

We suggest you try to first isolate the Intermediaries by defining a canvas specific to their business model and then re-insert them back into yours based on their Key Activities, Value Proposition and Customer Relationship. We believe that this is a valid approach and can actually lead legacy businesses to rethink how they approach their own intermediaries – and possibly even seek to disrupt themselves.

In Conclusion

In conclusion, we know that Intermediaries are an embedded part of the healthcare system. But not all intermediaries are bad. Case in point lets look at the evolution of the retail clinic, sometimes called convenient care clinics. In 2004, these clinics were seen by the American Medical Association as an unnecessary intermediary to the structure of the existing primary care doctor.  Many complaints were leveled against them ranging from their lack of qualified medical practitioners to their creating a gap between the patient and their primary care physician.  Ten years later, we have seen almost every general practice office staffed with NPs and PAs to create what seems to be fewer and shorter visits with the doctor. Furthermore, the retail clinics were the first practices to adopt the electric medical record en masse. This is now seen as a standard requirement for any practice.  Finally, many regional hospitals have begun experimenting with opening their own retail clinics to augment their coverage and provide a smarter triage for their patients.

As part of your business model you should work to identify and activate Intermediaries when they are needed and good, and disintermediate them when they are not!

Take time to incorporate these approaches into the Intermediaries block in your business model canvas. Regardless if your business model is aimed at Patients, Providers, Payers, and or Purveyors, defining the Intermediaries between your Customer Segment and your Value Proposition is important to creating your best business model.modelH Canvas 3 Intermediary Highlight

What is Next?

Next up we are going to look at defining Channels in healthcare business models.

Interested in what we are doing? Step up to the plate and get involved.

 

To your health,

The Team at imagine.GO

 

 

Teaching NEXT for Startups

Teaching NEXT for Startups

As part of my commitment to building an entrepreneurial community where I live in Florida, I will be teaching Steve Blank’s (the world renowned guru for Startups) “Pre-Accelerator” program called NEXT.   NEXT is a five-week “pre-accelerator” program rooted in Steve Blank’s Customer Development methodology. The NEXT program helps founders gain a crucial base of entrepreneurial skills and knowledge. It will focus on customer discovery, big market/big ideas, fundability, communication and go-to-market themes.

 

SWNEXT-1Here are the details:

  • When: Saturdays, September 28—October 26 | 1-4 pm EST
  • Where: University of North Florida Bldg. 15, Rm. 1303
  • Cost: Early Bird Single Ticket – $99 until 9/14| Regular Team Member Ticket (min of 2 tickets) – $99 until 9/21 | Students/Veterans- $75 until 9/19| Prices increase after 9/21
  • In Person Class: Sep 28, Oct 5, Oct 12, Oct 19, Oct 26

So you know, I make no money at this. It is part of my boardship for the non-for-profit iStartJAX and is a labor of love.  I am considered somewhat of a serial entrepreneur.

To learn more about Steve Blank and the value of this method, here is a good video. Blank summarizes the three most important steps in the discipline of startup development.

  1. Business Model Canvasing (Osterwalder, modelH)
  2. Customer Development (NEXT)
  3. Agile Engineering (Minimum Viable Product)

I have written a host of articles on Business Model Canvasing and I am in the process of developing a model and book specifically designed for healthcare, called modelH. You can read more about that here.  For  NEXT, course participants will immerse themselves with Steve’s concepts utilizing Alex Osterwalder’s business model canvas.

I have also written about the use of Minimum Viable Product and its importance to the lean startup. You can read more about that here.

For the customer development piece, we are going to provide hands-on, interactive, and practical application. This is not a theory course – we will be developing our customers for our startup ideas, me included!  As participants, you will be able to:

  • Receive constructive feedback and clarify business assumptions;
  • Discover new customers, customer segments and/or validate existing ones;
  • Generate and test prototypes and revenue models;
  • Amplify your network by interacting with like-minded entrepreneurs who are lean thinkers; and
  • Interact with entrepreneurial mentors of our local community.

I wanted to give you a preview of presentation topics. I will write more about these as we engage. You can see the full details here: Source:

SWNEXT-2Week 01: Customer Discovery

Knowing your customer is the number one priority of any company. As such, we will set out to help you define who you building your product for, their pain points, and what they need. We will introduce customer interviewing and come back to it each week. It is that important to the success of a business model

Week 02: Big Markets, Big Ideas

This week will help bring some reality checks to your idea and how it fits into the “market”.

Week 03: Fundability

Sales from customers are the best funding you can receive, but sometimes outside investment is required to scale a company. But just because you need money does not mean your idea is “fundable.” This week is about getting money for your idea – assuming it is even fundable.

Week 04: Pitching Your Idea

This is about the right way to sell your idea to investors, customers, and the market.

Week 05: Go to Market

Before you launch your product, you should have a basic understanding of models and what go-to-market tactics work and don’t work with each model.  This week is about how to go-to-market successfully.

As you can see, we have a lot of work to do. I hope to see you there.

Register at www.swnext.co/events/jacksonville-next

 

To your health

The Team at imagine.GO