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2011 Healthcare Reform and Innovation Survey


   www.kalypso.com
Agenda

•  Introduction to Kalypso
     –  The Kalypso Difference
     –  The Innovation Engine
     –  Software Expertise
•  About the Study
•  Detailed Results
     –  Market Issues
     –  Capabilities
     –  Gaps & Barriers
•  Getting Started

1/16/12                          2
•  Introduction to Kalypso
     –  The Kalypso Difference
     –  The Innovation Engine
•  About the Study
•  Detailed Results
     –  Market Issues
     –  Capabilities
     –  Gaps & Barriers
•  Getting Started



1/16/12                          3
The Kalypso Difference

Kalypso is a consulting firm focused exclusively on innovation.
Our people are leading business professionals who combine experience
in select industries with product and process innovation expertise.




1/16/12                            4
The Innovation Engine
Our services are designed to help companies become more innovative
and provide a systemic view of new product & service development.

                                  Business	
  &	
  Innova-on	
  Strategy	
  

                                                                     New	
  Product	
  
           Front	
  End	
        Por0olio	
  &	
  Pipeline	
         Development	
        Pricing	
  &	
  Value	
  
          Of	
  Innova.on	
         Management	
                                           Management	
  
                                                                      Execu.on	
  


                                                PLM	
  Technology	
  

                                          Leadership	
  &	
  Learning	
  

                                Intellectual	
  Property	
  Management	
  


1/16/12                                                          5
•  Introduction to Kalypso
     –  The Kalypso Difference
     –  The Innovation Engine
•  About the Study
•  Detailed Results
     –  Market Issues
     –  Capabilities
     –  Gaps & Barriers
•  Getting Started



1/16/12                          6
About the Study
Innovation in Healthcare
In February – May 2011 we conducted a survey of market issues driving
the need to innovate and how healthcare companies are planning to
address these market changes and opportunities.
                              Company Operations


          Market Issue                                     Need to
            Drivers                                       Innovate



                         Capability Maturity Framework

            Current                 Gaps &                 Future
          Capabilities              Barriers             Capabilities


1/16/12                                7
About the Study
We surveyed 31 individuals in
                                                    U.S. Companies
23 different healthcare organizations.
      Company Type                      Organization                      Role
                                                                                    Director
                     Provider /                        Prod Dev
           16%       Other                                               19%        Prod Mgmt
    32%              Payor
                                  45%      39%         Prod Dev   49%               Executive
                     Did not                           Support            19%
                     respond                                                        Did not
           52%                                         Did not
                                                                                    respond
                                         16%           respond
                                                                        13%
                     n= 31                             n= 31                        n= 31


           Members                        Revenue                       Geography
                     <1MM                              <$ 1 BN                      Single-state

                     1-20MM                            $1-10 BN                     Regional
           16%                           19%
    39%              >20MM
                                  32%                  > $10 BN
                                                                  32%     32%       National

                                                                                    Did not
            39%      Did not
                                  13%     36%          Did not
                     respond                           respond     16% 20%          respond
      6%
                     n= 31                             n= 31                        n= 31

1/16/12                                        8
•  Introduction to Kalypso
     –  The Kalypso Difference
     –  The Innovation Engine
•  About the Study
•  Detailed Results
     –  Market Issues
     –  Capabilities
     –  Gaps & Barriers
•  Getting Started



