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[Felicia.Captioner is Live]
SPEAKER:
Good morning, everyone. It is great to see so many people. People from Australia and ...
We have been active in this since 2009 and we are working with PolyWare that are appropriate with
dealing with complexity ...
That you have not thought about the full contest. A lot goes into understanding the coherency of an
enterprise.
The consis...
What happens when they are managed in a very traditional way and we have a lack of integrated
forces, they become awkward....
complexity. This example is a very fitting because you are dealing with hospitals that are
organisations. When you search ...
ones for you. You get a list of tasks. You have tasks that are still important and make the next 25%.
The other tasks, 51%...
agreement across an enterprise and are there any particular approaches you are found to be
beneficial?
MILAN GUENTHER:
My ...
Scandinavian country, seen as... A saying in Norway - every third person in Norway works in
healthcare related issues. In ...
is a small country, so you basically have to scale it back by 15, or something, to get the proportions. It
is quite heavy....
integration of all of this.
One of the challenges, one of the conclusions they found is that the logistics are key to this...
that need to be employed. Making models and overcoming modelling bias. So a business analyst and
a service designer would ...
SPEAKER:
Thank you. I loved both presentations. One of the challenges I think we face is that when patients are
admitted i...
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Transcript from EdgeTalks October 2017 – Reshaping healthcare enterprises by design

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Transcript from EdgeTalks October 2017 – Reshaping healthcare enterprises by design

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Transcript from EdgeTalks October 2017 – Reshaping healthcare enterprises by design

  1. 1. [Felicia.Captioner is Live] SPEAKER: Good morning, everyone. It is great to see so many people. People from Australia and Scotland and across the UK. If you are joining us today, just say where you are reporting from in the chat room. We have a couple more minutes, then we will start. SPEAKER:It is 9:30 AM. It is 6 October. This at all for this month. My name is Janet Wildman, an associate in England. We have a fantastic session lined up this morning. Before I go into that, I would like to let you know that if you would like to be a member for Edge talks and receive regular notifications of our meetings, why not indicate to us to you are, how we can stay in touch with you through the chat room. The other thing I would like to mention before we get into the session is that if you are connecting via your computer, we have video lined up so why not take the time to turn up the volume monitor so the session will run smoothly. Without further ado, the session today is focusing on reshaping healthcare enterprises by design. Today I would like to welcome John Gotze and his colleague Milan Guenther. They are enterprise design associates. Thank you for sparing the time to come and talk to us at Edge talks. We know it will be fantastic. If you are joining us today and beyond, why not use the chat box like you have been doing. There is a lot of conversation already happening in this area. Thank you for people who are sharing resources and please continue to do so throughout the session. Contribute on the chat box through the webinar. Join us on Twitter, using the twitter #edgetalks. You can send a request to join our Facebook group, School for health and care and Edge. I would love to stay in touch with you as we move further and beyond. My name is Janet Wildman from Horizon. Big applause for everybody who was joined the session and our presenters, John and Milan. They are enterprise design associates and they will tell us about the company and their expertise and the subject matter as they go forward. I will leave it to them at this stage. OK. MILAN GUENTHER: I am from Enterprise Design Associates and John is from Polyweb. We are collaborating. You can see that this talk has been made possible with intense collaboration with our network. Edge talk webinar (UKEDGE0610A) Page 1 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  2. 2. We have been active in this since 2009 and we are working with PolyWare that are appropriate with dealing with complexity in this endeavour of reshaping enterprises. This session has been made possible by Qualisoft. Thanks to them. Also for making this connection and this talk possible and contributing to the session. Also, Netlife, it is a strategy company in Oslo. Customer care, an an organised network, Gerry McGovern is the head. We are inspired by what people are doing in reshaping enterprises. Especially today, will have a blend of disciplines from enterprise architecture and talk about how these things fit together. Just two words about us. Enterprise Design Associates. We started off as a design agency. You can see some of our marvellous creations at the bottom. We have been founded on the premise of doing, this idea of pushing enterprise designs, what we actually want to do as designers is to have entrepreneurs with the enterprise, anything we do, a software or an app or a prototype, you name it, this is a