D E L O I T T E C O N S U LT I N G L L P • June 15th, 2015

NHLC Workshop

D O B L I N I N N O V AT I O N S Y S T E M

Session #1

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Advancing Innovation in Health

INNOVATION IN HEALTH CARE

National Industry leaders and business champions combining efforts to advance health innovation

• Conference Board of Canada

• Health Innovation Council of Canada

• Canadian College of Health Leaders

Provincial Political and industry shifts in strategy

• Innovation hubs

• Government innovation portfolios

• Innovation strategy

Provider Leadership from individual providers and coalitions, cross-sectoral shift

• Technology/infrastructure innovation

• Patient/client/population oriented

innovation

• Non-academic centres of excellence

in innovation

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Today’s Agenda

INTRODUCTION

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Introduction to Innovation

Aligning on a common definition and reviewing a set of useful frameworks

Problem Framing

Getting clear about the issues we are trying to address

Orthodoxies

Identifying the commonly held beliefs in healthcare that we may disrupt

Pain Points

Identifying a list of key pain points for patients through an end user-focused lens

Ten Types of Innovation

Exploring the use of the Ten Types as a way to generate new innovations

Wrap-Up

Summarizing the key points from today’s discussions

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Doblin has 30+ years of experience pioneering the application of design and business thinking to growth challenges

INTRODUCTION

1979. Doblin founded by Jay Doblin and Larry Keeley

2007. Doblin joins Monitor Group

1999. Innovation Landscapes published in HBR – bringing data visualization to innovation

1994. Co-develops McDonald’s facility for owner/operators to simulate business impact of new kitchen equipment with real-time customer data

1987. Doblin applies social sciences to business problems, a radically new idea and practice

2005. Larry Keeley named by BusinessWeek as one of 7 most influential innovation thought leaders

2012. Total Innovation – blending design thinking and analytics – published in HBR

2013. Doblin joins

1983. Doblin helps refocus Xerox from copiers to document management

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INTRODUCTION

Innovation myths – don’t fall prey

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DEFINING INNOVATION

To our users, our citizens, and / or our government

Creating value for our users and for our stakeholders

Ideally going beyond products or programs to platforms, delivery models, and customer experiences

Which is different than invention

Innovation is the creation of a new,

viable business offering.

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We believe effective innovators follow 4 important principles

INNOVATION FUNDAMENTALS

Be explicit about innovation ambition, then organize and execute accordingly.

1. Look beyond program innovation to transform other elements of your business system.

2. Drive innovation from deep and unconventional insights about users throughout the value chain.

3. Don’t be fooled by the mythical importance of creativity; focus on discipline instead.

4.

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BE EXPLICIT ABOUT YOUR INNOVATION AMBITION

ADJACENT

TRANSFORMATIONAL

TRANSFORMATIONAL INNOVATION

• Sophisticated innovations that transform how government operates, address new emergent needs, and radically evolve public perceptions

EXAMPLE: leveraging technology and data analytics to predict and tailoring health and wellness offerings according to client needs

ADJACENT INNOVATION

• Tailoring or extending existing programs and assets to serve users’ growing and/or evolving needs

EXAMPLE: an integrated mobile offering that offers personalized and on-demand access to health information and risk scoring

CORE INNOVATION

• Making incremental changes to the features or functionality of a program in order to reduce costs and/or improve user experience

EXAMPLE: offering an online scheduling and appointment booking features to coordinate care

WHAT NEEDS WE

SERVE

WHAT WE DO

CORE

Successful innovators are explicit about their innovation ambition

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Successful innovators build an innovation capability that matches their innovation ambition

ORGANIZATION

RESOURCES & COMPETENCIES

APPROACH

Clear definitions and approaches for the work to be done in generating innovations—phases, activities, deliverables, and decision rights

Organizational units to house the competency—teams, divisions, leadership—and interfaces that connect it to the broader enterprise and the world

The targets to guide performance, the measures to evaluate progress, and the incentives (monetary and non-monetary) to drive the supporting behaviours

The individuals who perform the work of innovation, the skills, tools, and training they need to do it capably, as well as the funding and time to fuel it

Prototype Concept Opportunity Demonstration Site

Launch

METRICS & INCENTIVES

ORGANIZE AROUND AN INNOVATION DISCIPLINE

Today’s Challenge

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Today we are going to discuss two archetypes

