Excel in Health: Proposition

Editor's Notes

• #3: 5 minutes Brief overview of course Introduce guiding document
• #4: 10 minutes
• #5: 15 minutes Two or three rounds, depending on time
• #7: 10 mins to discuss at table 10 mins to write out their own in their workbook
• #11: A value proposition tells the NHS why they should do business with you rather than your competitors, and makes the benefits of your products or services to them and their patients crystal clear from the outset.
• #12: NHS is about as risk averse and organisation as you can imagine. They are the epitome of loss aversion (care more about loosing something e.g patient health, money than about gaining something of equal value). They will usually choose stable, certain rewards over risky ones, even if the average payoff from both options is the same.  You must create a case for change that leads them to believe it is riskier to maintain the status quo than to make a change.
• #13: 4 step process – helps to break the task of creating your VP into a logical process and prevent you going astray before you waste lots of time and energy finding out that you are focusing on the wrong features of your innovation
• #14: The bigger picture Before approaching anyone in the NHS, or even starting to develop a solution, SMEs and entrepreneurs need to be aware of the current situation in health and social care. Research the overall market and understand how it all works.  Consider the growing population and associated costs, declining budgets, and limitation of resources; remember that although the NHS has a huge budget which provides great opportunities, it is a highly challenging market with expenditure and requests for time and resource challenged at every step.  This is why it is important to make sure claims about improving care and cost savings can be evidenced.
• #15: As this simple Venn diagram shows, your VP should focus on where the NHS need matches your products benefits. A good VP is 50% understanding the NHS need and 50% mapping that to your story
• #16: Don’t make the mistake of diving headlong into the solution before really understanding the problem you’re looking to solve. Start by asking yourself these questions ( the 4 U’s): Is the problem Unworkable? Does your solution address deficiencies in and/or fix a broken healthcare delivery process where there are real, measureable consequences to inaction? Are patient outcomes and experience currently being compromised due to the lack of a solution? Is fixing the problem Unavoidable? Is solving the problem driven by a mandate with implications driven by fundamental requirements associated with regulatory body requirements (CQC/NICE/MHRA) or is it driven by a fundamental requirement for better resource efficiency? Is the problem Urgent? Is it one of the top few priorities for the NHS? In selling to the NHS, you’ll find it hard to command the attention and resources to get a buying decision if you fall below this line. Is the problem Underserved? Is there a conspicuous absence of valid solutions to the problem/unmet need you’re looking to address?  Focus on the whitespace in a market or segment. If the answer is yes – then you know the market is primed for the solution You have to be in position to articulate the problem to your customer to get their attention. If you don’t fully understand what their problem is and how they would solve it without your product, you can’t find your value to them.
• #17: Don’t make the mistake of diving headlong into the solution before really understanding the problem you’re looking to solve. Start by asking yourself these questions ( the 4 U’s): Is the problem Unworkable? Does your solution address deficiencies in and/or fix a broken healthcare delivery process where there are real, measureable consequences to inaction? Are patient outcomes and experience currently being compromised due to the lack of a solution? Is fixing the problem Unavoidable? Is solving the problem driven by a mandate with implications driven by fundamental requirements associated with regulatory body requirements (CQC/NICE/MHRA) or is it driven by a fundamental requirement for better resource efficiency? Is the problem Urgent? Is it one of the top few priorities for the NHS? In selling to the NHS, you’ll find it hard to command the attention and resources to get a buying decision if you fall below this line. Is the problem Underserved? Is there a conspicuous absence of valid solutions to the problem/unmet need you’re looking to address?  Focus on the whitespace in a market or segment. If the answer is yes – then you know the market is primed for the solution You have to be in position to articulate the problem to your customer to get their attention. If you don’t fully understand what their problem is and how they would solve it without your product, you can’t find your value to them.
