Strategy Map and Scorecard 2017–2020

Approved, Board of Trustees, 4 November 2016

OUR VISION

A world in which no one has avoidable vision loss, resulting from the shared commitment of ophthalmologic societies, individual ophthalmologists, and those who work with them.

OUR MISSIONTo work with ophthalmologic societies and others to improve access to high quality eye care, in order to preserve, restore, and enhance vision for the people of the world.

o Ethical, transparent, and reliableo Inclusive, collaborative, and responsiveo People-oriented, humanistic, and caringo Innovativeo Professional and financially self-

sustainingo Committed to learning, thinking critically,

and making decisions based on evidence

OUR VALUES

GOALS

STAKEHOLDERS

CAPACITIES

LEARNING,GROWTH, & RESOURCES

Our mission: To work with ophthalmologic societies and others to improve access to high-quality eye care, in order to preserve, restore, and enhance vision for the people of the world.

A. Ophthalmologists lead teams that providehigh quality eye care in every country in the

world focused on meeting individual and community needs.

C. The ICO leads international ophthalmologyand collaborates with other organizations to

advance the eye health of all people.

B. Effective ophthalmologic societies andleaders support individual ophthalmologists and advocate with governments and others

to ensure eye care is resourced and coordinated.

2. Provide ophthalmologic societies andleaders with resources and skills to lead,communicate and advocate, and to serve

and retain their members.

1. Help individual ophthalmologists toenhance their clinical knowledge and skills and

professional competencies.

3. Advocate to decision makers for increasedresources for eye care by setting global

standards and providing expertise, models, and data.

7. Review and improve our governance and committees structures andstaff support, and make governance more transparent to our member

societies.

4. Improve our communications and marketing,particularly to individual ophthalmologists and

societies, so that all ophthalmologists are aware of what the ICO is and does.

Scale up and work in a global way

Upgrade our abilities

Enhance Education Empower Societies and Leaders Advance Eye Health

5. Build a global network of volunteer expertsin all areas of eye care and education, and

engage goal-oriented, committed, and passionate leaders in the ICO who are

representative of global ophthalmology.

6. Become more effective at fundraising andsecuring financial support for ICO programs

andinitiatives.

8. Increase and diversify income to the ICO using our intellectualproperty and other assets and capabilities.

OBJECTIVES

STRATEGY MAPOur vision: A world in which no one has avoidable vision loss, resulting from the shared commitment of ophthalmologic societies, individual ophthalmologists, and those who work with them.

Improve the way we work Invest for results

Objectives Initiatives

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Indicators of Success

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1. Help individualophthalmologists toenhance their clinicalknowledge and skillsand professionalcompetencies.

1.a. Define ways to increase and extend the value of the WorldOphthalmology Congress® (WOC).

1.b. Move to offer ICO Examinations online and explore thepotential for subspecialty exams.

1.c. Assess the feasibility of offering an ICO accreditationprogram to improve training of ophthalmology residents and,potentially, subspecialists and continuing medical education.

1.d. Evaluate the impact that ICO Fellows have had in theircountries and re-define the focus and duration of ICOFellowships.

lead

• Feasibility of accreditation of residency programs has beenevaluated and action plan developed by the end of 2017.(Objective 1)

• Needs assessment of ophthalmologic societies completedand ICO priorities for supporting members defined, by endof 2017. (2)

• At least 95% of member societies pay ICO dues each year.(2)

• Agreement with the International Agency for thePrevention of Blindness (IAPB), key NGOs andsupranationals on a coordinated plan for advocacy by endof 2018. (3, 2)

2. Provideophthalmologicsocieties and leaderswith resources andskills to lead,communicate andadvocate, and toserve and retain theirmembers.

2.a. Assess the needs of Member and non-Member societies in high, middle, and low resource areas and define clear ways for the ICO to collaborate with and support them.

2.b. Establish an Emerging Leaders Initiative in conjunction with supranational and Member societies and offer courses and resources on leadership and society development skills in cooperation with existing leadership development programs.

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• 6000 candidates take ICO Exams in 2017 and 7000 in2019, with at least a 10 percent increase each year indefined target countries. (Objective 1)

• Income from accreditation exceeds costs by the end of2019. (1)

• The ICO has 160 member societies (compared to 143 in2016), including at least 90% of active nationalophthalmologic societies, by the end of 2019. (2)

• The World Health Organization (WHO), IAPB, NGOs andother world bodies recognize the ICO as the globalophthalmology leader and consistently seek its advice andinvolvement. (3)

3. Advocate todecision makers forincreased resourcesfor eye care by settingglobal standards andproviding expertise,models, and data.

