Reflection - Learning Launch and Journey Mapping

Challenge

During 2014, I took a position as the Public Affairs Coordinator for the Market Access Department  of an international pharmaceutical company in South America, mainly dedicated to the diagnosis  and treatment of oncological diseases. I was primarily responsible for the design and  implementation of the policy and communications strategy to foster the company’ relations with  the political-institutional environment. Moreover, I was responsible for conducting specialized  advice on public policy; cultivating relations with key actors from Government and the private  sector, academia, and civil society; deploying the internal and external communication strategies,  as well as dealing with the media in the promotion of key themes and messages from the company.   In this position, I could develop and conduct the company's Healthcare Policy Impact Plan for  Uruguay, Paraguay, and Bolivia, as well as the 'External Communication and Public Affairs Plan', to  address the main political challenges of the organization in these three different socio-political  situations.

A big challenge me and my team identified by that time was how a severe constraint for many  patients currently in treatment for the diseases our company research and develop medicines for  was the extremely complex and tiresome internal processes and procedures patients needed to  follow within hospitals in Uruguay to obtain treatment after being diagnosed with any type of  cancer. From our constant dialogue with patients’ representative organizations, we got the  perception that a worrisome proportion of people who needed the medicines we develop were not  receiving the appropriate treatment in the right timeline, even though they were entitle to it by the  Law and the Uruguayan health policy in place.

My vision was that, as a pharmaceutical company, we had not only the responsibility of creating the  best medicine possible, but also of ensuring that every patient who needed it had the opportunity  of accessing the right treatment at the right time. Bearing this challenge in mind, we decided to start  and try a new ‘Patients’ Journey Mapping model’ in one important public hospital in Uruguay, to  detect and remover barriers for patients in the timeline between receiving a diagnosis and  effectively start the treatment of their oncological diseases.

Selection

To cope with this challenge, we decided to set up a ‘Learning Launch’, although we did not call it  that way by that time. No matter we did not use that precise design thinking language, my  organization was in the middle of an important transformation to become Agile, and many Agility  Methodology tools were being tested and implemented, so that my team’s surrounding  organizational environment was one of openness and enthusiasm towards experimentation and  trial to attaint more treatment access to more potential patients faster.

The whole purpose of this initiative was to map the main barriers oncological patients face to access  to the right treatment as well as to test whether an improvement in hospital internal processes in

terms of simplicity and speed in what we called ‘The Patients’ Journey’ in one of the major  Uruguayan hospitals specialized in oncology demonstrate an effective reduction in patients’ waiting  time to receive treatment after the right diagnosis. We reasonably assumed this would impact in  patients’ chances of succeeding in their personal battle against the disease. Moreover, if this specific  pilot showed a positive impact, we were willing the advocate for this tool and to generate the  needed alliances with the public sector authorities, which allowed to escalate this initiative to  several public hospitals in the country, with the goal of fixing their own ‘patients’ journeys’ as well,  driving a process of iteration and continuous improvement.

Application

Firstly, we collected the necessarily quantitative and qualitative data (performing a sort of ‘What  is?’ phase) via secondary statistics sources about cancer mortality in the country, as well as via  several in-depth interviews with many prominent oncologists, oncological patients, and their  representative organizations to better sustain our hypothesis. This stated that time delay in  receiving treatment after being diagnosed with cancer was a serious problem that affected patients’  opportunities of success in dealing with the disease. Moreover, we had to demonstrate that a  relevant part of this delay was caused by red-tape and bureaucracy in the public health system  procedures that hospitals were obliged to implement.

After several weeks of interviews, we considered this hypothesis was reasonably sustained by the  experiences and expertise transmitted by the experts involved. Thus, we asked for the necessary  permissions to go conduct our ‘experiment’ within the selected hospital, which could be assimilated  with our ‘marketplace’ to solve our ‘costumers’ pain’.

The most important oncological patients’ organization in Uruguay was a key ally in this endeavor.  Through their members’ record and with the due consent of the people involved, we got access to  those patients recently diagnosed with some oncological disease, who got closer to the referred  organization to obtain support and orientation in the started process of receiving treatment.

Having selected a list of patients with a sufficient degree of demographic diversity, we started to  map their respective journeys within the public institution. We help them to track and record every  step in the process of starting the treatment indicated by their doctors, through a personal digital  record book we provide them, in which they had to specify with details dates, waiting times,  requirements, expenses, and everything the hospital asked them in the timeline between diagnosis  and treatment beginning.

