Imagine going from
your doctor’s office to a pharmacy without a paper
prescription, but walking out moments later with the appropriate
medicine in hand, tailored exactly to your health needs and medical
history. Imagine as well that payment for the prescription is
electronic and automatic, and that you, your doctor or pharmacist is
able to call up a complete record of all the medicines you have ever
obtained, whether from a hospital or another doctor. Welcome to the
more efficient and safer world of e-prescriptions facilitated by a
seamless
medication delivery system. This system may be less than a decade
away.
Rx CANADA LEADS THE WAY
One of the leading players working towards this major breakthrough in
health care delivery is Rx Canada, a pharmacy-sponsored organization
that develops and implements innovative programs to improve patient
care—and a recent Bay Consulting Group client. Rx Canada credits Bay
Consulting partner Drew Huffman with putting the group on a path that
could revolutionize prescription fulfillment in Canada. “Drew expertly
led us to a clear mandate with renewed energy,” says Wendy Nelson,
president of Rx Canada. “He’s very low-key, but an incredibly effective
facilitator.”
Facilitation is
central to most of Bay Consulting’s work. It is the
process Drew chose to help Rx Canada evaluate its existing business
model and develop a strategic path for the future. Explains Nelson: “Rx
Canada was approaching 10 years as a company and our Board felt it was
the right time to examine our core purpose and develop formal
directions for the next decade.”
FIND THE RIGHT CONSULTANT
To help Rx Canada, Nelson looked for outside assistance from a
consulting company with private sector experience, an understanding of
IT solutions and extensive knowledge of the Canadian health care
sector. Bay Consulting scored high on all three counts.
At the same time, Rx Canada had a vision for e-prescriptions that would
build on the organization’s current strength in providing electronic
chronic disease management programs that pharmacists offer their
patients. Some 2,300 pharmacies, accounting for half the prescriptions
dispensed in Canada, now offer various Rx Canada adherence programs to
patients, but Rx Canada saw a future in which their company could
expand their role and serve as the hub or an electronic link for
e-prescriptions among patients, pharmacists, physicians, and all
payers. Today, such a link normally occurs only in a few small pilot
settings.
Drew’s winning proposal was relatively simple. Do extensive research on
present stakeholders, develop a business case, present alternatives for
the future and facilitate a retreat for critical decisions by the Rx
Canada Board of Directors, representing such large drug chains as
Shoppers Drug Mart, Loblaws, Canada Safeway and Pharmasave.
RESEARCH, RESEARCH,
RESEARCH
But successful facilitation is never simple. “Most people think
facilitation is just like waving a wand,” Drew says, “but a huge effort
goes into a final performance.”
Drew’s hallmark is research, research and more research. “You never
know as much about the subject matter as the client,” he says, “but you
need to know enough to provide guidance.” And being fully briefed
allows Drew to become an “activist” facilitator and to participate in a
discussion when clarification is needed, or if he feels the need to
push the discussion in a certain direction. “Drew was a walking
encyclopedia,” says Nelson. “And he was able to present controversial
material in a constructive way.”
At the same time, Drew believes that one can’t be an effective
facilitator without the credibility that comes from his more than two
decades of consulting—and facilitating—experience. Simply put, “A
facilitation involving senior people can’t be done by a 30-year-old.”
Adds Nelson: “Drew had to work with some individuals with strong
opinions. I don’t know how he did it, but he got everyone’s views on
the table, including the hidden agendas. At the end of the day, you
didn’t feel you were being facilitated.”
ACTIVIST FACILITATION
UNLOCKS IDEAS
Although he favours the activist model of facilitation, Drew never
loses sight of the essence of effective group decision-making: “It’s
about the client. The solution has to work for the group, not for me.”
As for the techniques he employs to help people grapple with tough
choices, Drew mentions three. “The most important thing is asking the
right questions,” he says. Again, research plays a big part. “Before
every meeting, I put together a detailed agenda, and I always develop a
list of questions for each item. I may have 20 pages of questions for
the one-page agenda that is distributed to the participants.”
Secondly, a good facilitator knows how to listen. “It’s all about
listening more and saying less. Let the participants talk, even off
topic, because it will loosen them up and spark other discussions that
may turn out to be critical.”
Finally, a good facilitator has to know when to cut off the discussion.
Before Drew begins, he tells the participants he will invoke closure
from time to time and often establishes credibility by giving the hook
to the senior person in the room.
UNDERSTAND THE CLIENT AND
MARKET
For Rx Canada, Drew wanted to first understand the workings of the
organization. What is the present business model of the company and
what pharmacies are supporting it? What is the current and future size
of the Canadian prescription market? What can we learn from how the
e-prescription challenge is being met in each province and
internationally?
Only after he found answers to these and other questions did Drew
examine such issues as whether the ultimate objective of a national
e-prescription hub would be technically, economically and politically
feasible,
He established a
working group of Rx Canada staff, Board members and
experts from the pharmacy chains across the country. Participants were
assigned particular research tasks and the group met four times over
two months. Information and findings were reviewed, discussed and
sometimes challenged. Research led to more research. Simultaneously,
Drew met regularly with Nelson, worked with Rx Canada staff and met
with all conceivable stakeholders in a potential national
e-prescription hub.
DECISIONS COME FROM OPTIONS
At the end, Drew developed an analysis and strategic options that
ranged from abandoning the current business model up to and including
forging ahead with the vision of an e-prescription hub. When it came
time to make the tough choices, there was considerable debate. Drew
facilitated the group through the difficult decisions at the retreat.
The result: a commitment to move ahead aggressively with the present
business model and to continue to resource the pursuit of the
e-prescription hub.
Meanwhile, the research and discussion process uncovered other
opportunities for Rx Canada. Plans were proposed to grow the business
through program enhancement, greater participation by current
pharmacies and expanding market share by attracting new pharmacies.
Together these measures now constitute the core components of the
company’s business plan and are contributing to ongoing renewal of the
organization, an unanticipated side benefit of Drew’s work.