means to an end. It is there only... It is only useful to help us transform people relationships. And the current state of our company is we are a smaller company, three partners, and 10 associates, so people not employed but working with us a lot on projects, and then we have a network of partners globally, agencies, large and small, and we do everything we can to make enterprises deliver and that is also what we will talk about today. This idea of enterprise design has been... In 2012, resulted in a book called Intersection. It introduces the basic framework we are using for enterprise design, integrating different perspectives, and just a few weeks ago, we had our fourth intersection conference in Barcelona. We do one every year and you can check out our YouTube channel on the confluence website. We are going to cut the talks of this year and add in a few... I will not make any promises. John, are you there? JOHN GOTZE: Yes. Are you there? Can you hear me? My name is John Gotze. I am from QualiWare, a Danish consulting company. According to Gartner, we are an enterprise architecture tool. We deliver a platform for enterprise architecture. Really we see the scope wider than enterprise architecture because they say it is a very specialised discipline. So we worked with general management systems, we work with digital transformation, we work with government risk and compliance. We do a lot in TDPR. We see it as a market opportunity. Our basic idea is highlighted here in the slides. The three Cs. Coherency and consensus and consistency. We think coherency is essential to any enterprise. I will add especially in healthcare. We work in other sectors. It is also very important in the oil industry, for example, or in government in general. The idea of coherence is we need to understand how everything works together and changes here. How do they impact and where they are. That is very often the reason why new initiatives go wrong. Edge talk webinar (UKEDGE0610A) Page 2 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  3. 3. That you have not thought about the full contest. A lot goes into understanding the coherency of an enterprise. The consistency part is, of course, it is confusing people do not speak the same language. Organisational and also cross-sectional interpretability is crucial. We have seen so many examples where there are problems in communications. Since we are a Scandinavian company, we focus a lot on creating consensus. The Americans do not really like it. We call it collaboration if they don't like it. The idea of getting people on board with the same thinking and same ideas and the same understanding of a problem context. It is very essential. That is one of the reasons, also, why we find great interest in working with designers like Milan and his team. And the design inking approach is actually very natural to us. We will talk a bit more about this later. Back to you, Milan. MILAN GUENTHER: Design thinking. You might have seen this cover of HBR, where they say it is not just for products, executives are using this approach to device strategy and manage chain. If you came up with design thinking, you will think it has always been the case. People are getting aware of that. Since then, people know design thinking is much more. If you actually want to do design thinking, in complexity, you can quickly get lost. This is the Metro map of our friends from Deloitte. It is all the methodologies you might want to look into adopting and integrating and combining when you want to do new design thinking. You have stuff on there like design thinking, scrum, def ops, philosophies like methodologies that have been around for a while. It is of reality you see in many organisations, that they try to come up with something that fits the context but the execution becomes overwhelming. Off the enterprise environment and the challenge bringing together all of the thinking. When we say enterprise design, it is important to say what we mean or to refer to with that term. The term has been around for a while. It is coming from French. We like to see it as the second definition from the generic. Undertaking more project, daring or correct is, a willingness to undertake new or risky projects. It also means endeavour, but the boundaries are not clear. For us, it is the idea that there are entrepreneurial people and they know the true scope the design needs to appreciate in order to deliver. In that sense, in the healthcare sector, that would be an enterprise. A big party would also be an enterprise. An enterprise is managed like this. You will get very familiar with this. Or you look into management theory, you have this chain and for some reason the supporting activities on top. All of the disciplines that we work with or like to work with, often have trouble fitting in. We especially like to integrate or work with people coming from these disciplines that have trouble fitting in, like design. We see customer thinking and product strategy on this map. Edge talk webinar (UKEDGE0610A) Page 3 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  4. 