TODAY’S CHALLENGE STATEMENTS

Meet the patients:

Understanding stakeholders enables us to focus on developing innovations that are targeted to the user

Stu Example patient #1

Helena Example patient #2

Challenge #1:

Enabling individuals to better manage their own health

Challenge #2:

Reducing the demand for emergency room services

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CLIENT PORTRAITS: CHALLENGE QUESTION # 1 Illustrative

Stu’s story

Stu is a 67 year old man diagnosed with Type II diabetes, hypertension and has issues with weight management. He has stopped smoking and moderated his drinking, but continues to struggle with maintaining a proper diet. He has experienced depression and anxiety due to not knowing what he might expect next and is not physically active. Stu lives with his grown daughter.

Goals

Stu recognizes the need to modify his behaviours but finds it difficult to change his diet and increase physical activity. He wants to continue to live as “normal” a life as possible.

Challenge #1

How might we help citizens like Stu to easily select and access the care that is best for them?

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CLIENT PORTRAITS: CHALLENGE QUESTION #2 Illustrative

Helena’s story

Helena is a 55 year old female with COPD and hypertension that is not well managed. She lives alone and has mobility issues. She is isolated with no family near by. She often experiences exacerbations and feels anxious about her inability to breathe – resulting in frequent trips to her local ED. She is a smoker.

Goals

Helena is increasingly limited in the activities she can perform independently and has recognized that her condition is getting worse. Helena is eager to get more active, reconnect with her friends, and resume some of her favorite activities in the neighbourhood.

Challenge #2

How might we provide alternative services for citizens like Helena to address their concerns and reduce their need to visit hospitals’ emergency rooms?

Updated

Problem Framing

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By starting with the desired outcome, we end up with better solutions and concepts

BALANCED BREAKTHROUGH MODEL

Start here

What’s Desirable? • Client needs

• Ascending trends in healthcare

• Leading insights from other jurisdictions

What’s Feasible? • Existing initiatives

• Critical capabilities and assets

• Partnerships

• Relevant emerging technologies

What’s Viable? • Economic impact

• Business model implications

• Strategic fit

What’s Viable?

What’s Desirable?

What’s Feasible?

What’s

Next?

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ORGANIZATION FRAMING: How might we [organizational goal]?

Framing Mad-lib

REVIEW PROBLEM FRAMING

USER FRAMING: How might we help [user] to [user need]?

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User framing clarifies who our target users are, and which of their needs we hope to address

REVIEW PROBLEM FRAMING

• Clear articulation of the central ‘business challenge’

• Shared sense of ambition and scope

• Clear and shared sense of the constraints of the solution space

ORGANIZATION FRAMING IS…

• Clear and shared sense of who or what we are going to study and why

• Understanding of what issues we are going to explore, and why they are relevant

USER FRAMING IS…

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ORGANIZATION FRAMING: How might we reduce healthcare costs and improve patient satisfaction by offering greater flexibility and choice?

Framing Challenge #1

REVIEW PROBLEM FRAMING

USER FRAMING: How might we help citizens like Stu to easily select and access the care that is best for them?

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ORGANIZATION FRAMING: How might we reduce demand for hospitals’ emergency rooms while maintaining the same level of care for citizens?

Framing Challenge #2

REVIEW PROBLEM FRAMING

USER FRAMING: How might we provide alternative services for citizens like Helena to address their concerns and reduce their need to visit hospitals’ emergency rooms?

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Exercise Time!

GROUP EXERCISE

Challenge #1: How might we help citizens like Stu to easily select and access the care that is best for them?

Challenge #2: How might we provide alternative services for citizens like Helena to address their concerns and reduce their need to visit hospitals’ emergency rooms?

ORGANIZATION FRAMING: How might we [organizational goal]?

USER FRAMING: How might we help [user] to [user need]?

