HfS Network
Barbra McGann
 
EVP, Business Operations, Healthcare & Life Sciences 
Learn more about Barbra McGann
It's Design Thinking heaven with TandemSeven as Genpact makes its OneOffice move
September 08, 2017 | Phil FershtBarbra McGann

"You guys really should evolve your lean capabilities into Design Thinking with your clients" was my conversation with Genpact's innovation lead, Gianni Giacomelli (pictured), a year ago.  "You should also do that with your research clients" was Gianni's response.  Exactly a year later, we open our  Research ThinkTank in Cambridge England to perform said exercises with our clients, and Genpact announces the acquisition of Design Thinking specialist TandemSeven in Cambridge Massachussets. 

Why is Design Thinking becoming so relevant to the middle-back office operations?

We see the emergence of Design Thinking as critical to help enterprises collapse these barriers between their front, middle and back offices - one of the core fundaments of achieving a true OneOffice framework.  You really can't be a digital organization if your operations are not supporting the front office in realtime, being able to respond to customer needs as and when they happen:

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Design Thinking offers an approach for a diverse group of people to work together to identify

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Infosys Looks to Fill Critical Gaps in Use of Design Thinking Through Acquisition of Brilliant Basics
August 04, 2017 | Barbra McGann

Infosys has announced the acquisition of the UK-based design-thinking firm, Brilliant Basics, and if it plays out according to the name, it is exactly what Infosys needs to bridge design to execution and impact.  The acquisition brings in a digital, strategy, and customer experience design capability, a global studio network, and brand name credentials including HSBC and INSEAD (online education experience) as well as new startups like CBI bank (business strategy and omnichannel touchpoints).  These are all valuable resources to Infosys and its clients, but what the service provider has had real challenges with is addressed in this quote from the Brilliant Basics web site – a framework and resources for scale:

“Our deep experience in working with talented people in the areas of service design, user experience and technology has allowed us to create repeatable processes for building digital products and services.” – Brilliant Basics

 

Source: Brilliant Basics web site

Infosys committed to training internal resources and using design thinking but faltered in scale and consistency

Influenced by CEO Vishal Sikka’s interest in design thinking, Infosys introduced human-centered design into its digital transformation methodology called AI KI DO, which receives positive feedback from clients. And, through Zero Distance, Infosys provides a framework for account and service delivery teams to work on getting to know their customers, ask questions, and make suggestions for change. Infosys is also using design thinking to help companies identify new growth opportunities and to change its own operations as the company grew fast and got a bit stuck in the “old ways” of hierarchical, process-centric decision making. (Read further: Is Infosys Stretching Past the Growing Pains?)

However, while Infosys partnered with Stanford d.school, brought in leaders with deep design expertise, and aggressively trained its leadership team and workforce on the concepts of design, it has not been able to address three challenges that stood out in the evaluation we did earlier this year on the use of design thinking to help reorient and/or transform business operations for impact on business outcomes:

(1) project management;

(2) moving from design to execution, identifying opportunities for reusable assets to scale; and

(3) unifying into single Infosys versus a technology/digital/product-focused Infosys and Infosys BPO. (HfS Blueprint: Design Thinking in the As-a-Service Economy)

It looks like the design approach of Brilliant Basics and the influx of design and customer experience experts could help address the gaps.

This type of acquisition is overdue by Infosys but it is not too late and shows its commitment to integrating human-centered design

Even though Infosys was one of the first to appreciate the value of design thinking for human-centered service design, other service providers moved faster to acquire and integrate design firms into their companies to bring in skilled resources and re-orient their methods and cultures (see: How design thinking plays an integral role in outsourcing, service design, and delivery). This work is still underway, though, with only early results and impact. It’s still not “par for the course” with any service provider yet. Infosys needs to focus on integrating Brilliant Basics into the organization, the culture, and the sales and delivery, quickly. This will be a challenge as Infosys has not done many acquisitions, and this one is very different from the traditional Infosys.

Bottom line: Brilliant Basics could be exactly what Infosys needs – the ability to manage and scale innovation. It appears to bring the kind of project management capability and design-to-action methodology that has been a missing link between the design expertise Infosys has hired and the solid engineering and service delivery capability it's developed over the years. Infosys needs to put a strategic focus on bringing this one into the fold in a way that builds on and out these capabilities that can help realize its vision to partner with its clients in a more consistent innovative and meaningful way.