4. What happens when they are managed in a very traditional way and we have a lack of integrated forces, they become awkward. We just launched a Twitter account called #entawk. It is the corresponding test age when something goes wrong, and the enterprise becomes awkward. When you treat something with that, if you find a funny picture, people retweet it. MILAN GUENTHER: An example of enterprise awkwardness. "Your call is important to us." When you finally get someone on the call, it's the wrong person. Or they ask who you are, what you want. It's actually a good exercise when you want to evaluate awkwardness, you think what would this behaviour look like if it was a person and not an organisation. We have one example, a very powerful example, from NetLife research. It's actually an example from the NHS. It has been fixed, so this problem doesn't exist anymore, but I still like to use it as an example. Paul, I think you have to play the video. PAUL WOODLEY: Yes, good morning, everybody. I'll start the video now. It's only about 2 minutes long. If you've connected through your phone, the sound will still play through your computer. SPEAKER: You got some some pain. And we observe people. One person came to this page and they put in some pain in the search box, and this is the first result they got back. See, real stories. Stomach cancer, right? So they got to this page, the first result, during treatment for a stomach ulcer, Deborah was devastated to find out that she had stomach cancer. At the age of 40, she had surgery to remove her stomach. Do you think that should be the first result if you search for stomach pain? Imagine if you went to your doctor and you say, "Doctor, I have a bit of a pain in my stomach." "Let me tell you about Deborah, she came in with a pain in her stomach, now she doesn't even have one." Things are getting better, with improved the search. Yes, we've introduced this new type ahead feature in the search. Just go and check it out. It's like that Doctor, "Don't even tell me, it's your stomach, isn't it?" They thought this was better. This was an improvement. "We've got a new feature, it's an improvement, now you get the wrong result even faster. Now we see you to death even quicker, you don't even have to write the entire word." MILAN GUENTHER: Thanks, Paul. So Gerry McGovern is talking about prioritising enterprise design. We're talking a little bit about how we are doing that. This was a video that made a lot of impact in the work that NetLife did. It's the Norwegian NHS, I would say. This is a little outline of today's session based on that. What are challenges with tackling, how can we make sure that we're working on the right thing, how to work with systems at scale, and then, at the very end, I am going to switch on my desktop screen sharing and show you how to use tools to model enterprises. How do we make sure that we are actually working on the right thing? We are in a context of Edge talk webinar (UKEDGE0610A) Page 4 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  5. 5. complexity. This example is a very fitting because you are dealing with hospitals that are organisations. When you search hospital and click on images, you often get pictures of the outside. Imagine the behaviour that you experience when dealing with a system like as if you are dealing with a person and then you get awkward things. They might scare you, they might be unhelpful, they might not help you in very difficult situations, actually. And they still might think that they are performing well because of that enterprise awkwardness that is inherent and just comes with scale, and comes with the complexity of these kinds of systems. If you switch to digital channels, this was the University Hospital of Norway's home page. You see a lot of numbers. You have jargon-like words. To be fair, all of this is in Norwegian. Even if you speak Norwegian, you are overwhelmed by this. This comes about through many stakeholders saying, "I need this, I want that on the page." It's a way for the enterprise to manifest itself in reality. When we talk about stakeholders for an enterprise, it is often like this elephant in the room. We're just working on one part, and no one wants to appreciate that the elephant is one figure and there are many people around trying to understand it and reshape it, but they only see one part of it. So our way to deal with that is to say that the enterprise is a space of intermingled concerns. We have ideas, questions, concerns, opportunities, and constraints. The idea is that an enterprise is this box that we can turn around and inspect, but it is very difficult to get a full understanding. Our work is based on this hard component called the stack. It is a framework to navigate complexity of the enterprise by looking at it from different perspectives. So who are we? What is the role that we are trying to have in people's lives? Down to the rendering - how does it manifest itself in reality. MILAN GUENTHER: Then you have elements from service design, from business from human-centric thinking. You can't do all of them at once, you can't do all 20, but you should have an understanding of which ones you want to focus on right now, given your challenge, and why. The way we want to use it in the project is to establish this as a common language, to say we can make a model of our enterprise to give them a toolbox so that they can express themselves and model, and make sense of the enterprise using these terms. Initially, it's very hard to get the right challenge at the right scope. This is why we introduced this methodology