Healthcare Fix Despite Government-Media Vitriol

Healthcare Targeted

Like our nation at large, I live in a politically divided state. We are equally Republicans and Democrats. This was demonstrated in the ‘16 election and evident by our two Senators being in separate parties. Everyone is hotly debating healthcare. In the lead up to the BRCA vote after the AHCA passed the House, I emailed both of them. Eventually, I received carefully crafted responses, likely sent by a staffer. Neither were focused on the real issues, instead they were filled with the same partisan lines we’ve seen in the news.

The healthcare debate is dividing our nation for no reason.
I thank my senators for their responses but neither had a true grasp on the real problems occurring within healthcare. We should not have acted like either
ACA or BRCA is better for the country. There are pros and cons to each bill. It would behoove lawmakers and citizens alike to investigate the facts before offering a canned assessment of healthcare. However, I believe we can unite and fix healthcare despite the circus in Washington.

I See Something Different

Virtually every week of my life I am helping healthcare organizations transform themselves through the IHI Triple Aim–better outcomes, lower cost and patient satisfaction through innovation practices. I have helped many of these organizations make enormous progress toward this goal, despite regulatory constraints. We could easily improve Triple Aim metrics by a factor of two through the adoption of a fraction of the best practices I have seen. With or without ACA, if we don’t act, insurance premiums will continue to increase. The trend is staggering. Premiums will not begin to match inflation until four things are done:

Healthcare providers must: streamline their operations, maximize licensure usage, apply the most effective technology,  and focus on treating the person, not the disease.

Addressing the Four


Healthcare operations are among the most clunky of any industry. Streamlining through the use of operational excellence principles is critical. Every person in America could be meaningfully insured and treated without a government mandate or a single payer system; however, we have to lower the cost to deliver care. It’s actually easier than the industry would like you to believe. I have audited thousands of appointments across multiple healthcare systems: many do not require an actual office/hospital visit, a large percentage do not require a physician, and many are not required by evidence based practices. These appointments fill the schedules, restricting access for higher acuity patients.

In addition, there is excessive waste in clinical and administrative processes. These add zero value yet are repeated constantly. I have seen major waste removed time and time again by expert practitioners working with health systems to modernize their operations to these best practices.


Staffing in healthcare is not unlimited. It takes half a generation to train many of them. We need to take advantage of every level of licensure. For example, in many states Advanced Practice Clinicians (APCs – Physician Assistants and Nurse Practitioners) can see many of the cases that currently go to a physician. In primary care, there needs to be an about face. High acuity, complex patients are the ones who should be using physician’s time the most. There is a perception that the patient only wants to see their doctor.

In the thousands of patients I have surveyed and interviewed, I have found this to be the case only about one third of the time when the patient is facing an appointment delay. Doctors need to see only the patients and cases that other clinicians cannot handle. APCs, RNs, LPNs and others can all focus more of their daily activity to match what their state allows them to do.


Next is technology. I’ve seen repeated installations of technology for technology’s sake. Only a handful of healthcare delivery organizations have the capability to determine the needs for a technology from both the clinician and patient viewpoint, research options and make purchase decisions. What I typically see is a radiography department leader being courted by an imaging firm or an EMR vendor singing praises of the latest module to a CIO. You can’t fix a broken process with a shiny new object.

This recipe is simple: fix the process and then add technology to advance the process toward the Triple Aim. Don’t let the medical device companies push what they think is best for clinicians and the patient. They’re not close enough to really know. The best innovations are ones created in the hospital or clinic, not the R&D center of a multinational conglomerate.

Treating The Patient

Finally, we have to treat the person. Unfortunately, many people who need care are not entering the system until it’s too late for an optimal outcome. A variety of social determinants impact a person’s health and their ability to get appropriate care. Areas that desperately need attention are behavioral health and patient education. The break-fix treatment model doesn’t work anymore. We can’t afford it so it’s time to be proactive. There aren’t enough physicians entering the workforce or enough dollars allocated to treat the future issues as we are now. We have to address poor health choices sooner in life.

Take Type 2 Diabetes Mellitus (DM) as an example. Diabetes plagues almost 10% of our population. This condition skews toward impoverished, minority communities. It is the 7th leading cause of death yet understanding and adherence to best practice care by patients remains elusive.2 Untreated, DM leads to vascular damage which then leads to more serious issues like nerve damage, amputations, blindness and eventually death, significantly raising the cost of care for that patient while simultaneously having a profound negative impact on their life. Patients following a proper treatment protocol significantly reduce or eliminate those expensive, life-altering exacerbations. This is true many conditions including congestive heart failure, hypertension or asthma.

Escape the Noise

I attended multiple, so-called healthcare innovation conferences last year. I listened to dozens of speakers. There were zero presentations on reducing cost. Instead, every organization, whether it was a payer, a medical device maker, software provider or provider, was looking to get a bigger chunk of the existing insurance premium dollar from another company for their own organization. This doesn’t save money, it merely shifts it around.

If lawmakers truly cared about health, we would ban smoking, the number one contributor to health issues and costs. Close to smoking is obesity. We have allowed our restaurants and grocery shelves to be full of low-cost, high-sugar and high-fat foods, practically begging for obesity. A myriad of health issues arise later in life due to obesity. These issues are expensive to treat, significantly more than the healthier, lean population.