3.a. Work with ophthalmologic societies and non-governmentaldevelopment organizations (NGOs) on strategic advocacy toenhance eye care services in underserved countries and helpthose who are blind or visually impaired attain their fullpotential.

SCORECARD (1 of 3)

Objectives Initiatives

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Indicators of Success

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4. Improve ourcommunications andmarketing, particularlyto individualophthalmologists andsocieties, so that allophthalmologists areaware of what the ICOis and does.

4.a. Expand and enhance our database of teachers, leaders, andindividual ophthalmologists.

4.b. Define distinct information that the ICO can offer toophthalmologists and reach all ophthalmologists in the worldwith communications that are current, interesting, important,clear, and concise.

lead

• Database contains at least 60% of world ophthalmologists,including 6,000 ophthalmic educators, 2,000ophthalmologic leaders and 80 percent of academicprograms, by 2019. (Objective 4)

• The ICO is the highest rated internationalophthalmological organization in key social media metrics.(4)

• At least 5 major ophthalmic NGOs collaborate and providefinancial support for ICO programs each year. (6)

5. Build a globalnetwork of volunteerexperts in all areas ofeye care andeducation, and engagegoal-oriented,committed, andpassionate leaders inthe ICO who arerepresentative ofglobal ophthalmology.

5.a. Identify volunteer expertise needed by the ICO, recruit andselect members of the network, and develop a listing/databaseof ophthalmologists to contribute to the WOC scientific programand to the other initiatives of the ICO.

5.b. Define an ICO leadership succession plan, recruit highperformers from regional and national leadership developmentprograms, and promote those who are most productive from ICOcommittees to leadership roles.

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• At least 16,000 registrants for WOC2018, 15,000 forWOC2020. (Objectives 4, 1)

• At least 50% of ophthalmologists in the world know whatthe ICO is and does by the end of 2018, measured throughsamplings at various congresses. (4)

• At least 2000 ophthalmologists contribute to the scientificprogram of WOC2018, with leading experts in allsubspecialties from all regions. (5)

• At least 800K USD raised by ICOFoundation each year,starting in 2018. (6)

• More than 100 individual donors contribute more than$10,000 to support the ICO each year. (6)

6. Become moreeffective atfundraising and securefinancial support forICO programs andinitiatives.

6.a. Assess past fundraising efforts; consider innovative,impactful, and new initiatives or projects; and define adevelopment (fundraising) plan with clear priorities, targets, andstrategies.

6.b. Evaluate what has been achieved with the Teaching theTeachers program and define a major initiative that can be thefocus of fundraising by the ICOFoundation, with a coordinatedapproach to ophthalmic companies, NGOs, and individuals.

SCORECARD (2 of 3)

Objectives Initiatives

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Indicators of Success

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7. Review and improveour governance andcommittees structuresand staff support, andmake governancemore transparent toour member societies.

7.a. Review the purpose, goals, reporting lines, staffing, andturnover of all ICO working groups and assess the outcomes theyachieve in order to maximize what they accomplish.

lead

• Process for nomination and election of ICO Officers andBoard members is clearly defined and understood by ICOleaders and member Representatives to the ICO at theGeneral Assembly. (Objective 7)

• The ICO maintains a clear, running list of specific and well-defined, measureable initiatives that are relevant to itsmission, with periodic reports on progress to the Board (7)

• The ICO has a clearly defined process for bringing morewomen and younger ophthalmologists onto Committees,the Advisory Committee and Board. (7)

• Critical skills needed by staff are defined in 2017, alongwith a plan to bring those skills on board when affordable.(7)

• Plan for promotion and expansion of ICO Examinationsadopted in 2017 and implemented in 2018. (8)

8. Increase anddiversify income tothe ICO using ourintellectual propertyand other assets andcapabilities.

8.a. Explore ways to maximize income from the ICOExaminations and WOC® and define strategic marketing plansfor both.

8.b. Develop more self-sustaining programs by identifying andfilling niches that are important to educators andophthalmologists worldwide where the ICO has particularexpertise and competence and that are not competitive withMember societies.