based on Gerry McGovern's methodology. We use our stack and we turn it into a questionnaire. They are basically boiled down to this oversimplified statements. Things like service design, service logistics, service delivery, and we just reduce it to bad services. This is an online survey where we ask people to fill out. It gives you this heat map to suggest that many people... It fails to deliver. It gives you this radar, this very basic idea where we might take action. So this is one survey that is being deployed. In the Norwegian case, they had the challenge to work on the entire landscape of hospitals and healthcare actors. Even though Norway is a much smaller country than the UK, there are lots of them. Basically, you make a very long list of tasks that people might want to do. Every stakeholder can put in a task. Again, sorry, this is in Norwegian. The survey basically asks which one are the most important Edge talk webinar (UKEDGE0610A) Page 5 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  6. 6. ones for you. You get a list of tasks. You have tasks that are still important and make the next 25%. The other tasks, 51% and upwards, are tasks that might be important for certain people, but they are not the ones that the majority of people come to the enterprise four. Referring to the comments just put in the chat box, this is actually a methodology that we use to get evidence that the challenge that we chose to work on is valid, that this matters to patients. You can also use it for employee experience. It has been introduced for websites, but we use it for a customer and employee experience. Each of the tasks that is important is a challenge to work on. It gives you something to measure, so if you are performing well at delivering this task then you are performing better. The opposite side of this kind of survey is that it gets you the tasks that are tiny tasks. You all know public websites where you have lots of use, and this is what enterprises like to do. Telling people about how good they are, how well they are doing, lots of self-centred messaging that gets in the way when people come and actually want to tackle one of the top tasks. So in this case, in the Norwegian case, the two top tasks came out that they decided to focus on worse symptoms and what happens to me during receiving treatment and during receiving care. [Felicia.Captioner is Live] For example, the story... What is wrong with me? What kind of treatment will I get? What will happen to me afterwards? There are some practical things. How do I get to the hospital? Where is the building? And so on. It is difficult to find the answers. If it is a virtual touch point, some kind of combination. Tackling this task actually requires appreciating the whole enterprise and system as a potential intervention for design. There is some advice from Kaiser Permanente. They are insurance company. A well informed patient is a good patient, they say. There is a question? No? PAUL WOODLEY: We have Kate with us, who were able to feed back to you with questions. KATE POUND: I am doing Twitter. The key thing for me is not a lot is going on in Twitter because everyone is so engrossed in the content today. To me, this discussion is almost fresh air to quality network in healthcare. It is learning new techniques and thinking. That is probably why people are absorbing so much today. I don't know if Janet has any questions on the chat room? JANET WILDMAN: A question here, if we could go back to it. It is from Shane Moore. How do we get consistency or Edge talk webinar (UKEDGE0610A) Page 6 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  7. 7. agreement across an enterprise and are there any particular approaches you are found to be beneficial? MILAN GUENTHER: My methodology I will explain is to it focus on what is important and not focus on what is not important. When it comes to ensuring different parts of the enterprise in different groups in different silos and teams are pulling in the same direction, it gets into making models like this one, for example. A model for content and bringing order into this kind of model. Which of the most important things? Can we organise ourselves around these few nodes when it comes to engaging with patients before treatment, during treatment, digitally and physically. This is the domain model that can be used in order to model Information Systems, patient flows and processes. And sharing these in making this a working tool is what we think is the key to getting the consistency we need. JOHN GOTZE: Just quickly, I think it is also a matter of getting the right data and information and data to the right people at the right time. People have different versions of the so-called truth, so that is one of the things we are focusing on in our platform, to make it a truly collaborative tool. If I, as an architect, model something involving the owners, we notify them. We strongly believe we can do a lot with technology in improving technology across the enterprise. MILAN GUENTHER: I hope we get to the demonstration of this. Let us speed up a little bit. In this case, the enterprise accepted reorganising around those concepts and it resulted in redesigned interfaces and a new repetition of who responsible for content for local government body, the hospital? Potential patients are not differentiating between