Tag Archives: metrics

Tech for good in healthcare: Insights from a virtual panel discussion

While the summer holidays are sadly fleeting the range of topics I come across that fascinate me and keep me energised and engaged is luckily infinite. I have picked some that I find particularly relevant to share with you today.

Today’s blog topics:

– Tech for good in healthcare: insights from a virtual panel discussion
– If you see a zebra don’t tell yourself it is a horse
– Leadership: Handling the statement “this won’t work here”
– Singapore and Switzerland comparing healthcare systems

Tech for good in healthcare: Insights from a virtual panel discussion

Last week I participated in a virtual panel discussion hosted by 3SC, a company dedicated to using technology for good to change lives. The topic of the discussion was “Tech for Good in Healthcare and Wellness.” I was invited to participate in my role as a member of the board of trustees for charity the Virtual Doctors.

The panel brought together a diverse group of experts, including Ariana Vargas, the founder of STIGMA, a mental health app; William Spencer from the British Red Cross; Alisandra Wederich from the Planned Parenthood Federation of America; myself; and Dr Daniel Grace, the Medical Director of the Virtual Doctors charity.

We spoke about the potential of technology to improve healthcare access considering increasing financial and human resource constraints in the sector. We also explored global considerations, including disparities in technology access, varying levels of tech literacy, data privacy, trust in healthcare providers and in technology, and the challenges of implementing tech solutions in different healthcare systems.

An important highlight from the discussion was the gap in tech adoption and maturity between different markets. Dr Daniel Grace shared his experience as a GP within the UK’s National Health Service (NHS), revealing how the COVID-19 pandemic accelerated the adoption of telemedicine in the UK, which until then had not played a role in the UK’s healthcare delivery. I contrasted this with data from the Swiss market, where telemedicine has been part of healthcare provision for almost two decades. In Switzerland health insurance providers leverage telemedicine companies as the first point of contact for patients with health concerns, leading to reduced costs. Patients are incentivised to use telemedicine services before visiting their family doctor through reduced premiums.

The panel discussion was recorded, you can find the recording here . I hope that anyone, who couldn’t take part, can still benefit from the insights we shared during our conversation.

Key take-away:  Tech in healthcare is not a one size fits all proposition, there are significant differences from market to market, regarding adoption readiness etc.

If you see a zebra don’t tell yourself it is a horse

In my last post I wrote about metrics and insights and about the broadly held but mistaken belief that you cannot manage what you cannot measure (link). A reader on LinkedIn agreed with the statement initially and added in the comments section “also, treatment without diagnosis is malpractice”. However, this is not necessarily true, because as a doctor you will often need to treat a patient’s symptoms while performing additional tests to diagnose the underlying condition.

The discussion reminded me of a great medical example that illustrates what happens when you only look at the obvious data, or the data that you can measure or easily collect, instead of exploring additional information or viewing the data in context to understand what is going on:

One of my relatives was diagnosed with bilateral carpal tunnel syndrome. Based on this the GP wanted to schedule an operation. I recommended we seek a second opinion, asking myself “why would a patient, who is retired, who does not spend hours doing manual labour, and never did, suddenly present with bilateral carpal tunnel syndrome?” Further assessments confirmed there was an underlying cause, extremely rare, but nevertheless. My relative received treatment avoiding operations that were not indicated and would not have alleviated the issue.

At medical school one of my favourite professors used to say, “when you hear hoofprints, don’t think zebras.” Conversely, if you see a zebra, don’t try to convince yourself it is a horse.

Key take-away: The data you collect is just the beginning, context is everything.

Leadership: handling the statement “this won’t work here”

In the course of any project, you will likely encounter the statement “Unfortunately, that approach won’t work here” often masked as “I don’t think you understand our specific situation”. While you might be tempted to interpret these phrases as a polite way of saying “No”, I encourage you to resist the temptation.

The reasons given will vary – market size, culture, geography, language and more. Often the phrase is shared with regional and global leads working with individual markets, but I also recall a colleague collaborating with individual teams in two distinct geographical locations within a large country who encountered the sentiment.

When faced with this situation, I always emphasize the importance of maintaining an open mind, listening actively and being open to constructive conversations, all of which will enable you to understand your colleagues’ position better. This in turn will permit you to adopt an effective management approach. A method that I have frequently found useful is to shift the focus from “how” to “why.” By identifying the driving force behind the desired change, teams can unite and work towards a common goal of finding a solution. If at all possible, try to engage in these conversations face to face.

Regardless of whether your project is met with enthusiastic support or critical questioning, I suggest you respond with the curiosity of a researcher reviewing data: there are no good or bad research results, just data. Every experiment provides you with information upon which you can act.

Try not to take resistance personally or view it as a challenge to your authority or qualifications. Admittedly, this can be easier said than done.

