Lessons from healthcare transformation

Lessons from healthcare transformation; think big, be bold and help others: An Interview with Heather Hancock

Leading Digital Transformation is a weekly podcast series produced in collaboration between The Digital Transformation People and Rob Llewellyn digital transformation advisor and founder of CXO Transform.

During this series, Rob interviews experienced practitioners, authors and thought leaders whose stories and experiences provide valuable insights for digital transformation success.

In this episode Rob speaks with Heather Hancock who shares her experiences and insights gained as an Executive Director, with many years experience leading the strategic direction and operations across national and international markets within the healthcare industry in both public and private sectors.

She has successfully developed and implemented company strategy and managed large scale transformation initiatives that have delivered real value for patients and improved financial performance too.

“If you’re going to do agile, which is absolutely the right thing to do, make sure you know what you need to have. What are the basic blocks that you need 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.” 

Listen here and read the full transcript below.

Strategy & Innovation Consultation

Rob Llewellyn [00:00:22] I’m joined today by Heather Hancock. Heather’s got 20 years of experience in health care gained in commercial functions across both the hospital provider and pharmaceutical supplier landscape. Heather is passionate about patient and customer-centric design in digital transformation, and she believes the technology has three purposes of value improve patient experience, improve population health and reduce the per capita cost of healthcare. To learn more about this, let’s jump into the interview with Heather.

Rob Llewellyn [00:01:01] Heather, welcome.

Heather Hancock [00:01:02] Hi. Thank you.

Rob Llewellyn [00:01:04] Heather, you’ve been working in the healthcare space for 20 years or so because we were 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?

Heather Hancock [00:01:21] Yes, 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. 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, your hospital doctor, and all of them will be asking you about 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 and 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 so 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 need to interact with perhaps your local pharmacy. So it becomes a system of healthcare 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 on now much more integrated in the system to help and enable people to live better lives, longer lives. So I think it’s been quite a bit of change, Rob.

Rob Llewellyn [00:03:27] So how is digital transformation helping to bring about this change,  Heather?

Heather Hancock [00:03:34] 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 eco-system 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 it 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 in how we help ourselves to be healthier.

Rob Llewellyn [00:05:11] Heather, our audience is scattered all over the world. And of course, you’re in the UK and very familiar with that 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.

Heather Hancock [00:05:29] Yeah, I will do. There’s a great company called Babylon, now, Babylon are an online GP system. I think they’re beginning to put their arms around very different countries around the world. And Ali Parsa is the chairman of that organization. He has a fabulous line that he always says in all the meetings, which is “healthcare in the palm of your hand”. And I think the advent of mobile technology means that in theory and it is a theory, Rob, that 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, where see 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 properly 24 hours a day. I think if even in rural Africa, which was somewhere that I’ve worked, everybody had mobile phones and the local organizations that 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’re in dependant 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 I can give you was something that I was in a 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 knee operation you would spend your time in hospital. You would get your prosthetic, you would have an operation, you would have this 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 went 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 health care now is available in a number of different areas to wrap around the patients.

Rob Llewellyn [00:07:52] I think that Babylon is a terrific example. And I’m gonna put a link to Babylon in the show notes so that people, particularly not in the UK, who 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, one of the big challenges that organizations are now facing in the healthcare industry as a whole in terms of making the progress that’s necessary?

Heather Hancock [00:08:19] 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 organizations 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 or the biggest challenge I think is being faced is to kind of get that personalized because people want to be able to pull information when they want to and how they want it from somebody that they want to speak to if indeed they do want to speak to and the organizations around them want to get a consistency of approach. You’re kind of put in the middle of that technology and you’re in a system where people think, well, I’ll just buy technology to solve my problems. I’ll just put lots and lots of platforms and 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 the way that they want to do and the 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 were all robots, this would all be easy, but we’re not.

Rob Llewellyn [00:09:44] 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?

Heather Hancock [00:09:59] Yeah. I mean, if only we could just have hindsight a lot quicker. That would be helpful, wouldn’t it? OK. 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 focussed on in my career. I’ve had a lot of people, some 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 operationalise it within my own businesses that I’ve worked in. And I think the challenge that I’ve always faced is, 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. 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 would be better to start with something that was smaller and then scale rather than go to full pelt and transformation.

Rob Llewellyn [00:11:46] How could we increase the speed of transformation, the pace at which it’s happening in the healthcare space?

Heather Hancock [00:11:53] 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. 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. 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 healthcare 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 touchpoints 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.  Your action would be 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’re then going to reduce the per capita cost of healthcare, which then benefits everybody because there’s more to go around. 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.

Rob Llewellyn [00:13:53] Do you think some of those concepts translate well to other industries, Heather?

Heather Hancock [00:13:57] I think so. You’ve always got a consumer at the end of it. I think you’ve always got a technology and 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 well 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 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 largely technology.

Rob Llewellyn [00:14:43] Now, whether we hear the word agile bandied around these days of organizations, does going agile really help, in your view?

Heather Hancock [00:14:53] I think it does. I’m going to quantify 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 on them. 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 focussed 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 it 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.  You know, 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, that 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.

Rob Llewellyn [00:16:24] 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 the right thing? Becoming more agile? What’s the challenges, Heather?

Heather Hancock [00:16:38] 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 dev-ops guys working with marketing how do they have a conversation that works in the best way? I think people then really have 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 make the kind of business performance and the financial 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 it in 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. So I think if you’re gonna do agile, which I absolutely think is the right thing to do, make sure you 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.

Rob Llewellyn [00:18:05] What advice would you give to those teams that are embarking on a digital upgrade now?

Heather Hancock [00:18:11] 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 go into is be bold. Yeah? Be bold. Really think about what you could do and don’t think oh, I’ll be conservative. Get people along that could be involved in this area and start to really pull the brainpower 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 standards high. You know, we just don’t want to just kind of, you know, 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.  You know, for me in healthcare, it was helping Ethel actually live 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 going to work in isolated areas. You’ve got to help people along the way. So really think team all the time. Build your team where these people love working in teams and gaining energy off others. So I think it’s I 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.

Rob Llewellyn [00:19:30] So you mentioned teams over. Of course, we need a whole range of different people, great people with a wide range of different skills, but just focussing on leaders. What do our leaders need to look like to help all of this happen?

Heather Hancock [00:19:44] Leadership is really key, Rob. You need to have a committed leadership team and in particular, the CEO, because you’re 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’s 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 or mission? Are we doing things as best as we could? How could we change it? I’m 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.

Rob Llewellyn [00:21:10] 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.

Heather Hancock [00:21:19] 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’d suggest people go.

Rob Llewellyn  [00:21:31] We will put a link to your LinkedIn profile in the show notes. Heather, thank you so much for your time today.

Heath Hancock [00:21:37] Thanks, Rob. Much appreciated.

Announcer: [00:21:39] We hope you enjoyed this episode of “Leading Digital Transformation” with Rob Llewellyn and The Digital Transformation People. Visit www.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 www.RobLlewellyn.com. Be sure to subscribe to the podcast and follow us on Twitter @TheDigitalTP and @RobertLlewellyn

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