Blog : Business Model Innovation

The World Needs Legacy Healthcare Companies and Start-Ups Working Together

The World Needs Legacy Healthcare Companies and Start-Ups Working Together

A Model for Innovation in a Legacy Healthcare

Healthcare companies are trying to be innovative – but are their very natures preventing them from realizing success? My question is a simple one – how can you take the best of what is necessary and combine it with the best of what is available and form something both new and necessary?

The Premise

Can you make gold from lead? Actually, it turns out that you can. It really is possible and has been done at Yale University in the 1970s. However, it turns out that it takes significantly more energy (and cost) than it is worth in return. Juxtapose this with the question, “Can a legacy healthcare company be agile and innovative enough to change itself and its environment?” And even if they can turn themselves into “gold”, is it worth the cost? Start-Up

The Hypothesis

I believe we must combine the necessary with the available and pick the best source for each – and work very, very hard to ensure they grow, together. We know that healthcare is approaching a “cliff” – and the hands at the wheel are the same ones that helped create the current dysfunctional system. This includes the patient, as well the insurance plans, the care providers, and the purveyors of all things health-related (like pharmaceutical companies). We know that we must alter course. The Affordable Care Act has given the impetus to force a change. But to change course, we need to change the system. The system, like a living being, is interconnected and will resist change applied externally. Moreover, change to any one part of it without consideration to the impacts on the rest of the ecosystem is futile. As the laws of physics tell us, things at rest tend to stay at rest. Businesses are similar. Unless there is an external catalyst forcing movement, companies, like objects, will stay put (and stagnate). There is an alternative to innovation at gunpoint – it comes in the form of taking a proactive approach to change. However change from within is really, really hard to do. But it can be done. Why not combine the best parts (contributions) of a start-up company with the necessary (working) parts of a legacy company to form agile, yet comprehensive, solutions to the dilemma? I believe this can be done through 3 simple steps:

  • Place innovation front and center by embracing the successful attributes of start-ups,
  • Create ecosystems of stakeholders that include patient, provider, and plan, and
  • Simultaneously find the operational efficiencies needed to address rising costs.

I know this works because I have done it. But it takes a lot of effort to start the process for a breakthrough.  It takes even more energy and communication to keep it going.

 

To your health,

The Team at imagine.GO

3 Ingredients for Health Innovation

3 Ingredients for Health Innovation

Healthcare Innovation Require Three Things

For well over the past decade I have made innovative healthcare companies my home. In that time, I have developed a simple litmus test to determine if the company I am working with is ready, willing, and able to create breakthrough innovation. Let’s call it my “3-legged Stool of Innovation Readiness.”  Like any three- legged stool, it cannot stand on only one or two legs – it takes all three.

An externality creating an impetus (Ready)

I have heard that only wet babies like change. While I am sure the part about the babies is true, I am not convinced that most companies are truly resistant to change. The inherent desire is there, which we will talk about next, but without some external force applying pressure, most companies will forgo change to focus on the problems of the here and now. I think of this as needing equal parts carrot (desire) and stick (impetus). However, very few companies are disciplined enough to apply their own stick. Ingredient number one of the three-legged stool is that impetus.

Look at the healthcare industry as an example. With the exception of those services rendered to consumers for direct cash payment (such as Lasik and liposuction), we have seen little change in quality or cost. In fact, many trends seem to point in the opposite direction. Now this is obviously not the entire fault of the healthcare industry – I have always argued that consumers are equally culpable. However like those folks that would rather eat potato chips and sit on the couch instead of getting out and exercising, companies do not often seek out a change in lifestyle – even when, change is necessary.

So along comes some outside force to require that change – The Affordable Care Act. Say what you will about its inability to address the underlying cost issues; Reform has forced the hand of the healthcare industry to do something about the problems at hand. And now that we are past the point of no return, these companies must act or potentially cease to exist.

Without PPACA, I am convinced there would be little or no room for disruptive innovators like myself within the “healthcare industrial complex”. As it turns out, we are now in high demand.

But even with the requirement to change, some companies are not willing to change. Many say they are but are merely paying lip service to that fact. Let’s talk more about that notion.