How a Healthcare Insurance Company is Bringing RPA and AI into Business Operations
August 02, 2017 | Barbra McGann

At HfS, we hear quite a bit about the challenges of incorporating RPA and AI into business operations, so when I spoke with a healthcare operations leader about his experience at a U.S. healthcare payer recently, I wanted to share it... but can only do so anonymously. Here's how RPA first - and AI down the road - is being incorporated into the business operations, by defining appropriate scenarios, thinking outside the box, managing proactive communications with staff, and looking to get people excited about the positive impact on jobs, relationships between payers, providers, and patients and healthcare consumers and on health, medical, and financial outcomes.

What is the use of Intelligent Automation in your organization today?

We are building momentum from our business case into implementation with robotic process automation (RPA) and defining a conceptual “bridge” to get into artificial intelligence (AI) – what is the use case and how to use to impact financial and medical outcomes.

Where and how did you get started?

Started by looking at RPA to drive additional efficiencies from labor and financial perspective and then realized that the organization needed to be considering a broader strategy. It isn’t just about the technology but how does it change the experience of the internal employees and the health plan members directly? We have a plan that we are iterating as we go… as we learn more about the capability and the potential impact. Using RPA and AI can change our internal processes and free up talented staff. We can change the way our employees interact with members, providers, and patients in a way that changes their experience and medical and financial outcomes.

How will employee roles change when RPA is introduced?  

RPA - and eventually AI too -- will free up our employees to engage more directly and interactively with our stakeholders such as healthcare consumers and clinicians. For example, today, the provider office has to fax authorization and wait for response. How can we use RPA and AI to ingest the form on a front end web site, have an algorithm that runs to identify “we always provide authorization for this service” and flip it back in seconds; or if not, route it for the appropriate review. This kind of intelligent automation frees up the care management team to do something more important; and hopefully, that translates into relationship and outcome uplift for the provider, member, or both.

Employees who are processing claims and reviewing authorizations, for example, have interactions and engagement with members, providers, and patients that are reactive and responsive. We could get in front of these same people more proactively if those processes and reviews were automated and only potential denials or exceptions were flagged. These employees could be reaching out, instead, to discuss a pended claim or questions about authorization. Our hope is that “in a year or two, we can shake our heads and say, wow, we used to have hundreds of people who are now creating personal interactions instead of processing behind the scenes.”

Who in the organization do you need to work with and how does that play out?

First, we had to go through a process with the enterprise architecture team and get approval to proceed. We are working with a service provider who helped define the scenarios and evaluate the technology. We then moved forward with a proof of concept that showed what we could deploy around claims payment and pended claims, the business story for our business unit colleagues. Then we laid out what is RPA and AI and demonstrated how it works—how you could address a claim that 15 people used to work on full time just for one fall out. It resonated. Over the years, I have had to advocate for software that we were excited about – rarely have had to sell a product or idea where the senior level is buying into it before the grassroots technical effort. That was the case here. The executive team could see the opportunity and get enthused about it.

How is the move to intelligent automation and “digital labor” impacting your workforce?

From a technical perspective, our CIO team is working through the details.  As the senior leaders get excited and then go into the team to talk to subject matter experts to codify RPA based solutions, the employees are concerned that their job is going to be automated and eliminated. You have to be able to tell the story to help employees understand that what is being automated is this routine action you do in the back shop today – that here is an opportunity to parlay your experience into interaction and impact with the members, providers, and patients. It’s a dialogue that is playing out pretty well.

We believe that as we move services people to working more directly with the providers and members, they will be performing work they will find more enriching. We also realize that we need to understand what skills and capabilities are needed for this. We are building out a robotic operating committee and working with business leaders to talk about – as we deploy these solutions and staff becomes available for different roles, what are those roles and what capabilities do people need for them. And we don’t want to move them into doing work that will be automated “next.” We are in early stages here. So far our efforts with intelligent automation have been grassroots with excited senior executives how have said, go into my organization and show me how it works. As we get scale, we will work through retooling.

Tell me about how the funding and business case development is coming along.

Our organization is quite rigorous around investment. When we talk about RPA and provide evidence of 4:1 and 5:1 return on investment the story becomes easier. We are always focused on continuous improvement and how that parlays into impact. Again, the story of using automation to free up skilled staff is powerful. For instance, in finance, changing manual reconciliation at the close of month with large team to be automated and the more complicated work being the focus of the human effort, the logic becomes more apparent and the investment, obvious.

From these “early stages” of about 12 months in, the momentum and excitement is gaining, and I anticipate that we will pick up speed with RPA and into AI over the next year with top down sponsorship.  What excites me most is the possibilities of what we can do to free up our own employees and at provider offices to anticipate and be more proactive about issues and concerns and eliminate bottlenecks and slow downs for higher quality service and interactions.

