Optimizing Skill Sets, Processes And Technology To Boost The Effectiveness Of Healthcare Delivery To Customers - ABF Pharmaceutical Conference Singapore

Slide 1: OPTIMIZING SKILL SETS, PROCESSES AND TECHNOLOGY TO BOOST THE EFFECTIVENESS OF HEALTHCARE DELIVERY TO CUSTOMERS Case studies, Concepts, and Debatable Ideas Kenny Ong CNI Holdings Berhad www.myCNI.com.my www.OOBEY.com

Slide 2: Summary: Long-term Objectives Strategies Enablers Resources Also known as L.O.S.E.R. www.myCNI.com.my www.OOBEY.com

Slide 3: Summary: Today’s presentation 1. Solution Model 2. Strategy 3. Resources www.myCNI.com.my www.OOBEY.com

Slide 4: Issues and Obstacles 1. Increasing costs 1. Safety of patients 1. Staff 1. Medical errors 2. ‘Cover cost’ overbooking 2. Hospital infections 2. Public-sector burden 3. Medical fraud 3. Shortage of specialist 4. Malpractice Doctors 2. IT: Privacy and 1. Geriatrics (2%) Confidentiality 4. Less time per patient 3. Episodic Care -> On- 5. Population Growth going care 6. Disparity and 4. Communicable Disease Maldistribution -> Non-communicable disease 7. Untested, risky new Technology 5. Rich and Poor segments www.myCNI.com.my www.OOBEY.com

Slide 5: Issues and Obstacles 1. Unregulated private 1. Lack of coordination sector 2. Poor customer service 2. Variations in Quality and 3. Short on personnel and Performance medication 3. Cultural and language 4. Long waiting time barriers 5. Access to self-care 4. Access resources 5. H/C workforce instability 6. Absence of clear 6. Black Market admission/referral 7. Fail to enforce policies Regulations 7. No standard protocols for 8. Expensive insurance different levels of H/C premiums 8. Over-focused on Profit www.myCNI.com.my www.OOBEY.com

Slide 6: Income Groups Urban, Expensive, cutting Affluent edge, private funds No money for high- Middle end, no access to low- Class end Poor, Government priority, Rural high subsidy, rural stations, cheap www.myCNI.com.my www.OOBEY.com

Slide 7: Our Role? Main Healthcare Providers ry Re ve q ue li Se De t st es rv ice qu Re Request Customers, Healthcare Patients Industry Service www.myCNI.com.my www.OOBEY.com

Slide 8: What is the Business Model? USP Market Profit Model Discipline www.myCNI.com.my www.OOBEY.com

Slide 9: What is the Healthcare Model? USP Funding Market Model Discipline www.myCNI.com.my www.OOBEY.com

Slide 10: Intro: Market Discipline • Mamak stall www.myCNI.com.my www.OOBEY.com

Slide 11: Intro: Market Discipline Product "They are the most innovative" Leadership "Constantly renewing and creative" "Always on the leading edge" Customer Intimacy Operational Excellence "Exactly what I need" "A great deal!" Customized products Excellent/attractive price Personalized communications Minimal acquisition cost and "They're very responsive" hassle Preferential service and Lowest overall cost of flexibility ownership Recommends what I need "A no-hassles firm" "I'm very loyal to them" Convenience and speed Helps us to be a success Reliable product and service www.myCNI.com.my www.OOBEY.com

Slide 12: Intro: Disciplines Product Leadership (best product) Operational Excellence Customer Intimacy (low cost producer) (best total solution) www.myCNI.com.my Leaders, Michael Treacy & Fred Wiersema; 1995 Ref: The Discipline of Market www.OOBEY.com

Slide 13: Summary: Today’s presentation  Done 1. Solution Model 2. Strategy 3. Resources www.myCNI.com.my www.OOBEY.com

Slide 14: Set the Strategies www.myCNI.com.my www.OOBEY.com

Slide 15: What is the End Objective? “…in the past 18 months, we have heard that profit is more important than revenue, quality is more important that profit, people are more important than profit, customers are more important than our people, big customers are more important than small customers, and that growth is the key to our success. No wonder our performance is inconsistent" CEO, Anonymous www.myCNI.com.my www.OOBEY.com

