A leading rehabilitation center is transforming the patient experience by leveraging augmented reality in a unique and remarkable way.

Customer expectations have evolved rapidly in the last 5 years. Transformed in large part by the pandemic, customer experience has gone from a corporate buzzword to a cornerstone of best-in-class service. Customers want to feel both informed, empowered and supported, and they expect personalized service on the channel of their choice.

Service organizations, by and large, are eager and willing to meet customer expectations. However, due to challenges stemming from the workforce shortage, such as skills gaps, worker burnout, and low employee engagement and retention, service leaders are also investing more and more in technology, including augmented reality (AR), to provide efficient service with fewer resources. The 2023 Service Leader’s Agenda survey found that 61% of service and customer support leaders expect their year-over-year investment in technology to increase this year. Additionally, when we further asked what technology they were prioritizing in terms of investments, 31% said AR.

As organizations turn their digital transformation efforts towards doing more with less, another challenge has emerged. How can they leverage technology to enhance customer and employee experience, increase efficiency, and still delivering meaningful and personalized interactions? Perhaps no vertical in the service industry understands this challenge better than healthcare.

Consumerization and the Patient Experience

Recently, the Service Council hosted the Smarter Services^TM webinar, How ExamMed & Shepherd Center are Exploring Healthcare Transformation with AR. During the webinar, Service Council’s CEO John Carroll was joined by Debbie Backus, Vice President of Research and Innovation at Shepherd Center, Faraz Zubairi, CEO of ExamMed, and Sam Waicberg, President of CareAR. Together, the panel discussed how Shepherd Center, with the help of ExamMed and CareAR, is leveraging augmented reality (AR) in a way that amplifies the human component, while still delivering efficient and empowered service.

Located in Atlanta, Georgia, Shepherd Center is nationally ranked as one of the top rehabilitation hospitals in America. Founded in 1975, the hospital treats more than 743 inpatients, 277 day program patients and more than 7,161 outpatients each year. Shepherd Center’s goal is to deliver more than just medical care to their patients. They want to deliver an experience that brings healing, hope, independence and dignity, while promoting safety and injury prevention.

While Shepherd Center is a world-renowned facility, Debbie says that the issues they face with patient experience are very similar to those of service leaders, “In healthcare, patients want to be able to have choices in the care they receive. They want quick results, but they also want to have access and the ability to decide what treatment they’re going to get.”

Faraz, founder of ExamMed, an award-winning and nationally recognized platform that connects patients, providers, and caregivers, echoes Debbie’s sentiments, “It comes down to two words: Comfort and trust. Healthcare is becoming consumerized in the sense that patients are expecting the same conveniences that they have with their banking apps. Being able to drive towards a delivery model that fosters and strengthens comfort and trust will help drive outcomes in a much more meaningful and measurable way.”

The Challenges of Remote Patient Care

Together with ExamMed, CareAR will provide Shepherd Center with a virtual care management platform that will provide a holistic support offering for patients and streamline their journey. The result will allow care providers to assess patients’ home environment, identify problems when they occur and intervene faster if possible.

As Debbie explains, the positive effects this will have on patients’ lives will be huge. “Being able to use AR to really understand what that environment looks like might mean the difference between patients having to stay in their wheelchair or in their bed all day, and being able to get up and interacting with their friends and family.”

A particularly unique feature will be the ability to measure and fit patients for wheelchairs virtually, a process traditionally done in person. In this healthcare use case, CareAR augmented reality enables a remote expert to visually grasp how each patient can best take advantage of assisted device features with precise graphical guidance using standard smartphones and tablets.  This immersive visual engagement eliminates language and jargon barriers to ensure best fit personalized results for every patient.   According to Sam, this scenario highlights the true power of AR to transform patient experience. “For patients, there’s a lot of time, effort and resources involved in coming into the clinic. To be able to instantly engage virtually with somebody in a way that allows them to start on their patient journey while still in their home, and get the context needed to accelerate their care is really powerful.”