Bottom line: While this interview is a bit like the old dating game where one person asked questions and the other sat behind a black curtain, it helps shed light on how enterprises that have been working one way for so long are making progress in moving forward with RPA and AI, considering talent and technology and how it changes the way we need to work going forward in healthcare operations.

Off-Shore-Based Service Providers Look to Develop “Meaningful” Presence in the U.S.
June 22, 2017 | Barbra McGann

The pendulum is swinging back. Over the past year, we’ve seen the increasing focus from India-based service providers to invest in building on-shore presence and capability in the U.S.  While spurred on by H-1B visa limitations and in-flight policies regarding minimum wage and the politics of “protectionism,” the long and short of it is that the U.S. citizens should benefit from local investments. U.S. governments and economic development entities are offering incentives for partnering with these service providers as they seek out “hubs” central to current and potential clients. Two recent examples are Indianapolis, Indiana with Infosys and Jacksonville, Florida with Genpact, where the cities offer tax incentives and colleges and universities can provide a talent pool.

It used to be “too expensive” for service providers to set up on-shore service delivery centers, but with the increasingly integrated and intelligent use of robotic process automation and cognitive computing and the motivation of politics and protectionism, this argument is fading. What is also relevant is when the partnership changes focus from outsourcing a task or point solution such as “collections” to business outcomes such as providing a better patient experience and increasing upfront payment (thereby reducing the need for collections), the service provider needs to be more integrated into the end-to-end process and business operation. That means having a local presence and interaction to provide relevance and create meaning and insight. (See “Recasting the patient billing experience” as an example). 

Our research (see Exhibit) shows the there is a significant drop across the board in the move to “offshore” business and IT work – finance and accounting and HR, in particular.  Case in point, we recently heard from a client about how Sutherland helped set up and recruit into a local service center for F&A services in a matter of a few months for a company that was separating from its parent.

Exhibit: Changing use of offshoring – shared services and outsourcing

 

Source: HfS Research in Conjunction with KPMG, “State of Operations and Outsourcing 2017”  Sample: n=454 Enterprise Buyers 

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How service providers are expanding local, U.S.-based presence

Investments by service providers in having short- and long-term U.S-based capability for clients include local service delivery centers and increasing co-location delivery teams as well as work-from-home options; education support through curriculum development in local colleges and universities as well as programs for K-12 to “entice” and enable interest in STEM (e.g., code.org and Girls Who Code) to create the workforce of the future; and transitioning workforces from clients to their own organizations.

Examples include:  

  • Genpact: In July, Genpact will add to its network of 12 U.S.-based service support and delivery centers by opening one in Jacksonville, Florida. This one will focus first on mortgage service support with processing, underwriting, and closing services for residential mortgage loans for a leading financial services institution 
  • Infosys: A new entry into this discussion, Infosys has far outstripped other service providers in pursuing H-1B visas to date and is now refocusing on building local presence and brand recognition. Infosys intends to develop four locations in the U.S., centered in “client clusters” and focused on particular capability areas such as artificial intelligence, user experience, and enterprise cloud. Its approach is to partner with local colleges and universities and offer incentives such as investing in student tuition and curriculum development. Infosys is also preparing for more long-term needs by looking at ways to entice a broader interest in STEM. The first partnership in this effort is in Indianapolis, Indiana, the heart of the U.S.
  • Cognizant: Its recent acquisition of Health Care Services Corporation’s TMG Group adds Medicaid and Medicare support in offices in Texas and Pennsylvania. This move provides its clients access to more local resources – people with knowledge and depth in government health as well as infrastructure.

Bottom line: Indian-based service providers have been building near-shore and onshore presence for a few years now, but it takes on new meaning and significance now as the context changes – politics, the impact of technology, objectives for partnering, and changing priorities around the skill sets that are needed. As a service buyer or government, university or economic development organization, be creative and also take a long-term view as to how these service providers can funnel the investments they are increasingly willing to take to have value locally to grow their businesses.   

HCSC’s Sale of TMG Health to Cognizant Shows A Move to Focus – and Partner– for Better Outcomes
June 16, 2017 | Barbra McGann

Earlier this week, Cognizant announced its intention to expand its footprint to support U.S. Government health operations through the agreement to acquire the TMG Health subsidiary of Health Care Services Corporation (HCSC).  On the flip side of that announcement, HCSC has carved out its Government health support function to be run by a partner – Cognizant. HCSC can benefit from Cognizant’s dedicated, prioritized, and leveraged (cross-client) resources to manage the operations services. However, to impact the health, care, and financial outcomes of its healthcare consumer base, HCSC will need to partner with Cognizant in a way that creates the OneOffice™ – a seamless flow of data, insights, and infrastructure for the front, middle, and back office. 

