Innovative Futures + Healthcare Innovation

March 25, 2019 at MOH, Riyadh, KSA (2 days)

New technologies are transforming the ways in which we live and work. Technologies enable incredible change. It is how we unlock their potential that matters.

Today we explore the future of healthcare.

Through positive wellness and personalised pharma, robotics and genetics, digital applications and patient-centric business models … the future of health is about specialisation and innovation, patient-centric solutions that are faster and more efficient. The fast-changing science is one factor, however far more significant is the convergence of pharma and biotech, insurance and hospitals, physicians and pharmacists … working together to make life better.

Healthcare Challenges

Rising costs

Spending on healthcare almost invariably grows faster than GDP. The rate of growth of healthcare spend has exceeded that of GDP since records began. Moreover, spending and economic recession are closely linked. We can expect to see the rate of growth of healthcare spend in Europe outstrip GDP growth significantly during the current economically difficult times.

Macroeconomic factors like aging populations or insufficient public funding are challenging both receivers and providers of healthcare. Adoption and penetration rates of clinical information systems vary greatly. In fact, the number (and size) of buyers varies from country to country, and is not necessarily dependent on the size of the country but rather on the structure of the healthcare system. Additionally, purchasing behavior is shifting towards more coordinated, joint purchasing.

Changing demographics

Service is in demand. There is increasing demand on the healthcare delivery organisations, and this is happening in every country. People live longer thanks to advances in understanding of the causes of diseases, and consequent improvements in diagnostic techniques and treatments. The average life expectancy in OECD countries has now reached 80 years and continues to lengthen. However, not only are people living longer, but increasingly people are living longer with chronic disease.

Filling the resource gap

Even as demand increases, there is a global shortage of clinicians. Countries with the highest number of clinicians per population will need to address graduate intake in to medical schools, which is falling in real terms in many countries. The challenge is not limited to doctors either, as enrollment in nursing colleges has also fallen in some countries.

Arguably, a storm is brewing in France, where the number of doctors over 55 is among the highest in the OECD. Combined with an overall reduction in the number of graduates emerging from medical school, France may well see the number of doctors leaving the profession exceeding those entering it. It is generally the case that a skills shortage increases costs (or reduces service quality), so a well-run health system makes sure staff are properly equipped and doing the right tasks for their skills and training. This presents an ethical challenge as some countries seek to fill the gap by recruiting doctors and nurses from other countries, thus depriving those societies of their healthcare professionals.

Focus on quality

What patients expect is changing. The quality of care is increasingly important – as patients begin to exercise their right to choose how and with whom they engage for their healthcare. They demand transparency of data and processes. As a consequence, healthcare organizations will need to focus on how quality outcomes can be published in a meaningful way for patients. Patient safety is the major focus of patient advocacy groups and healthcare leaders. They will enforce deeper investigations of medication errors, hospital acquired infections, wrong site surgery or pressure sores, like never before.

Becoming customer-driven

Where the patient needs to be — at the heart of care. To address the needs of the expert patient, and to start the transition of healthcare to a demand- driven model, some of the world’s leading hospitals are placing the patient firmly at the centre of everything they do. For example, the Cleveland Clinic in Ohio has a clear mission to improve the patient experience, and has a board-level Chief Experience Officer leading the Office of thePatient Experience. According to their website, the mission is to “ensure care is consistentlypatient-centered by partnering with caregivers to exceed the expectations of patients and theirfamilies.” Cleveland Clinic, along with a handful of other pioneering hospitals, has always been a bellwether in patient care, and it will be interesting to see how many other hospitals make similar arrangements.

Healthcare Opportunities

Moving towards a demand driven consumer model

As a society, we are changing rapidly, and this is apparent in the relationship between care providers and the citizen. Patients are increasingly becoming stakeholders in their own care journeys; they demand transparency in access and information about their care and importantly, about the quality of service provided. Citizens are now demanding access on their terms. They want to schedule appointments when and where it suits them, not the provider. They want the latest drugs or clinical trials; and of course, an end to surgical waiting lists. Or they want to begiven the option to ‘go private’ without incurring a personal cost.

The Internet is changing citizen behavior. This means the way governments interact with their citizens has to change too. Municipalities are providing more services to the citizen using technology. We will see healthcare providers do the same — adopt technological solutions to streamline processes such as setting up virtual appointments with doctors or looking up lab results online.

Healthcare is the last of the major supply driven industries. It will not be so for long. It will be the citizen that demands the transition to an industry that answers their needs, fears and aspirations.

Informed patients and the rise of social media

Patients are becoming more and more involved in their healthcare, with a higher stake in the journey than before.

