Rethinking Service Delivery


Innovation: Individualized Service through Group Delivery

Scholar: Amy Halliday

Most of us, businesspeople and laypeople alike, operate on the assumption that certain kinds of services can be delivered only during one-on-one interactions. Investment advisers, for instance, see clients individually to discuss personal finances. Lawyers meet behind closed doors with clients to review their private matters. And no one-on-one encounter is more intimate than that between a medical doctor and her patient.

In the quest for increased efficiency and flexibility, some service providers are reconsidering their delivery models and experimenting with ways of attending to more than one customer at a time while improving their ability to meet individuals' needs. In a striking example, Kamalini Ramdas, an associate professor at the Darden School (currently on leave at the London Business School), is working with Amy Tucker, MD, associate professor of cardiac medicine at UVA, to design a clinic where Tucker and her colleagues will meet with groups of patients at risk for heart disease. Tucker's team and Ramdas are thinking through the layout of the clinic and how patients will be served in it, individually and in groups.

At the clinic, located in UVA's Northridge medical building, Tucker and colleagues, including other doctors and nurse practitioners, will meet with a group of nine to 12 patients for a series of 90-minute sessions instead of meeting each patient separately in 30-minute slots. In these group sessions, Tucker and her team will provide each patient with the full spectrum of medical care offered in a traditional individual appointment. She will then follow up with private meetings for those who request them.

The logic behind this model is twofold. First, all patients in the group have something important in common: several risk factors for heart disease. Naturally, therefore, the doctor's advice to each patient and the patients' own queries are relevant to many participants. Second, group visits, which encourage a sense of community and shared learning, increase patient engagement  a critical factor in the treatment and management of chronic diseases.

Doctors can substantially increase efficiency and quality through such an approach. By delivering important information to many patients simultaneously, a doctor will have more time and flexibility to meet with those who need individual attention. Patients may end up benefiting from this clinic in unexpected ways, Ramdas predicts. Other people in the group might come up with questions they wouldn't have thought of. And especially bold participants might share symptoms or concerns in the group setting that some individuals weren't planning to disclose, even in private. Consequently, participants may end up learning as much from one another as they do from the doctor. And, of course, the group provides a natural patient support group. The net result is a healthier patient, served at lower cost.

Ramdas, who plans to write a teaching case on the cardiac care clinic with Tucker and Darden's Elizabeth Teisberg, notes that companies in other industries are starting to experiment with group approaches. For example, some high-end wealth management firms are prospecting new clients in a group setting instead of in individual meetings. According to Ramdas, whose research focuses on innovation in products, business models, and business processes, this creative rethinking of traditional customer-client interaction could open up wholly unexpected avenues of value creation.

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