TMG Health’s relationship with HCSC started back in 2005 when HCSC selected it to provide BPO services in support of its entry into the Medicare Advantage market. At the time, TMG Health provided some measure of enrollment, eligibility, claims, and billing support to a total client count of 30 plans covering 2.8 million lives. In 2008, HCSC acquired TMG Health for $100m, tucking in the BPO provider as a subsidiary. TMG Health has since added support for Medicare and Medicaid claims processing and member services and has local resources in Pennsylvania and Texas – for 32 health plans (+2 since 2009) and more than 4.3 million lives. TMG Health has not really grown its portfolio of clients although the footprint of services has expanded over time.  And public health programs continue to grow – in numbers and complexity as the industry moves to greater coverage and value-based care. The changes in the healthcare market driven by consumerism and compliance are driving healthcare plans to “rethink” their business and operations strategy.  

By exiting the “back office business,” HCSC can focus its investment and resources on becoming a more consumer-oriented company.

While retaining a partnership with Cognizant for its support/back office services, we expect HCSC to focus on becoming more consumer-oriented; to channel its resources to becoming insightful, tech-enabled, and overall “savvy” to impact health outcomes for its constituents. In the meantime, it can rely on Cognizant to provide a steady and increasingly optimized rules-based foundation. We expect Cognizant to tap into the Medicare/Medicaid COE it told us about in our last Healthcare Operations Blueprint research. The consolidation of its subject matter expertise, IP, and tools in the COE is to help manage the tricky business of complying with government policies and the continued growth of Medicare, Medicaid, Medicaid Advantage, and Dual-Eligible consumers – providing support for eligibility, enrollment, billing, claims, and applying its solutions around quality and reporting (e.g., STARServe). Cognizant has the right experience plus industrialization and scale and has the Trizetto and RPA capabilities to drive increased efficiencies and free up resources to support new growth in the Government Health operations business.

The Bottom-line: HCSC and Cognizant will need to partner to keep – or establish – integration between front and back office to impact health, care, and medical outcomes.

One place this arrangement could break down is if the back office support that Cognizant provides is not integrated with the front- and middle-office of HCSC (and its other clients). In order to impact health, care, financial, and quality outcomes, healthcare payers need to be healthcare-consumer oriented – understand the health, financial, economic, and social determinants of their constituency. A lot of that data is part of those back office systems and processes, so HCSC and Cognizant will need to be partners in defining workflows of the future that will support an insightful, consumer-oriented business that complies with government standards and also enables HCSC to better manage the health, care, medical, and financial outcomes of its public health base.

Training for jobs that don’t yet exist: the AT&T story
May 30, 2017 | Barbra McGann

Let’s turn that common lament we hear of a “talent shortage” on its head. What if you created a pipeline of talent that fit the needs of your business as it is growing and changing? While at the Infosys Confluence event recently, I heard about how AT&T has been taking steps for the last two years to create the very workforce it needs to achieve its vision.

 

First, determine what skills and capabilities your workforce will need in the future

“Based on industry and corporate direction, we chose six areas, including big data, IP networking, and software-defined networking, that we specifically want to attack as the skills of the future,” shared Candy Conway, VP, Global Managed Services Operations, Business Solutions and International at AT&T.

AT&T defined a set of roles that map to these areas, determined the associated competencies, and evaluated employees against the future landscape. They identified over 100,000 employees who will need to have a different or a more varied or developed set of competencies than they have today. “We then developed a roadmap and plan for getting these professionals into a relevant and meaningful career path that maps to the future of the company and the industry,” said Candy.

AT&T is a little over two years into this program. At this point, each employee has a prescriptive program managed through a learning portal - it identifies the role they are in currently, the one they target the future, the associated competencies for each role and the learning and education path to get there. For example, an employee could be in the network center and want to be a software engineer, and has a learning path mapped out.

The nuances of the skill areas also change quickly. “It used to be that skills would change a decade at a time, and that’s now accelerated,” said Candy. AT&T designed a program that would offer a number of options and flexibility – from internal designed and led courses, to “nano-degrees” in niche areas like web development and virtual reality to online master’s degrees from Georgia Tech and social-media based programs with badges (157,000 options) awarded as people complete courses. 

Investing in future skills is of value to the employee and the company

This plan is mapped to what roles that AT&T believes it needs to have in the future…. so employees can look for open roles and bid on the ones they want to fill. There are no guarantees that these roles will be filled by employees desiring them at AT&T, but the program still provides an advantage to the employee since AT&T is defining these roles (such as data scientist) with a forward-looking view, and therefore helping employees develop these competitive and marketable skills. Certainly, having invested in the person’s training, AT&T has an interest in keeping these people in-house and this is a way of creating loyalty, stickiness and a workforce of the future.

