Building a Sustainable Healthcare System

Building a Sustainable, Patient-Centred
Healthcare System
Ivan Choi
Principal, Palladium Group
Dr Avnesh Ratnanesan (Avi)
CEO, Energesse

Agenda
 The Australian Healthcare ‘Ecosystem’
 Major Challenges and Future Solutions
 Innovative Ways to Analyse Patient Experience
 Transforming the Service/Business Model via
Customer Experience Innovation
 Wrap-up
Building a Sustainable, Patient-
Centred Healthcare System

Understanding the Healthcare ‘Ecosystem’
Federal Government
State Government &
Public Hospitals
Patient/Consumer
Not-for-
Profit
Aged Care
Research &
Academia
Private Sector – PC &
Hospitals
© 2015 Energesse and Palladium Group

Journey through ecosystem is interdependent
Federal Government
State Government &
Public Hospitals
Eleanor
Not-for-
Profit
Aged Care
Research &
Academia
Private Sector – PC &
Hospitals

Thought Leaders Across Health Ecosystem

The State of Australian
Healthcare

 8Transforming the Customer Experience in Healthcare © 2015 Energesse and Palladium Group© 2015 Energesse and Palladium Group
6th
Australia — Health Outcomes

Australia — Well-Being Outcomes
45th

Health Sustainability – Cost Growth

Major Challenges in
Australian Healthcare

Epidemics of Modern Lifestyles

Grattan Institute Report, adapted from The Conversation 24 April 2013
Rising Costs of Medical Complexity

6 Major Challenges Leading to a Self-Propagating
“Vicious Cycle”

Address the 6 Challenges and Transform the
Vicious Cycle into a Virtuous Cycle

Align Funding with Vision — Measure and
Incentivise Outcomes

Improve Access to Care

Focus on Prevention, Well-being Integrative
Medicine

Integrate Care Across Pathways and Stakeholders

Most Important Reform by 2020
Change how success is incentivised:
Provider Activities ≠ Patient Outcomes

The Complex World of Patient Outcomes
How much is this going to
cost me (time, travel)?
Which is the best
hospital to get this
surgery done?
Am I really with the
best health insurance
provider for me?
How do I prevent this
illness in the future?
Are there alternatives to what
my doctor recommended?
Why can’t I get this
treatment in
Australia?

PanSensic Analysis of Patient Sentiment
Understand emotions, frustrations, motivators and root causes
(WHY) from customer perceptions

Patient Journey Analysis
Frustration points from 47,000 experiences

GP Clinic — “Did Not Attend’s” (DNA’s)

Patient Emotion Analysis
Frustration Map – GP Appointments
Customer
Intangible
Needs
Under-served
Over-served
Customer Tangible Needs
Under-servedOver-served
caring
advice
convenience efficiency
flexibilitycost
risk
control
respect
thoroughness
privacy
competence

Changing the Pathway: Patient-Centric
Appointment-Setting
“See how I’m in control?”
“Now you take control”
Result: 40% reduction in DNAs

Principles for Patient Centricity
Principles Indicative Frameworks and
Tools
Insights (Research/Data)
1. Define Vision, Strategy and
Objectives
Stakeholder Co-Creation
Balance Scorecard
Patient & Customer Outcomes
Activity & Efficiency metrics
2. Understand Patient
Experience (PX) Across Eco-
system
Patient Journey Mapping
(Functional and Emotional)
Stakeholder and Patient
Feedback & Surveys
3. Align Leadership, Culture and
Change Management
Co-creation platforms to assess
mindsets and engage patients in
design and decision-making
Patient Insights
Staff Attitudes
Engagement Surveys
4. Implement Systems and
Capabilities for PX
Understand and close gaps in
data/insights/implementation
Surveys and Responsive tools
for Multi-channels (e.g., Call
Centres, Social Media)
5. Adapting Strategies from
Ongoing Insights
Balance Scorecard
Customer Innovation Design
Tools
Management insights
Subject Matter Experts
Financial metrics
6. Apply PX to Products, Services
& Programs
Customer Innovation Design
Tools
Lean Startup
Internal Communications
Processes
Performance metrics for
channels, products and services.

