Three opportunities for more chemistry between hospital and MSB

By Healthcare, News

Now that the participation model does not seem to take hold, the following question arises: what can we as hospital and MSB do to join forces? “To date, the introduction of integrated funding has not meant that the hospital and MSB jointly manage healthcare in a smarter and more efficient manner”, is one of the conclusions from the ‘Integrated Fidelity Monitor’ recently published by the NZa. Three concrete opportunities in this article.

Why is it so difficult? An important reason why this objective does not get off the ground is the calculation system between hospital and MSB, which in many cases is primarily driven by volume. In some cases there are additional agreements about quality outcomes that are included in the settlement. Whatever the case, doctors who work for the MSB, are not affected by the incurring costs related to their choices – for example medicines, length of stay and diagnosis. The smart and efficient organization of healthcare in times of staff shortages remains the main concern of the managers and directors of the hospital organization.

Professional interlocutor. With the arrival of the MSB, a single point of contact has arisen for the hospital management, in which there is a joint sense of responsibility and a certain alignment of interests. This offers potential when it comes to joint performance management. How to redeem this potential as a hospital organization?

  1. Starting point: shared and concrete future vision.
    The healthcare landscape is changing, it’s clear that the role and position of the hospital is changing too. What the healthcare landscape looks like and what this actually means for the hospital and the different departments within the MSB, is to be agreed upon. It’s easy to see that directors are already on a different planet, while the MSB are occupied with production ceilings, internal calculation models and distribution of medical specialist capacity. By jointly exploring the strategic scenarios, a shared view of the urgency arises: the considerations and the opportunities that this offers.For example, in some regional hospitals together with the MSB we have experienced in practice what the different scenarios mean, also for the departments in the MSB: which healthcare do we no longer provide, which partnerships are important and which investments in technology and (ICT) infrastructure are needed? And which form of healthcare is being shifted internally to a specialist nurse?
  2. Maintaining a uniform working method: the right steering information.
    Medical and business manager form a crucial team in realizing the strategy and the clever organization of healthcare. In addition to formal authority for the medical manager, it is important that both maintain a uniform working method when it comes to steering. ‘Are we seeing the right patients? Do we provide healthcare in line with our chosen healthcare model (eg, do/do not perform surgery, e-consult versus screening, hospital stay)? Do we use our critical resources properly and how happy is our scarce staff actually?”In order to reach the right steering information, we are able to point out three success factors in practice: – Conducting the conversation about “when are you doing it right” and what do you want to know to get there, or even better; what do you want to know to stay there. – Developing together with the person in charge: making a semi-finished product better through good consultation. Only then does responsibility arise to also improve the quality of source information, after all ‘garbage in = garbage out’. – Transparency and the ability to down drill information to patient or employee level.
  3. From volume incentive to risk sharing and creating space to invest.
    It is not fair to jump to conclusions by saying that medical specialists at the MSB with the current incentives are only driven to make revenue and to monitor their own trade. However, in the current cooperation model, the MSB hardly bears any entrepreneurial risk. In the field of management accounting, sufficient research has been done to state that steering the performance is less effective without the right incentives.The path that has been taken to outcome steering offers opportunities. Let the medical and business manager themselves make a proposal for the results on which performance agreements can be made and which remuneration structure fits. Thus, with the space that has been created, a buffer for investments needed in technology and innovation can be supplied. So that the focus is no longer on distributing the proceeds, but on the transition to the right healthcare in the right place.

Share of independent insurance advisors increases further

By Insurance, News

The share of independent advisers in the distribution is increasing, but the evaluation of insurers’ services is deteriorating, according to the Performance and Distribution Monitor of IG&H. Are insurers properly pre-sorted?

Last year we reported that the independent consultant was on a strong rise. The most recent data show that this growth continues. With the exception of the life market, the share of independent consultant remains at least equal. In the commercial insurance market, individual income market and mortgage market, the share of independent consultant even increased. Due to the strong positioning of the advisor for advice requirements regarding mortgages, occupational disability and (new) business risks, this growth is expected to continue.

Tension field of interest advisers and insurers
However, the evaluation of independent consultants’ insurance services is declining. Historically, insurers in private sub-markets were better assessed than those in business submarkets. In the last measurements, this difference was reduced because the performance in private submarkets deteriorated. This is partly due to the need to realize cost savings.

The market is clearly in motion. Insurers are rearranging their processes and improving solvency, agitated and under pressure from shareholders and regulators. In the search for a new balance, the emphasis is now on cost reduction and risk reduction. That is why they make strong choices in the areas of products, processes, pricing and remuneration. In some cases in the non-life insurance market, this even leads to uninsurability within certain branches.

