Transformation in Healthcare

Hello and welcome to Leading Digital Transformation with Rob Llewellyn and the Digital Transformation people. In this podcast series, Rob interviews experienced practitioners, authors and thought leaders whose stories and experiences provide valuable insights for digital transformation success.

I'm joined today by Heather Hancock. Heather's got 20 years of experience in healthcare, gained in commercial functions across both the hospital provider and pharmaceutical supplier landscape. Heather's passionate about patient and customer centric design in digital transformation and she believes that technology has three purposes of value improve patient experience, improve population health and reduce the per capita cost of health care. To learn more about this, let's jump into the interview with Heather. Heather, welcome.

Hi. Thank you.

Heather, you've been working in the healthcare space for 20 years or so because we're talking about a very specific industry. Can you tell us about the healthcare in the last couple of decades and some of the challenges that it's been facing?

Yeah, sure, Rob, thanks for this. Healthcare is something that applies to everybody and I think we're all really interested in it, especially as we try to maintain our mobility as we age. If you look at kind of where healthcare has moved from and where it is now, we can kind of explore that a little bit. Going back sort of 50 years or so, it was very much you go to your local doctor, you tell them your ailments, he gives you some potions or lotions, or he may indeed give you some tests. You then wait, you then get the results of those tests and then you work solely with your GP to try and help you to get better or indeed to manage your condition. And if we look at kind of how that's moving now, you now have a whole load of people who will be interacting with you, from your nurse, from your doctor and your hospital doctor, and all of them will be asking you a number of different conditions and maybe treating those different conditions. Invariably people have more than one condition as well. They don't just have a sore foot, they've usually got a sore foot, an arthritic knee and perhaps a chest condition as well. And I think attitudes have changed as well. We used to be able to work with your GP and they would be the guardian of your health. I think now, as populations have grown and expectations have also grown with it, we now have a role to play as individuals within that. So healthcare now is in the remit of everybody can access it, and I think that's a real big difference. What it does mean, of course, to everybody is that now people need to work together in a system, so your doctor needs to work with the Nurses, your nurses need to work with the hospital doctors and you yourself needs to interact with perhaps your local pharmacy. So it becomes a system of health care with the individual largely at the centre. I think for pharmaceutical companies as well, they are no longer just a pill and a potion, as I mentioned, they are now much more integrated in the system to help and enable people to live better lives, longer lives. So I think it's quite a bit of change.

ROB so how is digital transformation helping to bring about this change?

Heather really pleased you've asked that. Back in the day, when clinicians were being educated about different surgeries or different medicines or different ways of doing things, their main way of doing it was actually meeting a person, discussing it and then seeing how they would adopt their clinical practice. If you now kind of look at the advent of mobile and social, people are able to access that information through various different ways. There are plenty of clinical trials now on websites which are looked at and monitored very closely. There is information from patients about how they're reacting to their medication. But also within the social arena, there is a lot of interaction between communities now explaining how different things work. That transformation is largely digital and I think the people who are in that ecosystem need to work within it as opposed to working around the outside of it. So it's a big change. Look at patients, for example, and I know we were discussing this a little bit earlier, if you look at my parents, who are in their 70s and 80s, they are largely dependent on their doctor for information and guidance as to what they will do and how they will keep themselves. Well, if you look at the generation that I'm in, we are now, even before we go to a doctor, we are probably looking on our website, talking to our friends, trying to understand the symptoms that we've got. So we almost go with lots of questions before we get to our clinician, and that is digital transformation, and that's only going to get better in my mind, and how we help ourselves to be healthier.

Heather our audience is scattered all over the world and of course you're in the UK and very familiar with that uk, UK landscape. Can you give us some examples, some great examples of digital transformation and how progress is being made in some countries and perhaps in the uk?

