Innovations in Primary Care: Lessons from the Center for Health Market Innovations' Primary Care Collaborative
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The Primary Care Learning Collaborative is an initiative of the Center for Health Market Innovations (healthmarketinnovations.org) This group of primary care provider organizations convened over the course of a year to discuss high-impact innovations that allow them to increase access, affordability, and availability of healthcare for the poor in developing countries. Working in Kenya, India, and Burundi, these organizations share best practices and insights from the evolution of their clinics in the Primary Care Innovator's Handbook. View this presentation for an overview of the Handbook, as presented to the Asia eHealth Information Network on April 15, 2015.
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Innovations in Primary Care: Lessons from the Center for Health Market Innovations' Primary Care Collaborative
- 1. Webinar: Innovation in Primary Care Insights & Learnings from the Primary Care Innovator’s Handbook Tricia Bolender for CHMI Steph Koczela, Co-Founder of Penda Health Dr. Devashish Saini, Founder of Ross Clinics
- 2. Today’s Plan Interactive Workshop • CHMI Primary Care Learning Collaborative and the Development of Primary Care Innovator’s Handbook • Member Spotlight: Penda Health • Member Spotlight: Ross Clinics • Q & A AGENDA
- 3. R4D and the Center for Health Market Innovations CHMI’s digital platform provides a way for people to learn about and connect with programs striving to improve the health of the world’s poor
- 4. Launching a Learning Collaborative in Primary Care Focus on Market-Based Solutions THE CHALLENGE THE OPPORTUNITY • Accessing quality, affordable primary care is a challenge in many low- and middle-income countries • Franchises and chains have proven to be promising models to lower costs, increase quality, and remove barriers to access • However, organizations employing these models continue to face challenges related to quality, sustainability, efficiency, and scale • Development of learning collaborative that facilitates knowledge-sharing and joint problem-solving • Peer-learning approach allows members to learn from each other’s experiences, increasing the speed and efficacy of problem-solving and innovation
- 5. Collaborating with pro-poor health innovators to address challenges to scale, sustainability and quality of care. • Five market-based healthcare chains and franchises from India, Kenya and Burundi • Peer learning to hold one another accountable and share learnings • Connecting through in-person meetings, video calls, and email listservs CHMI’s Primary Care Learning Collaborative Launched in November 2013
- 6. Member Organizations Over the course of one year, members met face-to-face and spoke monthly
- 7. Our Journey Goal and Objective • Primary Care Learning Collaborative goal of facilitating knowledge sharing between chains and franchises working to provide high- quality primary health care in low- and middle-income countries • Focus on both peer-to-peer knowledge exchange and sharing knowledge with field at large • Coordinated by R4D and funded by Bill & Melinda Gates Foundation, Rockefeller Foundation, UKAid, and HANSHEP
- 8. Learning Collaborative Model All Teach, All Learn
- 9. The Primary Care Innovator’s Handbook Launched February 2015 • Represents culmination of one year of activities of Primary Care Learning Collaborative • Goal to start an ongoing conversation between leaders and implementers of primary care initiatives about concrete tools, approaches, solutions, successes, and failures • Ultimate objective of helping primary care organizations to overcome challenges and scale
- 10. Areas of focus represent members’ key challenges SECTION ONE: SETTING UP AND EXPANDING CLINICS • What is the gap that your model is filling? • How do you choose the services that you offer? • How do you choose your clinic sites? • How do you develop your expansion strategy? SECTION TWO: PROVIDING CARE • How do you improve patient experience? • How do you best staff your clinics? • How do you instill change in provider behavior? SECTION THREE: SETTING UP EFFECTIVE SYSTEMS • How do you manage supplies and prevent stock-outs? • How do you create effective information systems? • How do you continuous improve your model?
- 11. What makes this Handbook unique Improvement Science
- 12. Shared Knowledge Output Lancet Blog
- 13. What this Handbook Is… And What it Isn’t • Reflections of what organizations have learned from their experiences, including concrete tools and processes • Intended to leave reader with ideas, tools, and inspiration that can be immediately tested, implemented, or adapted to their own work • NOT a prescriptive how-to guide for running these types of businesses; nor an academic piece with unassailable evidence about what will work in every context
- 14. Learnings from the Collaborative COLLABORATIVE MODEL CONTENT • Need to be open and flexible, based on members’ needs: from a focus on a specific “aim” towards more idea- sharing and problem-solving • In-person meetings crucial in developing trust and relationships • Worked well to have similar models, but spread across diverse geographies • Patient-centered innovation and publication in Lancet Global Health Blog: “The time is now for patient- centered innovation” • Primary care services offered and pricing • Marketing and increasing patient footfall
- 15. Today’s Plan Interactive Workshop • CHMI Primary Care Learning Collaborative and the Development of Primary Care Innovator’s Handbook • Member Spotlight: Penda Health • Member Spotlight: Ross Clinics • Q & A AGENDA
- 16. 16 World Class Healthcare for Kenyan Families
- 19. ensures consistent, quality care Environment of care The Right COs And our cutting-edge quantitative QA system
- 20. 20 World Class Healthcare for Kenyan Families Dental Care at Penda: Added four months after visiting the Ross clinic chain in India. Service level, hiring strategy, and payment structure all replicated from Ross. It is today the most profitable aspect of our business model.
