Matter. Julie Williamson
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debate, argument, consideration, and creation, and dedicated facilitation from GHX, the coalition working on the problem committed to building a demo for what they believed was possible—from an optimistic and curious position that challenged many assumptions being made in the industry about implantables.
They brought this demo to the GHX Supply Chain Summit in 2013 in the form of a site at the event set up to resemble an operating room, where they demonstrated how use of implantables in the scenario could be tracked and recorded for appropriate and timely billing, as well as to support patient notification. It was a big moment that really highlighted the success of the co-creation in defining the desired end state in a way that no single organization could have accomplished—all enabled by the discussions GHX prompted by going out to the market and saying, “Let’s solve for this.”
After the summit, stakeholders were eager to move forward on provisioning the whole solution. The insights generated from the co-creative process were enough to pique serious interest from influencers and buyers across the sector. This is just the type of access an elevated perspective creates, something we will dedicate an entire chapter to in the “Elevated Relationships” section. GHX was positioned to offer an even more powerful perspective on what could and could not be achieved in this space. But there was also a sobering realization: The “ideal” solution developed and showcased at the summit would be difficult to replicate in delivery because it required extensive technology, process, and behavior change from every single person end to end, including physicians and other highly specialized, highly trained people involved in the surgical processes. Coordinating all of this change at the same time simply would not be possible.
Armed with this refined perspective, GHX took a step back and reevaluated what would be the best edge of disruption to tackle first, now that the full problem set was defined. In the spirit of progress, in 2014 GHX decided to focus narrowly on AOM, Advanced Order Management, as a first step in solving for tracking implantables. Because the whole industry fully understood both the problem and the larger solution, solving for a piece of it became meaningful and important. Without that shared understanding, generated through the co-creation process, solving just a piece of the problem would have been out of context and potentially meaningless in advancing the industry toward the desired end state.
The result? Today AOM is improving accuracy and reducing invoice problems, and providing greater visibility than ever to implantables spend and use. It does this by automating many of the steps involved in managing implantables, from requisition to electronic purchase order creation. In the process, visibility of which implantables are being purchased and consumed becomes available. AOM tackles the first set of problems in the medical device supply chain that will move the industry toward the desired end state that everyone has co-created through the collaborative process. If GHX had not co-created with its market, it very likely could have developed a product that only solved for a tiny and potentially obsolete part of the problem. Because its leaders took the time to step back and invite others in, the solution fits today’s realities and tomorrow’s vision of an industry-wide, seamless integration of implantables management into the healthcare system, improving both costs and patient experience and safety.
Refining and learning about your understanding of your right edge of disruption is one of the underlying objectives of co-creating. You don’t want to go around giving out PowerPoint Promises. That kind of reputation will never give you the access you need to influence the marketplace. As you define your edge of disruption, remember that refining your ideas and narrowing your focus are a part of the process. Once the larger problem has been clearly articulated, achievable step solutions are legitimate ways to add more value.
As you define your edge of disruption, remember that refining your ideas and narrowing your focus are a part of the process. Once the larger problem has been clearly articulated, achievable step solutions are legitimate ways to add more value.
GHX has co-created with its market in other areas as well. In 2008, it began a similar journey to facilitate traceability of pharmaceuticals, an area with problems similar to implantables. It is very difficult to track down the ultimate recipient of a prescription, making timely recalls and patient notification incredibly hard if not impossible. More importantly, the pharmaceutical industry has issues with drugs being counterfeited, adulterated, and diverted from their proper destinations. These challenges can be addressed with a comprehensive approach to tracking and tracing pharmaceuticals, but again, no one organization could possibly own and deliver that end-to-end solution. As a result, almost twenty organizations in the industry participated in early discussions about the problem, including suppliers, providers, regulators, industry associations, and of course, GHX as the host.
Phase 1 for pharmaceuticals was a collaborative effort to develop requirements for the industry to define an Interoperable Track and Trace System that would provide a simple and accessible solution for users across the healthcare system. Phase 2 included building a prototype of a working interoperable system, designed to use prototyping to uncover additional requirements and further learning about how to handle security issues in a potential solution. The insights from Phase 2 were further used to engage with and inform regulators and policy makers, who play a very active role in healthcare. Using this iterative process, the working team was able to produce an exciting result for everyone.
The effort culminated in 2013 with the delivery of an end-to-end solution in a “live” scenario that included AbbVie, Inc., McKesson, and the Veterans Health Administration to jointly deliver an award-winning proof of concept that demonstrated full traceability on an interoperable system.3 In addition to those companies participating in the demonstration, Johnson & Johnson Health Care Systems, AmerisourceBergen, and others contributed to the development of the system. It was truly a collaborative effort from across the industry, and it provided a breakthrough moment in making what seemed impossible a reality. Out of that work, the industry is on its way to implementing real change in how pharmaceuticals are tracked, and everyone who participated in the effort has an opportunity to matter more as the solutions are designed and implemented across the industry.
Looking at these two examples, it would appear that the edge of disruption for GHX in this space isn’t just implantables or pharmaceuticals—it’s Track and Trace across the entire healthcare supply chain, or any other systemic problem that requires cross-industry collaboration! What GHX has learned about how to successfully define, develop, and execute co-created solutions in healthcare is unparalleled. The benefits to GHX of learning about the challenges it wants to solve through co-creation with its market cannot be overstated. The access these co-created activities provide is clear, especially as GHX nurtures elevated relationships (more on that in the next section).
For now, note that the co-creation approach gives GHX deep insight and knowledge to guide product development. It was also able to confirm that it was working at a meaningful edge of disruption, one that mattered more to its customers and other influencers in healthcare. Last, GHX has had an influential seat at the table for some of the most important conversations in their industry, and many clients would likely suggest that, going forward, it would be crazy to talk about something like Track and Trace without GHX in the room.
Consider that in September 2014, the US Food and Drug Administration (which regulates medical devices) published a final rule that includes the requirement for a unique device identifier to support tracking of medical devices, as well as a larger mandate related to product data. Luckily, thanks in part to GHX and its efforts to co-create a solution, the industry has already gotten a head start on solving this new challenge. Who do you think the manufacturers reach out to as they adapt to this new regulation, which is devastatingly complex to comply with in the real world? GHX may not own the end-to-end work, but having an end-to-end solution envisioned makes any individual piece more impactful and stickier—it matters more. The added value of co-creating when you are learning about your edge of disruption is that it amplifies rather than diminishes the value of the work you decide to do.
As a convener in the industry, GHX doesn’t shy away from tackling big and thorny problems, or from spending time— sometimes years—bringing the market along and crafting viable solutions that will resonate with customers. GHX’s success shows that you can’t be afraid of big problems, or of solutions that take time to evolve. In a complex industry