Stakeholder Orthodoxies

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ORTHODOXIES

"Essentially this has been a business that's been around for over a hundred years and it really hasn't changed much so any time someone's doing

something differently, its probably going to create some friction.“

Billy Beane, General Manager and Minority Owner of Oakland Athletics

Flipping Orthodoxies

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Orthodoxies shape our views of strategy and create blind spots that can make it impossible to see innovation possibilities; challenging them allows us to imagine how the system can be configured differently

An orthodoxy is…

• The rules, beliefs, and behaviours we accept or agree to

• Ingrained ways of thinking and acting – from habit or from previous successes

• Commonly held across organizations and industries

An orthodoxy is not…

• Incontestable facts or laws of nature

• What we all agree is wrong with the organization

• Narrowly shared opinions or feelings

Not all orthodoxies are bad – many provide the shared beliefs that help define an organization or industry

INTRODUCTION TO ORTHODOXIES

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• Hockey: 3 forwards, 2 defenseman

• Hotels: check in time is after 3pm

• Rental cars: rent cars by the day

• Pharmacy: people must physically be present to fill prescriptions at the pharmacy

• Provision of Care: care must be delivered in person

• Professional Scopes of Practice: regulated health professionals are the only people that can / should deliver services within their respective scopes of practice

Some common examples...

ORTHODOXIES

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Exercise Time!

GROUP EXERCISE

Identify closely held beliefs and assumptions shared by the healthcare system, constituents, and other organizations

Brainstorm how you might flip these orthodoxies

• Imagine life without the orthodoxy

• Consider users who don’t expect this norm

• Imagine a business or agency that does the opposite

• Think about a place in the world, or time in history, where this is/was very different

Add your post-its to the poster and share with the group

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What to expect after lunch…

AGENDA

SESS

ION

#1

SE

SSIO

N #

2

Introduction to Innovation

Aligning on a common definition and reviewing a set of useful frameworks

Problem Framing

Getting clear about the issues we are trying to address

Orthodoxies

Identifying the commonly held beliefs in healthcare which we may disrupt

Pain Points

Identifying a list of key pain points for patients through an end user-focused lens

Ten Types of Innovation

Exploring the use of the Ten Types as a way to generate new innovations

Wrap-Up

Summarizing the key points from today’s discussions

Session #2

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Recapping this morning’s discussions

AGENDA

SESS

ION

#1

SE

SSIO

N #

2

Introduction to Innovation

Aligning on a common definition and reviewing a set of useful frameworks

Problem Framing

Getting clear about the issues we are trying to address

Orthodoxies

Identifying the commonly held beliefs in healthcare which we may disrupt

Pain Points

Identifying a list of key pain points for patients through an end user-focused lens

Ten Types of Innovation

Exploring the use of the Ten Types as a way to generate new innovations

Wrap-Up

Summarizing the key points from today’s discussions

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ORGANIZATION FRAMING: How might we reduce healthcare costs and improve patient satisfaction by offering greater flexibility and choice?

Framing Challenge #1

REVIEW PROBLEM FRAMING

USER FRAMING: How might we help citizens like Stu to easily select and access the care that is best for them?

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ORGANIZATION FRAMING: How might we reduce demand for hospitals’ emergency rooms while maintaining the same level of care for citizens?

Framing Challenge #2

REVIEW PROBLEM FRAMING

USER FRAMING: How might we provide alternative services for citizens like Helena to address their concerns and reduce their need to visit hospitals’ emergency rooms?

Stakeholder Pain Points

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At Doblin, we apply user-centred research and a design-led approach to solve complex problems

USER-CENTRIC PROCESS

Frame research, immerse team in research, and identify a relevant set of insights

Deepen concepts, detail customer experiences, business rationale and roadmap

Bring together and examine insights and generate their related implications

Generate concepts, define concept elements, and articulate customer and consumer value propositions

DISCOVER

ANALYZE

DEVELOP

Know Users

Know Context

Incubate & Implement

Identify Insights

Evaluate Businesses

Explore Concepts

Make Plans

CREATE

START HERE

Framing

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Design research methods can help us uncover latent needs and fresh insights about users

USER RESEARCH

Primary Research Methods: • In-depth Interviews • Diaries • Ride-Alongs • Observations • Focus Groups

• Elicitation Exercises (e.g., Card sorting) • Interceptions • Surveys • DIY Interviews

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PAIN POINTS: CHALLENGE # 1

Pain point examples for patients like Stu

Understanding pain points will help contextualize the innovation that we are seeking to develop

• Anxious about having to manage all aspects of his health and diseases alone

• Tired of the constant need to monitor and manage aspects of every day life (i.e., diet)

• Tired of reporting to his physicians his health status—isn’t there and easier way to report blood sugar and BP trends

• Frustrated for not making progress against the health goals set by doctor— ”I eat and I exercise, but I can’t seem to lose the 15 kg my doctor says to and my BP and BS are still out of control”

