The Sick Care Process Improvement Canvas

If you follow the entrepreneurship blogosphere, you are most likely familiar with the lean startup methodology, including the concepts of minimally viable product (MVP), minimally viable pilot, the customer discovery process and the business model canvas.

Sometimes the model has to be tweaked, e.g. if you are creating a non-profit or social enterprise.

Sick care process improvement (SPI) is another example. Unlike a startup launching a new product or service, SPIs are designed to improve existing offerings with the goal of lowering costs, improving quality or bettering the doctor and patient experience-the quadruple aim.

While they are important and valuable, in most instances they should not be confused with "disruptive" innovation.

In addition, since these initiatives require mostly intrapreneurial skills and overcoming corporate barriers, the success factors are different from a startup launching a new product.

Some of the modifications should include:

1. Recognizing that that there are many stakeholders customer segments, not just one.
2. SPIs rarely succeed without satisfying the jobs, pains and gains of multiple stakeholders
3. Each stakeholder requires a somewhat different value proposition
4. In most instances, the value proposition will have to address quality, workflow, income, liability and time (QWILT)
5. Customer relationships (how to get, keep and grow "customers) is mostly about overcoming the barriers to clinical dissemination and implementation and technology adoption and penetration. That means doing one of the most difficult things-changing doctor and patient behavior.
6. Distribution channels have to overcome the organizational barriers, turf wars and vested interests involving multiple departments led by department managers that are not aligned
7. Key resources typically involve money, people, assets and intellectual property which are hard to find or define. One that is frequently neglected and scarce, particularly the higher you are in the food chain, is time.
8. Key partners , particularly when it involves outside IT vendors trying to get traction in your institution or organization, involve a bureaucracy or legal and IT departments which can slow or kill the initiative, or , worse, significantly maim it
9. Revenue stream improvement is almost impossible to define
10. Cost savings are almost impossible to define

As such, iCorps training for those interested in SPIs might not be anything more than innovation theater. What's more, not understanding these differences is one of many reasons why non-sick care entrepreneurs fail in sick care. It might also be why some question the value of "healthcare innovation centers" since most deal with sick care , not healthcare, and they make improvements, not create innovations.

SPIs are not strartups. Inventions are not improvements. Improvements are not innovations.They require a different way of thinking about how to create and measure their outcomes and impact. The KPIs for SPIs are different.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs