Dr. Ivan Zak and Ryan Leech discuss the importance of a reliable support process in a veterinary group. In this episode, our hosts talk about the three main support components: help desk, knowledge base, and learning management systems.
We cover the importance of having a knowledge-accumulation process that should start from the very beginning of the organization, and the opportunity for the veterinary consolidator to streamline the process of hiring/firing, budgeting, and more.
Hey, Ivan welcome back and welcome to our listeners. Welcome back to Consolidate That. We’ve got a fun back to our roots episode here of just Ivan and Ryan. And, I think we’re going to have a good time today.
Hey, Ryan, how are you? I heard you went to a graduation for a vets party last night.
I did. I did. I’m currently recording from Auburn, Alabama. I just went to the Auburn University graduation for the College of Veterinary Medicine and had a great time, met some really cool new veterinarians that are ready and. Bright-eyed and bushy-tailed to go out into the world and start doing some things.
So it was neat to sit there and listen to the speakers, talk about everything. And it was my first time hearing veterinarians getting sworn in and doing their oath and everything. And my big takeaway that I thought was interesting was that within the veterinary oath, the last sentence talks about the need and the pledge to continuously improve themselves professionally.
So I thought we’re always talking about continuous improvement and I thought it was neat to see that that was part of the oath. So congratulations to all the new graduates from Auburn and from all over the country.
That’s awesome. And yeah, you know, it’s, I think we forget sometimes that that’s embedded in the oath, the continuous improvement, and then we just look at it as a continuous education that we need to do.
But that’s very interesting. Thanks for that insight. So what I want to talk about today?
Today I wanted to go back to sort of what some of our early episodes were like, where I get to grill you about things that people need to have in place for consolidation. So I wanted to hear a little bit more about the enterprise support organization as we call it within VIS and, and what’s involved in that.
That’s a cool topic. I think that we can now expend a good episode on that. So the enterprise support organization is something that we identified is sort of usually the afterthought for consolidators. And that’s something that I think of it as a, maybe three major components. One is sort of if you will think like a classic help desk that helps you scale the processes and, as any Help Desk and the ticketing system, not just the task execution, it should be linked to a Knowledge Base and Knowledge Management process.
And then if you want to really scalable organization fast, as soon as you acquire practices and add people with a rapid pace. You also want the Learning Management System to be a part of it. So if you want to sort of parse all three or every one of them, which one do you want to start with? Where do you want to go with this?
Yeah, well, I think the first thing, so we’re talking about Enterprise Support Organization, which would include right. Help Desk, Knowledge Base and management than the Learning Management System. But I think the first thing is. Where should people go about starting with that? I think a lot of people have a good frame of reference on what that is, but at what stage of consolidation would you start implementing a support organization?
So that, you know, that depends if you’re following our frame of reference as a maturity model, but if you are, then this is what we really call the inception. And that’s a level one that goes right after the initial funding. So basically you found the money started buying the clinics. That’s when you should start it. And the danger of not starting it.
So let’s, let’s maybe parse each one of them and what they did. What happens in the consolidation, you buy in a first, second, third clinic. Now you’re sort of you’re forming the heuristic of how things work in your organization. Now you’re seeing the patterns, which patterns are then sort of transformed into processes.
As soon as you have the process. Number one, that you want someone else to repeat in the future. That’s when you need to start it, because the knowledge base is really alive. That’s why I refer to it more as a knowledge management process, rather than, you know, it’s not the book of knowledge that you own is like a dusty big folder with all kinds of SOPs in it.
It’s really how do we do things here and here? And that’s a part of a culture. When we were talking about the Merger and Acquisition course that I took at Harvard, they were talking about the culture is how do you do things here? And how do you actually replicated the process? Because if you’re growing horizontally, as you do in the first level, then it’s easy.
You’re talking together, you’re probably in the same leadership meeting every week. And then you start adding people. And especially in the second level, which is the process development. Then you are spreading your team and they start expanding vertically. So now you need to onboard people very quickly and teach them, how do you do business development?
How do you not do business development? And what is the filter there? How do you integrate the clinic? What do you not want to do when you’re integrating the clinics? So once you have a process that starts having the policies of the guard rails, you really want to have the central place where you store these processes and they are accessible.
Because when you’re buying the next practice and they need to find out how to do end of the day, or how do you hire new people? How does the talent acquisition happening all of that instead of answering the same thing over and over and over the scalability is built through the help desk and the knowledge base.
That’s I know that’s a big thing that we’re always, we’re always looking at is. Making sure that if someone’s answering a question once that is being captured, I bring him back to my days of selling software as the salesperson you’re getting that contact and that relationship built. But if you don’t have a good onboarding process in place, what will happen is.
People will start to have questions. They’re not getting it, they don’t understand the flow that there’s an entire help desk and an entire team, and a support organization in place. And then you’re getting a text at 4:00 AM Central Time because the East Coast is opening up for clinics. And they’re saying they’re having a problem logging into their software.