However, it isn’t just the patient experience that will be impacted by the new platform. Care providers want to provide best-of-class care, but they are often limited by factors such as capacity issues or lack of access to pertinent information. In this way, frontline agents are much the same. Preliminary findings from the 2023 Voice of the Field Service Engineer survey found that 87% of frontline agents gain the greatest job satisfaction from solving customer problems. When asked what they liked least about their job, 1 in 4 said it was time spent looking for information. In a nutshell, frontline agents want to help customers but don’t feel like they are being empowered with the information to do so.

Workforce and talent shortages are widespread throughout the entire service industry, from manufacturing to healthcare. Technologies such as AR and other information platforms will play a critical role in training, upskilling, employee engagement and retention. Says Faraz, “as a technology and service delivery platform, it’s on us to help give service providers the tools that they need so they have the right information at the right time to make the right decisions.

The Future of Healthcare is AR

While Shepherd Center is at the beginning of their journey, they are already thinking about the potential that AR possesses for remote healthcare. According to Debbie, the technology CareAR is providing could allow Shepherd Center to treat patients who currently are not able to travel to the clinic for financial or geographical reasons. “The remote opportunities that AR provides, especially when it comes to tele-rehabilitation, would allow us to get those people the care they need.”

Always forward-thinking, CareAR is already in discussions with Shepherd Center and ExamMed to look into additional opportunities to improve and expand on the patient experience. Says Sam, “While healthcare is a new frontier for us, it’s incredibly exciting to help deliver a better patient experience, and the possibilities for AR to do that are endless.”

Debbie agrees, saying that the intention is for AR’s impact to extend far beyond the walls of Shepherd Center. “We hope that we’re going to break down barriers for our patients so that when they go home, wherever they go, they’re going to have what they need to age gracefully with their disability.”

Reflecting on their innovation journey so far, and the roadmap that lays ahead, Debbie says the key to success is to never lose sight of the patient. “The patient is our north star. As we embark on this journey, we always think about each individual, what their needs are, what their possible barriers are, and what we can do to help.”

Watch the Smarter Services^TM webinar on demand to learn more about Shepherd Center’s journey to transform the patient experience with the help of CareAR and ExamMed.

ServiceExperts is a series of contributing articles from recognized industry professionals offering their thoughts, viewpoints and opinions on the latest trends impacting the service industry. Thomas Maiello has over 20 years of hands-on experience in new product introduction, global technical and product support, field service management and improvement strategies, and services technologies. He is currently the Director of New Product Introduction at Varian Medical Systems (a Siemens Healthineers company).  His focus on strategic data-driven programs to drive improved serviceability has resulted in significantly improved services profitability for several companies.  Before joining Varian, Tom managed global support teams at Morpho Detection, Smiths Detection, and KLA. Previously, Tom was enlisted in the U.S. Air Force, and earned a commission in the U.S. Army. Tom holds an MBA from Santa Clara University, an MS from University of Southern California, and a BA from State University of New York. 

…aircraft engines are designed to work, not to be worked on.”

Mike Gentile, Pratt & Whitney Technical Representative, 1987

The Goal

The goal for most service organizations is a world of 100% machine operational availability, delivered in a highly cost-effective manner. This outcome is enabled by “Smart Machines” and components capable of self-monitoring, self-diagnosing, and the self-healing of imminent failures, with sufficient time to pre-position staff and parts, as necessary, to intervene without causing an operational impact to customers.

The transition from reactive, “break-fix” maintenance to preventive and pre-emptive maintenance will result in the following:

1. Improved customer experience, through increased machine availability and planned downtime
2. Reduced service costs and improved profitability of the services organization
3. Minimized customer disruptions through elimination of unplanned service calls

The goal is to install machines with the minimum of effort and cost and once installed, to pre-emptively troubleshoot and repair machines remotely, exploiting current and to-be-developed-and deployed standardized services technologies (DfX; self-monitoring; health checks; self-calibrations; machine alerts; pre-emptive prescriptive call creation, assignment, and closure; embedded diagnostics, and feedback loops), as much as possible.