Lastly, it’s tempting to push forward despite encountering resistance, but remember “slower is faster.” Rushing teams forward without achieving clarity or agreement on the direction puts you at risk to fail. Take the time to address concerns, foster understanding, and ensure that everyone is aligned before advancing.

In conclusion, practice embracing the phrase “this won’t work here.” Be receptive to diverse perspectives, seek common ground, and approach obstacles with curiosity. By doing so, you will navigate uncharted territories more effectively and lead your team to success.

Key take-way: When faced with the sentence “this won’t work here” always take it as an invitation to a conversation.

Learning from Singapore: a health system case study

Singapore and Switzerland, despite their differences in geography, have much in common including an internationally recognised high standard of living and the availability of superior healthcare with comparable outcomes. However, in an article published in Swiss newspaper Neue Zürcher Zeitung (Sunday edition 9.10.2022) by R. James Breiding author of the book “Too Small to Fail: Why Some Small Nations Outperform Larger Ones and How They Are Reshaping the World,” Singapore achieves comparable healthcare results to Switzerland at 25% of the cost.

In 2021, Switzerland’s healthcare expenditure amounted to USD 7178.6 per capita, and the country was surpassed only by the United States and Germany according to various sources, you can find links to the data here.

So, how does Singapore achieve this admirable result? The answer, says R. James Breiding, is by incentivising citizens to reduce costs and by rewarding them directly for doing so.

MediSave, introduced in April 1984, is a national medical savings scheme which helps individuals put aside part of their income into a medical-focused savings account to meet their future personal or immediate family’s hospitalization, day surgery and certain outpatient expenses”. Source

While in Switzerland, individuals pay a monthly insurance premium without any incentive to reduce healthcare consumption, as the premium is lost regardless of healthcare usage, Singapore’s system rewards good stewardship of health budgets. Surplus funds from an individual’s Medisave account are transferred to the individual’s pension fund once a sufficient amount has been saved according to the article by R. James Breiding. Thus individuals who consume less healthcare are able to save more for their pension fund. In addition, these savings can be inherited by family members in the event of death. Beyond the MediSave scheme additional insurance is available to cover chronic diseases, such as diabetes, or treatment for illnesses such as cancer, where the costs are particularly high, thus sharing the risk across the entire population in Singapore.

The model in Singapore shows that when patients become an integral part of the healthcare system, deciding where, when and how to invest funds to access healthcare, and benefiting if they invest less, cost control becomes feasible.

The topic is much bigger than what I can reasonably share here, however, I hope it has sparked your curiosity.

Key take-away: Involving patients in health expenditure and allowing them to benefit individually from how they chose to spend on their health can lead to dramatically improved health outcomes at a fraction of the price.

I hope my blog posts provide you with useful insights and I look forward to hearing your thoughts. If you have a challenging project or personal challenge where an external perspective or potentially team or individual coaching might help, please contact me for an informal and confidential chat.

Best wishes

Isabelle C. Widmer MD

Photo credit: Screenshot of 3 sided cube Panel “Tech for Good in Healthcare and Wellness.” Panelists Dr Daniel Grace, the Medical Director of the Virtual Doctors charity and myself with Adriana Vargas, CEO Stigma, William Spencer from the British Red Cross and Alisandra Wederich from the Planned Parenthood Federation of America.

two children walking down a country lane showing unity of purpose, togetherness and harmony

Maximizing pharmaceutical operations: the power of organisational insights and proactive communication

I hope you are enjoying the summer and managing to hide away from the heat. I am writing this on a blissfully cold and rainy day. 

Today’s blog topics:

– The value of proactive communication
– Strategic pharmaceutical operations set-up considerations
– From data to insights: unleashing business potential
– If you cannot measure it, you cannot manage it

The value of proactive communication

I recently spent time with two siblings, aged eight and twelve.

In one conversation the younger one told me “When I was born, my sister was jealous. She was an only child up until then and as I was a baby, my mum gave me a lot of attention.” His sister listened patiently. He continued “My sister worried that I was more important than her, the new favourite child. However, it was just because I was a baby that my mum had to give me more attention. Nowadays, I still get more support, as I can’t do everything for myself yet, but there is no favourite child in our family.”

I was amazed by how matter-of-fact he was and by how his sister listened in a way that suggested the narrative was one they both agree on. I was impressed that the children’s parents had tackled this difficult topic head-on in a way that made sense to the children.

So why am I sharing this here? Because it illustrates that when we know that an issue will arise and that there is no hiding from it, it is easier to tackle it pro-actively, this is true in business and at home.

Key take-away: Address challenges early, shape the narrative, address concerns, and manage emotions.

Strategic pharmaceutical operations set-up considerations

Some topics come up regularly when I am working with organisations on their set-up. I considered sharing a checklist for you to use while running projects. Lists don’t make for great reading, so instead I have gone with a high level summary. If you think the checklist would be helpful, please drop me a line.