So is it right? That there should be something because you’re putting it in super early it’s capturing each one of those things so that it’s getting triaged and disperse to the right people at the right times.
Yeah. So, so let’s parse the Help Desk component. The idea came from the software when I was at Smart Flow, the way that, you know, every startup happens, you are the support.
And then when we had first 1, 10, you know, 30 clinics that was Pavel and I, so we were supporting our application and all of a sudden we realized that this is not scalable. So you need more people to do that. And then when we hired the support organization, we realized that these things need to be recorded and updated.
Which is the key here because processes in consolidation change day to day, week to week. And if not, everybody is updated on a slight change in the process. It’s not going to be delivered and replicated in the same manner. So when I left IDEXX and I thought, okay, what can I leverage from my previous experiences?
One of the things was building a strong help desk and support organization for the software product. And I thought, maybe consolidators need the same thing, but it has to be a well-orchestrated structure in which when the question arises from the clinic and they send that email or a phone call to CFO, COO, VP of Ops, whoever that is, it needs to be first filtered by the first tier agents. So they receive it as a ticket. You just literally put the ticketing system, like in the software support, and then the clinics are your sort of customers that you’re servicing. And they have a question. So they asked the question through the ticketing system that the first tier agent filters to which department it has to go to, who is the subject matter expert to answer this question.
And then they go to the existing knowledge base and they had tried to figure it out. Was there a question like this before, if there was, they can rapidly answer that question and not involved high executives answering every single question, but if it was never answered before, then they identify the department, whether it should be asked, they contact the subject matter expert and they answer the question only once. After that, the support organization should have the technical writing team where basically that answer is transferred to.
They converted into a knowledge base item with a similar structure. So it’s searchable and in the future, you can connect the bots to it. And then the answer is sent back to the person who asked the question, but the next time, the same question is asked. There’s an answer in the knowledge base and executives don’t have to be bothered.
Gotcha. So it does sound like quite a few people to add onto the team. Would it be something that you would maybe have the regional managers do double duty on or should it be sort of, an isolated component within the organization? Or should you sort of look outside for it?
That is a great question.
So if you think about the people that have bothered with these questions, usually what you’re run into the CFO says, I need to hire three more accountants because I’m over capacity or the COO says, you know, I’m overcapacity, we need the VP of ops. The support organization – you hire agents that look for information.
They are usually is the base pay support agents that you can hire instead of trying to increase the capacity of very highly paid professionals, like the executive team. So if you’re thinking that your CFO should be answering those questions because CFO doesn’t translate and says, Oh, we need a support organization.
They think that they are. Running out of capacity, so I need to expand my team because I’m over the capacity. And that is the interesting thing that people don’t notice instead of hiring more specialized people that can just create the knowledge base, the support organization, they need to create the knowledge base that is constantly updated.
So it’s not just easy, you know, Hey, let’s sign up for Fresh Desk or Zendesk and it’s working. You need to have a system that is capable of updating them as well. So in the properly setup organization, not only the support agents are looking for the answer in the knowledge base, but they always look whether it’s relevant and current, because otherwise it will be like a dusty book sitting somewhere, but the organization should be supportive by someone higher up.
So usually either a COO, usually COO, because this is the main engine that will create the scalability for the organization. You can probably be okay up to 10 hospitals without one at 20 or 30, you will really feel that you’re now stumbling. And then at that point, it’s really hard because if you’re, if you’re building it yourself, whose role is to build it.
Because if you’ll take at that point, the COO or CFO or CEO or anybody else, everybody’s up to their gills over the capacity. So then now taking a huge project and retrospectively going back into all the processes and capture them, it’s going to be extremely difficult.
It’s interesting that you say that because we talk about this often, but I’ve never thought about the fact that people will look at this problem and think that they need to expand their team.
So, Oh my gosh. We’re having such a hard time integrating, well, maybe we need to add a layer of new people between BD and the integration s s team or, Oh, we’re we don’t have our medical processes in place. Well, maybe we need to hire some vet techs that can work at the regional level and work those things out.
But you’re actually able to put in either an external team or put together, you know, people that can put together that information in a knowledgeable and intelligent way. So that’s kind of interesting. It’s I hadn’t thought about that as, as something, because you’re not having to hire them, specialized people, because you’re still getting the information from the correct sources independently.
Yep. Well, and the other thing is that if the organization that put is put together well, and it has the LMS component, which is, you know, it’s hard to justify from the very beginning, but if you’ll set a very simple process of recording videos. Right now, people will last camera shy with a COVID and Zooms and everything else.
And then if you put a simple process of not just creating a document and asking someone to record a document, but basically capture the video and then have someone in the support organization, converting those videos into the answers. And if it’s a repeated process that everybody needs to know, then add that to the onboarding process because the consolidators are ending people with a very, very high pace at the very beginning.
