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NHLC Workshop

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

D O B L I N I N N O VAT I O N S Y S T E M
Session #1
INNOVATION IN HEALTH CARE

Advancing Innovation in Health

Conference Board of Canada


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


Health Innovation Council of Canada

Canadian College of Health Leaders

Innovation hubs

Provincial Political and industry shifts


in strategy
Government innovation portfolios

Innovation strategy

Technology/infrastructure innovation
Leadership from individual Patient/client/population oriented
Provider providers and coalitions,
cross-sectoral shift
innovation
Non-academic centres of excellence
in innovation

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INTRODUCTION

Todays Agenda

Introduction to Innovation
Aligning on a common definition and reviewing a set of useful frameworks
SESSION #1

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
SESSION #2

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 todays discussions

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INTRODUCTION

Doblin has 30+ years of experience pioneering the application of design


and business thinking to growth challenges
1979. Doblin founded by Jay Doblin and Larry Keeley

1983. Doblin helps refocus Xerox from copiers to


document management

1987. Doblin applies social sciences to business


problems, a radically new idea and practice

1994. Co-develops McDonalds facility for


owner/operators to simulate business
impact of new kitchen equipment with
real-time customer data

1999. Innovation Landscapes published in HBR


bringing data visualization to innovation

2005. Larry Keeley named by BusinessWeek as


one of 7 most influential innovation
thought leaders

2007. Doblin joins Monitor Group

2012. Total Innovation blending design


thinking and analytics published in HBR

2013. Doblin joins


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INTRODUCTION

Innovation myths dont fall prey

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DEFINING INNOVATION

To our users, our


Which is different citizens, and / or
than invention our government

Innovation is the creation of a new,


viable business offering.

Creating value for Ideally going beyond products or


our users and for our programs to platforms, delivery
stakeholders models, and customer experiences

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INNOVATION FUNDAMENTALS

We believe effective innovators follow 4 important principles

1. 2. 3. 4.
Be explicit about Dont be fooled Drive innovation Look beyond
innovation by the mythical from deep and program
ambition, then importance of unconventional innovation to
organize and creativity; focus insights about transform other
execute on discipline users throughout elements of your
accordingly. instead. the value chain. business system.

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BE EXPLICIT ABOUT YOUR INNOVATION AMBITION

Successful innovators are explicit about their innovation ambition

TRANSFORMATIONAL INNOVATION
Sophisticated innovations that transform how
government operates, address new emergent
TRANSFORMATIONAL 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
WHAT
NEEDS WE
ADJACENT Tailoring or extending existing programs and
assets to serve users growing and/or evolving
SERVE needs
EXAMPLE: an integrated mobile offering that
offers personalized and on-demand access to
health information and risk scoring

CORE INNOVATION
CORE 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 WE DO

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ORGANIZE AROUND AN INNOVATION DISCIPLINE

Successful innovators build an innovation capability that matches their


innovation ambition

ORGANIZATION
Organizational units to house the
competencyteams, divisions,
leadershipand interfaces that
connect it to the broader
enterprise and the world
RESOURCES & COMPETENCIES
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

APPROACH
Clear definitions and
approaches for the work
Opportunity Concept Prototype Demonstration Launch
to be done in generating
Site
innovationsphases,
activities, deliverables,
and decision rights
METRICS & INCENTIVES

The targets to guide performance, the


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

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Todays
Challenge
TODAYS CHALLENGE STATEMENTS

Today we are going to discuss two archetypes

Challenge #1: Challenge #2:


Enabling individuals to better Reducing the demand for
manage their own health emergency room services

Meet the patients:

Stu Helena
Example patient #1 Example patient #2

Understanding stakeholders enables us to focus on


developing innovations that are targeted to the user
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Illustrative
CLIENT PORTRAITS: CHALLENGE QUESTION # 1

Stus 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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Illustrative
CLIENT PORTRAITS: CHALLENGE QUESTION #2

Helenas 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?

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Problem
Framing
BALANCED BREAKTHROUGH MODEL

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


and concepts
Start here

Whats Desirable?
Client needs
Whats Whats Ascending trends
Viable? Desirable? in healthcare
Leading insights from other

Whats
jurisdictions
Whats Viable?
Economic impact Next?
Business
model implications
Strategic fit

Whats Feasible?
Whats Existing initiatives
Feasible? Critical capabilities
and assets
Partnerships
Relevant emerging
technologies

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REVIEW PROBLEM FRAMING

Framing Mad-lib

ORGANIZATION FRAMING:
How might we [organizational goal]?

