The need for business related skills in driving innovation to cure cancer

5th Feb 2014

Tim Shaw, Nicole Rankin and Debbie McGregor, WEDG, CTC, Sydney Medical School

Response: "Service gaps and models for efficient Health service delivery" (Pennie Frow, Marketing, Business School)

Tim Shaw, Nicole Rankin and Debbie McGregor from the Medical School and the Workforce Education Group, began the conversation by presenting their work in improving service delivery and patient networks in the Cancer centres around the Sydney Hospitals (Catalyst Program which includes RPA (Life house), Concord AND St. Vincent's etc)

They focused on the particular problems in service delivery in the case of Lung cancer patients. They described the Service Cycle concept (which tracks patient journeys through records and local data). They identified the issues around

  1. Lack of timely diagnoses (lung cancer patients typically are diagnosed late when they present for symptom related illnesses)
  2. Slow referrals for treatment (symptoms treated for other illnesses before chest xray)
  3. Provider - Service Delays(especially for rural patients)
  4. Potentially curable cases not referred to surgery or palliative care
  5. Older patients with co-morbidities who do not engage in active treatment.
  6. Accessibility issues
  7. Competencies and its variability (of the treatment team)
  8. Multidisciplinary expertise needed in treatment team
  9. Patients have hi psychosocial needs.
  10. Early palliative care referrals (through community services and local services)

They identified the that changes need to be made around the following Relevance of information given, Magnitude of gap between services available and required, Burden of care (who bears this) and which points in the service cycle are most amenable to change. They also raised the issues around the idea of 'perspective' ie the need to examine the service cycle from the perspective of each person in the cycle, to see why the service gaps may occur (ie cost issues (point of view of the hospital management vs psycho social needs of patients on the ground in rural areas (from point of view of patient carer or local palliative care people).

Pennie Frow from the Business school responded form a 'service dominant' perspective speaking of the ideas of network analysis (examining the networks around the service delivery to see the intensity of interactions and the importance of each interaction - for example between GP and specialist team, as a means of identifying where services need to be strengthened for optimal impact on outcomes for the patient. Social network theory and patient perspectives on 'value' perception and value creation may help to strengthen the service cycle and empower patients to feel part of the co-produced service cycle.

Anya Johnson of WOS suggested action research as a means of changing the field itself

Corinne Mulley of ITLS suggested that clarity about what 'outcomes' and for 'whom' were being sought, should be a priority, pointing out that 'efficiency' within the system may contribute to 'number of patients serviced' type KPI, but may not serve the patient or the treatment team well in terms of patient outcomes.

Oliviera Marjanovic of BIS emphasised the need to move away from thinking of service delivery in healthcare as a linear process toward a more 'cloud' shaped notion around these processes.

The session identified several possible research collaborations and ended with a very lively discussion around the 'stigma' around lung cancer compared to other cancers, because of the perception of lung cancer sufferers as having 'caused it themselves' by smoking.