Business Innovation in Veterinary Medicine

Practice Innovation
Oculus Insights
Adam Little, DVM

The next decade will see more change in the
veterinary space the last 50 years

O U T L I N E
• Why change comes from the fringes of industries as opposed to the centre of it
• Where are we on that paradigm shift within veterinary medicine?
• What are the tactics that your organizations need to adopt to be successful in
that world of change?
• What are the common in-clinic barriers to innovation and how can they be
overcome?
• Design an action plan for your practice

D I S R U P T I V E C H A N G E D O E S N ’ T H A P P E N
AT T H E C E N T E R O F T H E I N D U S T RY

D AV I D R O S E , F O U N D E R , G U S T
“Any any company designed for success in the 20th century is
doomed to failure in the 21st”

PA L A W I N 1 9 0 0 ’ S
“Any motorist who sights a team
of horses coming toward him must
pull well off the road, cover his car
with a blanket or canvas that
blends with the countryside, and
let the horses pass. If the horses
appear skittish, the motorist must
take his car apart, piece by piece,
and hide it under the nearest
bushes.”

1 . I T ’ S A T O Y / S C I E N C E E X P E R I M E N T
2 . W E A R E N ’ T W O R R I E D
3 . O H # $ ^ & *

T H E S T O RY O F T H E
A U T O M O T I V E I N D U S T RY

1ST PLACE- 7.4 MILES
“SANDSTORM” (2004)

>1M MILES ON PUBLIC ROADS & 3M MILES OF SIMULATED DRIVER/
NIGHT
GOOGLE’S SELF DRIVING CAR (2016)

- E L O N M U S K , T E D 2 0 1 7
“November or December of this year, we should be able to go from
a parking lot in California to a parking lot in New York, no controls
touched at any point during the entire journey.”

F R O M > $ 1 M T O < $ 5 0 0 0
D R O P P I N G C O S T S

Volvo acquire Luxe - September 7, 2017

T H I S I S H A P P E N I N G
E V E RY W H E R E .

T I M E T O
R E A C H A $ 1 B +
VA L U AT I O N
IT HAS NEVER BEEN QUICKER OR CHEAPER TO MAKE AN IM

Amazon acquires Whole Foods for $13.7B

L E M O N A D E
I N S U R A N C E

In homeowners insurance in the US, a 1.6% market share makes you a
top 10 insurance company. And this exclusive club has been at it, on
average, for 104 years. Lemonade launched in September.

– S T E P H E N E L O P, C E O O F N O K I A
“We didn’t do anything wrong, but somehow, we lost”

WHY?
• Organizations are built to withstand change and have powerful immune systems
• Legacy partnerships put additional constraints on achieving product/market fit
• Legacy systems (eg. financial, legal, brand, etc) tether autonomous units
• Resentment within parent organization/frustration within core group
• When the going gets tough, decision-making becomes re-centralized
• Disrupting yourself is easy to talk about, hard to do

2017 is poised to be the worst year for retail ever

2016 WAS A RECORD YEAR FOR PET INVESTMENTS

N E W M O D E L S E M E R G I N G
• Virtual Veterinary Services- SaaS or On-Demand
• Mobile Veterinary Services +/- Kiosks- Home, Airport, Offices, Retail
Locations, Etc
• “Full-Stack” Veterinary Services - Online + In-Clinic Services

V I RT U A L V E T S E R V I C E S -
S O F T WA R E A S A
S E R V I C E
• Clinics license software tools
• Clinics provide telemedicine to their
clients
• Clinics set fees, scope of services, etc
• Advantages:
• Control of Experience
• Challenges:
• Time & Effort

O N - D E M A N D
• 3rd Parties provide support directly to
clients + Employ Vets as contractors
• Clients pay a monthly fee or a la-carte
fee
• Clinics can contract “out of hours
support” for existing clients
• Advantages: Convenience
• Challenges: Connectivity of Experience

“ F U L L - S TA C K ”
• Companies providing telemedicine + in-
home wellness services to clients
• Contract vets
• Subscription Plans +/- a la carte pricing
• Advantages: Comprehensive
• Challenges:
• Competitive to existing clinics
• Unit Economics