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• At least 40% of members of the ICO Board andCommittees are women and at least 20% are under 50years old by the end of 2019. (7)

• At least 80% of ICO committees have representation fromall four supranational regions. (7)

• At least 16,000 registrants for WOC2018, 15,000 forWOC2020. (Objectives 8, 4, 1)

• The ICO has reserves and investments equal to at least50% of annual core operating costs. (8)

SCORECARD (3 of 3)

Initiatives 2016 2017 2018 2019 2020

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1.a. Define ways to increase and extend thevalue of the World OphthalmologyCongress® (WOC).

Define plan for WOC2018

Implement for WOC2018 Evaluate/plan for WOC2020

Implement for WOC2020 Evaluate/plan forWOC2022

1.b. Move to offer ICO Examinations onlineand explore the potential for subspecialtyexams.

Pilot exam incornea/evaluate

Pilot online exams/subspecialty exams in glaucoma, neuro

Evaluate and expand implementation

1.c. Assess the feasibility of offering an ICOaccreditation program to improve training ofophthalmology residents, and potentially,subspecialists and continuing medicaleducation.

Assess needs of training programs/national societies and define business plan

Try accreditation in pilot sites/evaluate

More pilots/evaluate

Implement more broadly Evaluate and revise

1.d. Evaluate the impact that ICO Fellowshave had in their countries and re-define thefocus and duration of ICO Fellowships.

Evaluate impact of Fellows

Re-define Fellowships

Announce and implement redefined Fellowships Evaluate and revise

2.a. Assess the needs of Member and non-Member societies in high, middle, and lowresource areas and define clear ways for theICO to collaborate with and support them.

Assess societies’ needs and priorities for collaboration

Implement collaboration with 5 societies

Evaluate Implement with more societies Evaluate and revise

2.b. Establish an Emerging Leaders Initiative in conjunction with supranational and Member societies and offer courses and resources on leadership and society development skills in cooperation with existing leadership development programs.

Assess needs of YOs and society leaders

Research current LDPs and YO programs and define gaps

Establish ICO YO program/offer courses and resources to YOs and leaders at WOC2018 and supranational congresses

Evaluate and revise

3.a. Work with ophthalmologic societies andNGOs on strategic advocacy to enhance eyecare services in underserved countries andhelp those who are blind or visually impairedattain their full potential.

Assess priorities for ICO advocacy and define strategy with societies and NGOs

Implement/training for society advocates

Evaluate outcomes and revise strategy

DRAFT IMPLEMENTATION PLAN (1 of 3)

Initiatives 2016 2017 2018 2019 2020

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4.a. Expand and enhance our database ofteachers, leaders, and individualophthalmologists.

Define information we need to keep and plan

Expand database Evaluate/revise plan

4.b. Define distinct information that the ICOcan offer to ophthalmologists and reach allophthalmologists in the world withcommunications that are current, interesting,important, clear, and concise.

Hire commun. manager

Assess current communications

Define communications methods and plan

Implement Evaluate/revise

5.a. Identify volunteer expertise needed by theICO, recruit and select members of thenetwork, and develop a listing/database ofophthalmologists to contribute to the WOCscientific program and to the other initiatives ofthe ICO.

Define expertise needed Recruit experts to the network and engage them in ICO work

Evaluate and revise

5.b. Define an ICO leadership successionplan, recruit high performers from regional andnational leadership development programs,and promote those who are most productivefrom ICO committees to leadership roles.

Define ICO leadershipsuccession plan

Identify individuals who are potential ICO leaders and roles for them to play within the ICO

Systematically promote those who contribute most

Evaluate progressand revise

6.a. Assess past fundraising efforts; considerinnovative, impactful, and new initiatives orprojects; and define a development(fundraising) plan with clear priorities, targets,and strategies.

Assess past fundraising

Define development plan Implement Evaluate and revise

6.b. Evaluate what has been achieved with theTeaching the Teachers program and define amajor initiative that can be the focus offundraising by the ICOFoundation, with acoordinated approach to ophthalmiccompanies, NGOs, and individuals.

Evaluate Teaching the Teachers programs/ Define initiative for ICOFoundation

Implement new initiative Evaluate and revise

DRAFT IMPLEMENTATION PLAN (2 of 3)

Initiatives 2016 2017 2018 2019 2020

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7.a. Review the purpose, goals, reporting lines,staffing, and turnover of all ICO working groupsand assess the outcomes they achieve in order tomaximize what they accomplish.

