Seattle Children's Hospital (SCH)

Eugene Kolker

Today Healthcare is at the crossroads of many business, emotional, political, and societal issues. One of the questions people ask concerning Healthcare is: “How can it assist me personally to improve my health effectively and economically?”One powerful answer can come from re-focused efforts of strategic innovation and execution. Here, we introduce the concept of an “uber-customer” and. “customer” in Healthcare. An “uber-customer” in Healthcare is a patient, individual,with a sample size of n=1, while “customers” are the providers– doctors, nurses and surgeons.  

 “As uber-customers become more knowledgeable about the power of their own health actions and choices, they will expect superior quality from the customized Healthcare service.” 

To enable superior, quality services in the 21st century, Healthcare organizations have to re-focus on strategically addressing the key needs, pain points and hopes of their “uber-customers” (super-customers), by empowering their “customers”. To achieve this task, consider a robust, reliable and scalable approach called PPT-DAM: People- First, Process- Second and Technology- Third(PPT) enabled by Data, Analytics and Metrics (DAM).When applied with the classic Experiment-Execute-Evaluate iterative methodology, PPT-DAM is extremely potent. Its implementation at scale canensure that Healthcare will indeed help improve the health of each and every patient, n=1.  
 
“How can it assist me personally to truly improve my health, without breaking my bottom line?” is the question many people ask about Healthcare. Clearly, it is hard to come up with one universal answer. However, one answer relies on incorporating data to fuel strategic innovation and execution of data-informed approaches. These data-informed approaches focus in on the uber-customers by starting with their key pressing needs and reverse engineering to develop superior, 21st century services.
 
Many innovative companies, from “A”--Amazon and Apple, to “U” and “Z”--Uber and Zillow, are strongly customer-centric and utilize data, analytics and metrics (DAM) informed decision-making and execution. These DAM approaches ensure superior, customized, individualized services for their uber-customers of n=1. As uber-customers become more knowledgeable about the power of their own health actions and choices, they will expect superior quality from the customers and the Healthcare organizations.  

Healthcare organizations (federal and state agencies, provider systems, insurance companies, ACOs, integrated networks, and others) need to strategically innovate to focus on their uber-customers’ needs. How to do that effectively, economically and at scale? Learn from the innovators and customer-focused businesses mentioned above and empower the Healthcare customers: the primary physicians, specialists, surgeons, nurses, medical staff, and administrators. Truly enabling customers will result in transformational and sustainable changes of the entire healthcare ecosystem producing superior services for the uber-customers, patients, individuals of n=1.  
One of the key principals in the Healthcare is “do no harm”! This is magnified for the most vulnerable uber-customers, including the patients, who are being treated by intensive care units (ICUs). One of the major challenges of ICUs (as well as hospitals) anywhere in the world is to prevent patients from acquiring infections. Naturally, this is one of the uber-needs and pain points for the uber-customers. How did the PPT-DAM approach enable SCH (business) and its (internal) customers (physicians, nurses, managers) to address this pain point of the uber-customers (patients)? 

Earlier we described the Benchmarking Improvement Program, and Table 1 illustrates specific realization of the PPT-DAM approach for this program. The program began with the thorough analysis of the needs, pain points and hopes of the uber-customers (patients and families), customers (internal partners, medical chiefs, physicians, surgeons, nurses, managers etc.) and business (SCH). Their joint re-alignment ensured that this program is focused on the vital clinical outcomes metrics. As a result, key improvement areas were identified and prioritized, which, in turn, were incorporated in the strategic planning.  

Specifically, the Benchmarking Improvement Program recommended focusing on reduction of ICU infection rates, which became part of the strategic goals of the business. Then the hard work began with iterative implementation of the EEE (Experiment-Execute-Evaluate) methodology, a process of trials, errors and improvements. In turn, the concerted efforts of the customers and entire hospital system (business) enabled a significant reduction in these infection rates, which directly influenced the clinical outcomes for the uber-customers – our uber-goal!

Elsewhere we have described the PPT (People-Process-Technology) approach and shared our own case studies of its implementation in Seattle. Figure 1 describes a modified, implementation-oriented PPT-DAM approach by our CDO Analytics team with super-focus on super-customers and customers. Other relevant data stories have been described at cdoanalytics.org. We developed a robust, reproducible and scalable 3-step strategy for DAM-informed decision-making and execution based on the following: 

1 Identify the needs, pain points and anticipated outcomes of your uber-customers, customers and business (People – First), 
2 Implement the best consulting, services and business processes that support and are supported by the people (Process – Second), and 
3 Identify the appropriate technologies and diligently align them with your people and processes (Technology – Third).  
The above three steps have to be empowered by DAM and iteratively implemented with classic Experiment – Execute – Evaluate (EEE) strategy (Fig. 1).  
 
The combination of classic EEE iterative methodology applied with PPT-DAM is extremely potent. Its diligent implementation will ensure Healthcare organizations will indeed improve the health of its uber-customers, patients, individuals of n=1, by empowering its customers – physicians, surgeons and nurses. 

Table 1.A sample process for implementation of the PPT-DAM Approach.

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