After three months of the experiment implementation, we completed 20 detailed and specific  oncological ‘patients’ journeys’’ and we were able to draw a series of conclusions about where the  main ‘pain points’ and ‘bottlenecks’ in the hospital procedures and requirements were. This almost  ethnographic research led us to rapidly come up with a simple set of recommendations to cut red- tape and overbearing bureaucracy, gaining a valuable time for patients. Overall, the design of an  improved ‘Patient Journey’ model permitted to save patients’ around two months on average  compared with the typical journey we reconstructed from the 20 subjects involved’ record books.

These recommendations were promptly presented and discussed with the Ministry of Health in  Uruguay. Several months later a robust program to alleviate bureaucratic procedures and

requirements imposed to oncological patients in Uruguayan public hospitals was launched by the  public authority.

Insight & Approach

This Learning Launch experience allowed me to gain a lot of knowledge about the different variables  that might affect the oncological patients’ treatment experience. It was demonstrated that reasons  why people struggle with these terrible diseases are not only medical but also institutional, and we  had to carefully listen to our ‘customers’ to detect any organizational barrier preventing them to  access to the right treatment and make our best effort to remove them.

In terms of design thinking practices, I learned that tons of data and analytics are awesome but in- depth qualitative, rigorous data is as valuable. The whole success of this experiment was based on  an exercise of empathy towards a small number of real people and their daily journey within a  certain organization under specific circumstances. This kind of profound exploration of human  experience fed us with concrete and rich information to really understand how things were going  for oncological patients and what we could do to help them in their journey. By thoroughly focusing  on the experience of less that two dozen of people we were able to depict a very realistic and  appropriate picture of what was going on with oncological patients and public hospitals, and to  identify the main ‘pain points’ they were dealing with.

Something I think would be a great advance in the future, once the changes implemented by the  Ministry of Health reach most Uruguayan public hospitals, is to complement The Patient Journey  analysis with a Mind Mapping exercise, to facilitate the comprehension of patterns in different  patients’ potential diverse experiences. It is reasonable to state the hypothesis that people with  different backgrounds and specific conditions will also exhibit systematic variation in their specific  struggles within the hospitals as organizations, which could be better deciphered by a better  comprehension of their knowledges, skills, and attitudes, even permitting the creation of patients’  ‘ideal types’, and their own different challenges.