Patients are simply better informed than ever before. Information about medical conditions and treatments are now easily available on the Internet. This has to some extent, shifted the focus of the patient-provider relationship towards the patient. The advent of social media is also driving healthcare interactions in new ways. Patients are exploiting these resources to discuss treatments, procedures and even individual practitioners. Alongside, healthcare practitioners, agencies and charities too will need to use social media to communicate with their citizens; in times of crisis this will become a critical mechanism.

To address the needs of the expert patient, and to start the transition of healthcare to a demand-driven model, some of theworld’s leadinghospitals are placing the patient firmly at the center of everything they do. What this means is that healthcare agencies need to have a clear strategy to take full advantage of social media.

Patients exercising choice

Healthcare systems are under close scrutiny by society. With patients having a bigger say in what they choose and demand for, government policy is impacted and in turn, healthcare providers.

Healthcare needs to become demand-driven to satisfy the needs of citizens and governments. Patients increasingly want to decide how and when to engage with their healthcare environment. Governments, health authorities and the medical profession will be challenged to provide patients with the information and services that will allow citizens to make informed choices about their healthcare. This will mean publishing data on indicators of quality (such as outcome data, readmission rates, so on) and also introducing ways for patients to book appointments at hospitals at times that suit the patient, not the provider.

Patient-centered medical home

Episodic, disease-oriented care in hospitals is not the most effective or efficient way to deliver care. The advent of the patient-centered medical home (PCMH) acknowledges this reality. It promotes care relationships across a spectrum of providers and in a variety of locations, of which the one that is most attractive to the patient is their home. This approach encourages patients to become stakeholders in their care. The care delivery system will be designed so that it fully exploits information technology, helps coordinate care across the community and monitor thepatient’s conditions, and supports patient awareness.

It is the advances in IT to support real-time monitoring that will make PCMH the norm, the standard clinical practice. Hospitals will be able to discharge patients earlier, because they knowthat the patient’s condition can be continuously assessed, and interventions can take place toensure acuity is addressed outside of the hospital environment.

Hospitals as networks

Building hospitals without walls; care for patients without borders

Increasingly, hospitals are part of their communities, and all communities are facing the demographic and disease challenge, as described earlier. Hospitals may have to implement complex, multi-organizational processes to address these challenges in an efficient and effective manner. A shift in paradigm is called for that will mean large, tertiary hospitals building networks of smaller hospitals and primary care clinics. Care can then be divested to these networks, madeavailable closer to the patient’s home and therefore more convenient. This model will requirecoordination of all providers in the network and flow of information to continually manage the care of a patient through time.

Personalised medicine

The practice of medicine has always been based on evidence uncovered through observation. And today, clinicians are at an advantage. There is a host of diagnostic techniques available that allows them to make faster and more accurate diagnoses. Radiology allows clinicians to investigate structures deep within the body, whilst histopathology allows clinicians to investigate tissue samples using microscopes to identify tumors, viruses and so on.

Translational research and the advent of personalised medicine

Increasingly however, core science is providing new insights for the clinical community, particularly in the field of genetics. Translational research is about how fundamental scientific research benefits patient outcomes, either through the development of new diagnostic techniques, new drugs, or the modification of clinical practice, the latter often referred to as the Bench to Bedside cycle.

Workshop Agenda

Day 1: Innovative Futures

How companies in all sectors are driving and responding to the changing world:

0830 – 1000 : Changing World … the challenges and opportunities of an incredible changing world for business and society:

  • Making sense of change, power shifts and emerging trends
  • Harnessing the change drivers, seizing the best opportunities
  • Being human in a technological world, fusing physical and virtual
  • Implications for existing world, and tensions to resolve
  • Cases: AlphaGo to Impossible Foods, Jio Phone to WhatsApp
  • Tools: Change Drivers, Opportunity Maps.

1030 – 1200 : Rethinking business … learning from the world’s most innovative organisations and how they innovate:

  • Rule breakers and rule makers, challenging every convention
  • 100 companies who are changing the world right now
  • Gamechanging and Doblin’s 10 types of business innovation
  • Asking the right questions, solving bigger problems
  • Cases: GM to Microsoft, Meituan Dianping to Netflix
  • Tools: Rule Breakers, Business Innovation

1315-1445 : Innovating “future back”… starting from the future, to reinvent your world in your own vision:

  • Ambition and purpose. Why do you exist, what will you do?
  • Moonshots, being more audacious by changing your perspective
  • 5-3-1 horizon planning, from the future back and then now forward
  • Innovation portfolios to create tomorrow and deliver today
  • Cases: Ben and Jerry’s to Patagonia, Tesla and Syngenta
  • Tools: Moonshot Thinking. Defining Purpose.

