How might we shape the future of centralized and decentralized services for a premiere cancer center?
In Spring 2018, I was hand-selected by Professor Jeremy Alexis to lead a small team of ID students through a strategic framework development project on behalf of a leading cancer center in the United States. This client was interested in understanding centralized and decentralized services at analogous organizations and how these organizations have designed their intake and management processes in order to provide seamless and superior customer/patient/client service. They asked us to generate a framework to use as they develop future organization-wide services.
How do we define centralized?
When a function is managed from a central standpoint or authority.
Centralized organizations have a clear chain of command and responsibilities that travel through all or most of the levels within their hierarchy.
How do we define Decentralized?
When a function is managed independently or at a local level.
Decentralized organizations have delegated responsibilities in decision-making or determining independent processes to individual departments, empowering them to take action and handle most aspects of their operations on their own.
phase 1: conducting research on analogous organizations
We began our engagement by developing a list of attributes to describe the cancer center, its services, and the patient experience. From here, we determined a list of organizations that were analogous to these attributes in some way. For example—United Airlines requires precision, Trunk Club provides a customizable/tailored service, and Cisco’s offerings are relatively high cost.
We also developed a list of dimensions—elements that we explored further as we talked to our analogous examples. We wanted to understand how organizations fall on these spectrums with regards to how they operate their customer/client/patient intake and management processes.
ATTRIBUTES
Precise
High risk
Relatively high cost
Highly involved/intimately connected customers
Customer handed off to separate team for service
Highly secure/private data
High stress + emotion
Need for provider empathy
Customizable/tailored service
DIMENSIONS
Centralized vs. Decentralized (traditional sense)
High touch vs. Low touch
Live interaction vs. Non-Live interaction
Analog vs. Digital
Uses a CRM tool vs. Does not use a CRM tool
We arranged for 60-minute interviews with members of these organizations who could speak to customer intake and management processes and how these were handled in either a centralized or decentralized manner. Our aim was to understand how customers/clients/patients “move” seamlessly through an organization without loss of data or a break in quality in their experience.
Phase 2: Case Study Development
After conducting over 18 interviews on 11 different organizations, we developed 9 distinct case studies, delving into organizational structures, customer/patient/client flows, intake and management touchpoints, liaisons of customer engagement, internal systems for tracking and managing customer/patient/client data, and internal frameworks used. Ultimately, our case studies included our summarized findings that even detailed the strengths and weaknesses of each organization, all focusing on our client’s desire to better understand the relationship between centralized/decentralized elements within an organization.
In March 2018, we traveled to our client site to conduct a workshop with key stakeholders, walking them through our case studies and facilitating a larger group discussion about the pros and cons of centralization or decentralization for different touchpoints throughout the patient journey.
After our workshop, we built abbreviated case studies and a separate collection of best practices based on secondary research gathered from additional analogous companies.
phase 3: framework proposal
Our team spent the second half of the semester diving into our case studies and generating a framework for how our client could think about centralized and decentralized services they develop in the future.
The framework we developed contains four categories within which an organization can choose to be either centralized or decentralized—knowledge, culture, approach, and experience—along with a corresponding spectrum for each. Tools are included as an overarching facilitation device that help make the interplay between centralized and decentralized services possible for the organization and visibly seamless for its customer/client/patient journeys.
Throughout our research, we discovered that no organization is either fully centralized or fully decentralized, and many of which have services that appear more like a hybrid. To reflect this, each spectrum features a best practice for each side, as well as an “outlier,” which is a best practice example that departs slightly from the provided spectrum and shows that—in some cases and with careful planning—it is possible to realize the “best of both worlds.”
We presented this final framework in a workshop at the client site in May, and the work has received rave reviews and since been elevated within the organization to the Director of Strategy.
Special thanks to the whole team
IIT Institute of Design Students: Sabah Asif, Nathalie Cacheaux, Divya Jain, Jessie Yu
IIT Institute of Design Supervisor: Jeremy Alexis
Client: A. Ro, O. Chiu