There isn’t yet a “silver-bullet” solution and
all models have their strengthens and
challenges

Practices aren’t waiting around
either

I N N O VAT I O N I N
P R A C T I C E M O D E L S
• New equity models - fractional ownership
• Transparency of costs/services
• Subscription care models
• Explosion of tools to support digital
communication/clients/etc
• Flexible work environments
• Expansion of Peer-to-Peer Groups
• Services + Tech

A F E W T H O U G H T S . .
• Practice ownership interest has been decreasing, but that doesn’t mean that associates
don’t want to share in the success of the practice
• We are in a client-service business and if you don’t recognize that, someone else will
• Clients don’t leave kicking and screaming, they leave silently and swiftly
• You can’t do it alone
• The worst thing you can do is to stand still and the world isn’t waiting for your
permission
• Fire yourself from jobs that you shouldn’t do

P R A C T I C E M O D E L I N N O VAT I O N :
O V E R C O M I N G B A R R I E R S

S A L I M I S M A I L , A U T H O R O F “ E X P O N E N T I A L O R G A N I Z AT I O N S ”
When you’re attempting disruptive innovation inside a
big company, the immune system of the company will
attack you.
Large organizations are built to withstand change and
avoid risk, and now we’re telling them to move fast
and take chances.

M O S T C O M M O N P I E C E S O F F E E D B A C K
• We are doing fine already so why change?
• Our clients won’t want that
• Our staff won’t do that

W E A R E D O I N G F I N E .
W H Y C H A N G E ?

Y O U R E P R E S E N T O N E
P E R S P E C T I V E

C A S E S T U D Y:
We performed a workflow analysis
and started by conducting a time/
motion study
The average appointment length for
this practice was 55 minutes
2.5x longer than what the
appointments were booked for
No one knew that this was a problem

OU R MODELS OF
CARE WEREN’T BUILD
FOR TH IS FU TURE
Replied 3 days later!

C A S E S T U D Y:
Practice installed a “request an
appointment functionality”
Low levels of conversion - 55% of
folks that requested an appointment
didn’t follow-up through
High-levels of no-show rates
Took as much time to confirm
appointments as if people had called
through in the first place

V E T E R I N A RY P R A C T I C E S A R E N O T O R I O U S
AT M I S R E P R E S E N T I N G T H E I R B A S E L I N E S

F R E Q U E N T
+ S I G N I F I C A N T
+ F O R W H I C H T H E R E A R E N O E A S I LY AVA I L A B L E A LT E R N AT I V E S

I D E N T I F Y A P R O B L E M W O R T H S O LV I N G
• How do you identify problems in your practice?
• Staff?
• Clients?
• Data?
• Are the problems that you want to solve aligned with the problems that your
staff wants to solve?
• How do you weight or determine which problems are worth solving?

M Y C L I E N T S W O N ’ T WA N T T H AT

W H Y D O Y O U T H I N K
C O M PA N I E S FA I L ?

C O M PA N I E S FA I L
B E C A U S E T H E Y D O N ’ T
S O LV E P R O B L E M S T H AT
M AT T E R T O P E O P L E

S O F I E WA S A D E C I S I O N - S U P P O R T T O O L T O
H E L P V E T S M A K E FA S T E R & B E T T E R M E D I C A L
D E C I S I O N S

1,000+ 2,700+ 55,000+
$$$
3 months
$$
5 hours
$
3 months

T H I S H A P P E N S A L O T.

H O W W E L L D O Y O U K N O W Y O U
C L I E N T S ? ( S C A L E 1 - 5 )

H O W W E L L D O Y O U K N O W Y O U R C L I E N T S ?
• How many of you know the number of clients you have?
• # of clients that have come in the last year?
• # of millennial clients that have come in the last year?
• # of millennial clients that have multiple animals and have spent over $1000?
• # of millennial clients that have multiple pets and have spent $1000 and are non-
compliant on medications?
• % # of millennial clients that have multiple pets and have spent $1000 and are non-
complaint on medications and responded to a recent reminder to book an appointment?

H O W D O Y O U L A U N C H N E W
P R O D U C T S A N D S E R V I C E S ?

H A S A N Y B O D Y E V E R A S K E D
T H E M ?

