Test And Learn Before You Scale Your Project

The Pharma industry likes to aim big – understandably so. Why would you target one practice when you can cover a whole integrated care system?

But the problem with working on a larger scale from the outset is that it often becomes more difficult to manage and you can lose sight of what you’re doing. Who’s working out the lines of responsibility? What outcomes are you looking for at each step of the project? And how can you properly evaluate your results?

If your project is not effective, you risk more damage across a wider scale to many practices. The consequences of which could be devastating.

Resist the temptation to go all out at the start

Take Leicester as an example. With Leicester, Leicestershire and Rutland ICS, you’re looking at 138 practices and 25 Primary Care Networks in total. It would be great to run projects with them all at once.

But actually, it often makes far more sense to put a really tight project into one practice or primary care network first. Working at that level – always with scaling up in mind – will allow you to:

  • See in crystal clear detail what you’re trying to achieve
  • Work out exactly how you’re going to do it
  • Establish who is responsible for what at each stage of the project
  • Set out the intended outcomes
  • Measure and evaluate the outcomes at the end of the project.

Start small, perfect your process, then build

When I’m helping my pharma and medical technology clients embed their projects in patient pathways, I’m never afraid to start with one practice and/or one network – as long as when I do deliver a project at that level, I can then scale my project across many more practices and networks. So, always thinking ahead, I measure progress from month one. I do not wait six months before auditing, I literally gather the data from about four weeks in and track it all the way through.

At the outset, we agree to evaluate the project after month six, against the following five points:

  1. What we said we’d do
  2. How we would do it
  3. Who was responsible and for what within the project
  4. The outcomes we thought we’d deliver
  5. What we actually delivered and achieved

So by now we can actually start to demonstrate the outcome and have the information we need to make a firm decision on whether to scale up or shut down and return services back how they were previously.

NB. Do not fall into the trap of ‘extending the pilot’. There should be no grey area here. Simply take a firm decision. Is it working or not? Do we scale up or go back? Limiting the scale of your project during this test and learn stage will arguably make your decision easier.

Set outcomes that matter

The outcomes might be to reduce appointments in general practice, reduce referrals or admission into secondary care, or there might be very specific targets in terms of improved patient outcomes. This will be unique to each project. The critical point is to measure early and clearly to demonstrate how those figures improve across the six months. It then becomes a natural decision to go ahead and scale – or not.

Take a complete pathway approach

A complete pathway approach to your project is key when scaling up. Always look to understand – and cost out – every single step in the pathway so you can build a high quality, standardised approach without any unwarranted variation. Everything in the pathway should be specified, e.g., equipment, drugs, pathways, referral form, patient education, step up/steps down care and if required patient discharge. You then tie provider payment to delivery and audit to ensure everything remains on track. Everything you do should be specified.

The advantage is clear – the entire team can become completely interchangeable as you scale. You increase capacity by having a team of people working across different sites. This also navigates holidays, illness or even sabbaticals, when people in the team can seamlessly slot in. This is where having a standardised complete pathway approach comes into its own.

I have many examples of this being delivered within the NHS and across my Pharma and Medical Technology clients.

Variation can lead to disruption

When there is a variation of approach or you choose not to standardise, it means people can do their own thing, teams are no longer interchangeable, restricting you from increasing your capacity, your resilience and your sustainability.

Once standardised, you can focus solely on getting the right patient in the right place at the right time with the right healthcare professional who’s has the resource available to them to deliver that pathway of care. That’s why a complete pathway of care is what the NHS wants to focus on. This often gets missed when you’re busy focusing just on a little bit of the pathway that suits your own drug, device, appliance or technology.

The fact is, the NHS can’t afford to tinker around the edges or just try to fix bits of a pathway. Meaningful change comes when you look at the pathway in totality. It’s time to shift from looking at the acquisition cost of a drug or device or a piece of technology to actually look at the acquisition cost of a complete pathway.

Feel free to connect with me on LinkedIn if you’d like to discuss any of the points raised in this article.

Scott McKenzie helps pharmaceutical, medical technology and device firms increase revenue by getting their products and services in front of the right NHS decision-makers. Scott covers the topics in this article and more at this free webinar How To Innovate Your Sales Pitch on November 5, from 10-11 am. If you want to get your products fully embedded into treatment pathways Scott can help you. Scott and his team have doubled revenue for their clients and can share these processes with you too.