Together with a declining performance, this all forms a breeding ground for a lower NPS. Given the prominent and often even increasing importance of advisers in distribution, this creates a tension field.

Jan Pieter van der Helm
Director Insurance at IG&H
j.vanderhelm@IGH.NL

Princess Máxima Centre: from 11 workflows to 1 opening

By Healthcare, News

On May 18th, 2018, the Princess Máxima Centre opened its doors. The run-up to this opening was a rather particular period of time that did not go without its struggles. Today, the second blog of a series, in which we discuss the following question with the experts involved: how did the centre move from dream to reality in just over 8 months?

“No concessions regarding the opening date and patient safety”

“The first thing I did was create urgency”, says Ben van Miltenburg, the all-round transition manager who was involved in the project at the end of the summer of 2017. “At the administrative level, the need was already felt, but this was not yet the case in every branch of the organisation. The message to everyone was therefore twofold: we have to open on May 18th, and then everything has to be assured for the patients.”

Then an alarm went off: with our plan of action at that time it was not going to be feasible. Two things were needed: overview and coordination. On basis of this, it would be possible to set priorities. The question was: where do we start? Van Miltenburg: “That was the moment IG & H came into the picture.”

“A border collie that kept the herd together”

“You have to consider that the building was still an empty concrete box at that time”, says Van Miltenburg. “Everything was needed at every business unit and there was nothing available.” Once the urgency of this had been felt, everyone started to roll up their sleeves: “One thing was clear: we would not postpone the opening date. I kept track each week of how many people said that it must be postponed. Eventually I ended up with 206 tick marks. And yet we have achieved our goal.”

The 11 workflows that have been drawn up – including ‘HR and recruitment’, ‘care processes’, ‘compliance’, ‘finance & BI’ and ‘ICT’ – played a major role in this. “These were perceived as sort of little factories that all had to deliver at the right time”, says Bart van Sambeek, consultant at IG & H. “In the beginning, we took a thorough inventory of what was needed for a sure opening. We then translated this information into milestones, which we packaged into the 11 workflows. This way, everyone knew who was going to pick up what and when.” A hospital business only works if all cogs fit well together, but naturally everyone is more concerned with themselves – with their own cogs – than with the interaction. What we have therefore in essence created is an exoskeleton that kept the organisation-in-the-making of the Princess Máxima Centre together.

“The model of the workflows also meant that we had 1 language and 1 central steering mechanism”, adds Van Miltenburg. “In the workflows, people did what they were responsible for.” The intention was deliberately chosen to designate MT members as leaders of the workflows: “After all, they also lead the regular organisation.”

“If the transition team wanted something, it happened”

“In the end, we had about thirty to forty external experts in various fields – such as personnel & organisation, ICT, construction & design and planning – delivering extra capacity and crucial knowledge”, says Van Miltenburg. “In addition to substantive knowledge and experience, IG & H also provided the people necessary to help coordinate and make everything happen.” According to Van Miltenburg, this helped enormously in achieving objectives: “When we called something together with the IG & H consultants, it happened. This was also because I was able to act with the mandate of the board of directors. Everyone within the organisation honoured this, because nobody wanted the centre to not open on time because of them.” Repeating the core message proved to be a key element to success: “we had to open on May 18th and at that time it also it had to be assured for the patients. That core message gave a focus amidst the multitude of things that screamed for attention and energy. We have always looked at and emphasised what was necessary to be able to open on May 18th. That is what we have done together.”

“No pressure or control, but support”

“I knew for sure that it would work”, says Van Miltenburg. “I never doubted that. It was, however, crucial that patient assurance was guaranteed. We have looked at the processes meticulously for that.”

Within the overall plan of action, there were 2 methods. On the one hand, IG & H took care of the milestones planning and reporting, so that people could see exactly when targets were achieved or not. On the other hand, the transition team explicitly chose not to place control or performance pressure at the centre. We did not ask people why objectives had not been achieved, but what they needed to achieve the goals. They saw this as having been given support. What you notice is that people are used to performing within set limitations. But we were dealing with a very special – and temporary – situation in which that was not enough. We therefore did not say what had to be done to do something faster or better. We provided the means to accomplish what had to happen, regardless of the limitations. That could be manpower, information, alternatives, or decisions. By doing this, we were able to set things right again.

