The Sick Care Process Improvement Canvas

The Sick Care Process Improvement Canvas

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

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  • Manju Fernando

    Really a great article!

  • Vinny Sapra

    Well explained!

  • Mike Bullock

    SPI improvements explained in an excellent manner !

  • Patricia Macieira

    Super cool and simplified explanation

  • Nitin Mishra

    Well explained in layman terms.

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Arlen Meyers, MD, MBA

Former Contributor

Arlen Meyers, MD, MBA is a professor emeritus of otolaryngology, dentistry, and engineering at the University of Colorado School of Medicine and the Colorado School of Public Health and President and CEO of the Society of Physician Entrepreneurs at He has created several medical device and digital health companies. His primary research centers around biomedical and health innovation and entrepreneurship and life science technology commercialization. He consults for and speaks to companies, governments, colleges and universities around the world who need his expertise and contacts in the areas of bio entrepreneurship, bioscience, healthcare, healthcare IT, medical tourism -- nationally and internationally, new product development, product design, and financing new ventures. He is a former Harvard-Macy fellow and In 2010, he completed a Fulbright at Kings Business, the commercialization office of technology transfer at Kings College in London. He recently published "Building the Case for Biotechnology." "Optical Detection of Cancer", and " The Life Science Innovation Roadmap". He is also an associate editor of the Journal of Commercial Biotechnology and Technology Transfer and Entrepreneurship and Editor-in-Chief of Medscape. In addition, He is a faculty member at the University of Colorado Denver Graduate School where he teaches Biomedical Entrepreneurship and is an iCorps participant, trainer and industry mentor. He is the Chief Medical Officer at and and Chairman of the Board at GlobalMindED at, a non-profit at risk student success network. He is honored to be named by Modern Healthcare as one of the 50 Most Influential Physician Executives of 2011 and nominated in 2012 and Best Doctors 2013.

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