Customer Experience
Innovation

Patients (customers) used to be passive…

….but increasingly demand both choice and
control over how health value is created
Informed
Empowered
Enabled
Savvy
Engaged

Experience innovation requires suspension of two
deeply held beliefs…
Traditional process centric
view of the world…
…and your transactional or
product-centric view of the
patient (customer)

…in favour of a new paradigm
Where the
experience…
…and the
interactions
Are the of the innovation process

It’s also about getting beyond the “functional”
Functional Emotional Social

Example: GSK’s myAlli
myAlli (the only FDA-approved OTC
weigh loss drug) provides an
individually tailored online action
plan, food journal, lessons from
clinical experts, menus, shopping
lists, dining out guide and peer-to-
peer support

Indicative Customer Innovation Tools
Experience /
Journey Mapping
Ecosystem
Mapping
Hierarchy of
Engagement /
Trigger Map
Nudge Theory
(Behavioural
Insights)
Persona
Development
Experience Co-
Creation
Design Thinking /
Human-Centered
Design
Crowdsourcing /
Predictive Markets
Business Model
Innovation
Lean Startup
Business Wargames
Value Innovation
(Blue Ocean
Canvas)

• Build a rich picture of your customer’s journey
• Don’t be constrained by their interactions with your organisation
• Journey may or may not be linear
• Look for emotion and engagement triggers
• Look for confusion, pain, opacity, one-sided engagement
• Find opportunities to do things differently
Experience / Journey Mapping

Make the
diagnosis
Manage my
practice
Talk to
mum/Famil
y
Write script
Research
disease/c
ondition
Look for
alternatives
to medicine
Interact with
the
specialist/allie
d health
Research
latest
medicines/pro
cedures
Manage
health
finances
Feeling fear
and anxiety
about my
condition
See the
pharma
representative
“Get referral”
Stay healthy
prevent
illness
Navigate
the health
system
Review
medical
history
Treat the
condition
See the
doctor/Speci
alist
See the
Patient
Doctor Patient
The “traditional” health system is not designed to
holistically address the patience’s experience

Fear and
Anxiety
Worry
about
self/fami
ly
Put off
the visit to
the
profession
al
Denial of
conditio
n
See the
DoctorFill the script
See the
doctor
Wait,
wait,
wait
Make
appointme
nt
Wellness
Manage my
diet
Meditation
Alternative
medicines
Exercise with
Friends
Research
Share
Manage
Finances
Call Help Line
Research
latest
treatment
Track
Progress
On-line Search
Talk to
mum
Share
Experience
with
Others Second
Opinion
Read
about
other’s
experience
s
Navigate
Medicare
Loss of
work/work
stressNavigate
Private
insurance
Plan my
health
budget
- Indicative Only -
Depression
Example: Experience Map for HealthCo
HealthCo traditional Interaction
“Open Territory” Buy Plants
Consumer Experience Environment

• Understand who is interacting around the universe of the
customer
• Focus on experiences and triggers
• Look for opportunities to create/leverage/partner new capability
• Can ecosystem elements be combined to create new source of
value for consumer (e.g., Nike+ and Apple)?
Ecosystem Mapping

Google
Research
Allied
Health
Physician
Advocacy
Group
(Heart
assoc.)
Pharma-
cist
Friends
Medicine
(packa-
ging)
Specialist
Mydoctor
.com.au
Local
Nurse
Support
Group
Health
Direct
Friend
(who is a
Dr.)
Example: Ecosystem Map HealthCo.
Traditional Interaction
Potential Interaction

• Look for triggers that heighten the consumer’s engagement
• Identify ways to create compelling experiences and interactions
across the triggers
• Identify new experiences
• Identify new ecosystems
Hierarchy of Engagement / Trigger Map

DISENGAGED
NOT ENGAGED
ENGAGED
HIGHLY ENGAGED
EMPOWERED1
2
3
4
5
• Inspire others to engage
• Contribute to the “art” of the experience
• Seek to educate others
• Groom the next generation of consumers
• “Pay it forward”
• Share their experiences
• “Show off” their accomplishments
• Enhance their social status in the community
• Engage with friends, family, neighbours
• Competitive
• Seek benefits that go beyond the illness
• Tend to “like” your service
• Individual focus
• Beginning of emotional relationship
• Neither like nor dislike
• Purely functional relationship
• Limited engagement
• Not your customer or former customer
• If customer – grudging relationship
• May be an active detractor (inverted pyramid)
Hierarchy of Engagement