practical information and medical information. How long will it take to treat this? Whom I have to contact? What is really wrong with me? What kind of help do I need? This means that the treatment, of course. Then you have the information needs that come in at the different parts of the treatment. This includes before, during and after. Designing for the entire journey is important when you do... When you tackle any of the top tasks. It is not just about designing the website to give people what they need when they want to find out what is wrong with them. You have to look at the entire journey and see how the tasks manifests in different parts of the journey. It also means we have to concentrate on a few things that we are designing, in this case, patients and peoples concerned about family and friends. And of course, the staff and other things that are important to make the entire system run. That is where it gets into more systemic change and systemic transformation of enterprises that are increasingly becoming digital. JOHN GOTZE: Basically, I will tell a bit about a project we have been working on with a Danish hospital construction. A bit of context - if you think about digitalisation of healthcare, because that is at least in the Edge talk webinar (UKEDGE0610A) Page 7 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  8. 8. Scandinavian country, seen as... A saying in Norway - every third person in Norway works in healthcare related issues. In the future because of the ageing population and things, it will be more. It would almost be half of everyone who should work with it if you did not do anything. Digitalisation is not just something we want and have been working on, but something we have to do focus on much more. If you take a standard capability model at a standard healthcare provider, it looks like this. IT systems and operations is one small fraction of the healthcare, IT and healthcare provider. MILAN GUENTHER: The slides have not appeared at my end. So, if I move the next one, will it move? SPEAKER: I will do that for you as well. JOHN GOTZE: This is IT everywhere. This is actual mapping we did with the capital region in Denmark. An ongoing digitalisation effort from the IT division. It is not just down in IT operations are you need to think about the whole change and transformation of the enterprise. It is almost everywhere in the enterprise. The mappings here were green existing and red ongoing. Just say it is everywhere. If you look into, especially the IT vendors, but also in general, the concept of a digital hospital is getting out there. This is from IBM. There are many others with the kind of maturity model and the digital hospital framework. A lot of people say it is very IT-centric and what the IT people and ID vendors and IT Department says. In reality, we see a lot of healthcare personnel and professionals, they are actually taking in the new technologies. This is just a new effort in Denmark from one of the regions you have a large effort about digital innovation. They get sponsorships and funding from various places, government especially. But also foundations and whatnot. A lot of effort is going on here. You may well know the HIMSS maturity models. We say we are around stage VI and we want to reach stage VII and maybe even talk about stage VIII and stage IX. We are getting to a level where we need to have this, not just a closed-loop coordination across members, but a whole knowledge driven engagement, dynamic and multi-vendor, multi-organisation, very interconnected delivery model. That is basically the effort. There is a mapping here that Denmark tends to be fairly advanced in this. Sorry, I could not find where the UK and England is in this, but I guess you know about that. So anyway, the intent here in Denmark is to say we want to invest heavily in modern healthcare, so they are investing and I am not sure the conversion rate is right now. Maybe over £4 billion. A new hospital facility in in coming years. That might not sound a lot for Great Britain, but think that Denmark Edge talk webinar (UKEDGE0610A) Page 8 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  9. 9. is a small country, so you basically have to scale it back by 15, or something, to get the proportions. It is quite heavy. One of the effort is, "Well, we have built what is called a super hospital, bigger unit and sexualisation, it also decentralisation of a lot of the healthcare services.." A lot of E health and telemedicine. Chronic patients do not need to go to the regular control in the hospital. They use devices in their home. And video, Skype, whatever, to talk to their nurses and so on. Basically bigger units when the need of operations and stuff there. But get people away from hospitals so they only come there when the actual need for hospital services are there. That is, of course, somewhat of a challenge over the last years. The healthcare sector in Denmark has been pushed to government and the national budget to save a lot of money. There is been, sort of, requirement for efficiency increases of 2% per year for each hospital in Denmark. They just started saying, "Well, that may be not the right way to go." Over the last few years, there have been cutbacks in the sector. But huge investments at the same time. JOHN GOTZE: One of the investments has been at the largest