Encore! EP381: For Reals, Becoming Customer-centric, Transforming, or Innovating at a Very Large Organization, With Karen Root

You can listen to the episode here.

[00:00:00] Stacey Richter: Encore episode! For reals becoming customer centric, transforming or innovating at a very large organization. Today, I speak with Karen Root,

American Health Care Entrepreneurs and Executives You Want to Know Talking. Relentlessly Seeking Value. 

Why did I decide to encore this show about being customer centric and transforming or innovating at a very large organization? Well, two main reasons. First reason can be neatly summed up by this recent tweet from Rik Renard, which I have edited slightly to suit my own purposes.

Here's the tweet. The Achilles heel for most healthcare innovators. is overlooking the role of change management. The deal isn't sealed until the whole team is raving. Adoption doesn't automatically follow innovative thoughts, no matter how good they are or how much it costs to build or buy anything.

Take change management seriously. This is relevant to pharma companies, to big provider organizations, to SaaS vendors, to payers, pretty much anyone. So yeah, this show still relevant. But also, there's a number two reason for this encore. It's coming at ya smack in the middle of an ongoing series for boards of directors, CEOs, and CFOs of self insured employers.

As discussed last week in the show with Mark Cuban, healthcare has become financialized. There is a whole financial layer sitting in between health benefits and the employer, and dealing with that requires customer centricity, transformation, and innovation at the employer level. A little change management, if you will.

And with that, here is your Encore. I was at the PanAgora Pharma Customer Experience Summit. Let me tell you one of my big takeaways. Many at pharma companies who are trying to convince their organizations of the need to be provider and or patient centric are having a tough go of it. Heard that coming from every direction.

Seems there are quite a few pharma organizations out there who are not actually customer patient centric. It isn't so. Turns out they continue to be pretty darn brand centric. Whether or not anyone besides the CX team and the most successful KAMS realize this hard truth. This matters because from a provider organization, physician or patient standpoint, it's not what's written on the walls.

It's what goes on in the halls. It's what a company actually does in their interactions with the rest of the healthcare ecosystem that matters. And that builds their reputation. You see this lack of customer centricity and et cetera, et cetera. There are certainly other things going on here, but you see the lack of customer centricity manifesting, right?

You see the pharma reps, they get kicked out of hospital systems because the perception is they add little, if any, value. And in quotes, waste doctor's time. All they do is shove detail aids in our faces. Heard that recently. Look, this doesn't just pertain to pharma. This is a message for the whole industry.

But there is certainly a way to do well by doing good. And how that starts is helping provider organizations and patients improve patient outcomes. As the primary goal, being innovative to that end, it's about supporting the best practice standard of care and bringing resources to bear that are truly helpful.

That is how more of the right patients can get the right treatment drug at the right time or take their meds as per the A1A clinical guideline. It's probably also the way to sustainable business success. I have said it here a thousand times. People trying to do the right thing by patients all need to work together.

If there's a party in the mix that nobody else wants to deal with because they are deemed not a team player or they don't listen, yeah, that's what I call a competitive disadvantage. Beyond just squandering their ability to achieve their mission statement and improve patient care and lives, that is.

Today's conversation is with Karen Root, who was a speaker at the aforementioned Panagora conference. Today, we are talking about how to make transformation and innovation actionable at a large organization, maybe a pharma company, but pretty much any large organization with lots of people, lots of human beings with different motivations and goals.

As we all know, for every early adopter, there is, it feels like, five laggards who will fight you tooth and nail because they do not want to transform. They like being brand centric and it's been working out fine. Well, up until this year, at least. Karen Root is currently Director of Experience Strategy at BI, which is a pharma company.

For many years prior to her current role, she was an Enterprise Head of Brand and Culture at W. L. Gore & Associates. What we talk about in today's show is how to break down the historical. Brand is king mentality so that people want to follow with the awareness, courage and determination to do so everything that we talk about today can also be applied to pretty much any organizational transformation or the rollout of any innovation or new capability.

Here's the key things that Karen talks about, which are essential for an organization to transform. Maybe again in a way that is customer centric and or to roll out new innovations or capabilities. Number one, leaders must communicate a compelling vision that also includes a realistic assessment of what it's going to take to reach that vision and offer hope and the promise that the hard work and inevitable problems will all be worth it.

Number two, systems thinking. A consideration of the systems and the people who will need to be a part of the transformation, thinking through what is likely to go wrong and proactively planning for it. Number three, identify the right entry point. This should be a micro journey or a quick win so that the team can score a victory and get through the messy middle that exists in any transformation or rollout.