1445 – 1600 : Innovating “outside in”… thinking like a customer, to engage people more deeply, and develop a better business:

  • Framing your business around the customer’s ambition
  • Customers and consumers, segments, motivations, propositions
  • Reinventing your business model, the way you work
  • Aligning the organisation to make it happen successfully.
  • Cases: Airbnb to ARM Technologies, Harley Davidson and Nike
  • Tools: Customer Propositions, Business Models.

Day 2: Healthcare Innovation

How companies in healthcare, from hospitals to clinics, pharma and devices, are driving and responding to the changing world:

0830 – 1000 : Future Scenarios … the challenges and opportunities of an incredible changing world for healthcare:

  • The changing nature of healthcare, drivers and disruptors
  • Having a bigger vision, accelerating the ideas of Vitality 2030
  • Leading with a fresh perspective: What would X do?
  • Creative fusions, atoms to molecules, to create better concepts
  • Cases: 23andMe to Patients like Me, AliveCor to Infervision
  • Tools: X vision. Creative Fusions.

1030 – 1200 : Patient Futures … seeing the future healthcare experience from the patient’s perspective:

  • Rethinking from the patient’s perspective,
  • How to be more engaging, relevant, positive and personal
  • Defining a better patient proposition and healthcare experience
  • Implications for delivery, and for other stakeholders
  • Cases: Cleveland Clinic and Babylon Health
  • Tools: Customer Energisers, Customer Propositions

1315 – 1445 : Healthcare Futures … rethinking the business model for healthcare, and how it works for everyone:

  • Starting with the proposition, and defining new solutions
  • Demand-driven thinking to make better patient connections
  • Supply-driven thinking, to leverage assets, and partners
  • Rethinking the costs and revenue flows and balances
  • Cases: You
  • Tools: Customer Solutions, Business Model

1445 – 1600 : Future Today … being an innovative leader, defining your roadmap for implementation, and delivering it today:

  • Future back mapping, starting from 5 years and working backwards
  • Aligning the portfolio, current plans and new ideas
  • Accelerating the future, and balancing today and tomorrow
  • Having the courage to lead the future, with a growth mindset
  • Cases: You
  • Tools: Horizon Planning, Growth Mindset

Be the Gamechanger

The most innovative businesses see the world differently.

They don’t just seek to imitate the success of others, to compete in the markets of today, to frame themselves by their relative differences to competitors. Instead they play their own game.

I call them “gamechangers”, and have spent the last 24 months running competitions around the world, to find and rank the world’s most innovative companies by sector and geography.

So what’s the “game”? Well, in simple terms, it’s the market.

These companies go beyond innovating their products and services, their customer experienes and business models. They seek to innovate how their markets work.

Think of it like a sports game. How could you change the game? It could be anything from the pitch dimensions to rules of play, the team composition to the measures of success, the role of the referee to the participation of fans. Even the name of the game.

Now look at today’s most disruptive innovators – 23andMe to Airbnb, Brewdog to Buzzfeed, Casper to Coursera – they reframe, reimagine and redefine the market on their terms – who is it for, why people buy, what they pay and get, and how they work.

I’ve met and profiled over 250 “gamechanger” companies on my travels, in almost every sector, and in every part of the world. Corporate giants and start-ups, from Abu Dhabi to Berlin, Colombo to Qingdao.

There is no one way to change the game, but there are definitely some common traits:

  • Audacious – Gamechangers are visionary and innovative, but also daring and original; they seek to shape the future to their advantage.
  • Purposeful – They seek to make life better, in some relevant and inspiring way; they have a higher motive than just making money.
  • Networked – Gamechangers harness the power of networks, digital and physical, both business and customer networks, to exponentially reach further faster.
  • Intelligent – They use big data analytics and algorithms, machine learning and AI, to be smart and efficient, personal and predictive.
  • Collaborative – Gamechangers work with others, from ecosystems to platforms, social networks and co-creation, to achieve more together.
  • Enabling – They focus not on what they do, but what they enable people to do; and thereby redefine their marketspace, find new opportunities and redefine value.
  • Commercial – Gamechangers take a longer-term perspective, adopting new business models, and recalibrating the measures of progress and success.

Do you have a future mindset?

Today’s business leaders need a future mindset. That sounds obvious, but isn’t.

Most leaders have a “fixed mindset”. They keep stretching the old models of success. They stay loyal to the model that made them great, seeking to squeeze and tweak it for as long as possible. They seek perfection – to optimise what they currently do – which leads to efficiency and incremental gains.