• Frustrated by multiple sources of (conflicting) information and wishes there were fewer individuals involved or at least a few key that knew the important information

• Frustrated with his inability to receive timely and relevant help when he needs it and wishes the assistance was available earlier without the need for doctor visits

• Remembering to order medications and diabetic supplies before they run out

• Tired of repeatedly sharing his story with multiple services providers who try to help him with his various health issues

Updated

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PAIN POINTS: CHALLENGE #2

Pain point examples for patients like Helena

Understanding pain points will help contextualize the innovation that we are seeking to develop

• Feeling alone and increasingly socially isolated from her friends and neighbourhood activities

• Fearful that if something happens and she cannot contact help she will be “trapped” in her home alone and hurt

• Wishes she could understand what causes her exacerbations so she that could prevent them

• Caught in a vicious circle – difficulty walking and getting around, but needs to be more active

• Frustrated with the lack of access to respiratory rehabilitation expertise to better manage and maintain her health

• Confused about how best to manage her condition and multiple medications

• Never remembering to order the medications before they run out

• She is tired of the frequent trips, long waits and lack of privacy in visiting her local Emergency Department and having to repeat her medical history to a new physician/provider each time

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Exercise Time!

GROUP EXERCISE

Brainstorm pain points experienced by your group’s archetype

• Be specific

• Pain points include frustrations, unmet needs, and workarounds

• Think from the archetype’s point of view

Add your post-its to the poster and share with the group

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Recognizing and constructing across multiple types of innovation produced more robust innovation concepts

EXPLORING TEN TYPES OF INNOVATION

Network Partnerships with others to create value

Process Signature or superior methods for doing your work

Program System Complementary programs or services

Channel How your offerings are delivered to citizens or other users

Customer Engagement Quality of interactions you foster with the public & internal stakeholders

Economic Model How you fund programs or services

Structure Alignment of your talent and assets

Core Program Performance Distinguishing elements of your core program

Service Support and enhancements that augment your program

Brand Representation of your program

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Signature or superior methods for doing your work

Partnerships with others to

create value

How you fund programs or services

Alignment of your talent and assets

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Complementary programs or services

Distinguishing elements of your core program

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Support and enhancements that augment your program

Representation of your program

The quality of interactions you foster with the public and internal stakeholders

How your offerings are delivered to citizens or other users

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EXPLORING TEN TYPES OF INNOVATION

ADJACENT

CORE

You will need coordinated innovation across multiple (4+), interdependent types.

FOR TRANSFORMATIONAL INNOVATION

You’ll need innovation within multiple types (3-4) around a new offer.

FOR ADJACENT INNOVATION

For innovation in the core, you will be innovating within independent innovation types around existing offers aimed at current customers.

FOR CORE INNOVATION

TRANSFORMATIONAL

As you increase your level of ambition, you need to layer in more and more types of innovation…

4+ Types

3-4 Types

1 Type

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Health Leads | Prescribing solutions to improve health, not just manage disease

TEN TYPES | ILLUSTRATIVE INNOVATION

5 types:

When the patient / client visits a Health Leads partnered hospital the clinic team screens the patient for basic needs impacting their health status (e.g., employment services, utilities). They are then ‘prescribed’ specific resources which are ‘filled’ at the Health Leads Desk who is able to connect them with community / public resources.

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Exercise Time!

GROUP EXERCISE

Use the Ten Types of Innovation to identify ways in which your challenge statement might be addressed….

…we will prompt you with ten minutes left to group your different thoughts into a more overarching concept that tackles your challenge statement

Final Thoughts and Considerations

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Considerations

WRAP-UP

What are your biggest takeaways from our workshop today; what did you learn and how will you apply it?

What will you do to drive innovation in your team?

How did it feel participating in these exercises with your colleagues?

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We believe effective innovators follow 4 important principles

WRAP-UP

Be explicit about innovation ambition, then organize and execute accordingly.

1. Look beyond program innovation to transform other elements of your business system.

2. Drive innovation from deep and unconventional insights about users throughout the value chain.

3. Don’t be fooled by the mythical importance of creativity; focus on discipline instead.

4.

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Blaine Woodcock bwoodcock@deloitte.ca 416.662.1781

Lisa Purdy lpurdy@deloitte.ca 416.601.6403