• #18: Don’t make the mistake of diving headlong into the solution before really understanding the problem you’re looking to solve. Start by asking yourself these questions ( the 4 U’s): Is the problem Unworkable? Does your solution address deficiencies in and/or fix a broken healthcare delivery process where there are real, measureable consequences to inaction? Are patient outcomes and experience currently being compromised due to the lack of a solution? Is fixing the problem Unavoidable? Is solving the problem driven by a mandate with implications driven by fundamental requirements associated with regulatory body requirements (CQC/NICE/MHRA) or is it driven by a fundamental requirement for better resource efficiency? Is the problem Urgent? Is it one of the top few priorities for the NHS? In selling to the NHS, you’ll find it hard to command the attention and resources to get a buying decision if you fall below this line. Is the problem Underserved? Is there a conspicuous absence of valid solutions to the problem/unmet need you’re looking to address?  Focus on the whitespace in a market or segment. If the answer is yes – then you know the market is primed for the solution You have to be in position to articulate the problem to your customer to get their attention. If you don’t fully understand what their problem is and how they would solve it without your product, you can’t find your value to them.
• #19: Sketchnote by Karla. Even with this massive simplification, the NHS is a minefield. It might be called a ‘National’ Health service but its actually 10000 separate organisations. Who you are talking to dictates the How. You must know your audience and what motivates them before you begin. Research the overall market and understand how it all works. The customer or end user value proposition can sometimes get ignored in these conversations, and yet are key to the successful transformation of our healthcare system.
• #21: Example of infographic from Leeds Strategic Plan : making life simple for you to understand priorities and indicators. May also have a ‘plan on a page’
• #22: Remember you are giving them something to vote FOR and not just against. So cost is important but it’s the patient or staff benefit that will compel them to drive change. Demonstrate how and where the product will add value to people and the health and care system.
• #23: After you have determined the problem you’re solving and validated its criticality, ask yourself: What is unique and compelling about your breakthrough? Consider which evaluation methods you can use to determine whether each product is unique and compelling and how to measure potential adoption Consider, based on your identified need and market analysis, whether you need to evaluate CLINICAL OUTCOMES, SAFETY, EXPERIENCE, EFFICIENCY
• #25: Assigning a value to health outcomes = difficult It is important to make sure claims about improving care and cost savings can be evidenced. Be pragmatic
• #26: Convert your identified needs/ pains/ gains into measurable value. Stating facts like ‘improves patient experience’ is meaningless unless its evidenced and quantified e.g patient reported outcomes measure scales. If you can satisfy the top part of the value equation, the challenge now is the resources required and specifically the revenue cost of picking one intervetion over another. The intelligence regarding cost pressures or indeed savings opportunities is key in your value proposition. Savings may occur not only as reduced cost, but also as reduced length of stay, reduced time in theatre or a move of treatment from inpatient to outpatient.
• #28: Don’t make the mistake (a very common one) of thinking as all of your value ‘dossier’ or evidence portfolio as your value proposition. Your evidence are your ‘Core Pillars’ that support your VP. People often use value proposition and value story interchangeably . It helps if you think of you VP sitting above everything else and that it is your guiding proposition and core message to your audience. Everything else is better thought of as ‘supporting evidence’ to help you retain clarity about your VP and your goal. Don’t hand someone a 5000 word VP and expect them to tease out the bits important to them. It just wont happen. VP’s are fed by health economics and cost models and feed into business cases but are different things. The data informs the VP which in turn informs further evidence generation.
• #29: You might need to evidence more gains’ for the system to secure adoption as an SME. You can measuring potential customer adoption using the gain/pain Ratio Too many SMEs are so focused on the features they deliver that they sometimes fail to examine how hard it will be for customers to adopt their product and/or service − the gain/pain ratio involves measuring the gain you deliver the customer vs. the pain and cost for the customer to adopt it. Many healthcare decision-makers are looking for non-disruptive disruptions: technologies, products and/or services that offer game-changing benefits with minimal modifications to existing processes or clinical environments. Non-disruptive is critical to SMEs bringing innovative products or services to the healthcare market since the gain delivered will also be discounted by the risk associated with buying from a young company. Remember the NHS is risk averse and you need to make them believe it is more risky to do nothing than to take up your innovation. Loss aversion theory – people don’t like losing things so create the ‘case for change’ by building a sense of loss if they don’t take action. ‘This it what you or your patients will loose out on without our product’ A successful SME will, therefore, need to deliver an order of magnitude improvement over the status quo. If a proposition can’t deliver a 10x gain/pain promise, healthcare decision-makers will typically default to “stick” rather than bear the risk of a procurement decision. 