university hospital in Denmark, and they are relocating the existing University Hospital from the city centre, and moving it out to the University of (inaudible). In the new hospital, they say people first through research, digital solutions will be for all, to all, between all, everywhere and always. And that's where they started using design thinking - to think about the patient journey. Actually getting to the hospital and from the hospital is often a burden for the patient if you've been through an operation. The hospital don't want people to stay in the bed is more than absolutely necessary, so it's about getting them home after the operations and treatments. So they worked on thinking about this, and part of building the new hospital is building a new light rail system from the city centre to the new campus will stop also, arriving at the hospital, finding a place to park your car, and so on. And from the entrance to where you actually need to go. That's a lot of challenges for people, and that's why they have modelled digital touch points, all types of technologies. They think, in the next four, five years until it is operational, there will be some new technologies. So they have people looking out for what's new - digital signs and whatnot. So it's a Greenfields connected to an existing hospital. They need to think about the transition in a most smooth way. That's a benefit from all this. They can think out-of-the-box. They can plan to have only single rooms instead of double rooms. And they, of course, thinking a lot about the planning methodology is. If anyone is into enterprise architecture here, they chose a methodology called Togaf. So you cover both the strategic parts, the business processes, the data and information sharing, and all the IT systems and infrastructure. They made some maturity assessments, "Are we ready for this?" They found they were not actually very mature organisationally, but that's one of the reasons they brought in enterprise architects with a design and collaboration focus very early in this whole process. They use a bunch of methodologies for strategic design - a patient-centred approach rather than system-centred approach. They think about strategic alignment in all the investments. And they think about the whole standardisation and Edge talk webinar (UKEDGE0610A) Page 9 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  10. 10. integration of all of this. One of the challenges, one of the conclusions they found is that the logistics are key to this, both in terms of getting more efficiency, but also to get the right people empowered, so patients should know where they need to go and so on. All of this is part of the logistics. What they actually found, and I found that quite interesting in our work with them, is that a lot of effort, traditionally, goes into the clinical logistics because that's the sort of core treatment. But the patient experience is actually readily improved or not with the service logistics. So if a patient needs to be picked up by a guy, who takes them to the treatment. All that logistics stuff is actually what creates a lot of uncertainty and doubt for the patients. So they want to improve on that whole service logistics side of things in the hospitals. I think I'll skip that, that's more detail. And that's where we started modelling. A lot of different ways of modelling this, and Milan will show a little bit of this in a few minutes. Of course, a lot of workshops with doctors and patients to understand the processes and how to improve the processes. Since they have a running hospital, they use some of the facilities therefore testbeds to check all the new solutions will stop does it actually work? They build real models, do prototyping, and take in the whole design thinking approach. This is just summing up some of the architectural challenges. I just want to mention one - the naming conventions, and getting people to talk the same language. On and on, that proved to be one of the biggest challenges. MILAN GUENTHER: Thanks, John. I propose I will go just very quickly in 5 minutes to show how to use the models. And then we hopefully have three to 5 minutes for the day-to-day discussion. Is that OK? All right, so, do you see the approach slide? SPEAKER: No, we don't see that. MILAN GUENTHER: Can you give me control. SPEAKER: We can see that now. MILAN GUENTHER: The way we do it is we use a design (inaudible) methodology will stop with you is that with the enterprises and framework. Look at everything that matters, and then work on the enterprise incrementally with an adapted design thinking. Going through the typical steps, but using the stack and thinking about the different aspects that we need to look at and the different levels as a kind of guide. Using it like a lift. Getting to a rendering, testing that, validating it towards the different dimensions. Casting teams, including the disciplines that we need to draw on, but also the different stakeholders Edge talk webinar (UKEDGE0610A) Page 10 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  11. 