Slide 16: What is the End Objective? In the old days of HR… • Average training hours per staff • % of staff attending training • # of training programs • % of training programs conducted • Training needs analysis conducted • Competency models developed • Training budget as % of payroll What’s wrong with this picture? www.myCNI.com.my www.OOBEY.com

Slide 17: What is the End Objective? Moral of the story… 2. Innovation: – Business models – Products – Services 3. Market Leadership 4. Competitive differentiation End Objective? www.myCNI.com.my www.OOBEY.com

Slide 18: “What is the moral of the story?” www.myCNI.com.my www.OOBEY.com

Slide 19: What then are the End Objectives? 1. Level of Population Health 2. Health Inequalities 3. Level of Health System Responsiveness (patient satisfaction) 4. Distribution of Responsiveness within the population (segment satisfaction) 5. Distribution of health system’s financial burden within the population (who pays) The World Health Report 2000, World Health Organization www.myCNI.com.my www.OOBEY.com

Slide 20: Expectations and Objectives 1. ↓ cost 1. ↑ Prevention 2. ↑ access 2. ↓ Overcrowding in urban 3. ↑ Quality 3. ↑ Profiting from High-end 4. ↓ Variations in 4. ↑ FDI to ↑ H/C System performance 5. ↑ Meet segment needs 5. ↑ Utilization of resources 6. ↑ Workforce 6. ↓ Disparity ↑ Equity Management www.myCNI.com.my www.OOBEY.com

Slide 21: Some broad Solutions and Strategies… 1. Patient-centered care 2. Inpatient -> Outpatient 3. High-end care 4. Rural care 5. Public-Private sector collaboration 6. Preventive Healthcare 7. Government subsidy -> Private sector funding 8. Disruptive Innovation (“Just Good Enough”) www.myCNI.com.my www.OOBEY.com

Slide 22: Side Note: Disruptive Innovation n d rive ts o gy men ch nol ove n t te l impr r ese ogica e of p hnol anc g tec Performance m erfor tainin ustome rs P sus at c ance th ilize by Perform rb or ut so can ab New Performance trajectory *The Innovator’s Solution, Clayton M. Christensen Time www.myCNI.com.my www.OOBEY.com

Slide 23: Side Note: Disruptive Innovation • begin in unattractive or overlooked markets • high-quality, affordable alternatives • more convenient • less centralized locations • increasingly lower prices • for less complicated cases • less specialized training to deliver Also known as ‘Downwards Innovation’ *The Innovator’s Solution, Clayton M. Christensen www.myCNI.com.my www.OOBEY.com

Slide 24: Side Note: Disruptive Innovation Examples of Disruptive Innovation in serving the “Under-served” markets: 2. Angioplasty 3. LASIK 4. Home Pregnancy Kit 5. MinuteClinic - diagnoses < 20 conditions 6. Sonosite – portable ultrasound machine 7. Quantum Dot – self diagnosis of complicated conditions such as prostate cancer *The Innovator’s Solution, Clayton M. Christensen www.myCNI.com.my www.OOBEY.com

Slide 25: Side Note: Disruptive Innovation Ability to Diagnose and Treat t tien Inp a ital t Ho sp tien ral In pa G ene ital o sp t yH i en t i alt at ti en ec utp pa Sp DO O ut M M D C are Non ti ve na A lter *Will Disruptive Innovations Transform Healthcare, 19 August 2001, John W. Kenagy, MD www.myCNI.com.my www.OOBEY.com

Slide 26: Main Healthcare BSC Healthcare Objectives Customer Who do we define as our customer? How do we create value Financial Internal Process for our customer? How do we add To satisfy value for customers customers while while controlling meeting costs? Strategy budgetary constraints, at How do we enable what business ourselves to grow processes must and change, we excel? meeting ongoing customer needs Employee Learning and Growth www.myCNI.com.my www.OOBEY.com

Slide 27: Healthcare Industry BSC Financial Customer “To satisfy our “Who are our target stakeholders, what customers? Financial objectives must we accomplish?” What is our value proposition?” Learning & Growth Internal Process “What capabilities and “To satisfy our customers, tools do our employees in which internal business require to help them processes must we excel?" execute our strategy? www.myCNI.com.my www.OOBEY.com