1/16/12                          9
Benchmarking Market Issues
Top Concerns for Product Development:
There was general agreement that two issues (Retail Exchanges and ACOs) were of major
concern, after which agreement fell off significantly.
See Health Care Reform Magazine for a more in depth discussion on the top issues.
                                                               Market Issues
                                                        Retail Exchanges
                                         Accountable Care Organizations
                                        Transparency to Cost and Quality
                                        Alternative Care Delivery Models
ASO / ASC - increased demand for and/or complexity of relationships
                                            Changing Channel Strategies
                                 Mandated Medicare Reduction in Spend
                                 Change in Reimbursement Methodology
                                                     Health and Wellness
                                                        Aging Population
                                    Increased Demand for Customization
                                         Benefit Carve Outs / Exclusions
                                      High Deductible Health Plans v 2.0
                                         Sharply Tiered Network Designs
  Role / impact of essential community care providers in commercial
                                                  Medical Health Records
Source: Kalypso Healthcare Survey Data 05.11.11
                                                                           0%   10%   20%   30%   40%   50%   60%
1/16/12                                                                    10
Benchmarking Capability Maturity
Companies believe they do not yet have formal product development capabilities in place;
however, they plan to have “advanced” product development capabilities in the near
future.
This is typical of other industries, where the experience is that making this change is often
a 5 to 10 year effort and expectations often outpace ability to change.
                                                      Current State vs. Future State
                                                                                          Avg. Current State            Avg. Future State


                              Technology
                                                                                                     1.41

Six Elements
                               Resource
of Product                  Management                                                        1.35
Development
                                Process
                            Management                                                                  1.15


                                  Products                                                                1.29


                               Innovation                                                        1.36
                                                                                                                              Current State
                                  Strategy                                                                                    Future State
                                                                                                         0.91


                                                  0              1                 2         3                      4                       5
                                                            (Developing)        (Basic)   (Formal)              (Advanced)         (World Class)
Source: Kalypso Healthcare Survey Data 05.11.11

1/16/12                                                                    11
Benchmarking Gaps & Barriers

There are significant differences of opinion between leadership and staff on what the
major issues will be in achieving targeted capability improvements
Agreeing to where to focus, and overcoming these barriers will be a major factor in
achieving planned improvements to meet the emerging competitive threats in the industry



                                              Gaps & Barriers by Level
100%                                                                                       Leadership = Directors, VPs, Senior Executives
 90%                                                                                       Product Managers & Staff = Product management
 80%
 70%
 60%
                                                                                                                       All Responses
 50%
 40%                                                                                                                   Product Managers & Staff
 30%
                                                                                                                       Leadership
 20%
 10%
  0%
        Resource    Technology - Leadership   Strategic   Innovation   Organization   Resource     Technology -
       Availability Core Systems              Alignment     Culture     Alignment     Capability     General



                                                                                         Source: Kalypso Healthcare Survey Data 05.11.11




1/16/12
                                                                  12
•  Introduction to Kalypso
     –  The Kalypso Difference
     –  The Innovation Engine
•  About the Study
•  Detailed Results
     –  Market Issues
     –  Capabilities
     –  Gaps & Barriers
•  Getting Started



1/16/12                          13
Innovation Transformation Framework
Kalypso uses an integrated approach to improve our clients’ ability
to innovate


          Finance/ ERP                                                       Sales/ CRM


                                       Innovation Strategy

                               Portfolio & Pipeline Management
                        Front End
                       Of Innovation       Development       Commercialization


                                Product Lifecycle Management

                                 People, Leadership & Culture

            Human                                                           Supply Chain/
           Resources                                                             ERP


1/16/12                                         14
Innovation Mgmt. Implementation Approach
         Our Innovation Management implementation approach is designed to be
         scalable and adapt to our clients’ unique situations
                                        Phase I                              Phase II                 Phase III
                                        Assess                       Detail Design & Piloting Roll-out Institutionalize
                           Innovation Engine
                               Diagnostic                               Detailed Process Design
Implementation Approach




                                                                       Design Workshops
                                  Solution Architecture                                    Training           Organization
                                         Design                                            Materials            Roll-out
                                Design Workshop                         “Quick Hit”
                                                                      Implementation
                                                  Stakeholder                              End-to-End Process Piloting
                                                   Alignment                                     & Refinement
                                           Pipeline                                                                 IT Systems Design
                                        Rationalization                                                                 and Rollout
                                    Project Team Formed                                    Champions for Change
                          •  Prioritize for “to be” framework        •  Design integrated cycle time process •  Begin roll-out
                          •  Validate high level design elements     •  Pilot on projects                    •  Continuous Improvement Plan
                          •  Initiate “Quick Hit” implementation     •  Construct Training Plan & Materials     (Measure, Monitor, Improve)