Triple points! If you can find a micro moment that has some emotionality connected to it from your customer's perspective or patient perspective, if you can fix a so called moment that matters, it really matters. Consider starting by looking into call center logs, finding a common complaint and fixing it.

Do it this way, and it's harder for anybody to complain that the status quo is so super amazing and tell you to talk to the hand. Number four, determine how you are going to measure what your quick win accomplished, as well as your whole larger transformational effort. Number five, ensure you have a full story arc here that shows the before and the after that clearly articulates that the before, the status quo is problematic and that we have to, with urgency, get to the after.

And number six, Never forget that we're working with human beings here and not, as they say, rational economic actors. One heads up in the conversation with Karen today, we talk a lot about the so called J-curve. As Karen says, and you can look this up, whenever you introduce a new anything into an organization, at some point, there's going to be a mess up.

And when something messes up, the whole team will spiral into a so called. trough of disillusionment or a trough of despair. Sometimes it's called, this is the rock bottom hook of that J in the J-curve. The thing is, if a leader's vision isn't sufficient or their will to continue isn't sufficient, then the organization.

quit at this low point instead of working through it and coming out in a better place on the other side of the J. And you know what happens then from that point forward until eternity, everybody who brings up implementing an innovation or transformation will definitely hear the lecture about the time we tried that and how it failed miserably.

So the J curve, check it out. Don't underestimate it. Thank you. One very last thing. If you are working for a large organization like a Fortune 500 large, and you have succeeded in moving a transformation forward, like being actually patient centric or customer centric, for example, hit me up. I would certainly love to hear your thoughts on how you did it and why you think you were successful and the impact that you had.

My name is Stacey Richter. This podcast is sponsored by Aventria Health Group. Karen Root, welcome to Relentless Health Value. 

[00:08:37] Karen Root: Thank you so much for having me. I appreciate it. 

[00:08:40] Stacey Richter: So Karen, you have a disclaimer I hear. The thoughts and ideas I'll share today are my own and may not reflect those of BI or Boehringer Ingelheim.

And as I like to say, especially if my jokes don't land. 

Obviously, leading an innovative or a customer centricity transformation at a large company requires a certain amount of skill. And those skills might be different than those that you would need at an agile, smaller kind of company. Yeah, as you look at any transformation, you're trying to develop a synchronicity among people.

The human beings are going through the change. We're trying to bring some new capabilities forward, but it actually happens within each of us as individual human beings. So the challenge becomes when you get a large size company, thousands of people, you know, in some cases a startup is more agile when it comes to change because of the number of human beings.

Yeah. And I could also see it being exponential or logarithmic, just because you have double the number of people doesn't make it double as hard. It might make it 10 times as hard or something like that. 

[00:09:50] Karen Root: Correct. I look at it like that full on campaign. You need to have top down support without leadership.

You're not going to get the initial push. You also need to start from bottom up in the grassroots effort because the folks who are going to be executing these changes need to believe in you. They need to have the understanding of what's in it for them. In order to change people, they have to want to change.

If they don't see value, you're not going to get the lift. 

[00:10:22] Stacey Richter: Any initiative to introduce a new capability or a new innovation into the organization, it starts with the leaders coming up with and then expressing a vision. So it sounds like what you're saying is it's not enough just to like have a vision that there has to be a sort of framework that's put around this vision.

What needs to be included in a vision or a vision sort of exercise or the. deck or something like what do you have to have as a leader as part of the vision that's going to be successful? 

[00:10:49] Karen Root: When we think about vision, oftentimes we think about our individual visions. I can think about I'm creating a vision.

I'm trying to create it for the organization, but I do it from a framework of one myself. In transformation, we have to adjust the approach to that vision. We have to break it down into a couple of key steps. One of them is you're trying to develop a vision for hundreds to thousands of people. It needs to be in its most simplified format, understandable.

It needs to have some level of inspiration. It also needs to have purpose. That purpose is what unites employees behind the change. It's what they utilize to get through the change curve. And there's really two curves when we think about transformation that are very important to understand. One is called the J-curve, and you can google this.

It's utilized to reflect very often the fact that especially leaders, people have expectations. That change happens easily that you go from point A to a new elevated capability point B and it's a nice archical dotted line. In reality, it's all sorts of disruption when we try to operationalize things. So making sure not only in the communication of the vision that is an end state, but the midterm of why we're doing this.

So that your people have something to hold on to during the tough times, disruption is going to happen. It's just how do we minimize its impact? 

The features of a good vision statement are to make sure that what a leader is talking about is understandable, that it's inspiring, that it has purpose. But now we're getting into something.