“When you work with so much external knowledge and experience, there is always a solution”, says Van Miltenburg. “Within their own domain, people do not always see the whole picture. When we asked why something had not been delivered on time, for example, they often thought it was because it was too expensive, even though the board was prepared to make extra funds available if needed. In addition, the transition team also exerted pressure on the suppliers: “We flew in some of the apparatuses months earlier than usual. This requires a certain level of creativity that you do not need in normal business situations.”

“We would have never made it without the voting mechanism”

A final element that was essential in the coordination was the voter system. Van Sambeek explains this clearly: “The workflows and components of a hospital organisation are all interlocked. When a workflow wanted to pass on a decision or milestone that had an impact outside its own workflow, it had to be submitted to all of the other workflows for voting. So everyone could indicate whether they agreed or not, with which we could ensure that all cogs continued to connect. This meant that people had to think and co-decide on matters outside their own domain. In view of the short period, it was necessary to do this.”

“We would not have made it without that mechanism”, says Van Miltenburg. “Because everyone had to see and approve almost any final decision, we were able to avoid many unpleasant surprises and gaps. In addition, no one could ‘duck away’ at a later stage. When you make decisions together on everything, you also bear the responsibility of delivering in accordance with the agreements. The voting mechanism has therefore really been invaluable!”

How can IG&H help you?

By Announcement Site, IGH

Putting your customers above everything and understanding their gains and pains, is our starting point. 90% of your success is in implementation, is our belief. This is reflected in our getting it done mentality and our ability to create flow in your organisation, leading to better results and more happy customers. In order for you to accelerate and sustain change, we help you to build new capabilities and extend your partner ecosystem.

Curious about how we can help you connect the dots? We created a short video to provide you with a crisp-and-clear explanation. Watch it now!

Granular share of wallet data for all major product lines for truly data-driven sales management

By Analytics, Insurance, Uncategorized

What they wanted
Make data-driven choices in the broker market: that is what leading Dutch omnichannel insurers want to be able to do. Key questions are: Who are today and tomorrow’s leading brokers? Where do we stand in terms of both volume and NPS? How do we enhance our position to realize sustainable growth? To this end, they wanted to gather in-depth data on volume, movements, share of wallet, and NPS. Read More

Digitalization: the right approach for lasting success

By News, Technology

Digitalization is a complex undertaking. Unfortunately, this appears to be a well-kept secret, and as a result, digitalization is a laborious process for many companies. Often, they don’t achieve the set goals. The question is: What’s the right way to go about it and make your process succeed?

An interesting and topical research conducted by Gartnerreveals 6 points at which digitalization appears to go wrong: a conservative culture, sharing and collaborating too little, an organization that is not ready for digitalization, a talent gap, a way of working that hampers talent, and challenges involving change. All of these are recognizable obstacles that our IG&H consultants often come across at the companies which choose to work with us. All the more reason to have a close look at digitalization.

Doing ‘something’ with digitalization, but what?

“We need to do ‘something’ with digitalization.” It’s a frequently heard statement made by many company managements. This generic announcement has to do with the fact that many organizations have only just begun to discover that IT is a big part of their product. Some industries have even grown into true software factories – such as banks, which solely create software and algorithms. Virtually, this means IT is the only remaining product for them. In retail, growth continues steadily through e-commerce, and in healthcare, the digital component also keeps expanding. In short, automation is indispensable to everyone who wants to respond quickly to their customers’ demand. Of course, this is essential if you want to survive – or, even better, if you want to distinguish yourself!

It is good to realize this, but awareness alone will not get you far. For example, your current process design and way of working may be at odds with your digitalization plans. In that case, what are you supposed to do? Adjusting such matters is expensive and time consuming, and it often comes with risks. If you don’t handle digitalization the right way, your process will fall apart before you’ve had the chance to go through it from A to Z.

Knowing what’s going on

If, for example, your system isn’t properly documented, it will be difficult to digitalize it. Before you start with a transition towards digitalization, it is essential to be abreast of various aspects within your organization.

Many companies are dealing with legacy issues, which make it hard to quickly respond to user needs. Larger organizations that have gone through mergers and acquisitions, for instance, can easily work with 3 or more CRM systems. In such cases, you often don’t know exactly who your customers are. This makes it difficult to develop a good, central overview of your customers, which would allow you to utilize every opportunity and achieve true customer loyalty. Additionally, companies often lack insight into the productivity of and the value delivered by development teams.