Embedded hardware and software diagnostics greatly reduce the need for on-site visits and replacement of fully functioning components, allowing service technicians to replace only components that have failed a pre-initiated self-test.

If required to visit the customer site, the goal is for the service technician to arrive with a thorough understanding of the machine issue, and to have all required replacement parts, tools, and expertise readily available to support and resolve the issue.

Through smarter product design (a.k.a. concurrent Engineering, DfX, smart design) companies should develop the tools and capabilities necessary to support a data-driven services business, where customers are targeted with tailored services offerings, delivered nearly invisibly, and resulting in zero operational downtime, high customer satisfaction scores, and lower services costs.

This goal will require an on-going culture shift to become a proactive service organization: an integrated, systems-based data-driven organization, spanning the services business.

Current View: Types of Maintenance

Maintenance of large, complex, expensive, capital equipment installed at customer sites generally falls in to one of three categories:

• Reactive maintenance: “corrective” maintenance that is generally characterized by the “break/fix” mindset.
• Preventive maintenance: proactive maintenance without intelligence, that is prescribed by completion of PM checklists, monthly or quarterly or annual PMs, and without any consideration for “use of machine” characteristics.
• Predictive maintenance: anticipatory maintenance that monitors the performance and condition of machines during normal operation, a known state, to reduce the likelihood of catastrophic failures and address machine issues pre-emptively.

Through on-going, real-time machine performance feedback; comprehensive and standardized data extraction, analysis, and modeling; and on-going implementation of the initiative across all product lines, companies can shift the service model and deploy a new and disruptive approach for customers, improving overall availability and customer satisfaction scores while simultaneously improving service profitability.

It Starts with the Data

It starts with the data: accurate, timely, complete field service data that answers the following questions:

• How are machines failing in the field?
• Which failures are the most expensive (in both cost and time)?
• Which failures are the most frequent?
• How many of those failures could be predicted?
• Could the failures be mitigated through better preventive maintenance?
• Which failures are the most problematic to effectively troubleshoot?
• What can we do with the data (machine performance logs, calibration logs, log files, …) that the machine currently generates?
• What requirements are being levied in new (and upgraded) product design to address these questions/failures?
• Do the preventive maintenance checklists reflect machine operation and machine failure characteristics?
• Are frequent, on-going installation and field tasks being automated?

A Needed Culture Shift/Transformation

Culture Shift in Service:  Technicians will need to shift from the traditional “break-fix” mindset to the preventive/predictive maintenance mindset. Provide the service technician with a prescriptive service call/task: “Check coolant level in subsystem 3” or “Check calibration of X-ray tube”, or “Run Bad Pixel Map on Detector #8”.  Offering general guidance or tasks (i.e., “Check machine for faults”) does not provide sufficient direction or granularity to pre-emptively resolve the machine issue.

Culture Shift in Installation:  Installation teams are required to plan, stage, install, qualify, and obtain customer acceptance in the shortest time possible to minimize installation costs.  Machines need to be designed with ease of installation at the forefront.  Developing automated test and upgrade scripts, configuring hardware and software for late-stage final configuration, and automating most of the tedious post-installation calibration and checkout processes will greatly reduce installation time and costs.

Culture Shift in Technology:  The technology necessary to enable the transformation of the field service engineer will include developmental and in-place services technologies. These include tools such as augmented reality (AR), new sensors and instrumentation evaluation, secure remote connection to the factory (both machine and technician) to collect, archive, and analyze machine performance data to trigger pre-emptive service events, and components, subsystems, and systems that self-monitor and “call home” pre-emptively, before failure/machine shutdown.

