- 1.Dr Vijay RaaghavanEngagement Manager I Medium Healthcare
ConsultingModerator : Dr Vivek Desai I Co-Presenters : Dr.(Col.) R
R Pulgaonkar I Dr. Sachin Wagh I Dr. Vishal Beri
2. Who are we We are a niche healthcare consulting firm, driven
by the challenge of new possibilities in healthcare and the
translation of these ideas into reality. Our goal, very simply, is
to make a difference, which may explain why we tend to go beyond
research and analysis to adopt a more pivotal role in the manner in
which we help our clients execute various interventions . 3. WRONG
BEGINNING All too often, innovation starts from the wrong end
Companies develop a particular technology and then try to find a
customer who wants to buy it. Instead they should start by
identifying a need before they think about technology. Ray Avery,
founder and CEO of Medicine Mondiale 4. GOING BACK TO TISS DAYSOct
2007 , TISS Class RoomClass : InternationalHealth Policy The need
for innovating something for someone must begin with a strong
justification on Why Ever Do It and How will it change the life of
the patient tomorrow, the day after and the year after Dr Ramila
Bisht, My teacher , Mentor 5. RIGHT BEGINNINGD VF
DISSATISFACTIONVISION FIRST with how things are nowof what is
possibleset of concrete steps Gleicher proposed a simple formula
for validating if innovation was required / worth undertaking If
Dissatisfaction X Vision X First set of Concrete steps product is
> RESISTANCE , then Innovation is possible 6. RIGHT BEGINNING
Must be executable* !& IMPROVE QUALITY IMPROVE ACCESS REDUCE
COST * CONDITIONS DONT APPLY 7. Lets take a case where we smell a
need for innovation THE DOCTORCASUALTYSTAFF THERECEPTION
RECEPTIONISTTHE CALLER 8. If we superimpose the problem Problem /
Challenge : How could care givers navigate patients when they cant
see / feel them and are stuck at remote locations ?D
DISSATISFACTIONVISIONFIRSTof what is possible set of with how
things are nowconcrete steps 9. SO , WHERE CAN WE INNOVATE ?
FINANCING D PROCESS T E C N O L O G YTS PII T A S KM EG IO UN MD
PIB U S I N E S SZLR O L E124+3P A T I E N T HXP APM A R K E T I N
G REI I DRX C WII AEB R A N D I N G RC H A N N E LG ECE
DELIVERYPRODUCT 10. Lets begin with a real life case that we
crackedFor a client of ours,weconceptualized aFAMILY MEDICINEDOCTOR
CLINICMODEL and hadto scale up thismodel across aHUNDREDlocations.
FUN 11. So where is the Challenge and the dissatisfaction ?DTHE
CURRENT OUTPATIENT MARKET LANDSCAPEThe drawbacks of ahighly ITled
initiatives Doctor so close ,yet so far with doctor so engrossed
into inputting the data into the system, there is very little he
has left with the patient who D is sitting right acrossPersonalized
touch ofYour GPHOW COULD WE BE HIGHLY PERSONALIZED AND YET BE
TECHNOLOGY SENSITIVE AND an extremely difficult aspect to scale
across aMANAGE SCALE ? network FUN 12. STAGE 2V VISIONof what is
possible1 PATIENT CENTERED THINKING & PATIENT has to be at the
core of everything we do. FUN 13. STAGE 2V VISIONof what is
possible2CONSISTENCY OF EXPERIENCE/SERVICE DELIVERYACROSS THE
ENTIRE NETWORK PATIENT CENTERED THINKING & PATIENT has to be at
the core of everything we do.FUN 14. STAGE 2V VISIONof what is
possible3DELIVER GREAT CUSTOMER EXPERIENCE THROUGHEMPATHY, DIGNITY
AND RESPONSIVENESSCONSISTENCY OF EXPERIENCE/SERVICE DELIVERYACROSS
THE ENTIRE NETWORK PATIENT CENTERED THINKING & PATIENT has to
be at the core of everything we do.FUN 15. STAGE 2VVISION of what
is possible4 AFFORDABLE PRICE - HELP TOWARDS REDUCING HIS OVERALL
