Managing the Today, Creating the Tomorrow

Call me a nerd but I’ve always been a fan of business models.  I find it fascinating when a company can identify a consumer need then create a unique product or service that realizes that need.  There are a ton of famous examples…Amazon to shopping Uber to transportation Netflix to home entertainment…and yes Apple to personal computing personal communications, music distribution, and probably soon banking.  And it’s not always about the technology.  Who thought 25 years ago college students would spend hours each day in a gathering spot drinking expensive coffee and eating fancy named pastries or fitness nuts spending hours in a shelled warehouse without air conditioning lifting weights, running, jumping, all to do something called a WOD. These companies succeeded because they identified a consumer need and built outstanding products and services to meet that need.  

What I find fascinating are not only the products and services that disrupt an industry by super exceeding a consumer need but the spark that conceived the idea.  As legend goes, Reed Hastings thought up Netlix after getting hit with a late fee after returning Apollo 13.  As a consumer he designed a completely different business model that shook up an industry.  Their business model was simple:  monthly subscription for unlimited rentals, with no due dates, late fees, or shipping fees. Managing the today…

Now here’s what’s interesting.  The business model created by Netflix resulted in substantial growth.  But as the technology and consumer needs evolved so did the Netflix business model. The streaming service of today is much different from the mail service from the early 2000’s.  Creating the tomorrow.  

Successful companies not only create a successful model but pivot or create new models that better meet consumer needs.  Back in the late 90’s managers quickly dropped their Franklin Planners for the latest craze tool….the Palm Pilot.  The PalmPilot with the little stylus was an amazing device to write notes, manage calendars, and tasks.  But the company business model did not evolve fast enough and today this space is dominated by Apple and Samsung.  

So, let’s talk pharmacy. To be blunt, the current pharmacy model is ineffective.  Look at the data.  Poor medication management costs this country over $200 billion annually per various studies. Too often patients are not on the right medications, do not have access to needed medications, and do not take as prescribed.  If you are a caregiver in a hospital in the emergency room or a nursing unit you see this every day.  The patient who cannot afford insulin and thus is admitted because her blood sugar is out of control, or the teenager who ends up in the emergency room because he can’t afford his inhaler.  Also, the number of patients taking over 25 medications is staggering.  Theirs’s little chance this combination of medications is achieving the optimal outcome.

During the past several months I’ve spent time in the field observing, conversing, and in some cases immersing myself in the patient experience. I’ve spoken to patients in our hospitals, retail pharmacies, in their homes, and their churches.  I wanted to better understand their medication experiences both good and bad.  And not just the surface stuff and the layers within the onion.  Their emotions, pains, and concerns.  What scared them, what concerns do they for family members, etc. In the design thinking world this is considered the empathy stage.  

So, let me share my scribbled notes.

• Not surprising cost is a big issue.  But not just the actual cost of medications but the lack of cost awareness…as in not knowing the cost until reaching the pharmacy counter.  I spoke to one patient who was quite embarrassed when she went to the pharmacy and learned her co-pay was over $100. She couldn’t afford and ended up leaving.  And did so in front of other customers.
• Getting to the pharmacy to pick-up prescriptions.  It’s interesting…some consumers prefer going to the pharmacy while others hate it.  For those that hate, it’s an Amazon world.  Bring it to me.  
• Speaking of access…. many patients have transportation issues.  Either they cannot afford transportation, or they are not healthy enough to leave their home.  Not everyone has a car and lives within 5 minutes of CVS.  
• Personal Service was a common theme.  Healthcare is personal and patients need to trust those assigned to their care.  Often patients commented that the person on the other end of the phone or at the counter were just checking a box instead of helping address and answer their concerns. 
• Understanding the drug.  The name is too confusing and there is too much information on a little 2 x 2 label. Font size of 2…. really.  What are the basics?  What is the drug, what does it do, when should I take?
• Taking. You seriously want me to open these many vials…especially with those crazy caps.  Make it easy.
• Reminders…Yes, we’re human and sometimes forget.  Reminders.
• Who can answer my questions…if I can read that little print on the vial, I can call the pharmacy and speak to someone I’ve never met or previously dialogued? 
• ?Too many meds. Are my meds working together like a symphony or like my son’s garage band?  

Within pharmacy we are having to deal with many of today’s issues…as in managing the today.  But at the same time, we need to pivot our thinking and begin considering the planning for the tomorrow.  Let’s be honest if the model doesn’t change, neither will the results and that would be tragic.  It’s time to bring out the markerboard and create.