[00:12:45] Stacey Richter: Interesting here, figuring out as a leader, what is likely to happen so that the vision can be sustained, that somebody doesn't make some kind of fiery speech, and then it doesn't go exactly perfectly, everyone gets discouraged, and that's kind of the end of that. I think what you're communicating with this J-curve is that, that anytime you move the cheese, as it were, or shake things up a little bit, there's going to be an issue.

You had this process that everybody was working on for absolutely years. Everybody exactly knows what's going to happen next. You start moving things around. There's going to be a mess up, like something is going to happen. It gets worse before it gets, gets better. And unless a leader also sort of includes in their communication, hey, this is likely to happen, then you're probably never going to make it across that trough onto the other side.

[00:13:38] Karen Root: Absolutely. If you think about the change curve in a human being, you go in through states, somebody says, Hey, I'm going to move your cheese. Per your last reference, I'm going to move your cheese to this new capability. You know, we start with shock. Sometimes there's a desire to be defensive or to fight it.

Then there's oftentimes anger and frustration that leads us to that prof of disillusionment that we talk about. The thing that gets us out of it. is hope. So that hope seed has to be planted well in advance, because then we go into a place where folks will experiment. That is the recipe for success. But to get human beings to that state, we have to have enough of the vision that is accompanied by a realistic expectation, a strong purpose, and yes, that, that desired inspiring end state to get through that prof of disillusionment.

It is there where it has to be, hey. This isn't going to be easy. We're doing something that hasn't been done here yet. And the other aspect and key to that is really looking at your systems. So systems are like the second key thing. Yes, you need the vision. You also need to know that as you input this change in the organization, Where are the problem points?

Where are your bottlenecks going to be? You don't have the ability to foresee and anticipate everything, but you do have the ability to run some mapping of your systems and say it's likely going to happen here. If we think about healthcare in a regulated industry, We know that medical legal regulatory, that is going to be a place where folks have to have some adjustment to this new way of working.

So anticipate that, know it, communicate it. You have to get real with folks and you have to level set on the expectations. Hey, we need to allow more timing here in the early stages. Because we're working through this learning curve, after time, we'll get better, we'll get faster. 

[00:15:42] Stacey Richter: A lot of people, when we think about a new innovation, the external becomes top of mind.

Like we think about product market fit and we do market mapping and we do all of these things externally. And what I'm hearing you say is that If we're talking about a large organization here, it's just as important to really think through the internal organization and do those same kind of exercises internally.

Exactly like you were just saying, there's all kinds of internal dynamics and internal politics and just people. So really thinking through if we have this innovation to create the transformation that we're looking for or to take advantage of this external market opportunity. Then, alright, who are all the parties that need to be involved, what do they need to do, what's in it for them, what's the with them across the board, and then what might be scary for them, or what's their pushback going to be, which could just be, we've never done this before and I'm very comfortable doing what I'm doing.

So it might just be just change in general, and everyone fears change. But maybe there's other issues too. People fear that this innovation is going to take their job, so they're directly undermining it. But going through the exercise of really thinking through, as you put it, what are the systems that are involved in the organization and how might they all react so that they can be addressed.

All of this can be addressed proactively and a smart, proactive plan can be put into place as opposed to reactively. People are clapping back, and this is a surprise. 

[00:17:12] Karen Root: It's exactly it, Stacey. The organizational system has a unique culture, and there are influencers and leaders throughout that really can draw people and help propel forward.

So leverage your people, understand where they are in the change curve, and take those early adopters that have influence. that people listen to and let them be the front end and storytell and share their experiences so that people can get over the fear, see some value, jump on the bandwagon and help make the change you're trying to drive.

[00:17:47] Stacey Richter: So one of the things that you said is super important to get people over this trough of despair when things start changing. You can see this happen a lot, like I think we all might have examples of somebody had a great new idea. There was a little bit of resistance, but they, we tried it anyway, and then something bad happened and everyone's like, Oh, that, that went terribly wrong.

And then a year later, somebody else has a similar great idea. Right? And people are like, Oh, we tried that before and it failed. Like it almost retards progress in a way to have those examples hanging over an organization. If you quit. 

[00:18:25] Karen Root: It's really hard, right? Because now people have an experience and now you're not just starting from a level playing field.

You're starting from a disadvantage because now you've got to take people that had a negative experience with what you're trying to do and you have to not only get them. from neutral, but you have to get them from that deficit back up to neutral to be willing to open their mind on this new way. 

[00:18:50] Stacey Richter: So as a leader, you cannot quit in the trough of despair, leadership rule number one, you got to get people out of there.

Otherwise you're damaging your future prospects. 