11. that need to be employed. Making models and overcoming modelling bias. So a business analyst and a service designer would make different models for the same challenge, so connecting those different ways to think. This is where we invented this language which focuses on the enterprise design. A very simple language of just the three elements. Using this language to model different things, such as processes. This is an example of a healthcare start-up in Paris. Taking, for example, a customer experience of what's happening to patients with data. In this case, people are always late, and this is messing up our schedule. Missed appointments are actually one major issue to tackle. Let me just try to share my screen. Do you see my screen? PAUL WOODLEY: Yes. MILAN GUENTHER: Excellent. You see our enterprise framework stack is in as a guide so we can click on the experience icon and hopefully get an example of our hospital customer experience map. The different things that then appear in the journey, we can drill down and say what does the stuff in this experience look like if we model it on a touchpoint level. This gives more of a descriptive experience, so what are really the channels, what are the actions, and what are the touch points? We can look, for example, who is using this touch point. Kevin is a persona that we integrated in the repository. The people aspect, which is personas and the touch points, but also the technology. And then we can combine those different elements in blueprints, where we can use all the different elements - for example, to say what is our overall hospital mapping. Have the customer experience on top, the touch points, and the service experience below. And something very practical, like handling payment, which we can describe in more detail and with a different language that is more adapted to operational design or process design. This language is designed to integrate different viewpoints and then link to languages or notations or models that are more specifically designed for one purpose. Just for the example, we have our insight that we know our hospital is suffering from this patients being late, so we actually made a blueprint that is specifically mapping the elements that are relevant to this problem, so the touch points on top… Then we say what we need to change to improve this? We can also, for example, make a prototype. So this is all I wanted to show, and we are kind of right on time. Just one more thing. We are doing training in London, if you are interested. So, feedback? SPEAKER: Please bear with us, Paul, I'm wondering if you could help us by just putting (inaudible) on. Thank you, Paul. [Felicia.Captioner is Live] I live there, Paul? Edge talk webinar (UKEDGE0610A) Page 11 of 12 Downloaded on: 06 Oct 2017 2:10 PM
  12. 12. SPEAKER: Thank you. I loved both presentations. One of the challenges I think we face is that when patients are admitted in A&E departments, everyone knows their journey. You can see the journey we are facing and how close they are getting to a four-hour deadline. Once they are admitted to the main body of the hospital, that disintegrates completely and the patient's journey becomes invisible. Mobilising that sort of scrutiny around why patients are waiting on an hourly, never mind daily, basis and reducing their stay is a challenge they are facing. For many hospitals, they do not have electronic observations. That is the transition we have to make. How do you think that is being tackled in Denmark? JOHN GOTZE: Some of the stuff we are working on nowadays is based on things that are already heavily digitised. We have patient systems in place, even though that creates an ongoing thing with the capital region and they just introduced a new patient journal system and that is had some transition challenges because they, for example, moved from having medical secretaries to typing into the journal and have the doctors do it together with the patient. That is a social change for many of the physicians. Anyway, the digitalisation and the data driven thinking is fundamental to all of this here. We can talk a lot about design sprints for the perfect patient journey, but if the data and information is not there, it is up you all the way. SPEAKER: I agree. I work on an expert group that includes one of the line managers from Jaguar, and they have 45 seconds to fix part of the line that goes down that would bring about a delay in manufacturing. You can only imagine that sort of thing happening ever patient waited longer than 45 seconds to get something they needed. JANET WILDMAN: Take you to everyone who has participated either on Twitter or the chat box. So much information to take on. The recording will be available on the Edge website. If you are looking for more information, it will be available to you today. Later on today. But I would like to give a big applause to John Mark who has taken us through a wealth of information. We obviously have a lot to learn and a lot to share. Hopefully we can invite you back some other time. We know you have the book out and you have events coming up and we will promote and support that is much as we can. We have gone over the 10:30 mark. It is so interesting area. Thank you and have a wonderful weekend and see you at the next Edge talk, on 3 November. We will keep the chat box open. If you are interested in staying in touch with us, let us know. From everyone from the Edge Talk team, thank you and see you next month. Take care. Edge talk webinar (UKEDGE0610A) Page 12 of 12 Downloaded on: 06 Oct 2017 2:10 PM

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