A real desire to change (Willing)

So the second ingredient is a deep desire or a sincere willingness to embrace change.

I have heard that addicts will not change their lifestyle until they hit bottom and bounce. I am not sure it is that drastic for healthcare companies. But obviously, a company must be willing to make room for new thinking and new thinkers before it can change.

Let’s take a lesson from science here. Consider that adding any catalyst to a mixture creates some reaction. However, most catalysts get used up in the reaction. If you are being asked to both implement a new disruptive idea and create a culture of change readiness (where none exists) at the same time – be forewarned. What I have found is that you do not want to be the straw that breaks the camel’s proverbial back.

What I mean by this is that to realize large-scale sustained change within a large company, you need an established platform for change in place. Staring from a cold stop requires all of your energy to just get the ball rolling, and leaves you no time or resources to implement your new ideas. So, if you find yourself in this scenario, ask yourself if you are primarily a “change agent” or an “innovator.” A change agent is willing to focus on creating the infrastructure required to sustain change and introduce new ideas –which may or may not be their own. This is noble work and requires a full commitment to the long-term culture of the company that one is changing. An innovator, as described in this discussion, is about creating new value and getting new ideas to market fast.

So, if you are primarily an innovator and you are focused on getting your idea to market quickly, without having the luxury of a change platform in place – you will likely meet roadblock after roadblock. And you will become frustrated. And you will want to quit or be asked to as you gain the reputation for not being able to “get anything done.”

So this cautionary tale is for both you the employee and for you the employer. To the employer, I recommend investing time and energy in facilitating change readiness so that you can bring change agents in and they will have success. For you the employee – make sure you know who you are and which role you are being asked to play. This will ensure your happiness and their success.

A means to invest in the future (Able)

So the final ingredient is the hardest to come by – ability. Even with the previous two (assuming they are ready and willing) – a company must be able to change. They must be financially stable enough to commit resources in the form of capital and talent directly to unknown or uncertain outcomes. For a company struggling to stay afloat, or concerned with the cost of upgrading their core “plumbing”, this can be a frightening and unrealistic necessity.

So know the environment you are going into and the one that you are in. If your company is not willing to dedicate at least 1% of their capability budget to innovation/R&D, then you will forever be chasing ideas and never implementing them. Great leaders like AJ Lafley from Procter & Gamble understood the need to invest in radical ideas. Ask your leadership if they are willing to “put their money where their mouth is” – with no strings attached.

A quick note of caution in this respect – if you are promised a budget based on other conditions (like finding savings elsewhere) – you are most likely not going to get it. We all know that overruns and unforeseen circumstances or priorities are common occurrences, and if you budget is relying on the efficiency and generosity of another group – be prepared.

A Final Note

When you find all three of these ingredients in a company – jump on the opportunity. My coming to Florida Blue (the Blue Cross Blue Shield Plan of Florida) in January of 2010 to be their Chief Innovation Officer, was predicated on their alignment with these three requirements for “breakthrough innovation.” As such, we were able to accomplish some amazing things and be counted among leaders in the healthcare payer space in innovation.

And if you are lucky enough to find all three ingredients, it is your job as an innovator and/or change agent to respect and nurture them within the organization. Ensure that you continually and effectively lead the clarion call for the importance and progress of your work. Congratulate your peers and leadership for their commitment to innovation, and remind them of their professional responsibility to advocate for, and push change in your company. Most importantly share in the victories you have created with and because of their sacrifices.

To your health

The Team at imagine.GO

Workshop on Health Consumerism

Workshop on Health Consumerism

The Journey to Consumerism for a Healthcare Company

I will be speaking at the 4th Annual Medicare Advantage Strategic Business Symposium in San Juan, Puerto Rico on December 4-5 at the Gran Melia Resort where I am conducting a pre-conference workshop entitled “Member Engagement: A Journey to Consumerism for Medicare Health Plans”.

Design for the consumer is often overlooked as companies rush to build capabilities to fill mass-market needs for markets they do not understand. The push for a retail solution cannot bypass the need to understand who your customers are. The graveyard of poorly designed “consumer” health solutions reminds us of this fact.