C A S E S T U D Y:
T E L E M E D I C I N E
• Hill’s launched a telemedicine trial for
practice’s to perform rechecks in Fall of 2015
• Trialled in key accounts, all of which were
interested when approach
• No one used it
• Feedback
• Concerns about legal exposure?
• Why would I do this?
• I want to see the pet in person

C A S E S T U D Y:
T E L E M E D I C I N E
• Launch of telemedicine trial
• Promoted on Facebook
• Encouraged clients to share
• Gathered feedback on which services
people wanted
• Addressed the most common
questions that people had

T E C H N I Q U E S T O U N D E R S TA N D C L I E N T N E E D S
• Ask them! Structure Feedback
• During a visit - “Hi Mr. Smith, we are considering launching a new service
would you be able to do let us know what you think”
• Follow-up reminders/surveys
• Landing Page Tests
• Pre-Sell Packages- Etc

M Y S TA F F W O N ’ T WA N T T O D O
T H AT

PA I R U P W I T H S O M E O N E N E W

S H A R E O N E S T O RY A B O U T A N I N I T I AT I V E /
P R O J E C T / I D E A T H AT D I D N ’ T W O R K O U T

W H AT T O S H A R E ?
• What did you try to implement?
• How was it communicated to staff?
• What was the reaction from your team?
• Why did it fail?
• What happened afterwards?

Engagement - “Why weren’t we
included in this decision”
Context - “Why are we doing this?”
Incentives - “This seem like more work
for me”

C R E AT I N G A C U LT U R E O F
E X P E R I M E N TAT I O N

5 S T E P S T O C R E AT I N G A C U LT U R E O F
E X P E R I M E N TAT I O N
1. People need to have clarity of the process and feel included in it.
Autonomy
2. Define success. You need to be able to figure out what you are shooting
towards and people need to know what they will be measured again
3. Define a timeline. What will be done and by when?
4. Who is responsible for what? How will they be measured?
5. Mitigate Risk. Celebrate failure.

I N N O VAT I O N I S N ’ T A T O P D O W N
E X E R C I S E
Y O U R J O B I S T O C R E AT E T H E
C O N D I T I O N S T H AT A L L O W Y O U R S TA F F
T O B E I N N O VAT I V E

R O L E S V S T I T L E S
1. Discovery
2. Implementation
3. Evaluation

D I S C O V E RY
• Who?
• Curious/Try New Things
• Close to customers/clients
• What?
• Identify Problems
• Keep a Pulse on Trends
• Search for solutions

I M P L E M E N TAT I O N
• Who?
• Like Structure
• The person who gets things done
• Strong communicator/well respected for
staff
• What?
• Puts the concept into practice
• Ensures that each staff member has their
role

E VA L U AT I O N
• Who?
• Likes numbers and evaluates practice
performance
• Close to customers
• Ability to see trends in information
• What?
• Define ROI
• Measure success of in-hospital concepts
• Inform direction of discovery phase

H I R I N G F O R I N N O VAT I V E P E O P L E
• What is a project you have worked on outside of your formal job?
• What’s an example of a job that you were poorly managed in?
• How would you solve a, b, c problem in our clinic?
• What type of people frustrate you?
• What business/brand do you think has a great customer experience? Why?
• If you weren’t working for us, who would you want to work for?

- P R A C T I C E C O N S O L I D AT O R
We emphasize to owners that we aren’t going to come in and
“change things”, but after we purchase the practice it’s the staff that
insists we do.

G R O U P E X E R C I S E : D E V E L O P
Y O U R P R A C T I C E ’ S A C T I O N P L A N

P R O C E S S
1. Introductions (5 min)
2. Problem Discovery (20 min)
3. Problem Analysis (30 min)
4. Solution Brainstorming (25 min)
5. Creation of Implementation Canvas (25 min)
6. Wrap-Up (5 min)

G O A L S
1. Crowd-source a library of the most important and frequent challenges
facing your practices
2. Deploy a series of techniques to overcome these problems
3. Development of an action plan that can be used to put change into your
practice