       1/16/12                                         Steering Committee Review      15      Steering Committee Review
Innovation Engine Diagnostic
Our Innovation Diagnostic Sets The Stage For Redesigning And
Transforming Your Capabilities
                          Step 1:                                                                                                               Step 5:
                 Evaluate Current Product                Step 2:                         Step 3:                   Step 4:
                                                   Complete Innovation            Identify Innovation                                          Develop
                   Planning Processes &                                                                      Design Future State
                                                      Benchmarking                Gaps / Opportunities                                      Transformation
                   Innovation Strategies                                                                           Process
                                                                                                                                               Roadmap

 Objectives      Detailed understanding        Gather specific data to       ID gaps in current          Determine practices and Blueprint for
                 of the current                understand current            processes relative to       organizational changes transformation.
                 innovation and product        practices against             best practices. Develop     needed                  Detail “Quick Hit”
                 planning process              industry benchmarks           value prop. for change                              Opportunities


Key Activities   • Refine project objectives   • Conduct interviews          • Analyze benchmarking      • Compile findings from       • Map path from current
                 • Mobilize project team       • Compile interview             and interview data          previous work to compile      state to desired future
                                                 responses & compare         • Compare to best practices   holistic view of planning / state
                 • Hold Kick-off meeting                                                                   NPI process
                                                 to Maturity Model             and ID gaps                                             • Align with implement-
                 • Schedule interviews,                                        and opportunities for     • Leverage relevant best        ation timeline
                   workshops, & updates        • Assess existing metrics
                                                 against industry database     improvement                 practices                   • Develop change program
                 • Gather and review                                         • Prioritize gaps and       • Design future state
                   relevant process            • Identify barriers to                                                                  • Goals
                                                 collaboration (internal       improvement                 process architecture
                   documentation                                               opportunities                                           • Communications
                                                 and with key partners)                                  • Determine proposed org.
                 • Collect and analyze                                       • Identify key business and   design required to
                   existing metrics            • Identify organizational
                                                 constraints                   performance drivers         support process
                 • Examine s/w tools in use                                                                architecture
                 • Review as-is for 1-2
                   recent projects

 Deliverables    • Project Plan                • Interview summaries  • Process gap analysis             • High-level process         • Transformation
                 • As-is Process Map           • Summarized Planning/ • Detailed Findings &                architecture                 Roadmap
                 • Initial Quick Hit list        NPI Objectives         Recommendations                  • Organizational design      • Quick-Hit Plans
                                               • NPI Maturity         • Executive Summary                                             • Final Report
                                                 Scorecard              with Prioritized
                                                                        Recommendations


1/16/12                                                                      16
Product Portfolio Management
Kalypso uses a rapid prototyping approach to design, implement, sustain
and optimize Portfolio & Pipeline Management.

  Create Pipeline Visibility Through
  Iterative Portfolio Design and Test                                           Validate Governance, Teams and
  •  Leading practice design is tailored to client specific requirements
                                                                                Sustaining Processes
  •  Design is tested immediately with real data for validation                 •  Pilot implementation of processes, teams and tools guide
  •  Value of analysis is confirmed through executive presentation                 improvements and roadmap phasing
                                                                                •  Decision making becomes part of the way work gets done

                                                                                                                               Portfolio Phase-Gate
                                                                                                                                    Integration
            Executive                                 Organizational             Portfolio Working
            Objectives                                Requirements               & Decision Teams

                                  Portfolio
                                   Design

            Facilitated                              Portfolio
             Portfolio                                 Data                            Portfolio
              Review                                 Analysis                          Calendar
                                                                                                                                Portfolio Process &
                                                                                                                                 Off-Cycle Process



  Develop Advanced Scenario Planning and Optimize Strategy
  •  Scenario planning is enabled and drives proactive resource allocation
  •  Innovation strategy, roadmaps and internal capabilities are tightly
     integrated with portfolio decision making to optimize investments

1/16/12                                                                    17
Portfolio Design Elements
The innovation portfolio management base design includes all components
needed to gain pipeline visibility to enable decision making.