- 21. 21 World Class Healthcare for Kenyan Families Quality of Care Benchmarking: A brainstorm with LifeNet led to the idea of exposing our providers to comparable benchmarks to encourage behavior change. When we implemented this strategy we went from 35% compliance to 79% compliance in 5 months.
- 22. 22 World Class Healthcare for Kenyan Families Put your patients at the center and design for them. They’ll tell you what they want – so ask them!
- 23. 23 World Class Healthcare for Kenyan Families Track Return Rate not patient numbers.
- 24. Today’s Plan Interactive Workshop • CHMI Primary Care Learning Collaborative and the Development of Primary Care Innovator’s Handbook • Member Spotlight: Penda Health • Member Spotlight: Ross Clinics • Q & A AGENDA
- 25. Today’s Plan Interactive Workshop • CHMI Primary Care Learning Collaborative and the Development of Primary Care Innovator’s Handbook • Member Spotlight: Penda Health • Member Spotlight: Ross Clinics • Q & A AGENDA
- 26. Lessons from the Primary Care Innovator’s Handbook Dr Devashish Saini MBBS MSHI Founder & Family Physician Ross Clinics, Gurgaon, India
- 27. About Us
- 28. About Us ➔Reviving the tradition of the Family Doctor ➔Long-term relationships based on Trust ➔Chain of Primary Care Clinics in Gurgaon ➔Focus on Middle-Income Families ➔Consultation, Dentistry, Physiotherapy ➔Lab Tests, Health Checks, Vaccinations ➔Home Visits, Corporate Health Services
- 29. About Us ➔4 Full Clinics, 6 Satellite Centres ➔20,000+ lives served in 2014 ➔Lean model - Space, people, products ➔Diverse service platter ➔Empowering People ➔Heavy reliance on Technology - Simple Tools ➔Current Focus: Standardisation ➔Future Plans: Collaboration, Expansion
- 31. Lessons from the Collaborative ➔Setting SMART Goals for the Organisation ◆ From Loss-making to Profitable ◆ Alignment of Operations to Vision and Mission ◆ Supervision of Middle Management ➔Quick Innovation Cycle ◆ Ross Smile Card ◆ Follow-up Calls ◆ New Medicines ◆ New Services - Speech Therapy
- 32. Lessons from the Collaborative ➔Listening to the Customer ◆ Focus Groups, Calls ◆ Listening to the Staff! ➔Being part of an International Network ◆ Similar Innovations in Diverse Settings ◆ What we are doing is Worth the While!
- 33. Insights from the Journey So Far
- 34. Insights from the Journey So Far ➔Start Quickly and Keep Innovating ◆ Background Surveys vs Paying Customers ◆ Each Community is Unique ◆ Quick Innovation Cycles ➔Keep the Model Lean ◆ Core Services and Products ◆ Be Frugal but Don’t Cut Corners! ➔Additional Revenue Streams ◆ Fixed Fees, Retainerships, Premium Services
- 35. Insights from the Journey So Far ➔Focus on People ◆ Train, Encourage, Supervise, Hand-hold, Grow ◆ Culture of Respect, Transparency, Trust ➔Focus on Operations ◆ Details! Details! Details! ◆ Technology can Help! ➔Share the Dream ◆ With Everyone!
- 36. Insights from the Journey So Far ➔Make Friends ◆ Going out of the Way ◆ Sharing Critical Information ◆ What would I do if this was my bro/sis/parent/child? ➔Exploit your Network ◆ Bootstrapping/”Beg-borrow-steal” ◆ Ask for Help! ➔Have lots of Patience! ◆ Enjoy the Ride!
- 37. DOWNLOAD THE INNOVATOR’S HANDBOOK HealthMarketInnovations.org/ Handbook Tricia: tmorente@r4d.org Lane: lgoodman@r4d.org Stephanie: stephanie@pendahealth.com Devashish: devashish@rossclinics.com
Notas do Editor
- Right people to do the right treatments 80% are 8 cases Protocols Rob’s work has gotten us into IPIHD and RWJF