Considerations for pharma operations set-up planning:

1) Is the organisation I work for centralised or decentralised? Does my organisation have a strong culture of how to approach projects? How does this influence the type of set-up that makes sense from a global, regional, and local point of view? What pre-existing systems, structures and teams do we need to respect?

2) What is the context we are working in considering: products, indications, budgets, launch timelines and market size? How does this influence how we will engage with customers, our internal headcount, and rollout timelines? Where will we focus our activities? What activities, channels, materials, events, conferences, trials are necessary/make sense and what are the codes and regulations governing these in different geographies?

3) What systems do we have, what systems do we need? How will we approach data husbandry, analytics and GDPR?

Large companies have experts on all the above topics, most smaller companies do not. A colleague, who works for a small biotech company recommends “Don’t sweat the small stuff, focus your energies, identify gaps and hire accordingly.”

Key take-away: A gap analysis before you start plus a detailed check list and realistic timelines will ensure your setup planning is straightforward.

From Data to Insights: Unleashing Business Potential

Companies collect vast amounts of information on customer interactions, website visits, call centre metrics, and more. While this data is essential for daily operations and for monitoring key performance indicators (KPIs), its real value lies in generating actionable insights for future strategies.

Asking yourself the following four questions can help you unlock the potential in your data:

1) Relevant Information vs. Easy Data Collection:  Does the data we collect align with strategic objectives or is it primarily easily accessible information? If not, what data are we missing?

2) Unveiling Insights: Can we extract additional meaningful insights by analysing the data for patterns, trends, and correlations, to provide a deeper understanding of operations and customer behaviours?

3) Enriching Data Sets: What additional data from other sources across the organisation can we/should we explore to gain a more comprehensive view?

4) Tailored Key Performance Indicators: Would it make sense to assess the KPIs we currently use relative to the desired outcomes to ensure they are fit for purpose and if necessary, to adapt them?

Generating actionable insights from data involves investing in advanced analytics and expert interpretation, empowering businesses to make informed decisions for future growth and innovation.

Key take-away: Data collection is the foundation, but insights derived from data pave the way to success. By asking the right questions, exploring relevant information, and adapting KPIs, companies can unleash the power of data and drive their businesses to new heights.

If you cannot measure it, you cannot manage it

This quote is usually attributed to management consultant Peter Drucker, and with 3.5 million hits in google, it is easy to see why. However, according to a post entitled “Measurement Myopia” on the website of Drucker institute Peter Drucker never said it.

With a science background and a medical degree that involved taking many multiple choice tests, where absolute statements were almost always incorrect, my instinctive reaction to absolute statements is a sense of unease.

There are things that are hard to measure and manage (e.g. systemic bias), some that are easy to measure and hard to manage (e.g. life expectancy trends in the UK) , and some that are easy to measure and manage (e.g. phone response times in a call center) that may be less important to your business in the grand scheme of things than others.

In a Guardian article from Feb 10th 2008 entitled “the rule is simple, be careful what you measure” management editor Simon Caulkin, wrote “’What gets measured gets managed – even when it’s pointless to measure and manage it, and even if it harms the purpose of the organisation to do so”

He proposed two problems with “if you cannot measure it, you cannot manage it”:

1)The implication that management is only about measuring the visible figures

2)The easy to measure drives out the hard (e.g. phone response time measuring versus managing systemic bias)

In the article Simon Caulkin also observed “what is measured, matters, because measures set up incentives that drive people’s behaviour. And woe to the organisation when that behaviour is at odds with its purpose”.

I experienced this first hand many years ago when I missed out on a part of an incentive bonus because I chose not to perform an activity that no longer made business sense, based on the evolution of the product during the calendar year, instead doing other activities that did make sense. At performance review time my manager agreed with me in principle saying, “I agree, it didn’t make any sense for the business, so your decision was sound, but it was one of your targets, you didn’t let me know ahead of time and this is just how the system works”. Which was fair enough from a management perspective, but it also illustrates the importance of being clear on what behaviours you are fostering with your measurement and incentive system. A paper that is frequently cited in this context is V.F. Ridgway’s “Dysfunctional consequences of performance measurements.”

Key take-aways: 1) Peter Drucker never said, “if you cannot measure it, you cannot manage it” 2) Not every popular statement is correct 3) Many things are hard to measure but still need managing 4) Just because you can measure something, doesn’t mean you should 4) What is measured matters, because measures set up incentives that drive people’s behaviour.

I hope my blog posts provide you with useful insights and I look forward to hearing your thoughts. If you have a challenging project or personal challenge where an external perspective or potentially team or individual coaching might help, please contact me for an informal and confidential chat.

Best wishes

Isabelle C. Widmer MD

Photo credit: Annie Spratt @ Unsplash