                                             Portfolio Scope
                                     When and how does a project enter and
           Project                       exit the innovation portfolio?
                                                                                           Strategic
           Definition                                                                      Buckets
 Do we all mean the same                                                           How do we classify
 thing when we say                                                                 innovation projects to
 “project?”                                                                        monitor investment?



           Inclusion                                                                         Resource
           Criteria                                                                          Pools
 Is this project big enough                                                        What do we need to
 to spend time doing                                                               deliver innovation
 portfolio analysis on?                                                            portfolio objectives?




                        Project Basic           Project                            Evaluation
   Project-Level        Information             Reporting Data                     Criteria
       Data             How do we identify      How do we slice, dice and          How should we value one
                        projects?               aggregate portfolio information?   project against another?

1/16/12                                              18
Kalypso Contact




                                        Andrew	
  Nygard	
  
                                        Senior	
  Manager	
  
                                        andrew.nygard@kalypso.com	
  
                                        415-­‐378.3274	
  




          hPp://kalypso.com/company/people/andrew-­‐nygard/	
  

1/16/12                            19

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Healthcare Survey HIgh Level Results

  • 1. 2011 Healthcare Reform and Innovation Survey www.kalypso.com
  • 2. Agenda •  Introduction to Kalypso –  The Kalypso Difference –  The Innovation Engine –  Software Expertise •  About the Study •  Detailed Results –  Market Issues –  Capabilities –  Gaps & Barriers •  Getting Started 1/16/12 2
  • 3. •  Introduction to Kalypso –  The Kalypso Difference –  The Innovation Engine •  About the Study •  Detailed Results –  Market Issues –  Capabilities –  Gaps & Barriers •  Getting Started 1/16/12 3
  • 4. The Kalypso Difference Kalypso is a consulting firm focused exclusively on innovation. Our people are leading business professionals who combine experience in select industries with product and process innovation expertise. 1/16/12 4
  • 5. The Innovation Engine Our services are designed to help companies become more innovative and provide a systemic view of new product & service development. Business  &  Innova-on  Strategy   New  Product   Front  End   Por0olio  &  Pipeline   Development   Pricing  &  Value   Of  Innova.on   Management   Management   Execu.on   PLM  Technology   Leadership  &  Learning   Intellectual  Property  Management   1/16/12 5
  • 6. •  Introduction to Kalypso –  The Kalypso Difference –  The Innovation Engine •  About the Study •  Detailed Results –  Market Issues –  Capabilities –  Gaps & Barriers •  Getting Started 1/16/12 6
  • 7. About the Study Innovation in Healthcare In February – May 2011 we conducted a survey of market issues driving the need to innovate and how healthcare companies are planning to address these market changes and opportunities. Company Operations Market Issue Need to Drivers Innovate Capability Maturity Framework Current Gaps & Future Capabilities Barriers Capabilities 1/16/12 7
  • 8. About the Study We surveyed 31 individuals in U.S. Companies 23 different healthcare organizations. Company Type Organization Role Director Provider / Prod Dev 16% Other 19% Prod Mgmt 32% Payor 45% 39% Prod Dev 49% Executive Did not Support 19% respond Did not 52% Did not respond 16% respond 13% n= 31 n= 31 n= 31 Members Revenue Geography <1MM <$ 1 BN Single-state 1-20MM $1-10 BN Regional 16% 19% 39% >20MM 32% > $10 BN 32% 32% National Did not 39% Did not 13% 36% Did not respond respond 16% 20% respond 6% n= 31 n= 31 n= 31 1/16/12 8