Slide 28: Linking BSC to Strategy Financial Revenue Growth Productivity Market Value Customers Base Share Gain Positioning Adjacent New Retention Market Business Internal Process Operational Product Customer Investment Excellence Leadership Intimacy Strategy Learning & Growth Competencies Information Motivation, Systems empowerment, alignment www.myCNI.com.my www.OOBEY.com

Slide 29: Segmentation vs. Solution Model Product Leadership (best product) Operational Excellence Customer Intimacy (low cost producer) (best total solution) www.myCNI.com.my Leaders, Michael Treacy & Fred Wiersema; 1995 Ref: The Discipline of Market www.OOBEY.com

Slide 30: The McPlaybook* Make it easy to eat Make it easy to prepare • 50% drive-thru • High Turnover • Meals held in one • Tasks simple to learn hand & repeat Make it quick Make what customers want • “Fast Food” • Prowls market for new • Tests new products products for Cooking Times • Monitored field tests *Adapted from: Businessweek , Februrary 5th 2007 www.myCNI.com.my www.OOBEY.com

Slide 31: Strategy: Value Disciplines Operational Excellence Product Leadership Customer Intimacy • Competitive price • New, state of the • Management by art products or Fact • Error free, reliable services • Easy to do business • Fast (on demand) with • Risk takers • Simple • Have it your way • Responsive • Meet volatile (customization) customer needs • Consistent • Market segments of information for all • Fast concept-to- one counter • Transactional • Proactive, flexible • Never satisfied - • Relationship and • 'Once and Done' obsolete own and consultative selling competitors' products • Cross selling • Learning organization www.myCNI.com.my www.OOBEY.com

Slide 32: Strategy: Value Disciplines Product Leadership (best product) Operational Excellence Customer Intimacy (low cost producer) (best total solution) www.myCNI.com.my Leaders, Michael Treacy & Fred Wiersema; 1995 Ref: The Discipline of Market www.OOBEY.com

Slide 33: Strategy: Value Disciplines Product Leadership (best product) Operational Excellence Customer Intimacy (low cost producer) (best total solution) www.myCNI.com.my Leaders, Michael Treacy & Fred Wiersema; 1995 Ref: The Discipline of Market www.OOBEY.com

Slide 34: Sample KPIs for Each Discipline Operational Product Customer Intimacy Excellence Leadership • Price • Marketing • Customer • Selection Knowledge • Convenience • Functionality • Solutions Offered • Zero Defects • # of Successes • Penetration • Growth • # of Failures • Customer Data • Learn from key • Customer-success users focus • Interdisciplinary teams • Pipeline www.myCNI.com.my www.OOBEY.com

Slide 35: Summary: Today’s presentation  Done 1. Business Model 2. Done Strategy 3. Resources www.myCNI.com.my www.OOBEY.com

Slide 36: Optimizing Resources to Meet Strategy www.myCNI.com.my www.OOBEY.com

Slide 37: Alignment: 4-Wheels Service Model Model Resources Structure Strategy Principles Leadership Person www.myCNI.com.my www.OOBEY.com

Slide 38: Alignment: Framework Principles • Equity • Protection of the Poor • Cost-effectiveness • Efficiency www.myCNI.com.my www.OOBEY.com

Slide 39: Alignment: Framework Structure • Org Structure • Job Design • C&B • Policies & procedures • Decision making • Job fit • Management Systems • BSC and KPIs • Decentralized & Empower www.myCNI.com.my www.OOBEY.com

Slide 40: Alignement: Framework Leadership • Role modeling • Vision/Mission/Philosophy • Leadership Style • Delegation & Empowerment • C&B, Promotions • Sense of Urgency • Customer focused • Best practices • Bottom line management • Tradeoff between Cost vs. Value www.myCNI.com.my www.OOBEY.com

Slide 41: Great Social Transformations happen when: 1. Public Awareness and Engagement 2. Political Leaders followed rather than led 3. Scientists, Engineers, Religious Leaders, Young People who led the way www.myCNI.com.my www.OOBEY.com

Slide 42: Alignment: Framework • Identification and Recruitment Person • Incentives • Training • Values • Motivation • Competency Analysis • Education/Curriculum www.myCNI.com.my www.OOBEY.com