PositiveNeutralNeutral/Negative
EmotionalState
DISENGAGED
“Safety & Security”
NOT ENGAGED
“Basic Maintenance”
ENGAGED
“Enlightenment”
HIGHLY ENGAGED
“Social Currency”
EMPOWERED
“Inspire Others”
1
2
3
4
5
“Found
others
with same
condition”
“Sick and
confused”
“Getting
Results”
“Heatlh
Setback
“Got the right
Information”
“Met an
inspiring
person”
“Overcame
Anxiety” “Felt like a
widget”
HighEconomic/Social/Health&Well-beingLow/NegativeUtility
Life-stage
Example: Trigger Map for HealthCo
Wait, wait,
wait
Call Help
Line
Share
Experience
with Others
Read about
other’s
experiences
Worry
about
self/family
Alternative
medicines
Research On-
line
Depression

Let’s Innovate

 Eleanor, a finance professional in her 40’s, has 2 teenage children. Juggling her busy work and family life
has caused her to neglect her health in recent years.
 Eleanor suffered a stroke at work and was rushed to St. Vincent’s Hospital.
 After a four-week stay, Eleanor is discharged. She suffers mild disability impacting her mobility and
manual dexterity.

 Eleanor finds this initial phase of her recovery utterly frustrating.
 She and her husband have to arrange for her visits with a myriad of practitioners:
- Her family doctor—to get prescriptions for 6 different drugs
- A neurologist: her attending neuro while at the hospital
- Various therapists at the hospital’s outpatient rehab unit (which has a high patient load and long wait
times)
 Eleanor finds it difficult to keep up with the appointments and the medication she has to take everyday.
 Eleanor feels she needs more frequent therapy sessions than what she’s receiving from the outpatient
unit. She knows her private health insurance covers some standard “extras” but does not know how best
to mix and match with those with what she could get at the rehab unit.
 Eleanor has learned about different recovery approaches but she’s overwhelmed by her health
practitioners’ varying opinions
Immediate Post-Discharge

Narrative
 Eleanor’s “Intensive Rehab” phase is dotted with a few triumphs (gradual progress reversing her
disability) and occasional exasperation—her impatience with the slow pace of recovery and not being
able attend to her family life like before.
 She has had more follow-up diagnostic tests and visits with other specialists for precautionary
reasons.
 Each time, she has to repeat her medical history and inform all the practitioners about her latest test
results and dosage adjustments for a couple of her medications.
Intensive Rehab

 At the 6-month mark, Eleanor has completed “rehab”. She has even managed to return to work part
time and fully regained her mobility.
 However Eleanor is now finding it difficult to stick with her lifestyle changes, such as keeping up her
new diet, exercise regime, quitting smoking and complying with all her prescribed medication.
 Eleanor worries she is slowly slipping back into the “routine” that contributed to her having the stroke.
Studies indicate that there’s a 40% chance of a recurrent stroke within 5 years and she may not be so
lucky next time.
 She would be keen to engage the stroke recovery support network, partly to help others.
“Sustenance” (Maintaining Lifestyle Changes)

Eleanor and her family
Practitioners
Family doctor (GP)
Specialist doctors
(e.g., neurologist)
Allied health
Payor (Medicare, private
health insurance)
1. Immediate Post-
Discharge
2. “Intensive
Rehab”
3. “Maintenance”
(Sustained lifestyle
changes)
Pharmacist

Debrief

Wrap-up

1. You’re probably improving existing touchpoints on an
efficiency model
2. You’re probably worrying about how to make
improvements only within the confines of your own silo
3. You buy in to the patient-centric approach…without
thinking holistically enough or sufficiently engaging the
patient
4. You’re probably looking at your data from an activity-
based “supply” perspective…which is probably driving
the wrong decisions
Key Takeaways

How can we help you transform and
attain Patient/Customer Centricity?
Map Organisational and Department Strategy
and align strategic initiatve portfolio
Analyse and resolve customer pain points
Improve compliance with hospital services
Improve Patient Experience

How can we help you transform and
attain Patient/Customer Centricity?
Led the strategic visioning for
a cancer research and
treatment institution
Established innovation
strategy and management
system for a pharma
(marketing & sales) company
Created strategy
management system at a
major healthcare provider
undergoing significant
transformation
Drove business model
innovation at an aged care
provider via a
customer/design-led
approach
Formulated and war-gamed
channel strategy for a pharma
company
Steered growth strategy for a
med device company
Facilitated brand planning
kickoff for a pharma company
by socialising new innovation
paradigms
Led customer co-creation
(doctors and pharmacists) at
a life science company
Formulated go-to-market
strategy (specialists) for a
pharma company entering a
new therapeutic area

Building a Sustainable Healthcare System

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