Instead a “future mindset” is prepared to let go of the past. To explore the future, to experiment with new ways of working and winning. Failure is a way to learn, and innovation becomes the norm. Change is relentless inside, as it is outside. Innovation is their lifeblood. Like Jeff Bezos loves to say “it is always day one”.

With a future mindset, the CEO needs new attributes:

  • Sense maker – to interpret a fast and confusing world, to see new patterns and opportunities, what is relevant and not, to shape your own vision.
  • Radical optimist – to inspire people with a stretching ambition, positive and distinctive, to be audacious, to see the possibilities when others only see risk.
  • Future hacker – they start from the “future back”, with clarity of purpose and intent, encouraging ideas and experiments, leveraging resource and scale.
  • Ideas connector – da Vinci said innovation is about making unusual connections;  connecting new people, new partners, new capabilities and new ideas.
  • Emotionally agile – whilst organisational agility is essential, emotional agility matters even more; to cope with change, to be intuitive in making sense, and making choices.
  • Entrepreneur at large – keeping the founders mentality alive, hands-on working with project teams to infuse the mindset, to be the catalyst and coach.
  • Having grit – “gamechanger” leaders need to go against the grain, to persist but know when to move on, to have self belief and confidence, guts and resilience.

The future is a better place to start

Start from the “future back”.

Trying to evolve in today’s complex and confused world is unlikely to lead you towards a bright and distinctive future. It will extend your life a little longer, but it will be tough and uninspiring, with diminishing returns.

Instead jump to the future. I tend to start with five years ahead, although it may differ by company. 5 years is long enough to change the world, but close enough to be real. Start by creating a positive, collective and inspiring vision of the future market. What will it be like? What will people want? Why? How? Where? Then consider how to win in this new world.

This is where “moonshot thinking” can be really useful. “Why be 10% better, when you could be 10 times better?” 10 times more profits, more customers, more quality, reduced cost, reduced time. Whatever. By giving yourself a “How could we do it 10x better” challenge you take a new perspective, solve problems in different ways.

Be inspired by ideas from other places.

Explore how ARM or GE, Inditex or Netflix, Glossier or Novo Nordisk have changed their markets. Choose any of my 100+ “gamechanger” companies! How did they do it? How did customers respond? (Remember, they often serve the same customers as you!). You can’t learn much from competitors, but you can learn a lot from relevant parallels.

Copy. Adapt. Paste.

Customer insight also matters. Deep dives and design thinking, exploring the emerging trends and deviant behaviours. This can enhance and validate your ideas, but the problem with most customer insight is that it is filtered by our current world. You need something to disrupt your thinking.

I have a great box of disruptive techniques. Some are really simple – like break then remake the rules, like imagine its free then find a way to make money, like reverse polarities and many more. The point is to disrupt your conventional thinking.

From this, ideas rapidly emerge. You need lots of ideas about the future. But these are fragments of the real answer. The real creativity comes in fusing together into bigger “concepts”. These could be customer solutions, or new ways of working, new revenue streams, or new business models, and new market scenarios.

Once you have a clear and collective ambition for the future, it’s time to work backwards.  “If this is how we want to be in 5 years, where do we need to get to in 3 years, and then in 1 year?  Therefore what do we need to start doing now?” You develop a “horizon plan” for your business; a strategy roadmap if you like, but developed backwards.

The important thing is that by working backwards, you have jumped out of the morass of today. You’ve avoided the assumptions, limitations, problems and priorities of today’s thinking. You have a more inspiring “gamechanging” future, and have started to map out the steps to get there. Most likely with different priorities in the short-term too.

Of course the steps on this journey might change, but it’s going to be an exciting adventure.

Change the way we think, resolve the conflicts

In today’s busineses, we have created artificial divides in how we think and operate. Digital and physical seem like two different worlds, global and local seem like alternative strategies that cannot combine, many still struggle to align value to customers and shareholders in a mutually reinforcing way, and short and long-termism continues to confuse our priorities.

Our thinking within business, has created separate and apparently conflicting approaches. The opportunity is to make the combination of both approaches world – “fusions” if you like – to be innovative in the way you combine apparent opposites.

Digital and physical are two sides of the same coin.

There is only one world, unless you believe Ray Kurzweil, and it is the real one. It’s human and physical. Digital technologies are incredibly powerful, enabling people to connect, to work, to learn, to play in new ways. From mobile phones to blockchains, 3D printing and augmented reality, digital allows us to do more, do it faster, do things we could never do before. But it’s still about humanity.