If you want to develop towards a so-called Digital Factory, so ‘IT’ truly becomes the measurable factory of added value, you need to know such things exactly. Only then, you can correctly set up IT processes, select the right people (and provide teams with the right coaching to achieve objectives), and use proper tooling! The construction industry has embraced this approach years ago: those who design a bridge have a computer calculate the required strength of the construction. Manual labor is completely unacceptable, and in many countries – including the Netherlands – it is even forbidden. But when it comes to digitalization, many organizations go back to old-fashioned ‘manual labor.’ Remarkable, because as with a bridge, a lot is at stake here. Therefore, it seems more logical to use the right tooling. After all, this ensures that the construction rests on a solid foundation that won’t collapse after you’ve built the bridge.

What direction will you take?

After you’ve defined the desired goal, you need to determine what direction you and your company will take. The strategy is essential, as is the transition itself.

Before delving into this, it is important to realize that there is no 1 formula for success when it comes to digital transformation. Elements such as company culture and the need for change play a significant role. A retailer who still wants to exist in 3 years, for example, should really have their online branch in place. In some other sectors, the urgency is a little less high, which means there’s more time to handle digitalization.

Get to work enterprise-wide

Should IT be part of the business or vice versa? It is the central question of a discussion held within many companies. The answer is: it doesn’t matter. What matters is that you’ll only succeed if you truly work together. Eventually, there will no longer be a ‘business’ and ‘IT.’ They will converge.

Moreover, you should look at the data/analytics part: how will you measure and what data do you need for proper and timely control? Even better, how will you predict what may happen, and are you currently anticipating this? To this end, elements such as the right KPIs and dashboarding, which are often still highly spreadsheet centered, should be fully in order and automated…!

Briefly put, think carefully about how you measure. What you really need to track is the number of people who love to use your product! This is crucial. Unfortunately, not many companies judge themselves on this user adoption. A missed opportunity with far-reaching consequences, because ultimately, users determine your long-term success. If you provide a pleasant experience by optimizing processes using IT, you’ll secure your organization’s future. This is just as important as the quality of the product you deliver – the experience is part of your product or service!

How to go about it

A number of the issues discussed above can be tacked perfectly with the introduction of a Low-Code platform and an Agile way of working. As OutSystems is currently the best Low-Code platform, IG&H has decided to work with it.

With a Low-Code platform, you can build software faster and better. Like the name suggests, you need very little code. You largely model software the way you would model a bridge, car, or plane. The difference is that with this model, you subsequently generate the software with 1 press of the button. Moreover, there’s a level of flexibility: when you have specific software that you cannot yet model, you can add it manually later – hence, the word ‘Low.’

Furthermore, maintaining models requires less time than maintaining hand-written software. So with a Low-Code platform, you considerably lower your company’s maintenance costs, making more money available for innovations and improvements.

Organizations with legacy systems can keep using these sources through OutSystems, but get the opportunity to rationalize them in a phased and low-risk way. In the meantime, they already benefit from shorter lead times for new functionality andmodern, pixel-perfect user interfaces. Using these, they can support and improve the much-needed customer experience.

In addition, OutSystems offers the possibility of rapid prototyping. This is the quick development of prototypes without high costs, which often enables the delivery of a prototype within several weeks – very useful when you want to test new concepts in practice! If you combine rapid prototyping with a smart use of data analytics, you can quickly book results.

Using OutSystems, we help organizations make a successful transition to sustainable digitalization. All the points we’ve discussed in this blog are covered during the process.

Interested in what we can do for your organization? Don’t hesitate to contact me. You can also find us at the NextStep conference on October 8thand 9th, which IG&H will attend.

Enabling a strategic assortment renewal at a Dutch non-food retailer

By Casestudys, Retail

What they wanted
A big Dutch non-food retailer wanted to get a better grip on commercial processes to accommodate further professionalization of the organization. Therefore, a short-term strategic assortment renewal was needed. Its realization required a clear organizational structure, transparent end-to-end processes, and pragmatic tools. Additionally, the implementation of first-time-right store transformation processes should result in the rollout of the new store concept.

What we did
We designed a clear, complete organizational structure, including clear descriptions of jobs and responsibilities based on best practices in the market. Furthermore, we provided the design and implementation of end-to-end processes in close cooperation with middle management. In doing so, we focused on having constant insight into progress to enable monitoring and management. Quick wins were implemented right away. For example, we held daily stand-up meetings for operational control. We also realized simplification by introducing event classification, among other things.