[00:19:01] Karen Root: Yes, if folks have had a bad experience, what becomes really important there is quick wins, right? The value statement. Because if you can demonstrate value again, that with your clarified vision of inspiration is what gets you through the hard times. So if you are bringing forward, let's talk about a customer experience end to end and you think that's a body of work that could take four to six months, you really need to say, what's my micro journey? Can I tackle a call in a contact center and look at how do I improve that experience versus the entire end to end journey of multiple stakeholders? You've got to show that I can make this change and it has value, immediately impactful, measurable value.

That is what gets people out of that trough of despair or disillusionment and gives them hope. Again, hope to experiment, to try new things, to take on the learning. 

[00:20:03] Stacey Richter: There's so much talk in the healthcare industry about improving the patient journey or improving outcomes, which, you know, you say improving outcomes.

That's huge. There's just so many factors that go into that little statement, like so many things have to slide into place for an outcome in air quotes to be improved if we're talking about patients or a patient journey, for example, or a customer experience journey. So it sounds like what you're saying is that as a leader, you might put the whole journey up on that board, which includes Any number of different intersecting tributaries of activity or just even a long linear flow.

But then what you've got to do is identify one of them. You called it a micro journey. So like just one kind of episode of hair or one episode of customer experience, just one. thing. Really focus on that. So maybe you tee up like, Hey, ultimately we're going to achieve this amazing thing, but we're going to start with come up with something measurable at that one point in time.

[00:21:05] Karen Root: Yeah. If we think about customer experience, it's the aggregate impact a customer patient or any stakeholder has across all touch points. Some of those touch points, we call them moments that matter, where a customer or patient is making a decision, they're having an interaction, they're making a choice.

Those that are fraught more with emotion tend to have more impact for the person, right? If we can think about that as human beings, those moments in our lives that have the most emotional connection. are the ones we remember most strongly. So we actually look to identify those. So when you look at the journey overall, what you'll see is if the pain scale from pleasure to pain is 0 to 10, 10 being the worst, some moments may be a 0 to 3, some moments may be a 4 to 6, and some moments may be a 7 to 10.

If you can find the 7 to 10 and fix them, your overall journey perception in the mind of your customers or patients are going to be significantly improved. 

[00:22:14] Stacey Richter: So it sounds like as a leader or a strategist thinking through. What do we want to do here? The right micro moments to select as our starting point here are ones that we feel like we can have a quick win.

Number one, because that's going to drive the internal change that we might be looking for. But significantly, if we can find a micro moment that matters to our external patient, customer, whatever we're doing here, then that also will have a bigger impact. So if we can find a quick win, that is a real moment that has some emotionality that's connected to it.

That's a perfect place to start because we might actually. succeed in, as you said, in the aggregate, creating a much better patient journey because they'll remember that point in time quite a bit more. But then also that's a success story that we can bring back to the organization. 

[00:23:10] Karen Root: Absolutely. You want to work with the worst experience first if you can find it.

If you have the ability to map that out and know pretty quickly, and your internal systems can often be a great source of information for that. What are the complaint calls? What products or questions are always coming up? If you can prevent a call from coming in. If we think about all the investment that across healthcare we make in reaching out, educating, helping folks make decisions.

Contact centers are the one place where the customer initiated the call. So they have to have enough of that emotional impetus to drive that activity. So if we can start there, there's usually a great tell that here's an indicator of where I can start and make some headway. 

[00:23:59] Stacey Richter: That's a pretty hot tip. I say that for two reasons.

For the externality, because obviously if a patient in that moment when they're really frustrated has a good experience, I've heard it said that's one way to have a customer for life is to help someone when they know they really need help. Like even if it's a problem that they think they're having with you.

But also one of the things that you really fight against internally and I'm not telling anybody anything you don't know, the status quo is so difficult to overcome. The status quo somehow gains this impenetrable aura of being amazing, right? Like it's just. It's so difficult to convince someone that something that is not the status quo is so much markedly better that we should stop doing what we're doing.

But if you select like a call center, you're dealing with people who already have an issue. Like you can't, it would be very difficult for someone to just claim that moment in time is so great that we shouldn't try to improve it. 

[00:24:58] Karen Root: And I think if you look at the number one reason of why folks are calling in, and that could be patients and or customers, HCP customers.

If you can think about it and not just the terms of that one call, but again, step back and look at the system. The system says that typically the call that you have is reflective of nine or 10 other folks. And what can you do then to communicate better on your website? Can you add some education somewhere?

So if we can eliminate the call from ever happening, how would we do it? And to change the experience, not just a better call, but an overall better experience that eliminates the need for the call. 