  • 9. •  Introduction to Kalypso –  The Kalypso Difference –  The Innovation Engine •  About the Study •  Detailed Results –  Market Issues –  Capabilities –  Gaps & Barriers •  Getting Started 1/16/12 9
  • 10. Benchmarking Market Issues Top Concerns for Product Development: There was general agreement that two issues (Retail Exchanges and ACOs) were of major concern, after which agreement fell off significantly. See Health Care Reform Magazine for a more in depth discussion on the top issues. Market Issues Retail Exchanges Accountable Care Organizations Transparency to Cost and Quality Alternative Care Delivery Models ASO / ASC - increased demand for and/or complexity of relationships Changing Channel Strategies Mandated Medicare Reduction in Spend Change in Reimbursement Methodology Health and Wellness Aging Population Increased Demand for Customization Benefit Carve Outs / Exclusions High Deductible Health Plans v 2.0 Sharply Tiered Network Designs Role / impact of essential community care providers in commercial Medical Health Records Source: Kalypso Healthcare Survey Data 05.11.11 0% 10% 20% 30% 40% 50% 60% 1/16/12 10
  • 11. Benchmarking Capability Maturity Companies believe they do not yet have formal product development capabilities in place; however, they plan to have “advanced” product development capabilities in the near future. This is typical of other industries, where the experience is that making this change is often a 5 to 10 year effort and expectations often outpace ability to change. Current State vs. Future State Avg. Current State Avg. Future State Technology 1.41 Six Elements Resource of Product Management 1.35 Development Process Management 1.15 Products 1.29 Innovation 1.36 Current State Strategy Future State 0.91 0 1 2 3 4 5 (Developing) (Basic) (Formal) (Advanced) (World Class) Source: Kalypso Healthcare Survey Data 05.11.11 1/16/12 11
  • 12. Benchmarking Gaps & Barriers There are significant differences of opinion between leadership and staff on what the major issues will be in achieving targeted capability improvements Agreeing to where to focus, and overcoming these barriers will be a major factor in achieving planned improvements to meet the emerging competitive threats in the industry Gaps & Barriers by Level 100% Leadership = Directors, VPs, Senior Executives 90% Product Managers & Staff = Product management 80% 70% 60% All Responses 50% 40% Product Managers & Staff 30% Leadership 20% 10% 0% Resource Technology - Leadership Strategic Innovation Organization Resource Technology - Availability Core Systems Alignment Culture Alignment Capability General Source: Kalypso Healthcare Survey Data 05.11.11 1/16/12 12
  • 13. •  Introduction to Kalypso –  The Kalypso Difference –  The Innovation Engine •  About the Study •  Detailed Results –  Market Issues –  Capabilities –  Gaps & Barriers •  Getting Started 1/16/12 13
  • 14. Innovation Transformation Framework Kalypso uses an integrated approach to improve our clients’ ability to innovate Finance/ ERP Sales/ CRM Innovation Strategy Portfolio & Pipeline Management Front End Of Innovation Development Commercialization Product Lifecycle Management People, Leadership & Culture Human Supply Chain/ Resources ERP 1/16/12 14
  • 15. Innovation Mgmt. Implementation Approach Our Innovation Management implementation approach is designed to be scalable and adapt to our clients’ unique situations Phase I Phase II Phase III Assess Detail Design & Piloting Roll-out Institutionalize Innovation Engine Diagnostic Detailed Process Design Implementation Approach Design Workshops Solution Architecture Training Organization Design Materials Roll-out Design Workshop “Quick Hit” Implementation Stakeholder End-to-End Process Piloting Alignment & Refinement Pipeline IT Systems Design Rationalization and Rollout Project Team Formed Champions for Change •  Prioritize for “to be” framework •  Design integrated cycle time process •  Begin roll-out •  Validate high level design elements •  Pilot on projects •  Continuous Improvement Plan •  Initiate “Quick Hit” implementation •  Construct Training Plan & Materials (Measure, Monitor, Improve) 1/16/12 Steering Committee Review 15 Steering Committee Review