Reflection - Learning Launch and Journey Mapping Challenge During 2014 , I took a position as the Public Affairs Coordinator for the Market Access Department of an international pharmaceutical company in South America , mainly dedicated to the diagnosis and treatment of oncological diseases . I was primarily responsible for the design and implementation of the policy and communications strategy to foster the company ’ relations with the political - institutional environment . Moreover , I was responsible for conducting specialized advice on public policy ; cultivating relations with key actors from Government and the private sector , academia , and civil society ; deploying the internal and external communication strategies , as well as dealing with the media in the promotion of key themes and messages from the company . In this position , I could develop and conduct the company 's Healthcare Policy Impact Plan for Uruguay , Paraguay , and Bolivia , as well as the ' External Communication and Public Affairs Plan ' , to address the main political challenges of the organization in these three different socio - political situations . A big challenge me and my team identified by that time was how a severe constraint for many patients currently in treatment for the diseases our company research and develop medicines for was the extremely complex and tiresome internal processes and procedures patients needed to follow within hospitals in Uruguay to obtain treatment after being diagnosed with any type of cancer . From our constant dialogue with patients ’ representative organizations , we got the perception that a worrisome proportion of people who needed the medicines we develop were not receiving the appropriate treatment in the right timeline , even though they were entitle to it by the Law and the Uruguayan health policy in place . My vision was that , as a pharmaceutical company , we had not only the responsibility of creating the best medicine possible , but also of ensuring that every patient who needed it had the opportunity of accessing the right treatment at the right time . Bearing this challenge in mind , we decided to start and try a new ‘ Patients ’ Journey Mapping model ’ in one important public hospital in Uruguay , to detect and remover barriers for patients in the timeline between receiving a diagnosis and effectively start the treatment of their oncological diseases . Selection To cope with this challenge , we decided to set up a ‘ Learning Launch ’ , although we did not call it that way by that time . No matter we did not use that precise design thinking language , my organization was in the middle of an important transformation to become Agile , and many Agility Methodology tools were being tested and implemented , so that my team ’s surrounding organizational environment was one of openness and enthusiasm towards experimentation and trial to attaint more treatment access to more potential patients faster . The whole purpose of this initiative was to map the main barriers oncological patients face to access to the right treatment as well as to test whether an improvement in hospital internal processes in terms of simplicity and speed in what we called ‘ The Patients ’ Journey ’ in one of the major Uruguayan hospitals specialized in oncology demonstrate an effective reduction in patients ’ waiting time to receive treatment after the right diagnosis . We reasonably assumed this would impact in patients ’ chances of succeeding in their personal battle against the disease . Moreover , if this specific pilot showed a positive impact , we were willing the advocate for this tool and to generate the needed alliances with the public sector authorities , which allowed to escalate this initiative to several public hospitals in the country , with the goal of fixing their own ‘ patients ’ journeys ’ as well , driving a process of iteration and continuous improvement . Application Firstly , we collected the necessarily quantitative and qualitative data ( performing a sort of ‘ What is ? ’ phase ) via secondary statistics sources about cancer mortality in the country , as well as via several in - depth interviews with many prominent oncologists , oncological patients , and their representative organizations to better sustain our hypothesis . This stated that time delay in receiving treatment after being diagnosed with cancer was a serious problem that affected patients ’ opportunities of success in dealing with the disease . Moreover , we had to demonstrate that a relevant part of this delay was caused by red - tape and bureaucracy in the public health system procedures that hospitals were obliged to implement . After several weeks of interviews , we considered this hypothesis was reasonably sustained by the experiences and expertise transmitted by the experts involved . Thus , we asked for the necessary permissions to go conduct our ‘ experiment ’ within the selected hospital , which could be assimilated with our ‘ marketplace ’ to solve our ‘ costumers ’ pain ’ . The most important oncological patients ’ organization in Uruguay was a key ally in this endeavor . Through their members ’ record and with the due consent of the people involved , we got access to those patients recently diagnosed with some oncological disease , who got closer to the referred organization to obtain support and orientation in the started process of receiving treatment . Having selected a list of patients with a sufficient degree of demographic diversity , we started to map their respective journeys within the public institution . We help them to track and record every step in the process of starting the treatment indicated by their doctors , through a personal digital record book we provide them , in which they had to specify with details dates , waiting times , requirements , expenses , and everything the hospital asked them in the timeline between diagnosis and treatment beginning . After three months of the experiment implementation , we completed 20 detailed and specific oncological ‘ patients ’ journeys ’’ and we were able to draw a series of conclusions about where the main ‘ pain points ’ and ‘ bottlenecks ’ in the hospital procedures and requirements were . This almost ethnographic research led us to rapidly come up with a simple set of recommendations to cut red- tape and overbearing bureaucracy , gaining a valuable time for patients . Overall , the design of an improved ‘ Patient Journey ’ model permitted to save patients ’ around two months on average compared with the typical journey we reconstructed from the 20 subjects involved ’ record books . These recommendations were promptly presented and discussed with the Ministry of Health in Uruguay . Several months later a robust program to alleviate bureaucratic procedures and requirements imposed to oncological patients in Uruguayan public hospitals was launched by the public authority . Insight & Approach This Learning Launch experience allowed me to gain a lot of knowledge about the different variables that might affect the oncological patients ’ treatment experience . It was demonstrated that reasons why people struggle with these terrible diseases are not only medical but also institutional , and we had to carefully listen to our ‘ customers ’ to detect any organizational barrier preventing them to access to the right treatment and make our best effort to remove them . In terms of design thinking practices , I learned that tons of data and analytics are awesome but in- depth qualitative , rigorous data is as valuable . The whole success of this experiment was based on an exercise of empathy towards a small number of real people and their daily journey within a certain organization under specific circumstances . This kind of profound exploration of human experience fed us with concrete and rich information to really understand how things were going for oncological patients and what we could do to help them in their journey . By thoroughly focusing on the experience of less that two dozen of people we were able to depict a very realistic and appropriate picture of what was going on with oncological patients and public hospitals , and to identify the main ‘ pain points ’ they were dealing with . Something I think would be a great advance in the future , once the changes implemented by the Ministry of Health reach most Uruguayan public hospitals , is to complement The Patient Journey analysis with a Mind Mapping exercise , to facilitate the comprehension of patterns in different patients ’ potential diverse experiences . It is reasonable to state the hypothesis that people with different backgrounds and specific conditions will also exhibit systematic variation in their specific struggles within the hospitals as organizations , which could be better deciphered by a better comprehension of their knowledges , skills , and attitudes , even permitting the creation of patients ’ ‘ ideal types ’ , and their own different challenges .