[00:25:42] Stacey Richter: And I can see what you're saying has a minimal trough of despair, just because it wasn't great to begin with.

There's probably less defensiveness if you are really careful as a leader where you choose to start. Right? Like it's definitely a thought process. What are you trying to achieve? What's that overarching vision? But the entry point into the process by which we're going to go after that, it sounds like is really critical.

And choosing something very carefully. Considering, as you said, the systems that are in play, the stakeholders, what their likely reactions are going to be, you know, picking the right thing and the right entry point into that thing can really make all of the difference there

And to measure it, right? We can't manage what we don't measure.

[00:26:29] Karen Root: So to make sure that whatever change we're trying to create or design an experience around and make an improvement, we have to not only measure in quantitative ways. But qualitative. So bring in perception metrics, that's customer satisfaction, customer effort. 

[00:26:48] Stacey Richter: Earlier you said that the way to get out of the trough of despair is to make sure that there's hope. So that individuals, when they fall in, they have the vision to latch on to and pull themselves out of that trough, that they're, they can focus on the North Star. And I'm wondering, just especially given the allure of the status quo, Whether there's a carrot as well as a stick or whether there's a stick involved here.

If an organization doesn't choose to innovate or they, there's people in it who don't see any particular need to innovate, right? Like they're like, ah, the North Star, that's nice to have. Let's just keep going along and getting along, you know, cause anytime you do try to innovate, there's always a measure of conflict, which is the underlying theme of this whole conversation that we're having.

What's the downside to not being able to innovate and can that downside, have you seen it being used successfully to motivate people to move forward with innovation? 

[00:27:51] Karen Root: That's the nature of a story arc, right? If we are good storytellers, we have the clarity of the end state, but we also have the stick, as you mentioned, of what happens if we don't change.

If we don't enable customer experience or digital capabilities, how does our competition have an added advantage and capability that could overtake us by whatever amount in the next two to five years or sooner? What happens to the organization without this new ability? Think about just what happened with COVID and how that perpetuated and propelled so much innovation, but also a lot that was on the cusp.

Screen to screen, virtual, telehealth, all these things were starting to emerge, but they really, because of the need, were sent spiraling forward in advance because they offered a capability that allowed us to remain competitive. and allowed us to differentiate from others that did not have that capability.

That has to be part of the story arc that you're telling as you share out the vision. We have to know, hey, if we don't do this, this is the ramifications. Here's the potential direction that happens as a result. Oh boy, I don't want to be stuck there. I don't want to be part of the reason that we're not competitive anymore that we lose business, it's really understanding that whole spectrum of impact, the good and the potential downside as we move forward to try to lift up this new capability. 

[00:29:29] Stacey Richter: Recapping the points that have come out in this conversation. So it all starts with leadership having a strong vision that is understandable and that offers inspiration and hope.

But then included in that leadership, the executive team, whoever's trying to push the innovation forward really needs to think through systems, as you called them, who needs to be a party to this, breaking it down in a way into who can influence on the positive, who can be a front runner here, a champion of the innovation, but then also who might be fearful that this is going to cause a negative consequence to them personally or to their department.

Just recognizing and thinking through and mapping out what all those dynamics might be. From there, we get into IDing the entry point. Like, really thinking through, as you called them, quick wins. We talked about the call center. Places where we can either minimize the trough of despair, or... That when it's fixed, the impact will be significant enough so that everyone can measurably, because that was another thing you said, you have to be able to measure it, point to these successes mapping that all out.

But then furthermore, there has to be a storytelling element here. So we've got vision systems, IDing the entry point, and then what's the story here? Leadership really has to have a story. That also shows like the before ain't so great, but like the before is not going to get us where we need to be and is not necessarily a safe path, right?

Like it's a road to trouble if we continue down this path. So really being able to story tell to demonstrate that we have to actually make this change. And then as we talked about also, there's a measurement component. Is there something else? 

[00:31:18] Karen Root: I'd say that's a great recap. The only thing I'd add, we have to remember that these are human beings and to look for those tells the language, the behavior, the decisions, tell us what's going on that we can't see inside their brains and how far along on this change curve are they and where do they struggle?

[00:31:38] Stacey Richter: Yeah. It's all about people and by looking for the clues, success leaves clues, we can really identify how far we've come. 

Karen Root, thank you so much for being on Relentless Health Value today. 

[00:31:52] Karen Root: Thank you so much for having me. 

Links to everything discussed on the program today can be found at relentlesshealthvalue.com. If you visit the website, relentlesshealthvalue.com, you know, you can subscribe to the show so that every week the episode is automatically sent to you so you don't have to remember to go to the website to download it. Thanks so much for listening.