Slide 43: Alignment: Framework Enablers Resources • Technology • Equipment Funding • Materials • Public • Intellectual • Private Property • Partners • Property www.myCNI.com.my www.OOBEY.com

Slide 44: Each Discipline Requires Different Priorities & Resources Organization, jobs, skills Culture, values, Operational Product Customer norms Excellence Leadership Intimacy Information and systems Management systems www.myCNI.com.my www.OOBEY.com

Slide 45: Each Discipline Requires Different Priorities & Resources Operational Excellence •Central authority, low level of empowerment Organization, •High skills at the core of the organization jobs, skills •Disciplined Teamwork •Process, product- driven Culture, values, •Conformance, 'one size fits all' mindset norms •Integrated, low cost transaction systems •The system is the process Information and systems •Command and control •Quality management Management systems www.myCNI.com.my www.OOBEY.com

Slide 46: Each Discipline Requires Different Priorities & Resources Product Leadership Organization, jobs, •Ad hoc, organic and cellular skills •High skills abound in loose-knit structures •Concept, future-driven Culture, values, •Experimentation and 'out of the box' mindset norms •Person-to-person communications systems •Technologies enabling cooperation Information and systems •Rewarding individuals' innovative capacity •Risk and exposure management Management •Product Life Cycle profitability systems www.myCNI.com.my www.OOBEY.com

Slide 47: Each Discipline Requires Different Priorities & Resources Customer Intimacy •Empowerment close to point of customer contact Organization, jobs, •High skills in the field and front-line skills •Customer-driven Culture, values, •Variation and 'have it your way' mindset norms •Strong customer databases, linking internal and external information Information and •Strong analytical tools systems •Customer equity measures like life time value •Satisfaction and share management •Focus on ‘ Share of Wallet’ Management systems www.myCNI.com.my www.OOBEY.com

Slide 48: Alignment: Framework Model Resources Structure Strategy Principles Leadership Person www.myCNI.com.my www.OOBEY.com

Slide 49: Example: Inpatient -> Outpatient for Rural Clear referral policies Basic facilities in all areas Reward for performance vs. Technology: robust and input withstand electrical fluctuations Expand specialist services Routine maintenance, in periphery replacement, renewal Government funds Expand insurance coverage In-store clinics Ethnic H/C Workforce Clarity of roles ↑ Nurses and para-medical staff Ensure protection Increased competence and value for money Continuing education for staff Regulate www.myCNI.com.my www.OOBEY.com

Slide 50: Example: Patient-centered Healthcare to ↓ Costs Reward providers who Tools to make decisions push patients System to capture patient Measures to focus on experiences and patient competency consequences Quality of Patient decision making Definition of roles Education to change mind-set Skills to make decisions Training patients with chronic diseases www.myCNI.com.my www.OOBEY.com

Slide 51: Different types of Patients Self Reliant Need Help Seek Searchers Collaborators Change Seek Streamliners Delegators Stability www.myCNI.com.my www.OOBEY.com

Slide 52: End Notes www.myCNI.com.my www.OOBEY.com

Slide 53: Activity Grid to optimize resources Increase (↑) Create (+) What are features/ What are features/ activities/services to activities/services to increase? introduce? Reduce (↓) Eliminate (-) What are features/ What are features/ activities/services to activities/services to reduce? eliminate? www.myCNI.com.my www.OOBEY.com

Slide 54: What’s Next? Areas in urgent need of research: 2. Health System Delivery 3. Health Promotion 4. Non-communicable Diseases 5. Nutrition 6. T/CM 7. Health Economics www.myCNI.com.my www.OOBEY.com

Slide 55: Solution to ‘Global’ problems All it takes are: 2. A Clear Objective 3. An Effective Technology 4. A Clear Implementation Strategy 5. A Source of Financing Example: Eradication of Small Pox *Time magazine, March 24 2008, Jeffrey D. Sachs www.myCNI.com.my www.OOBEY.com

Slide 56: “There is no shortage of examples of how we can attain our goals, only a shortage of will and stamina…” www.myCNI.com.my www.OOBEY.com

Slide 57: Thank You. soft copy of slides: www.totallyunrelatedrandomanddebatable.b logspot.com