Start with people. How can you enable them to achieve more? To live better, to have more fun, to do better for the world. Whatever matters. I work closely with Richard Branson and his Virgin teams. Their mindset is to “start from the outside, and then work in”. Design a better customer experience. Built on your ambition and insight, and then explore how you could deliver it with new and existing capabilities.

Global and local are opportunities for every business.

I love Amazon’s “Treasure Truck” … Most of us have never connected with Amazon beyond the website and the delivery guy. Amazon is huge, global and anonymous. But the Treasure Truck is real. It travels around the country, bringing its pop-up store to local neighbourhoods, fun and games, bargains and demos. For Amazon, it’s a chance to make real connections, listen to people, and to be local.

We can all see a backlash in society against relentless globalisation, huge corporations, and social inequality. We see a lack of trust in brands, and know that authenticity matters. Etsy shows us that even the smallest and most local artisan businesses can also be global. For every business, local and global markets are within reach, however it’s also about combining scale and standardisation, with relevance and individuality.

Ideas and networks should be the core of your business.

Gamechanger businesses need a compelling idea, a core purpose, an inspiring proposition, that can spread fast and contagiously. In a digitally-fuelled world, the most innovative businesses embrace “ideas and networks” to drive exponential impact – like WhatsApp creating $19bn in three years, Airbnb $40bn in 9 years, Alibaba $476bn in 18 years, Amazon $740bn in 23 years.

Think about that concept of “exponential” … The power of networks – be it franchisees, or distributors, or customers and users – lies not in the number of members, but in the connections between them. Networks have a multiplying effect. Exponential. Consider, for example, Rapha, the sportwear brand that brings together people with a passion for cycling, who conveniently meet at their “Cycle Club” stores, and buy their premium gear. A fantastic “ideas and networks” business.

Finally this idea of short-term and long-term being in conflict with each other.

Jeff Bezos never has this problem, nor Elon Musk, nor Richard Branson. They focus on the long-term, recognising it will require some years of investment to get there. They all of course lead privately-owned companies. But every public company has the same ambition to innovate and grow. And so do most of their investors, actually.

The reality is that any company’s stock market performance is based on its future earnings potential, not its past. The better you can engage with equity analysts, journalists and investors themselves to explain why you will deliver a better future worth waiting for, then you get their support. If you don’t engage them in your future vision, plans and innovations, then they will default to looking for short-term evidence. It’s really in our hands, to work together to create a future we want to invest in. And to share the greater risk and rewards.

Time to embrace your future mindset

We live in an incredible time … More change in the next 10 years than in the last 250 years … remember? I know that sounds a little crazy, but think about Hyperloop in 3 years, a tipping point to electric cars in 5 years, Mars missions in 8 years. They are all real, and possible.

Digital platforms connecting buyers and sellers in new ways, blockchain having the potential to transform relationships and trust, 3d printing having the potential to transform value chains to deliver anything personalised and on-demand, AI and robotics giving us the capabilities to be superhuman in our minds and bodies.

These are just some of the fantastic new capabilities that enable us to innovate beyond what we can even imagine today. The future isn’t like the future used to be. We cannot just evolve or extrapolate the past. Today’s future is discontinuous, disruptive, different.

It is imagination that will move us forwards … unlocking the technological possibilities, applying them to real problems and opportunities, to drive innovation and growth in every industry, in every part of our lives.

Imagine a world where you press “print” to get the dress of your dreams, the food of your fantasies, or the spare parts for your car. Instantly, personalised and on demand. Think then what does that mean if we don’t need the huge scale of manufacturing plants, warehousing and transportation. Maybe we will even subscribe to the IP catalogues of brands, rather than buy standard products, in the ways we currently subscribe to Netflix.

Time to embrace your growth mindset … Unlock your Einstein dreams and Picasso passion … Embrace your Mandela courage and Ghandi spirit. Be more curious, be more intuitive, be more human. Ask more questions. Don’t be afraid to have audacious ideas, to challenge the old models of success, and turn future ambitions into practical profitable reality.

How else did Zespri reinvent the Chinese gooseberry as the kiwi fruit? How else will SpaceX reach Mars by 2025? How else did Netflix came to be, or NuTonomy, or Nespresso, or Nyx?

This is why 23andMe’s Anne Wojicki wont give up in her quest to make DNA analysis available to everyone, and to ultimately find a cure for cancer. And it’s why Jack Ma didn’t give up as he rose from $1000-per year English teacher to technological royalty.

The secret is the future mindset.

To realise that the future is malleable. So we need to grab hold of it, and shape it in our own vision. To our advantage.

This is what “gamechangers” do.


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