Review ICO governance and committee structure and function and modify as needed

Hire staff with needed competencies when possible

Re-evaluate governance and committee structure and staffing

8.a. Explore ways to maximize income from theICO Examinations and WOC® and definestrategic marketing plans for both.

Define separatemarketing plans for the WOCs and Exams

Implement marketing plans

Evaluate success ofmarketing plan for WOC2018 and revise plan for WOC2020

Evaluate success of Exams marketing plan and revise

8.b. Develop more self-sustaining programs byidentifying and filling niches that are important toeducators and ophthalmologists worldwide wherethe ICO has particular expertise and competenceand that are not competitive with Membersocieties.

Assess needs of educators and individual ophthalmologists

Definepossible programs and potential impact and income

Implement pilots Implement more broadly Evaluate and revise

DRAFT IMPLEMENTATION PLAN (3 of 3)

External Drivers Implications Objectives

Health innovation

o There are continuous advances in methods of diagnosis and treatmentthat make it possible to significantly advance treatments.

o There are new developments in medication.o Some technological advances are very expensive and many new

technologies are not currently practical for the economics of developingcountries.

o Not all new technologies are critical.

o Ophthalmologists need to engage in life longcontinuing professional development to stay currentwith medical innovation, with evidence-basedtechnology assessment, and critical thinking skills.

o Unequal access to care is increasing. Need for healthcare systems to balance low cost solutions and the bestcare.

o Care in low resource areas requires specialconsideration.

1, 3, 5, 8

Health demographics

o Aging populations and lifestyle changes increase the prevalence of eyeconditions and risk of vision loss.

o In many lower and middle income countries there are fewophthalmologists and not enough treatment facilities for the increasingpopulation.

o Less developed countries are experiencing developed world diseases.There are changing public attitudes and demands for care.

o In order to meet these demands there is a need formore prevention and treatment, and for more trainedophthalmologists and teams.

o People in less developed countries expect developed-world standards of care.

o There needs to be a minimum standard ofcomprehensive eye care for low resource settings.

1, 3, 5, 8

The Role of Ophthalmology

in Eye Health

o In developed regions greater need and new techniques are driving moreophthalmic sub-specialization.

o There is increasing use of auxiliary staff to deliver eye care, who can betrained faster and cheaper.

o The role of ophthalmology is changing, and is less understood bydecision makers and the public.

o Increasing disparity in the role of ophthalmologists indifferent regions, particularly with regard to refraction.

o Ophthalmology needs to clearly define its role, inmeeting regional and national needs, focused on mostcritical fields determined by members.

o Ophthalmologists need to determine their attitude andapproach to these changes.

2, 3

Industry and Public/Private

Partnerships

o Both pharmaceutical and healthcare industries see potential growth indeveloping regions and emerging markets for their products andservices.

o There is a blending of corporate and non-corporate with venturephilanthropy: private-public partnerships growing in many regionsincluding Africa.

o The Sustainable Development Goals/Country Specific Recommendationsare creating momentum for public-private engagement in healthcareprovision.

o There are ethical issues that ICO and other healthcareorganizations need to be aware of in terms of fundingand focus.

o There are also opportunities for new alliances withsustainability and impact.

2, 3, 6

Drivers and corresponding strategy map objectives (1/4)

External Drivers Implications Objectives

National Societies

o Many ophthalmologists are not members of their national societies:societies struggle to provide value and benefits to members.

o National societies are mostly run by ophthalmologists and some do nothave all the essential business and leadership capabilities needed towork effectively.

o Societies report they lack: leadership, development, funding, supportnationally, time or money to develop education and materials for theirmembers, good relationships with Government, skills in advocacy, andlobbying power.

o Societies need to provide incentives for individualophthalmologists to join their membership.

o How could societies engage more ophthalmologists? o The current business model of national societies limits

their work and impact.

2, 8

Competition o Strong (and some well-funded) national and supranational societies arerunning well-attended conferences, developing quality educationprograms and securing individual ophthalmologists from other countriesas members. There are increasing numbers of subspecialty societiescatering to the needs of ophthalmologists.

o There is increasing potential for duplication andcompetition, and for ICO to lose its standing as theprimary worldwide ophthalmology society.

o The ICO needs to occupy niches that are important toophthalmology worldwide where it has particularexpertise and that are not seen as competitive withwell-funded societies.