Yeah, I will do. There's a great company called Babylon now, Babylon on online GP system, and I think they're beginning to put their arms around very different countries around the world. And Ali Pasa is the chairman of that organization and he has a fabulous kind of line that he always says at all the meetings, which is health care in the palm of your hand. And I think the advent of mobile technology means that in theory, and it is in theory, Rob, anybody in any part of the world can gain access to a doctor that can help them with their condition. I think that's something that can be done. Even within the uk, we're seeing where waiting lists are very long for people to access their GP or their doctor, that there is now a facility where you can dial up through Babylon or others to speak to a GP to just talk about some of your concerns. And this can be done probably 24 hours a day. I think if even in rural Africa, which was somewhere that I worked, everybody had mobile phones and the local organizations there were using mobile technology to access patients that perhaps had malaria or other illnesses. So whereas before it was very much segmented where you are and which country you were in, dependent on the healthcare system that you actually took access to, now I think with the use of mobile technology, that has widened to be much more accessible to everybody. And there's two examples. A third example that I can give you was something that I was meeting, I was at a couple of days ago, where we were talking about hip operations. In the past, people would be for a hip operation or a knee operation, you would spend your time in hospital, you would get your prosthetic, you would have an operation, you would have the therapy associated with that operation and that would all be done in hospital. Now people have worked out that, one, they don't want to be in the hospital and two, they'd like to go home and actually you can get care or coaching on getting you well again in your home, because we have online facilities, we have web cameras, all that can help you to get better in a kind of place of your choice. And that's the examples that I'm giving you. The past where it was just through one channel, has really dramatically changed where healthcare now is available in a number of different areas to wrap around the patient.

I think that Babylon is a terrific example, Heather, and I'm going to put a link to Babylon in the show notes, so that people, particularly not in the UK and might not be so familiar with it, can go and take a look and see what progress they're making in the healthcare space. So, Heather, what are the big challenges that organisations are now facing and the healthcare industry as a whole, in terms of making the progress that's necessary?

One thing that we all need to do is put the patient at the centre, because what's right for one patient is not going to be right for another one. And that largely depends on an awful lot to do with the people themselves. I think where organisations worked in the past is they want consistency of approach, they want a system and therefore they want to impart information into that system and for that system to then push that information to whether it's the patient or whether it's indeed the clinician. I think the biggest problem that the biggest challenge I think has been faced is to kind of get that personalised approach, because people want to be able to pull information when they want it and how they want it from somebody that they want to speak to, if they think they do want to speak to. And the organizations around them want to get a consistency of approach. You kind of put in the middle of that technology and you're in a system where people think, I'll just buy technology to solve my problems, I'll just put lots and lots of platforms in, I'll put in mobile, I'll put in social, I'll do all those different things. But you've still got people at either end of that system and they are interacting with it in a way that they want to do in a way that they would like. And it doesn't actually flow according to theory. So I think that's the biggest challenge, is the interaction of the people with the processes and the technology, I think, is the biggest piece. If we all robots, this would all be easy, but we're not.

So a certain degree of progress has been made, Heather, and of course, to different degrees in different places. If we could apply hindsight, what would you do and what wouldn't you do?

Yeah, I mean, if only we could just have hindsight a lot quicker, that would be helpful, wouldn't it? Okay. One of the things that all companies want to do is transform their organization and make it more digital. And it's such a broad terminology. I think there's three areas that I certainly have focused on in my career. I've had a lot of people from consultants telling me about what to do. I've read some fabulous books and some literature about giving me the theory of what to do. And then I've kind of tried to operationalize it within my own businesses that I've worked in. And I think the challenge that I've always faced is making sure that technology is integrated and that in kind of layman's terms, it actually speaks together, it flows. I think then putting the people within that technology and looking at the interaction with it, that's been very challenging. Some People have adopted it really quickly and run at it. Other people have actively pushed against it and didn't want to do it. That's another piece. And then I think the processes around it, you realize when you start unpacking these processes that they are quite convoluted. And if you're wanting the change, you've actually got to make them streamlined. And I think in hindsight, it would have been good to kind of pick an area and to really get people used to doing one particular way and to get used to the change in the way that their jobs are going to be folded out, in the way that the organization is going to run. And then trying to scale up in my organizations, it was always been right, okay, transform my entire organization. And I think in hindsight it will be better to start with something that was smaller and then scale rather than go to full pelt and transformation.