Throughout the entire sort of existence of consolidation. And then every time you hire someone, do you really want to go over a mission, vision yourself? Do you want to go over core values? Do you want to go over the general? How do we pay here? How do we get the laptop? How do you like all of these things?
The sooner you get the Learning Management System component and have responsible people capturing the processes. It’s the whole process that is called assessment for knowledge leaks in the organization where you’re trying to capture all the sources of communication. All the sources of transferring the process, because someone calls on the phone, someone texted someone something.
It’s on the Slack. It’s through, God-forbid Skype for business, which is I’ve never seen. And all of this stuff is just basically, it’s the knowledge leakage because someone said something that person was painted that time to do that. And then every time you ask them to say something again, it’s a) annoying, b) expensive.
So if you can capture all of those things also into the video format and then push it through the Learning Management System, you can create onboarding of internal people very quickly, as well as when you’re buying the clinics and create the whole integration process. So there’s actually for this support organization, there are two customers if you will. There’s servicing the internal processes within the enterprise, and then there’s servicing the clinics. If we are looking at the clinics as sort of customers of consolidation and it’s a support organization for these customers, then there’s this sort of two angles that you want to build the organization for that.
So a lot of the things we talk about when it’s just you and I were talking about the perfect consolidator, right. What we would say if you were to build one and learn from every mistake that’s been made out there. So is an enterprise support organization and all of those things standard. Is that something that you should be able to walk into of the 50 consolidators in the industry, walk-in, and have seen it in 40 plus of them?
Well, I don’t know if people call it the same way. So some people think that having a task management system is similar and it’s not having task management. It’s really, I assigned the task to you. You completed the task. And I know about that. So that, you know, this is sort of what, what that is. But having the scalability of answering the questions, they’re the same, it’s a little bit different.
So when we’ve seen, not everybody has the from the get-go, but I think everybody who gets roughly to 30 maybe clinics, they understand they need something like that. And then one way or another, they arrive to the idea. Well, if you’re following our maturity process, you’ll bump into that on level one.
It will just say you need to start knowledge accumulation.
Nice. That’s helpful. I think about it cause I’m always thinking on the, on the sales side of things of how to differentiate yourself in this highly competitive marketplace that the different consolidation groups are looking at and having something like this, a way to go to the veterinarians and the clinics and be able to tell them that you’re not only.
Capturing the data and the information that matters, but making it so that they can access it easier. It seems like it would be a pretty major competitive advantage going forward.
Well, there’s one more thing that is very important in this structure. This is the only probably way to communicate with your clinics and get their feedback because yes, people are deploying some sort of surveys, maybe one software integration, but this is continuous communication with your clinics.
So there’s always an opportunity in any help desk software that you implement within the support organization that you can. After every time they ask a question, ask them how was our service, and then you can find out that. I don’t know, the finance department is maybe slower to answer them than the operations department or vice versa.
And then as the executive team, you can review that as a metric and have your customer success metric at the level of the organization. And truly back the statement that we care about our people. It’s not just writing on the wall. It’s basically what we do in how we do it. So you can measure if the clinics are happy with you and you can quantify it.
And when it’s low, you can course-correct it.
Yeah. Like, like you said, early on the goal of it is that you have multiple clients and as the consolidator and the executive team and the corporate side of everything, you should also be looking every single day that your clinics are your clients, they’re your potential clients when you’re in the business development process, they are your brand new freshly onboarded clients when you’re there. And then they’re your long-term loyal and most valuable clients once you’ve reached that point of stabilization and business as usual. So I’m having that data to be able to do the NPS scores and the, and the feedback is, is obviously key.
There’s another trick to it. So we talk a lot about consolidation as sort of a value stream. And the value stream of consolidation is basically how do they deliver the value? It’s not about treating animals. And we talked about it in a couple of conversations that value stream at the level of the clinic if you’ll follow sort of lean process, it is how the patient gets into the clinic, how they’re marketed to how they’re treated, how they’re charged for it and how they leave the clinic. That’s their value stream.
But consolidation value stream is how do we source clinics, convert clinics, do due diligence, buy clinics, and then integrate and improve. So within that value stream, once you start measuring each stage of that value stream, you will find out that you will start bumping into the bottlenecks.
And if you have your thesis buying a hundred clinics within the next 18 months, and if you’re seeing that integration is not going as fast and smooth. It’s not always in replicating the team and adding the entire new integration teams sometimes is by inserting the support organization, which will add scalability without adding people significantly.
Wonderful. Well, I always appreciate these insights from you. I think it’s very helpful to be able to get these things together as always a great conversation and really helpful. I know we’ve got some great new guests scheduled, so we’ll be back to having guests again next week. And again, Ivan as always appreciates chatting with you.
Likewise Ryan and don’t party too much with the vet students there.
They’re too young for me.
All right. Have a good one. Thanks.