This kind of investment can help a company attract and keep the “best and brightest” with the most potential for helping grow a company. Individuals who feel a company cares enough to invest in their talent development, keep their skills relevant (and competitive), and give them options in a career are more likely to stay with that company.  AT&T also will have skills relevant to the future – the future workforce – without having to go out and 'find them'. 

The bottom-line: Become a learning organization in order to be relevant to your customer base, stay competitive, and grow.

Take a look at the vision for your company. What do you want to be able to deliver to your customers? What experience do you want to create for them? What outcomes matter over time? Determine what roles and competencies, and what training, education, and mentoring will develop your workforce to achieve it.

Businesses need to be increasingly agile to address the rapid changes driven by consumer expectations and digital technologies. That means employees also need to be agile – and managed in a way that encourages and rewards-based learning.  The market is increasingly competitive for candidates who have future-oriented “soft skills” like critical thinking, problem-solving, and creativity, and the ability and interest in learning. This program provides a model for how a well-established, “legacy” brand can embrace a  learning culture to enable an agile workforce relevant for competitively positioning the company for growth long-term.

How EXL is taking a “grassroots” approach for incremental digital transformation - for itself and clients
May 25, 2017 | Barbra McGann

EXL is going broad and deep from its core strength in analytics. At its recent EXL Client, Industry Analyst, and Advisor Day, the service provider showcased its theme of “Accelerating Digital Transformation” driven by “look deeper” with analytics.

We heard from both EXL and clients during the day that while clients appreciate that “digital” can help “transform” their staid businesses into one seamless capability that is more flexible and responsive, it doesn’t feel real or short-term. Their businesses are too siloed, risk averse, and focused on the day to day. The sense I got from the day was that EXL is “right there” with its clients facing these challenges – meaning, it is not behind, and it is not way ahead and looking over its shoulder. EXL is working shoulder to shoulder with its clients -- at the grassroots level-- to figure out the vision for a more customer-centric, insight-driven, and agile business, map it out, and take the steps to get there. The service provider is doing this by keeping its focus on the core strength of analytics, and addressing gaps it has had in data management and automation in particular.

 

The front office is only as effective as the middle and back allows it to be

EXL’s traditional strength is in the middle office with industry-specific services support and analytics and in the back office with finance & accounting BPO. The front office cannot be effectively customer centric—responsive and personalized—if it doesn’t have a flexible data infrastructure through this middle and back office to drive context and act with speed, precision, and fluidity. EXL is working with clients where it sits – in that middle and back office, particularly in insurance, healthcare, and financial services.

For example, with one client that started as a headcount-based cost reduction BPO play in F&A, EXL proposed a number of workflow process and “digital” enablers such as RPA and chat to have a more interactive and responsive function. The client has been able to remove itself from a fairly heavy-handed “oversight” of the day-to-day and EXL has been able to find and implement efficiencies for faster processing, fewer errors or points of confusion, and greater satisfaction all around. A key solution element here was the human-centered approach: the team took the time to interview people involved in the current process at the client and at EXL, understand what was not working, and design and test out solutions that were people, process, and technology oriented (a.k.a. design thinking).

Building out the data chain

Over the past couple of years, EXL has hired, acquired, and developed a broader spectrum of capability in analytics modeling and reporting to build out this core strength. It’s been a differentiator for execution, but not across the full analytics spectrum and not at scale. Now it’s expanding upstream into data and data management, built-in proprietary technology and partnerships for “bots,” and supplementing the shift through its data acquisitions such as RPM Direct and Datasource.

Its viewpoint of the impact of data and analytics was demonstrated through an example in the middle office of an insurance client. EXL created a digital interface for customer acquisition, combined it with its LifePro policy admin system and data analytics. The client uses the database to target and segment customers for campaigns. Interested customers can use mobile or internet portal access to apply. Based on the back end integration with the underwriting and pricing engine, the customer gets a quote and the company can bind the policy online.

The role of robotics

The conversation around robotic process automation and artificial intelligence (the latter less of a focus and still a point of view to be developed, it seems) is constantly tied to analytics.  EXL’s observation is that “clients now seem to be taking a more pragmatic approach to intelligent automation” – how to institutionalize it, not just use it. One client example was of setting up a COE in a “build, operate, transfer” approach where EXL initially builds out the automation strategy, governance, use cases, service orchestration layers and bot skillsets. If you are interested in this approach, it’s one that we haven’t heard quite as clearly articulated from other service providers, and an area that we do hear is a challenge for global business services centers, for example. Some companies like Ascension Health and SEI Investments have to take the leadership on their own, but others may appreciate this kind of support to get RPA not just used but infused into the organization. I do get the sense this is a newer offering for EXL, so do your due diligence on the availability of skills and capabilities across different suites, but we often hear from clients that EXL makes a responsive, transparent partner.