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

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REVIEW PROBLEM FRAMING

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

ORGANIZATION FRAMING IS USER FRAMING IS

Clear articulation of the Clear and shared sense of


central business challenge who or what we are going to
study and why
Shared sense of ambition
and scope Understanding of what issues
we are going to explore, and
Clear and shared sense of why they are relevant
the constraints of the
solution space

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REVIEW PROBLEM FRAMING

Framing Challenge #1

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

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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REVIEW PROBLEM FRAMING

Framing Challenge #2

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

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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GROUP EXERCISE

Exercise Time!

ORGANIZATION FRAMING:
How might we [organizational goal]?

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

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
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Stakeholder Orthodoxies
ORTHODOXIES

Flipping 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


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INTRODUCTION TO ORTHODOXIES

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
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ORTHODOXIES

Some common examples...

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

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GROUP EXERCISE

Exercise Time!

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 dont 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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AGENDA

What to expect after lunch

Introduction to Innovation
Aligning on a common definition and reviewing a set of useful frameworks
SESSION #1

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
SESSION #2

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 todays discussions

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Session #2
AGENDA

Recapping this mornings discussions

Introduction to Innovation
Aligning on a common definition and reviewing a set of useful frameworks
SESSION #1

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
SESSION #2

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 todays discussions

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REVIEW PROBLEM FRAMING

Framing Challenge #1

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

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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REVIEW PROBLEM FRAMING

Framing Challenge #2

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

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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Stakeholder Pain Points
USER-CENTRIC PROCESS

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


solve complex problems

ANALYZE CREATE
Bring together and Generate concepts,
examine insights define concept
and generate their Explore elements, and
related implications Concepts articulate customer
Identify and consumer value
Insights propositions
START HERE
Make Plans

Framing

Frame research, Deepen concepts,


immerse team in Know Users Evaluate detail customer
research, and Businesses experiences,
identify a relevant business rationale
set of insights and roadmap
Know Incubate &
DISCOVER Context Implement DEVELOP

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USER RESEARCH

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

Primary Research Methods:


In-depth Interviews Elicitation Exercises (e.g., Card sorting)
Diaries Interceptions
Ride-Alongs Surveys
Observations DIY Interviews
Focus Groups
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PAIN POINTS: CHALLENGE # 1

Pain point examples for patients like Stu


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 statusisnt 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 cant 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

Understanding pain points will help contextualize the


innovation that we are seeking to develop
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PAIN POINTS: CHALLENGE #2

Pain point examples for patients like Helena


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

Understanding pain points will help contextualize the


innovation that we are seeking to develop

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GROUP EXERCISE

Exercise Time!

Brainstorm pain points experienced by your


groups archetype
Be specific
Pain points include frustrations, unmet needs,
and workarounds
Think from the archetypes point of view

Add your post-its to the poster and


share with the group

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EXPLORING TEN TYPES OF INNOVATION

Recognizing and constructing across multiple types of


innovation produced more robust innovation concepts

Network Process Program System Channel Customer


Partnerships Signature Complementary How your offerings are Engagement
with others to or superior programs or delivered to citizens or Quality of
create value methods for services other users interactions you
doing your work foster with the
public & internal
stakeholders

Economic Model Structure Core Program Service Brand


How you fund Alignment Performance Support and Representation
programs or services of your talent Distinguishing enhancements of your program
and assets elements of your core that augment
program your program

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Signature
Partnerships or superior
with others to methods for
create value doing your work

How you fund Alignment


programs or of your talent
services and assets

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Complementary
programs or services

Distinguishing elements of
your core program

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The quality of
How your offerings interactions you
are delivered to foster with the
citizens or other public and internal
users stakeholders

Support and Representation


enhancements of your program
that augment
your program

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EXPLORING TEN TYPES OF INNOVATION

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

FOR TRANSFORMATIONAL INNOVATION


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

FOR ADJACENT INNOVATION


Youll need innovation within multiple types ADJACENT
(3-4) around a new offer.
3-4 Types

FOR CORE INNOVATION CORE


For innovation in the core, you will be
innovating within independent innovation
types around existing offers aimed at current 1 Type
customers.

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TEN TYPES | ILLUSTRATIVE INNOVATION

Health Leads | Prescribing solutions to improve health, not just


manage disease

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.

5 types:

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GROUP EXERCISE

Exercise Time!

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

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Final Thoughts and Considerations
WRAP-UP

Considerations

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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WRAP-UP

We believe effective innovators follow 4 important principles

1. 2. 3. 4.
Be explicit about Dont be fooled Drive innovation Look beyond
innovation by the mythical from deep and program
ambition, then importance of unconventional innovation to
organize and creativity; focus insights about transform other
execute on discipline users throughout elements of your
accordingly. instead. the value chain. business system.

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Lisa Purdy
lpurdy@deloitte.ca
416.601.6403

Blaine Woodcock
bwoodcock@deloitte.ca
416.662.1781

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