  • 16. Innovation Engine Diagnostic Our Innovation Diagnostic Sets The Stage For Redesigning And Transforming Your Capabilities Step 1: Step 5: Evaluate Current Product Step 2: Step 3: Step 4: Complete Innovation Identify Innovation Develop Planning Processes & Design Future State Benchmarking Gaps / Opportunities Transformation Innovation Strategies Process Roadmap Objectives Detailed understanding Gather specific data to ID gaps in current Determine practices and Blueprint for of the current understand current processes relative to organizational changes transformation. innovation and product practices against best practices. Develop needed Detail “Quick Hit” planning process industry benchmarks value prop. for change Opportunities Key Activities • Refine project objectives • Conduct interviews • Analyze benchmarking • Compile findings from • Map path from current • Mobilize project team • Compile interview and interview data previous work to compile state to desired future responses & compare • Compare to best practices holistic view of planning / state • Hold Kick-off meeting NPI process to Maturity Model and ID gaps • Align with implement- • Schedule interviews, and opportunities for • Leverage relevant best ation timeline workshops, & updates • Assess existing metrics against industry database improvement practices • Develop change program • Gather and review • Prioritize gaps and • Design future state relevant process • Identify barriers to • Goals collaboration (internal improvement process architecture documentation opportunities • Communications and with key partners) • Determine proposed org. • Collect and analyze • Identify key business and design required to existing metrics • Identify organizational constraints performance drivers support process • Examine s/w tools in use architecture • Review as-is for 1-2 recent projects Deliverables • Project Plan • Interview summaries • Process gap analysis • High-level process • Transformation • As-is Process Map • Summarized Planning/ • Detailed Findings & architecture Roadmap • Initial Quick Hit list NPI Objectives Recommendations • Organizational design • Quick-Hit Plans • NPI Maturity • Executive Summary • Final Report Scorecard with Prioritized Recommendations 1/16/12 16
  • 17. Product Portfolio Management Kalypso uses a rapid prototyping approach to design, implement, sustain and optimize Portfolio & Pipeline Management. Create Pipeline Visibility Through Iterative Portfolio Design and Test Validate Governance, Teams and •  Leading practice design is tailored to client specific requirements Sustaining Processes •  Design is tested immediately with real data for validation •  Pilot implementation of processes, teams and tools guide •  Value of analysis is confirmed through executive presentation improvements and roadmap phasing •  Decision making becomes part of the way work gets done Portfolio Phase-Gate Integration Executive Organizational Portfolio Working Objectives Requirements & Decision Teams Portfolio Design Facilitated Portfolio Portfolio Data Portfolio Review Analysis Calendar Portfolio Process & Off-Cycle Process Develop Advanced Scenario Planning and Optimize Strategy •  Scenario planning is enabled and drives proactive resource allocation •  Innovation strategy, roadmaps and internal capabilities are tightly integrated with portfolio decision making to optimize investments 1/16/12 17
  • 18. Portfolio Design Elements The innovation portfolio management base design includes all components needed to gain pipeline visibility to enable decision making. Portfolio Scope When and how does a project enter and Project exit the innovation portfolio? Strategic Definition Buckets Do we all mean the same How do we classify thing when we say innovation projects to “project?” monitor investment? Inclusion Resource Criteria Pools Is this project big enough What do we need to to spend time doing deliver innovation portfolio analysis on? portfolio objectives? Project Basic Project Evaluation Project-Level Information Reporting Data Criteria Data How do we identify How do we slice, dice and How should we value one projects? aggregate portfolio information? project against another? 1/16/12 18
  • 19. Kalypso Contact Andrew  Nygard   Senior  Manager   andrew.nygard@kalypso.com   415-­‐378.3274   hPp://kalypso.com/company/people/andrew-­‐nygard/   1/16/12 19