P R O B L E M D I S C O V E RY

P R O B L E M D I S C O V E RY
• Grab a marker and a a few post-it notes
• For the next three minutes, silently, right now as many challenges that
you are facing in your practice. They can be internal or external. Be specific
• After your time is up, place your post-it notes on the wall

P R O B L E M
D I S C O V E RY
• Each of you has dot stickers
• You will vote on your favourite
problems by placing a dot sticker
on that post-it note
• Maximum of three votes
• Don’t vote on your own

P R O B L E M A N A LY S I S
• We have identified the top 3-5 problems that people want to solve
• If your problem was selected, please sit at one of the tables and grab your
post-it note.
• For the rest of you, please join one of the following tables. That will be the
group you are working with for the remainder of this exercise.
• The goal is to unpack this problem

P R O B L E M A N A LY S I S
• In 10 minutes, you will have to present your problem.
• Who is this a problem for? Clients, you, your staff?
• What impact does it have on your practice? What metrics have been
impacted?
• How have you tried to solve it in the past?
• What do you see as the biggest barriers to overcome it?

TA B L E S
• Table 1- Topic
• Table 2- Topic
• Table 3- Topic
• Table 4- Topic
• Table 5- Topic

P R O B L E M A N A LY S I S - E X A M P L E
• BAD - We don’t have enough time
• BETTER- Our appointments always run late and we don’t have enough
time
• BEST- Our patient intake has increased in time as we have grown and it
is taking our staff too much time to check-in pets and now everyone is
rush and running out of time

P R O B L E M A N A LY S I S - P R E S E N TAT I O N S
• Nominate a team lead
• They will have 5 minutes to present the challenge your group is going to
tackle this afternoon
• Groups will have opportunities to share questions

S O L U T I O N B R A I N S T O R M I N G

I M A G I N G T H E F U T U R E S TAT E
• Rapidly brainstorm ideas
• Quantity over Quality
• Take a piece of paper fold it 3
times so that you have 8 squares
• 40 seconds per square
• Follow timer

I M A G I N G T H E F U T U R E S TAT E - PA R T 1
• You are to use visualizations to
describe that ideal experience
• What is the journey that you want
your user to go through
• It can involve technology, it could just
be a work flow
• Don’t overthink it
• You will have time later to expand

I M A G I N G T H E F U T U R E S TAT E - PA R T 2
• Another 1 minute per square to
add detail
• Use a post-it note and write down
any additional information you
think is important to explain

I M A G I N G T H E F U T U R E S TAT E
• Each person in your group will
have 2-minutes to walk their team
members through their ideas
• Dot vote

I M P L E M E N TAT I O N C A N VA S

• Over the next 25 minutes, you will have the opportunity
• One per team
• This will be your implementation guide
• Current state = your problem analysis
• Future state = your team’s crazy 8 storyboard

• Pain Points
• Anticipated Benefits
• Success Metrics
• Key Stakeholders
• Barriers
• Tools
• Unanswered Questions
• Timeline

• Definitions - https://docs.google.com/document/d/
1TvAbeuVq6GnXsqpAAV6o77JBPmELGiPztDqncdpB46s/edit?usp=sharing
• Example - https://docs.google.com/document/d/
1oOawMpk03yCUm5OJQ8gjx3Q_yDXQ3J6cGVLsmeUk4mg/edit?
usp=sharing
• Blank for Exercise- https://docs.google.com/document/d/
1NUPWoaamEi-5WpM4YB6dEQctip3GHowDRJJ1HzF12Us/edit?
usp=sharing

T I P S
• Don’t search for perfect answers
• Leverage your team members
• Be exhaustive
• Complete each box
• Submit each canvas online

A D D I T I O N A L R E S O U R C E S
1. Startup Stash
2. Product Hunt
3. NAVC’s Veterinary Innovation Council

T H A N K Y O U !
A D A M L I T T L E , D V M
A D A M . L I T T L E @ G M A I L . C O M
@ E X P O N E N T I A LV E T

W R A P - U P
• Presentation of Canvas
• What surprised you about this exercise?
• What is something that surprised you about your practice?

I N T R O D U C T I O N S
• Pair up with the person near you (not someone you know)
• You will have 120 seconds to introduce your practice
• Identify one thing that you came here to learn
• Then switch

Business Innovation in Veterinary Medicine

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