The Workshop

The workshop will consist of a conceptual part and a practical part.

In the conceptual part of the workshop, we will be learning about the difference between Consumerism versus Retail, which I have written about before. And YES, there is is a difference. We will also look at what a retail market looks like for a Medicare health plan.

In the practical part of the workshop, we will be designing for a great Medicare insurance customer experience. To do this, we will be using the first part of my 3 part Collaborative Business Model Innovation Method For Healthcare. This visual language for healthcare system thinking, problem solving and solution design was designed to enable companies to quickly generate consumer focused business models and test them easily. The method is derived from years of healthcare experience delivering innovative solutions within both large legacy companies and entrepreneurial start-ups.

Healthcare-focused Consumer Personas

In our workshop, we will focus on defining your customer, creating a value proposition, and designing a customer experience.

We will then use some design thinking tools to help craft a value proposition for our exact customer.

And hopefully, if we have time, we will discuss how to then create an experience that will be meaningful for a consumer and result in a purchase decision.

We will start by defining which Medicare customer is the one we are focusing on – because they are definitely not all the same. This requires us to think in terms of their jobs to be done as well as our business needs.

I look forward to seeing you there. Contact me if you are interested in attending.

To your health,

The Team at imagine.GO

Customers Want What They Want – MVP Helps Get it to Them

Customers Want What They Want – MVP Helps Get it to Them

Minimum Viable Product

Customers want what they want not what you want for them. As such, the discipline of Minimum Viable Product is one I hope you learn more about soon.  I think Eric Ries says it best, but I wanted to sum up my perspective for you.

MVP as a methodology enables designers to determine whether people want what they are building – in a manner that gauges acceptance and demand – yet preserves capital and time. This is accomplished by allowing designers to validate assumptions about their “product” in two important aspects: its value and the demand for it.

Customer

By definition, MVP is the version of a product that gets built through one cycle of a build, measure, learn loop – as fast as possible. Once the MVP is confirmed (keep in mind, it may take a few iterations), other lean methodologies can be employed to build upon it.

MVP = 3 things: value, use, & speed

Valuable – understand if your product is valued

Make an assumption about the value-exchange created by your product and test it thru iteration until it validated or dropped. Value is defined through the lens of the customer – not what you want for the customer. If no value is confirmed, no product should be created.

Usable – make your product usable and it will get used

MVP asks that you focus on delivering product experience – not on documentation or large feature sets. Usable is more broad a term than just usability. The real test is the usage of the product in the manner you anticipated, not necessarily its first pass at usability. Although you can’t get usage without usability, so be careful not to forsake usability for speed and minimum moving parts. Form and function must appear simultaneously – with minimum function allowing for a simpler form.

Speed – take your product to market quickly

By only building what is deemed most valuable in order of priority to the customer, and progressing through iterative builds, you ensure speed to market and successful releases. When you are wrong, you fail fast (and cheap). MVP assumes iterate until you find the ideal solution. Start small and add on based on customer need.

modelH - Minimum Viable Product (MVP)

So how can you best focus on your (MVP)?

Getting to MVP is actually fairly simple. I suggest this path.

  • Start with the features that allow the “app” to be deployed, and no more. Be disciplined here. Do not let your shovel makers and hole diggers get the better of you. Get to the orange juice quickly. You can work on other recipes soon enough.
  • Launch to your defined early adopters (they are forgiving) and get feedback. Oh yeah, it stands to reason to work with people who want to work with you. If you know people do not like the taste of orange, avoid them. Finds the ones that do and test your MVP with them first. If you cannot “sell” the vision to your early adopters how will you do it with anyone else?
  • Add what is relevant to extend value incrementally. OK, do not let the shovel makers and the hole diggers add a little bit at a time and test it. Make sure you are keeping true to the original “value” part of the app!
  • Now just keeping doing that!

This BLOG by Alexander Osterwalder is very useful for helping you get started.

By the way, you should not use MVP as a start if you are not committed to proceeding with other lean methodologies afterwards that allow for a continued iterative process – lest you lose the “value” in your product. More on this at another time.

 

To your health,

The Team at imagine.GO