Culture Shift in Engineering:  The most important questions that designers and design engineers must constantly ask and assess include:

For the board, component, assembly, system, machine that I am designing …

• How can it fail, and what type of flags, embedded diagnostics, self-checks, and other alerts can I build in to pre-emptively address and resolve the issue before it affects the customer?
• How should the PM checklist be written to ensure that critical failures are monitored and addressed during planned maintenance? What type of machine odometer(s) do I need to design into the machine to facilitate usage-based maintenance and critical component reliability monitoring?
• What components/parts are available that reduce life cycle cost?

Life Cycle Cost Modeling

Management has to make resource tradeoffs. Every time a design engineer is reassigned to work on a service improvement, a customer feature is being de-scoped.  Work with the finance organization to develop and vet a Life Cycle Cost Model which calculates the improved lifecycle profitability of the service feature. This enables service leaders to prioritize, and rank order service improvements on those that offer the biggest “bang for the buck”.  Evaluate both improved profitability and Return on Investment (ROI) to arrive at a package of service improvements.

Putting it All Together: End-to-End Solution

The successes in reducing service costs and improving customer outcomes lie in the ability to wrap operational performance around the capabilities of the equipment.  The key to achieving the overall goal is developing and implementing an integrated and comprehensive approach across all services and engineering disciplines, as well as all product lines, rather than attempting a fragmented, disconnected approach.

Approach or “How-To”

1. Benchmark related and unrelated industries/companies.
2. Start small with one product line in one region or one customer.
3. Baseline the installed base.
4. Determine which issues are the most expensive to resolve in dollars and hours.
5. Start with the data the machines are already generating and capturing.
6. Work with Engineering. Show them the data and develop solutions collaboratively.
7. Work with Finance to develop and apply Life Cycle Cost Modeling to possible solutions.
8. Implement solutions, collect feedback, and drive feedback.
9. Focus on continuous improvement.

In Summary

Product development collaboration, and on-going and continuous feedback in the form of field data (machine performance data, Field Service Reports with all required timestamps, parts usage, First Time Fix Rate, etc.) will drive the transformation.  Continuous evaluation of service requirements, technologies, and processes early in product development will enable companies to accomplish the goal of improved customer outcomes in parallel with measurable improvements in services profitability.

You can learn more about designing for serviceability and how your organization can leverage field service data to improve customer and business outcomes, listen to the inService Podcast episode, “Improving Serviceability & Lifecycle Profitability,” with guest Thomas Maiello here. 

ServiceExperts is a series of contributing articles from recognized industry professionals offering their thoughts, viewpoints and opinions on the latest trends impacting the service industry. Jim Bohn, PhD is an author and researcher-practitioner focused on improving organizational performance one person at a time. Dr. Bohn has decades of on-the-job experience in addition to a strong foundation of academic research. Dr. Bohn has organizational expertise and insight stemming from decades of successfully leading leaders. His business insight derives from observing the organizational behavior of multiple Fortune 500 organizations, ranging from hospitals and healthcare to retail and finance, service, manufacturing and telecoms.

He served in a variety of roles in the corporate world beginning in 1973, personally leading the transformation of multiple underperforming teams to achieve award-winning levels of success. Retiring after 33 years with Johnson Controls, Dr. Bohn launched his own Change Management and Organizational Transformation Practice, PRO/AXIOS LLC. Dr. Bohn has a unique blend of hands-on, in-the-trenches experience in addition to a rich pedigree of research from his Ph.D. studies. In addition to lecturing at local universities, he is the author of several books including, “Architects of Change: Practical Tools for Executives to Build, Lead and Sustain Organizational Initiatives,” “The Nuts and Bolts of Leadership,” “Getting I.T. Right: Installing the Organizational App,” “If Your Water Cooler Could Talk,” and “People Development: The best part of leading a team,” all available on Amazon.com. 

