Going to the “gemba” in healthcare or competing for the project from Walmart.
This took place back in August but I have finally got some time to write about it only now. The CEO of the company I worked for asked me to help him to compete for a development of the information system for Walmart clinics. He wanted me to make a demo of a clinical decision support for one of conditions they treat.
First I made some research online. There are quite a few online resources about retail clinics but the best place to start is the Convenient Care Association site. Unfortunately we haven’t got a membership there and I cannot comment on the value provided by it. That could be a good source of evidence based practices for retail clinics.
A great deal of knowledge I got from the book “Convenient Care Clinics: The Essential Guide to Retail Clinics for Clinicians, Managers, and Educators” by Joshua Riff, MD. This book is an excellent source of information about retail clinics. It covers topics from evidence based practices to operation metrics associated with retail medicine. I can’t recommend this book highly enough to anyone who wants to get involved into the industry.
Next I spoke with a friend of mine and a great physician Armand Dorian, MD. He had an experience of running several retail clinics and gave me a valuable input. But even after all the online research, reading a great book and speaking with an entrepreneurial physician I had a feeling that I was missing something important. It was time to do what “lean” people call “go to the gemba” — go and see what was really happening rather than read about it. They say that nothing can give you a better understanding of a process as seeing it firsthand.
And so did I. I opened cvs.com and found the closest Minute Clinic. I was not sick and was not in need of any medical treatment. The service that attracted my attention was a tuberculosis skin test. It was cheap, only 28 dollars and it needed two visits. A follow up visit was a great chance to clarify uncertainties left after the first one.
The whole “going to the gemba” thing has worked just great for me. I learned a lot about the process. I watched a nurse practitioner working with me and their information system. Before returning to the clinic again I had chosen a condition I was going to prototype for the demo. It was a sore throat. And on my second visit I asked a lot of questions to clarify a sore throat treatment. The nurse practitioner gladly responded to all of them. After all I have got a great feeling of the convenient care clinic business processes. And I didn’t have a tuberculosis which was not bad as well.
I documented scenarios and wrote down some user stories. I sketched sore throat wire frames on paper and then the first couple of them with Balsamiq Mockups. It was the right time to get our development team involved. But at that time I had just finished reading a book about AngularJS and wanted to give it a try. Moreover I wanted to try the formstamp — AngularJS widget library from Health Samurai. How much a project manager can do having such a library? You can check a screencast or an app itself.
I always enjoy using tools produced by our developers at Health Samurai. After all if not a developer like me can use these tools they should be good.
A couple of months later the same CEO approached me with a new opportunity - a bariatric patient engagement solution. I knew that to make it I have to go to the gemba, but should I start gaining weight?