Another place EXL is building scale is in its library of function- and industry-specific bots and partnerships with third parties including WorkFusion, Automation Anywhere, and Blue Prism. With automation, the service provider is willing to guarantee productivity and cost benefit, and change the traditional BPO engagement model. As you consider how you want to partner with EXL, take a look at its bot library, its subject matter experts, and consider the balance with your own capabilities. When you look at solving a problem and impacting an outcome and then designing the solution in between, rather than the previous outsourcing approach of lift and shift, you have more flexibility in your business.

Bottom line: Rethink your partnership style and challenge EXL.

Tap into these areas where it is investing: analytics; platform-based services; “advanced automation”; and human-centric digital transformation.  What to watch: the need to scale in these focus areas and become a more credible powerhouse in consulting to lead the charge.

“Igniting Innovation”: KPMG features an experiential approach to digital transformation in its Analyst Day
May 05, 2017 | Christine Ferrusi RossBarbra McGannMelissa O'Brien

Just about 90% of CEOs who participated in a KPMG survey are concerned with the issue of changing customer loyalty, and the majority believe current their company’s products and services won’t be relevant to current customers in 3 years. That means they need innovation – now. They see technology (often referred to as “digital”) as an opportunity to move, but 85% of the surveyed CEOs feel they don’t have time to think about disruption and how to respond to it with innovation. This sets the scene for KPMG’s Analyst day recently in Boston. KPMG looks to bring purpose and passion for helping clients be successful in making innovation a part of the core of their businesses – through a diverse workforce, solutions, and collaboration.

With this backdrop, four themes stood out to us during the day about how KPMG is working with its clients:

  1. A vision for “OneOffice” – work designed to address customer needs using “digital labor” and systems. Digital transformation is (finally) moving from the front office (customer touchpoints) to include the middle and back office (business functions and transactions) – and talk is moving from “how do we use ‘digital’” to “what problem do we want to solve for our customers and how do we use the possibilities of talent and technology to do it.” At HfS, we refer to this concept as “OneOfficeTM” – the need for businesses to break down silos in their organizations to create a more effective data and workflow for business outcomes, so this theme resonated with us.

As we are focused on “ making it real” and providing examples of where it is happening, we appreciated the story that KPMG told about a client they worked with to map out the customer experience. They registered a number of customers on an app and these customers recorded their experience in real-time, as did employees. KPMG captured the data in the Pathfinder tool and used it as input during a journey mapping session with employees from across the organization, front and back office, including a finance director, a customer service manager, and a valet. They talked through the points in time when the customers and employees had a poor experience and came up with ideas that were then prioritized for addressing through the client’s own innovation management approach. What stands out here is the breadth of people included in capturing the experience (customers and employees from different business units and IT) and the way the experience was captured (an app in real-time), which led to in-person workshops to map out various customer journeys and an action plan.

 Additionally, staying true to the “ embedding innovation” theme, KPMG trained a number of the employees in departments throughout the client on the design thinking principles and methods used in the initiative. These people are networked as a COE. The team also has access to an analytics tool to continue to capture and analyze data on their journey.

2. A focus on defining and enabling the evolving role of workers and work. “Even in a digital world, humans are still the most important investment, the secret element of our brands, and the magic asset in the company,” said Robert Bolton, capturing the tone of the recent day. One example of a workforce transformation in progress was launched when a client started a discussion about the size and shape of the workforce of the future. This has led to questions such as “How do you know you have the right size?” “How does it have to change because of the advent of RPA and artificial intelligence?” “What are the impact on entry level jobs and the way those jobs provide a launching pad for careers?” “How does it impact learning, training, career paths?”

KPMG is not just working with clients to address these questions but shared its own experience in a changing workforce through the use of digital labor. For example, instead of having new hires who are eager, smart MBAs do mundane and repetitive audit work while they “pay their dues,” KPMG is able to automate much of that work and provide a more stimulating and challenging role for the talent they’re bringing on board.  It’s changing the culture and employee work allocation models.

This area of “ digital labor” is one that the shared services and outsourcing group at KPMG is hearing a lot of questions about as well, according to the group’s global head, Dave Brown. Digital labor and cognitive are on the forefront of activity in evolving operating models and defining who (or what) does what. “Digital labor, simply put, is another form of outsourcing,” said Dave Brown.