Addressing Competence: the key to change in service

I sat down with a group of service technicians to ask them about an upcoming change. The room was a bit tense. I was from Corporate and they were skeptical about my interest. Technicians never say they’re not interested in help from Corporate, but they clearly don’t have much interest in someone who has never pulled a wrench or fixed a chiller.

I don’t blame them. Here’s why. Competence is their badge of honor, their demonstration of capability. A guy like me who hasn’t done that work doesn’t really merit the honor that comes with competence in that domain. Technicians pride themselves on their competence, and the greater the challenge and achievement, the higher their personal assessment of their competence.

Competence: A critical human motivation

Competence is one of the most powerful motivations in human nature. Everyone wants to be competent. Even the smallest child likes to say, Look at what I did!” No one wants to be a loser. And competence is a key motivation in service. Technicians pride themselves on their ability to accomplish difficult and demanding tasks. They like gaining a reputation for competence. “That guy knows what he’s doing,” is the highest compliment that can be paid to a technician. So, executives must ensure that any change taking place in an organization doesn’t tamper with or reduce technician competence.

Here’s an example: When I met with those technicians (and everyone who manages a change in service should make a deliberate effort to meet with a team and listen to their concerns) something slowly came to the surface. The screens on the new handheld devices were difficult to read and the aging technicians were concerned they would not be able to see what was on the page. That would have put them in a touch situation with their customer (to whom they want to demonstrate competence) by not being able to get the information the customer was seeking. Being competent in front of a customer is #1 for technicians. Anything that degrades their competence will build resistance to the change. It’s that simple.

A second way competence influences change

People observe other people all the time, especially successful people with good track records. This happens in service too. Some people are legendary. Perhaps because of significant successful projects, major certifications, or even fixing a runaway situation with little hope. These people are known for their competence.

Why is organizational influence important in change?

In your organization you have influencers that may not appear on an organizational chart. Or if they do, they are not in managerial roles. However, everyone knows who they are. Everyone knows their names. These people are incredibly competent and they have major influence on your change. When you get ready to roll out a change, these people will be asked what they think. In that moment, your change is on the line. If you haven’t spoken with these key organizational influencers, your change is in trouble. Again, people will look to the most competent person and ask what they think.

So what do you need to do?

The simplest and most basic thing you can do is sit with a few other leaders and ask the following question: “Who is going to have the most influence in the acceptance of this change?” Then make a point to get together with those people one-on-one ahead of launching the change. Find one or two that can be ambassadors of this specific change – people who believe in it and who will communicate to the field. Talk through the implementation issues – where are the risks? Where are the problems? What do they recommend? Listen to their language, their concerns and the issues they raise. Address those issues in your project plan. Use their language when you communicate the change. Let the organization know you spoke with them. Not everyone is going to like the changes you institute, but if you address this key issue of competence, both at an individual and influence level, your change is going to have a better chance at success.

Supply chain challenges continue to vex service leaders. In the 2023 Service Leader’s Agenda survey, Service Council found that, when asked what the most significant factor impacting their service business was, supply chain challenges remained in the top 3 for the second year in a row.

In March of 2023, Service Council launched the Service Supply Chain: Service Parts Management survey to gain insight into the challenges, strategies and successes experienced by service leaders in supply chain and parts management. The results signaled that, while organizations are rethinking their strategies to accommodate the continued flux of service supply chains, poor visibility and siloed data continue to hold them back.

Visibility and Overstock Issues Hinder Organizations

Visibility is becoming increasingly more important as service supply chains grow more complex. And yet, nearly half of service leaders say that they don’t know where parts are. 43% of respondents said that poor visibility into available parts across the supply chain was the biggest challenge their service parts business currently faced. Additionally, more than 1 in 3 service leaders are struggling with siloed data, listing poor integration of service parts with the overall service business their second biggest challenge (38%). The lack of visibility into the service parts business is being felt by frontline agents as well. In the 2022 Voice of the Field Service Engineer survey, frontline agents said that spare parts inventory visibility came in second on their wish list of desired capabilities.