What we achieved
Together, we have established a future-proof buyer-planner organization offering better grip on category management: the non-food retailer can react to the market proactively and has more control of closing stocks, revenue, and margins. In addition, first-time-right processes regarding the planning of store and shelf layout have led to an effective management of the flow of goods, resulting in a 95% product availability. We have also realized an end-to-end assortment renewal process. The result: a controlled assortment renewal of 30% in 2017, up to even 50% in 2018. Moreover, we have improved the quality of article data entry: the margin of error dropped from 60% to less than 10%.

What they said
“Thanks to IG&H, we have re-obtained grip on and control of key commercial and supply chain processes. This is crucial for achieving our revenue, margin, and stock-level targets.”

UMC: performance-driven care administration

By Clientcases, Healthcare

What they wanted
Solid business operations start with a well-performing care administration. Like many healthcare institutions, the UMC struggled with burdens: there were many correcting tasks for the care administration, registration tasks for specialists, control tasks required by the insurer, and change implementation tasks imposed by the government. To depart from all this, the care administration had to switch from stopgap solutions to improvement. The goal: timely, correct, and complete registration at the source. This would allow the institution to get in control and lay a foundation for horizontal monitoring, which means that the insurer performs checks beforehand instead of afterwards.

What we did
Together, we conducted a data analysis to identify the main sore points. Subsequently, we set up an audit program for improvement projects, which we rolled out to the departments. Then, we created a process design – new in terms of content – and set up the Lines of Defense model. Management information was organized using correct and supported performance indicators. Finally, we established a program organization with stand-up and day start meetings, as well as training courses.

What we achieved
With our help, the UMC has taken a major step towards departing from correcting tasks and creating an optimal chain of registration. We created a supported Lines of Defense model and ensured commitment to registration securities. Furthermore, we introduced a new way of working, tightening priorities, project activities, and the allocation of tasks. Also, the focus has shifted to transparent communications on processes and substantive matters. Moreover, openness and feedback have improved collaboration.

What they said
The Ministry of Health, Welfare, and Sport has made this project an exemplary case for other care administrations. At the Congres Horizontaal Toezicht Zorg (congress for horizontal monitoring in healthcare), the case was highlighted as an example of success. The client’s feedback: “In terms of quality, IG&H has done an excellent job providing methods that we can apply in practice. IG&H made a difference. It has been tangible in the solution they offered, but also in its reception and the way it works in practice. The organization has noticed a positive energy boost.”

Successful implementation of experiments into business

By Clientcases, Organizational transformation

What they wanted
This organization needed experiments to be successfully implemented into the business.

What we did
We introduced an Agile way of working. In addition, we provided coaches with training and guidance, teaching them and the teams a range of skills. Moreover, the standard innovation process was upgraded using clear steps for each stage.

What we achieved
The experiment teams’ delivery has become more predictable. Their ability to think ahead has improved, and they highlight complexity. Furthermore, both the business and partners come on board sooner and in a better way to prepare a smooth implementation stage.

What they said
Some client quotes: “I have become a more effective coach.” “We reflect on future important matters to a greater extent.” “IG&H left us with something truly valuable. This place is better than it was several months ago.”

Large Dutch bank digitalizes mortgage processes

By Banking, Casestudys, Clientcases

What they wanted
“Consumers demand speed and convenience when applying for or modifying a mortgage. Having insight into and control over the mortgage process is increasingly important in this regard. To remain competitive, we must respond to these needs. At the same time, we are faced with the challenge of complying with the ever-tightening (European) regulations. What we want is to be ready for a mortgage market that will change radically as a result of digital developments!”

What we did
As a forerunner in innovation, we use our proven approach to set organizations and the mortgage sector into motion. For this bank, we translated the view on source data usage into a new service provision concept and a setup of underlying processes. Then, we accelerated the implementation using our toolset, which we have started to build since the launch of our initiative ‘Handig!’ (Handy!). In addition, we ensured that the organization was on board by working in an Agile manner.

What we achieved
With our help, the organization has adopted a data-driven way of working. To better serve customers, it now uses data from reliable sources instead of paper documents. Moreover, consumers enjoy more speed and convenience. Submitting an application is simple, and they get a definite answer within one day 80% of the time. As a result, the decision on buying a house is an easy and fast one to make, which has led to an increase in revenue. Moreover, focus has been placed on efficiency and customer-orientation. Mortgage applications have increased by 20% in three months, while cost has decreased by more than 50%. In addition, acceptance has become much more reliable: the risk of fraud has reduced significantly.

What they said
“IG&H had the vision, knowledge, and experience to help our organization digitalize the mortgage process. We are now a frontrunner in a radically changing mortgage market, and we increased our market share by 10%!”