4. Innovation starts with culture. Innovation needs to be a way of working in companies – it can’t just be siloed in one department or area. Key features of a culture that embrace innovation include diversity – of workforce and partner ecosystem; collaboration; and experimentation (these are also principles of design thinking). Having a culture and environment where it’s “OK to fail” is also a lynchpin of innovation.  To provide a “space” and showcase for innovation, KPMG has broken ground for a new facility in Orlando to provide its clients and train its workforce with a multidisciplinary, hands-on, collaborative, high-tech experiential approach. And it’s partnering with the academic community to help develop (via technology, data sets, and case studies) the future workforce during the university years – for example, combining soft skills like teaming, collaboration, and critical thinking with critical technology skills for analytics and the subject matter expertise of accounting.

5. Deep investments in software to improve and automate complex processes. KPMG’s Spectrum unit created several “business intelligence engines” to automate and analyze several complex corporate processes like third party risk, contracts, and regulatory compliance like Automatic Exchange of Information (AEOI.) Beyond Spectrum, other tools KPMG discussed at the event include its KPMG Digital Responder, for security threat discovery and analysis and its KPMG FIRE regulatory reporting automation tool. While the KPMG teams mentioned a number of tools and IP throughout the day, and showcased a handful, a little of it felt “mysterious” – they were referenced by name and not explained or shown. These days when everyone is still exploring what digital really can do for them, showcasing case studies and tools can be really impactful in getting the message across.

What does this mean to you?

Digital transformation and innovation continue to dominate corporate boardrooms as buzzwords. But actually implementing requires a lot of complex detailed decisions that spur significant changes to the ways companies operate every day. What’s impressive about KPMG’s message is the firm’s ability to talk at the 100,000-foot strategy level but then dig into the last mile delivery details.

For clients that already work with KPMG, if you’re not seeing the kinds of messages the firm presented at the analyst day, then it’s time for a meeting with your account team. Talk about how some of KPMG’s new (and even not so new) techniques are being or could be, applied to your engagement. Don’t take it for granted that your account team will automatically propose new ideas so be proactive in asking for innovation.

For non-clients, take a look at Spectrum and other KPMG tools as stand-alone solutions. The Spectrum team told us they do sell the tools separately – they don’t just get embedded into larger services deals. This gives you the opportunity to get access to KPMG IP and operational expertise without having to exit any existing services engagements you have in place.

For an organization that candidly admits it was on the slower end of developing a stake in front office, its recent investments and acquisitions (a whopping 51 in the last 3 years) show that it’s quickly catching up, and also tying together the concepts of front, middle and back office nicely and in a forward-thinking way.  Using their own interpretation of OneOffice, KPMG is forging ahead to help clients (and itself) break down the legacy barriers to become more intelligent and responsive client-centric enterprises.

"How was your experience today?” Using a design thinking exercise for quick and meaningful feedback “in the moment”
April 28, 2017 | Barbra McGann

The time a person has the most interest and insight into an activity is when they’re doing it. Did you just finish helping someone or facilitating a meeting and wish you could quickly get feedback on what the person or attendee is thinking?

What did they like? What did they wish you did differently, more of, eliminate, change, or add? What bright ideas do they have that you just wouldn’t think of yourself? Sometimes people’s quick thoughts and reactions can be the most valuable feedback. In the moment, you are also likely to tap into the “gut reaction” and how they are feeling.

To get feedback in the moment, we’ve been using a design thinking exercise in our HfS Summits. The exercise we use is based on the simple and useful questions in the Stanford d.School toolbox (link).

Source: Tools from Stanford d.school

Here’s how we use it: We put pens and sticky pads on all tables, plus a flip chart or whiteboard somewhere in the room. (When you start to do more design thinking you’ll realize that sticky notes and design thinking go together like water and ducks.) Then towards the end of the day we do this exercise to get feedback to confirm, challenge, and share on our objective.

Our question: How can we evolve the HfS Summit to be more interactive, engaging, and meaningful? In the next 5 minutes, write down what comes to mind to finish the following:

  • I liked…
  • I wish…
  • What if…

Then we encourage attendees to get up and put their sticky notes on the flip chart pad under the phrase that starts the same way. Soon, we have people up and milling around, colorful walls, and energy flowing.

Almost everyone writes something – either because they have something to say or perhaps because they feel peer pressure to perform. By asking these questions, we get specific feedback on sessions, logistics, and content – the good, the bad, and the ugly. The insights, ideas, and feedback also show us themes among what on the minds and in the interests of our attendees, and we see where there are really strong feelings.