• #30: Framework that can help when considering pain/ gain ratios and chance of your product getting adopted. Sometimes brilliant innovations fail to get any traction in a real healthcare setting. Why? The innovator hasn’t fully understood the impact of the innovation in a real setting, and spread and adoption is too challenging in reality. In a complex environment like the NHS it can help to have some of these attributes Taken from Trisha Greenhalgh’s book; How to Implement Evidence Based HealthCare. Great read if you want to get under the skin of some of the challenges faced by NHS decision makers when implementing innovation today. But originally taken from Everett Rogers’ ‘Diffusion of Innovation Theory’. The single most important one is relative advantage. If the clinician or buyer does not believe your product is ‘better’ ie. Faster, cheaper, safer, better outcomes then forget it. . It’s worth considering evaluating these attributes and then highlighting the powerful ones in your VP if they are validated as real pain points in the system.
• #34: Without explicitly saying so, Uber expertly highlights everything that sucks about taking a traditional taxi and points out how its service is superior. The simple (yet highly effective) copy above, taken from the Uber homepage, excellently conveys the simplicity and ease that lies at the heart of what makes it such a tempting service: The smartest = You’re clever!! One Tap = it’s simple!! Comes straight to you = you don’t have to even move a muscle!! Cashless = you don’t even need money!! Not convinced? More reasons to ride…
• #35: Clinical audience, traditional layout and not overly designed (although there was supporting marketing materials). Assumes some knowledge that SVR is a good outcome measure and that PR is current NICE recommended, gold standard treatment. Otherwise, its very clear what the product is for and the benefit it can deliver. Question half way through confirms the need is a true need in the mind of the reader.
• #36: If you can’t explain it simply, you don’t really know what you are trying to say It should be CLEAR, COMPELLING, AND DIFFERENTIATING. As short, sharp and tailored as you can manage.
• #37: Remember that the value proposition will change depending on who it is presented to….outcomes first or cost-effectiveness first? Core message could be different. If you can quote costs and cost-effectiveness per patient or trust specific value this is even better. It might be worth market research into what each group already knows and believes , what their values and priorities are. Keep it simple: Better, faster, cheaper, safer Have a go! Does it look different than your first attempt?
• #38: Test your value proposition until you get it right! Validation is essential. You can pre-empt some of the challenges by assessing barriers to entry, readiness for adoption, market potential/market opportunity etc…but you never fully know how it will land until to test it out. Ask the decision maker (clinician, manager, policy maker, finance director) : Are they persuaded by your Value Proposition and the supporting evidence AND do they believe that change is possible.
• #40: Is it clear why value proposition is so important? Your whole business strategy depends on it and it will guide your content in business plans/ evaluations and cost models. You need it for everything you sell. It will change with time and as your markets, needs and expectations evolve. Always think and reflect on the two key questions: What promise of value are you offering? Do your customers recognise and believe in that value?  These are not easy questions. If you have done your research and you are not sure of the answers, get out and talk to people. Best talk to some customers and potential customers. Otherwise talk to advisors, mentors, non-execs or anyone who will listen. There is no more important question on which to seek advice. By all means avoid the business jargon of the words value proposition. But keep the concept at the heart of your strategy.
• #43: Real-World Data (RWD) and Real-World Evidence (RWE) are playing an increasing role in health care decisions. Real-World Evidence (RWE) is the clinical evidence regarding the usage and potential benefits or risks of a medical product derived from analysis of RWD. Real-World Data (RWD) is the data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources, for example: Electronic health records (EHRs), Claims and billing activities, Product and disease registries, Patient-generated data including in home-use settings, Data gathered from other sources, such as mobile devices RWE can be generated by different study designs or analyses, including but not limited to, randomized trials, including large simple trials, pragmatic trials, and observational studies (prospective and/or retrospective). Why now? The use of computers, mobile devices, wearables and other biosensors to gather and store huge amounts of health-related data has been rapidly accelerating. This data holds potential to allow us to better design and conduct studies in the health care setting