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
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
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?
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
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!
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
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!
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!