Examining change as a project allows staff buy-inGone are the simpler days when solutions were sociopolitical. Today, companies offer everything from hair solutions to shoe solutions. Radiology has its share of solutions, but only
Examining change as a project allows staff buy-in
Gone are the simpler days when solutions were sociopolitical. Today, companies offer everything from hair solutions to shoe solutions. Radiology has its share of solutions, but only Siemens Medical has embraced them as the cornerstone of its corporate philosophy.
The task of turning an overused term into Siemens' raison d'etre has fallen into the hands of one person, Louise Morgan, senior vice president of Siemens global solutions. Morgan has been assigned this task not as part of a sweeping corporate reorganization, but as a project designed to change the attitude of some 30,000 employees worldwide.
The goal is to improve the delivery of healthcare. To achieve this, Siemens must improve the quality of care while containing or reducing costs in the healthcare system. Changing diagnostic procedures or enhancing diagnostic equipment will not necessarily result in such improvements. The solutions, according to Morgan, may lie in refining the more mundane activities that accompany the diagnostic process. These may be administrative tasks involving patient management, for example.
"You might have to look at what is going on before and after diagnosis," she said. "This has to do more with the general flow of work. It may be nonclinical, more operative. It may be just looking at beds."
In examining the workflow of hospitals, Morgan has found that up to 10 hours may elapse from when the decision to discharge is made and when the patient actually leaves the hospital. This is way too long, she said, considering the relatively few tasks that need to be performed. A workflow model developed by Siemens has reduced this gap from 10 to as few as two hours.
The model relies on an information technology system to organize and automate the discharge process. It lists or even provides the doctor with the reports necessary to discharge the patient at the time the decision to do so is made, notifies the nurse or social worker to call relatives who can pick up the patient, tells the pharmacy to prepare medication, and alerts housekeeping to clean the room.
"Just taking away the human interfaces and having things done simultaneously will cut the time tremendously," Morgan said. "The patient will be thrilled to get out faster."
Many of the processes that hold potential for more efficient patient care might be addressed through IT, as the administrative side of healthcare has lagged the technological advances made on the diagnostic side. Improved data acquisition methods in the form of multislice CT, for instance, and digital gamma cameras have increased the speed of exams. More powerful computing platforms have reduced the time needed for postprocessing and interpretation.
Progress in these areas, however, must continue. In MR, for example, Siemens' parallel acquisition techniques may offer the clinician the choice of speeding the exam or increasing resolution. A frail patient may undergo a shorter exam, thanks to iPAT, whereas the physician may opt for a higher resolution study for a diagnostically challenging case.
"The ability to adjust to patient circumstances is a key component in developing a solution," Morgan said.
Morgan is about nine months into the project, which has a self-imposed two-year deadline. By September 2003, she expects to have developed the procedures that Siemens staff can use routinely when looking for solutions to customers' problems.
"I am not saying it will be completed on all points, but the project has to be institutionalized by then in the patterns of how people work so that it will run on its own," she said.
By conducting this effort as part of a project rather a corporate reorganization, Morgan hopes to avoid threatening the authority of executives she needs to bring onboard for the project to succeed. Currently, the business units within Siemens Medical are focused primarily on modalities. Imposing a solutions-based approach to marketing means these units must work together.
"To get groups within an organization to accept a transition, you have to make certain they are involved in producing that transition," she said.
Morgan has assumed the role of fact finder and expediter, seeking to cut a path along which key personnel within the Siemens organization can travel from their current position as product provider to solution provider. This path is being paved in steps. The first is a mobilization of employees--the development of means by which staff come to understand the vision behind solutions, she said. Rather than linger in the hypothetical, Morgan has chosen to focus on a tangible area.
"Cardiology was chosen because it touches a broad area of the organization, from information technology to CT, MR, nuclear medicine, angiography, ultrasound, special products, even OR and electromedicine," she said.
The goal is to bring these groups together using patient welfare as the unifying idea.
"When there are conflicts, we can often resolve them by asking what is best for the patient," she said. "That almost always pulls everyone back from turf battles."
Morgan is putting together a consensus mechanism she describes as a "solutions academy." Attendance may be in person or online. In either case, staff from different business units, such as MR and CT, work together to create solutions that improve patient care.
Crossing established lines of authority is not easy, particularly when hierarchies are entrenched. Solutions necessarily may not be complementary. Decisions may have to be made whether to sell an MR or CT scanner, gamma camera, or cardiac cath suite. In fact, there is no single cardiology solution, and Morgan is the first to admit it. Her intent is to come up with a mechanism by which solutions can be devised for individual customers.
This mechanism need not be profound. To a large extent, customers will determine the type of solution Siemens will provide. Many customers today view Siemens in much the same way they view other product vendors, as a source of capital equipment. If that is all the customer wants, that is precisely what the Siemens customer will get, Morgan said.
"For a long time into the future, a very large portion of our business will be the classic product business, because that will be the way many customers want to deal with us," she said. "It is the customer's choice how to deal with us."
Morgan aspires to more, however, and she expects that the Siemens customer base will evolve with the company's ability to provide sophisticated answers to problems. But first the company has to come up with those answers and then prove that the answers work. Designing solutions with substance--the second step on the path to achieving a viable solutions-based corporate game plan--will do this.
Morgan is now developing pilot projects, targeting December 2002 as the end point for the first one. The details will be released at that time, she said. This process will lead to the development of the first definable Siemens solution in 2003.
The third step is "value selling." To achieve this, Siemens staff must establish the clinical value of their solutions. They need to understand the problems of their customers and to implement the means for solving those problems.
"What we want to do is diagnose for prescription," Morgan said. "A customer should tell us what the problem is, we will diagnose it together, and then we offer them the prescription for it, as opposed to saying. 'I have this prescription, now what problem will it solve?'"
The final step on the path to a solutions gestalt is external marketing, she said. The key here is to come up with proof for each claim Siemens makes for its solutions. Anecdotal support is not enough. Siemens must come up with exact measures that unequivocally point to the advantages of its solutions. Just identifying the right measures is challenging, Morgan said.
"There are thousands of things you can measure," she said. "But we have to find the ones that are most relevant."
This is being done by working with luminary sites, where proposed solutions can be implemented, tested, and proven. Siemens will use these sites in much the same way they use sites that now serve as showcases for flagship products in MR or CT.
The development of these sites is a critical element of the overall effort to implement solutions-based thinking at Siemens. Only by demonstrating that solutions work can Siemens use solutions to increase sales, according to Morgan. And only if the bottom line is affected will Siemens staff embrace solutions as a way of corporate life.
"People have to be convinced that solutions are the way to go," she said. "Showing that they work is the best motivator."