This feedback is an addition to the formal surveys. The design thinking exercise engages attendees in a way that the formal survey doesn’t. For example, any event organizer will tell you their frustration with attendees who leave the “what else would you like to see?” or “anything else you want to tell us?” sections blank. But in the moment, when everyone is still engaged in the event, they easily share ideas and commentary.

I often get asked how to get started with Design Thinking. Although the tendency is to attach design thinking to a workshop – and there are proven benefits to taking a day or more out of your regular schedule to do this – you can also incorporate design thinking principles and activities into the way you work on a regular basis. This is one example of an activity that is so easy and simple, that you can immediately start to use it in meetings, in conversations, with sticky notes or even electronic questions in text messaging.

Bottom Line: If you want to understand someone’s experience and get feedback that you can wrap into a future interaction, meeting, activity, or event, ask: What did you like? What do you wish for? What if?

WNS and Its HealthHelp Acquisition “Will Not Deny” Health Care
March 27, 2017 | Barbra McGannReetika Fleming

“Denial is not an option.” Contrary to the typical (and here, oversimplified) pre-certification, “approve” or “deny” approach to utilization of services in health care, HealthHelp launched a new model of utilization review based on the premise of non-denial procedures, and that utilization management is about collaboration and education. HealthHelp taps into its evidence-based database and network of physicians and academics to review and approve or to recommend alternatives to procedure requests. In tandem, HealthHelp drives studies and education opportunities to lead to better medical and financial outcomes when providing or using health care services. In short, the company that WNS just acquired is building out a patient- and healthcare provider-centric approach to utilization management designed to match procedure and treatment to the patient’s needs and network.

HealthHelp took roots in the founder’s own pain 

The HealthHelp approach is tied to the experience of its founder, Cherrill Farnsworth, who found the number of denials and appeals she managed for radiology procedures discouraging and painful. Thinking about “how to do this differently… why do we have to deny”? Cherrill tapped into her network of people at medical centers and universities, creating a collaborative model on the premise of using data, insights, and education. Instead of a review, approve/deny, the approach is review, approve and/or educate and/or recommend. The approach uses an increasingly sophisticated system of data, digital technology, and relationships. HealthHelp is taking product development further into the realm of machine learning and artificial intelligence, as well.

What gives HealthHelp the “right” to make recommendations to healthcare providers and patients?

An approach like this one—essentially, a break from the norm—depends on the credibility of the data, technology, and people involved. HealthHelp faced the challenge in the early days of people not being sure that a “non-denial” approach would be effective for containing costs. With 15 years of data, though, the company has been able to ingrain a lot of experience and knowledge into the approach and platform, to the extent that now 75% of prior authorization requests get approved for providers or are responded to with recommended changes that are approved by providers, without any human intervention. In about 25% of the cases, it goes to nurses for review; 6-7% of which are forwarded to doctors, and after that, the provider has the option to and can still disagree and go with treatment, which happens in under 0.5% of cases.

Results to date show improvement in the quality of care, which impacts Star and HEDIS ratings and reduces the cost of care by making sure the right kind of care is provided versus the lowest transaction cost at a point in time.  Also, in a fee-for-service model, a healthcare provider gets paid for the procedure regardless of the result. As the industry shifts to value based care with payments tied to outcomes, approval based on evidence or alternatives becomes more strategic to positively impacting outcomes (and payments). This approach, therefore, seems to have further credibility in the value-based care model and can help healthcare providers move into the new world of healthcare.  HealthHelp worked with CMS to get approval to qualify this program under provider education/quality improvement initiative and thus be included in the 85% Medical Loss Ratio for health plans.

The acquisition by WNS brings a complement of resources to both organizations and its client base

The healthcare industry is so ingrained in a yes/no approach that it took a few years before the model got adoption, primarily with mid-tier healthcare organizations. Joining with WNS gives HealthHelp the opportunity to scale and support a broader range of payers and providers. WNS also has a wealth of analytics capability, talent development and industrialization expertise that is complementary to HealthHelp, with resources that can help expand and develop the services and technology platforms to impact healthcare outcomes more broadly.

The acquisition of HealthHelp is part of the WNS strategy to shift attention from the cost of transactions to the cost of quality care and support—towards patient centricity. To date, WNS’ work in healthcare has been mostly analytical and transactional services: billing, collections, provider network services, and claims processing. HealthHelp brings in clinical and operational expertise to impact medical, as well as administrative outcomes, thus closing the loop. It also brings a human-centered (aka design thinking) approach to solving problems and developing a new business capability that the healthcare industry needs.