SPEND ON HEALTHCARE GREAT CUSTOMER EXPERIENCE THROUGH EMPATHY,
DIGNITY AND RESPONSIVENESSCONSISTENCY OF EXPERIENCE/SERVICE
DELIVERYACROSS THE ENTIRE NETWORK PATIENT CENTERED THINKING &
PATIENT has to be at the core of everything we do. FUN 16. STAGE
2VVISION of what is possible5SUPERIOR CLINICAL OUTCOMEAFFORDABLE
PRICE - HELP TOWARDS REDUCING HISOVERALL SPEND ON HEALTHCARE GREAT
CUSTOMER EXPERIENCE THROUGH EMPATHY, DIGNITY AND
RESPONSIVENESSCONSISTENCY OF EXPERIENCE/SERVICE DELIVERY PATIENT
HAS TO BE AT THE CORE OF EVERYTHING WE DO.FUN 17. STAGE 2 A
TECHNOLOGY PLATFORMVTHAT SUPPORTED ALL OF THESE6SUPERIOR CLINICAL
OUTCOMEAFFORDABLE PRICE - HELP TOWARDS REDUCING HISOVERALL SPEND ON
HEALTHCARE GREAT CUSTOMER EXPERIENCE THROUGH EMPATHY, DIGNITY AND
RESPONSIVENESSCONSISTENCY OF EXPERIENCE/SERVICE DELIVERY PATIENT
HAS TO BE AT THE CORE OF EVERYTHING WE DO.FUN 18. STAGE 3FIRST F1
set of concrete steps REACH OUTTO THE PATIENTFUN 19. STAGE 3FIRST
F1 set of concrete steps WE SPOKE TO 150 PATIENTS WHO VERY RECENTLY
HAD COMPLETED THEIR PHYSICIAN CONSULTATIONIN SOME CASES THE FOLLOW
UP AND WERE VERY FRESH TO SPEAKABOUT THEIR EXPERIENCE. THIS
INCLUDED A MIX OF CORPORATE ,NON CORPORATE , STAND ALONE CLINIC
SETUP 20. STAGE 3 : What patients had to say about their physician
consult experience ?FIRST Reasons forReasons for
DissatisfactionSatisfaction /wowset of concrete steps hardlyThe
doctor did She just asked me one touched me to feel my question and
thats ithealth problem The doctor did not spend time listening to
my problem The doctor understood myexact problem and so theThis
doctor didnt even ask if Iwas allergic to penicillin, she medicines
began to workstraight away prescribed themedicine I70%I I % 0 1
IIThe doctor was busy doingIIIIIsomething else I IThe doctor was
busychatting with someother doctor andwithout even askingme the
details of mypain went on towrite prescriptionOthers FUN 21. STAGE
3 : Reached out to the other end the PhysicianF2FUN 22. STAGE 3 :
Reached out to the other end the physicianF2 WE SPOKE TO 35
PHYSICIANS ON THEIR EXPERIENCE OF WHAT THEY FELT WERE THE GOOD
POINTS , PAIN POINTS OF THE CONSULTATION. WE SELECTED FACILITIES
THAT HAD IT INFRASTRUCTURE IN MOST CASES A LAPTOP / DESKTOP WITH A
HIS.FUN 23. STAGE 3Some leads from the Doctor interviewsF
2.1PATIENTS DONT LIKE IF WE DIDNT SHOWCONCERNCan we look at[the
CORPORATE team make us type type and type]using IT differently ?THE
TOP MANAGEMENT IS MORE WORRIED ABOUT DATA[less worried about
patients problems the system ofcomputerization is good, but it cant
be at the cost of a patients DOCTORS MAY?BE RELUCTANT TO USE
COMPUTERStime]Whenever I HAVE EYE-EYE CONTACT, I am able to BUILD A
RELATIONSHIP with thepatient PATIENTS LOSE FAITH IF WEDONT DIDNT
UNDERSTAND THEIR PROBLEM CHANGE! WHAT YOUSometimes patients get
frustrated with USWE TEND TO FOCUS MORE on theASDONT monitor
sometimes patients tend to mistake us forNEED TO 24. STAGE 3 Some
Options that can give us the best of both the WorldsF 2.1Will it be
wiser to retainerdoctors written KEYING INPUTS VOICE
INPUTSprescription and yet get ITinside? HOW TO RETAIN?PEN &
PAPER AND YET GO DIGITALTOUCH INPUTS PEN &
PAPERTHEINPUTSTRADITIONAL! WAY HELPS INMAINTAININGTHE PATIENT
PHYSICIAN EYETO EYE CONT 25. STAGE 3F 2.1AN OPTION : BEST OF BOTH
THE WORLDSPEN & PAPERHOW TO RETAIN? PEN & PAPERAND YET
GODIGITALTHE DOCTOR CONTINUESTO WRITE OVER ITDATA CONTINUES TOREACH
THE CLINICALHEADPATIENT CONTINUES TOFEEL THE PHYSICIANINVOLVEMENT