Heather, how can we increase the speed of transformation, the pace at which it's happening in the healthcare space?

So let's just take an example of a new medicine, for example, that's come out that's going to change the way that a particular disease is managed. I think what you need to do is have a really good think about how you're going to communicate those messages through all of your particular channels. And some of them will be people, and some of them will be events, and some of them will indeed be your different channels that you'd use that people can pull information from. And I think letting people know that there is a menu of different things available that they can pull in to absolutely give them their own personalized approach is probably the way that you increase the pace. I think what companies want to do is control that pace and control it at the pace of themselves rather than the customer. And I think that's where it goes wrong, because if the customer doesn't get what they want, when they want it, then they're likely to just go somewhere else. I mean, it doesn't matter which industry that they are. And I think in health care in particular, because it's so regulated and because it's rightly so, and because it has to have a sequence of different things, I think we need to look all the way through and say, well, what are the touch points of that particular disease pathway? Who are the people that they're interacting with? What information needs do they know? What kind of coaching and teaching do they need to have in order to make them feel confident? And what is the role of the patient in that, to make them fully informed and if you've got that, you've got a great patient experience, well that really helps. You're actually looking at how that patient fits into the population, which is what the healthcare system wants to do. And if you increase the kind of efficiency of that process, you then going to reduce the per capita cost of that healthcare, which then benefits everybody because there's more to go around. So. So I think that's how you increase the pace, Rob. I think you've got to involve those three elements all working in symphony together.

And you think some of those concepts translate well to other industries, Heather?

I think so. You've always got a consumer at the end of it and I think you've always got a technology and you've always got a process and you've always got people interacting with the different parts and they're interacting, I think in different ways because they're seeking information and I think in healthcare they're probably seeking information not only about themselves but how other people have fared, which I guess can be applied so families can cope with different things. So in the case of a car, I've just bought a car, I can tell you now my whole family were involved because they all had different aspects of it before we actually chose the final piece. I think before we would have just gone down to a showroom. Now I had my four kids and my husband all looking at cars because we needed to buy a vehicle. That accommodated us all and that was through largely technology.

Now Heather, we hear the word agile banded around these days in a lot of organizations. Does going agile really help in your view?

I think it does and I'm going to qualify exactly where it does. If you look at the complexity of execution. So how we get stuff done, basically one person is not in charge of the entire end to end process. Invariably you get teams and the best teams have a number of different people. And I think the biggest thing that I've found is getting those teams to work to a specific business question and produce an output because that's actually why companies are running. They're producing an output, they're not actually producing a process. I think Agile can really help in that because it changes your mindset. Everybody gets focused on the task in hand, you know what's realistic, you know from your backlog, what you can do, what needs to be changed and allows a greater level of conversation. I think agile also enables you to be able to produce something that your customer or your client wants. Now back in the day I think it was just, well, this is what the design Spec is here is what you wanted and it was kind of. Well, that's not actually what I meant. Now there gives a number of iterations all the way through that you can produce something that your customer wants. That said, Agile isn't right for everything and Agile won't solve your problems if you haven't got your strategy right. And if you haven't got the business problems that you're trying to solve identified upfront, all you'll end up doing is just becoming busier, producing more things that actually don't have any value if it's adopted in a very chaotic fashion.

Now, with so many organizations having really good intentions to adopt agile ways of working, what do you see are the biggest challenges they're facing in doing that right thing, becoming more agile? What's the challenges, Heather?