2, 3, 4, 5, 6, 8

Drivers and corresponding strategy map objectives (2/4)

Internal Drivers Implications Objectives

Visibility and brand

o Awareness of ICO and what it does is low among ophthalmologists andmany do not know the ICO at all. Some who know the WOC® do notrealise it is a program of the ICO.

o It is unclear to various key stakeholders what the ICO does or why itswork is important.

o Where ICO work is known, it is known for different things (e.g., Exams,Fellowships) in different parts of the world. This can lead to confusion.

o ICO does not have a unique value proposition that isclear to members and others globally. There arenegative consequences for both ophthalmologistengagement and for governance.

2, 3, 4, 7, 8

Membership o Member societies do not understand the relevance of ICO to their workand do not have a clear understanding of membership benefits.

o There are conflicting perceptions of ICO. Societies in developedcountries believe developing countries get more benefits. Developingcountries believe ICO focuses on Europe and America.

o There is criticism from members about the quality and form of ICOcommunications to members and the difficulty of feeding back on keyissues.

o Need to balance the needs of societies in all regionsand to adjust perceptions to be relevant and equitableto all. There is a risk of alienating members if this is notdone.

o Need to return palpable, concrete value to members.o Need to educate societies about the ICO and enhance

two-way communications.

2, 3, 4, 6

Income o There is a need for funds to deliver a range of services.o Not all of the services that ICO delivers can be charged for.o While ICO has a range of income sources - Exams, WOC, ICOFoundation -

this portfolio is not predictable. The income portfolio is vulnerable.

o There are limited finances to support work the ICOwants to do. This makes it hard to plan for and realizesustainable development.

o The ICO needs to develop self-sustaining programs.

2, 4, 5, 6, 8

Governance o ICO Board members are recognized and prominent leaders in their field,which gives the ICO instant credibility.

o Despite recent structural changes to improve decision making there issome unhappiness about governance processes among members.

o The ICO governance process can be quite bureaucratic andcumbersome.

o There are concerns among leaders about continuity,choice, sustainability and effectiveness of thegovernance structure.

o Attention is needed to the effectiveness of thegovernance structure, processes and sustainability.

2, 4, 5, 7

Staff and Volunteers

o There is a small staff team who are under pressure to deliver a range ofsupport options to a range of stakeholders.

o Staff numbers have grown in recent years and staff primarily fulfil avolunteer support role.

o Using volunteer groups for work is inclusive. There are high numbers ofgroups running many projects, with their purpose and the resultsexpected not clearly defined.

o Prioritization of time and budget is difficult withoutclearly defined goals, results, data, and evaluation.

o Without cohesive and aligned approaches there ispotential for overlap and loss of impact.

6, 7

Drivers and corresponding strategy map objectives (3/4)

Internal Drivers Implications Objectives

Work and initiatives

o ICO projects offer both financial risks and opportunities. There is nocentral coordination of how initiatives are identified and progressed.

o Not all initiatives are seen as being ICO offerings- so not valued in thesame way.

o Different stakeholders want different things from the ICO. It is not clearhow and who can decide where to focus energy and effort.

o The ICO needs to shape and organize the projectportfolio, so it is clear at whom projects are aimed at, what they are achieving, and how they supportfinancial sustainability.

2, 6, 7

Individual OphthalmologistNeeds

o The ICO offers products that may be of value for individualophthalmologists but lacks a direct line of communications with them.

o Most ophthalmologists are not aware of the ICO offerings, nor able toask for offerings to be developed.

o The “role” of the ICO in relation to individualophthalmologists and societies needs defining.

1, 2, 3, 4, 6, 8

Drivers and corresponding strategy map objectives (4/4)

Contact the ICOICO Headquarters:711 Van Ness Ave., Suite #445San Francisco, California 94102United States of AmericaFax: +1 415 521 1649Phone: +1 415 521 1651Email: info@icoph.org

ICO Examinations Office:Simon Keightley, MBBS, FRCOphth, FRCS, ICO Director for ExamsUnit 2, Forest Industrial ParkForest Road RedbridgeLondon IG63HL EnglandFax: +44 208 500 9091Email: assess@icoph.orgWeb: www.icoexams.org/contact

ICO International Fellowships Office:Cordula Gabel-Obermaier, Executive for FellowshipsBerthold Seitz, MD, ML, FEBO, Director for Fellowshipsc/o Department of OphthalmologySaarland University Medical CenterKirrberger StraßeD-66421 Homburg/Saar, GermanyFax: +49 3212- 3200120Email: fellowship@icoph.orgWeb: www.icoph.org/fellow