26. STAGE 3m F2.1IMPLEMENTED EVIDENCE min i 1.5 BASED CARE n The
one page EMR capture system not only increased the INVOLVEMENT of
the Physician on a consistent basis, but 2 also ensured that LOT OF
THINKING backed by EVIDENCE BASED MEDICINE went into DECISION
MAKING. INCREASED EYE-EYE TIME1.5 Patient Particulars ,Illness
Summary, Vitals , Observations and Drug Therapy also meant that we
could steal close to 8.5-10 minutes of the care givers time to the
patient. 2 CONSISTENCY IN DECISION MAKING 2 Clinical Quality Head
could first Audit Physicians decision making by using these filled
forms as a PROXY and then could spend time with the Physician on
improving practice/outcomes.THE ONE PAGE EMR THAT WE CREATED BECAME
OUR AUDIT9 MINUTE/PATIENTTOO AS WELL ! 27. STAGE 3F2.2 ONCE WE GOT
HERE , WE REALIZED THAT IT WAS VERY CRITICAL TO ENSURE THAT WE
ATTAINED CONSISTENCY IN CLINICAL DECISION MAKING. THIS IS WHERE WE
SOUGHT THE HELP OF A PROTOCOL DEVELOPING FIRM AND CUSTOMIZED THE
SAME HOW DO I?ENSURE THAT I DELIVER CLINICAL PROTOCOLS FOR 60 The
rules MOST COMMON CONDITIONS COMPARABLE TREATMENT OUTCOMES ACROSS
100 LOCATIONSSOUGHT! SUPPORT FROMA PROTOCOLDEVELOPMENTFIRM. 28.
STAGE 3 PATIENT SATISFACTIONF2.3How likely is it that you would
recommend this hospital to a friend orcolleague? NeverAbsolutelyHOW
DO WE? KNOW IF THEPATIENT LIKED US 0 12 3 4 5 6 7 8 9 10AND KNOW
THATWE CARE ? A Net Promoter Score can be Promoter 56%calculated by
subtracting thepercentage of detractors fromthe percentage of
Promoters.Passive30%% Promoters - %DetractorsWEDetractor!
IMPLEMENTEDNET PROMOTER Net Promoter Score14%SYSTEMNet Promoter
Score 42%Ultimately, the theory behind the Net Promoter Score
metric is that a facility willexperience long-term and sustainable
growth only if the Percentage of Promoters isgreater than the
percentage of Detractors 29. SO WHERE DID WE INNOVATE !FIRSTF set
of concrete steps SCALE ROLE AUGMENTATIONPROTOCOL DRIVENCAREEMR :
PAPER & DIGITAL PATIENT CENTERED OUT PATIENT BUSINESS MODEL 30.
OUTCOME ? PATIENT SATISFACTION PHYSICIAN SATISFACTION COMPLIANCE1
TECHNOLOGY Pen and Paper helped us in keeping it low cost-High2
PRESCRIPTION Could retain the traditional way and yet go digital
!High HighWRITING3 RECORD KEEPINGCould retain a hard copy, this
also became the - -audit tool and a bible for improvising
Physicianpractice!4 STANDARDIZING Building protocol for specific
conditions High Mediustandardized the treatment plan m5 MONITORING
The protocol driven care pathway helped us in ensuring that
informed decisions were made and they - MediumOUTCOMES were
consistent across locations and physician profiles FUN 31. Its time
for YOU to Innovate 32. Thank YouMedium is a healthcare consulting
firm. Our services includeBusiness Strategy, Marketing & Sales,
Quality & Patient Experience,Performance Transformation,
Healthcare Franchising. and PublicHealth. We are innovative,
passionate and performance-driven.But, most of all, we are
committed to delivering significant andtangible business impact for
our clients. Our clients have rangedfrom large hospital chains and
single-specialty hospitals to primarycare clinics, medical
equipment manufacturers and private equity.www.med-ium.com 33. 1
INNOVATION FOCUS WORKSHOP8 4 EXPLORE 2 CORE TEAM INTRO MEETING
PREPARATION WORKSHOP OBSERVE &LEARNFULL STEAM AHEADWORKSHOPS 3
KICK OFF WORKSHOP OBSERVE & LEARN EXPLORE 5 TRENDS &
TECHNOLOGY7 6DISCOVERCUSTOMER EXPLOREFRICTIONSINNOVATION
OPTIONS9NEWPRODUCT RAISE IDEAS 10 1ST CONCEPT IMPROVEMENT
WORKSHOP