I think it's still. It's making sure that you've got the customer in mind when you're doing things, whatever that might be, and ensuring different people work in different ways. So you've got the DevOps guys working with marketing. How do they have a conversation that works in the best way? I think people then really have both backlogs that sometimes are just not feasible and so you end up producing things that are either late or they're not quite what is required. And I think that's the biggest challenge around is you've got to get in the Agile mentality. How do you link the kind of the business performance and the financials performance with the Agile teams to make sure they're all working together to produce an output? I think where I've seen Agile work best, and I have seen many, many organizations, it works well. Where you've got that real clear focus, where you haven't got that focus, and I've seen this in many organizations as well, then that produces challenges. I think if you're going to do Agile, which I absolutely think is the right thing to do, make sure we know what you need to have. What are the basic blocks that you need to have to enable your transformation? Make sure your team is totally onboarded so they understand the principles of Agile, and then make sure you've got a really good Scrum master and a really good product owner that's going to help you. And if you haven't got those things in place, find somebody that can help you. To do it would be my advice because otherwise it becomes very frustrating for everybody.

What advice would you give to those teams that are embarking on a digital upgrade now?

Yeah, that's a good one. I would say Think big and start small. That's where I'd start from. And the next piece definitely I'd go into is be bold. Yeah, be bold. Really think about what you could do. And don't think, oh, I'd be conservative. Get people along that could be involved in this area and start to really pull the brain power into that organization and into that group to try and work out what it is they want to do. And the change that you're embarking on, I think really set the standards high. Just say, we just don't want to just kind of change our business. We want to transform our business. And we want to transform our business because actually we want to be the best that we can be. Because there's a real reason for me in healthcare, it was helping Ethel actually lead a longer, happier life so she could enjoy her children, so she could enjoy her grandchildren. And be brilliant at that. Be really brilliant. And the final piece is, I think gone are the days, as I mentioned before, where you're gonna work in isolated areas. You've gotta help people along the way. So really think team all the time. Build your team where these people love working in teams and getting energy off others. So I think it's think big, be bold, be brilliant, and really help others on the way. And then I think you've got it. I really think you've got it.

So you mentioned teams, Heather, of course, we need a whole range of different people, great people with a wide range of different skills. But let's focus in on leaders. What do our leaders need to look like to help all of this happen?

Leadership is really key, Rob. You need to have a committed leadership team, and in particular the CEO, because you are not just changing their business, you are transforming their business. And in their mind, they need to believe that that transformation is going to be worth the hard yards. So you need somebody that is brave, somebody that is able to be flexible and resilient, because it's not going to be simple all the way through. Somebody that doesn't need to know all the answers. In fact, if somebody says, I know everything, then you know that they're wrong. This area is moving too quickly. I think they need to be constantly looking and learning and applying those practices within their organization, but then also taking conversations with everybody to understand, is this working for us? Is this hitting our mission? Are we doing things as best as we could? How could we change it? And really bringing those people together. I think the leaders need to have great empathy. So we talk about iq. That's always pretty much a given. But eq, I think if you're going on a transformation, you need that in spades. And so I think the leader of the future needs to be pretty multi talented, resilient and flexible, but also with an empathy for their organization and the people that they're working with to lead them through this transformation.

Heather, we're going to have to wrap it up there, but before you go, where can people go to connect with you? Learn more about some of the things you've been talking to us about today.

Well, Rob, thanks for that. I'm a great advocate of LinkedIn. There's some amazing information coming on there and LinkedIn would be certainly my channel of choice at the moment and that's where I suggest people go.

We will put a link to your LinkedIn profile in the show notes. Heather, thank you so much for your time today.

Thanks Rob. Much appreciated.

We hope you enjoyed this episode of Leading Digital Transformation with Rob Link Llewellyn and the Digital transformation people. Visit thedigitaltransformationpeople.com to secure the knowledge, talent and services you need for Digital transformation success. To continue your journey as a certified Transformation professional, visit rob llewellyn.com be sure to subscribe to the podcast and follow us on Twitter hedigitaltp and Obert. Llewellyn.