Focusing on the number of insured won’t fix healthcare nor will it break it. Patients are empowered to cooperate when we focus on getting the proper treatment to them using a method they prefer. Reimbursements must reward outcomes achieved, not actions taken. Healthcare providers that continue to force patients to high-cost facilities (hospitals) by overqualified medical staff (MD/DOs) with a protocol that doesn’t follow the latest evidence based medicine (EBM) can no longer be tolerated. Patient behavior must be guided by insurers, including Medicaid, by pushing EBM practices. Allowing these things to continue is kicking the proverbial can down the road until we hit a healthcare version of the 2008 subprime market collapse.

Leading the Charge

Institutions like Jefferson Health, UPMC and Kaiser Permanente are leading the way in true healthcare reform with thought leadership practices like population health, innovation centers and vertical integration.

We cannot allow partisan politics continue to slow true transformation of our healthcare system for those it impacts most, patients. We don’t need regulations to deliver the right care. I’ve seen it. However, I’ve more frequently seen the opposite.

Worse, the division, angst and spectacle Congress has created and the media has fueled has paralyzed and misled those inside and outside healthcare. Regardless of government direction, hospital administration must take the reigns. We need strong leadership cooperating and developing a real solution; our country’s and citizens’ health depend on it.

Adam Ward is an Innovation Consultant for Simpler, an IBM Company. Initially trained as an engineer, he designed cars for 12 years before switching to improving processes, products and services in healthcare, where he has worked as a consultant for several large healthcare systems, public and private in the 10 years since. His passion is radical performance improvement while delighting the customer–patients and clinicians. He started his personal health transformation in 2009 and has finished multiple Ironman triathlons.


Longevity Doesn’t Reward The Innovator

Creative professions that innovate like coding, engineering, and design need career turnover to stay fresh. When I see innovator work anniversaries over ten years I feel sad. Over twenty, and I genuinely feel bad for them. If the number of years is thirty or more, I feel sincerely depressed. Note, I am impressed by their loyalty and perseverance but not their creative drive. Longevity is only good when it stays full with learning and growth.

Years ago, people worked for one business their whole life and then retired, frequently with a good, employer-provided pension. Years ago, people used home phones. Years ago, people read newspapers. Years ago, you had to shop in an actual store to buy hobbist gear. Today, there is precious little left of any of those. Innovator corporate monogamy should go the way of the dodo as well.

Here is the truth: big businesses don’t care about their employees. There is no reward or honor for a lifetime of loyalty to a company. The employees are “curmudgeons” or “stuck-in-the-past” or “old-timers” who “just don’t get it.” Although, I hear some version of “people are our biggest asset” all the time, I rarely see evidence of this. I have actually been asked to manage out people near the end of their career.

If a business doesn’t care about you, why do you stay with them? My hypothesis: because you’ve settled. You’re most creative and innovative years are done. You’ve stopped learning. You saw your world as the size of your department or the size of your business. You stopped trying new things because the business didn’t like it. You stopped being a true innovator.

You matter to a business as long as you’re boosting revenue or cutting costs and are getting along with your boss. There is still some humanity and mistakes are occasionally forgiven, but rarely without career impact. Few are the “Jack Welch blows up lab and eventually ends up as GE’s CEO” stories today. Innovators must experiment and be risky.

As an innovator, I am constantly looking for improvements: little to big, incremental to disruptive. An innovator never settles. They never accept the status quo. They never “get used to it.” An innovator pushes. Rules aren’t there to be followed, they’re there to be challenged as opportunity shows itself. Their internal drive frequently forces them to try stuff that gets them in trouble as they push the boundaries. Innovators never settle.

So, when I see an R&D employee celebrating 16 years (like I did on LinkedIn this week), I have to wonder how effective they still are at innovating. One thing is for certain, it’s not as much as it used to be. To me, that’s not something to celebrate, that’s something to mourn.

Don’t get stuck in the rut. If you’re in an innovator role and you’re approaching or past the ten year mark at your current employer, you may need to move on, or find yourself obsolete.

Margin Creates More In Life

Full speed will drain you.

I have been fortunate to be a highly productive individual. I define productivity as output per unit. I can squeeze the maximum output for a given level input from many areas: time, effort, and money. I have had my hand in multiple things simultaneously as well as a few things. In a society where busyness is not just expected but celebrated, productivity, despite technological advances, has dropped. Sure, we can do more now then we could a few years ago, but what we could do relative to what we have is getting worse and worse. Reflecting on my 30 year work career, I have found that margin is crucial to productivity. 

Margin has several definitions. Margin in business is measured as the difference between revenue and expenses and less frequently referred to as profit or net income. Margin is also the amount of white space around the text on the page. The dictionary calls margin a border. In this article, I define margin as the difference between capacity and usage. 

Time and money are the two most abused areas regarding margin. People rarely have extra in either. When margins disappear, problems arise. The slimmer the margin, the less variation is acceptable. Any hiccups get magnified when margins disappear. 

trafficTake traffic as an example. As road capacity is reached, almost anything can drastically slow traffic: roadkill on the side of the road, a car tapping the brakes, bad weather, or an emergency vehicle on the side of the road. Worst case is an accident in the middle the road. Traffic can be stopped for hours! However, as space increases between vehicles, hiccups cause no problems at all. That’s is the power of margin. 

That’s the same in life. The less margin, the more potential for a massive slow down or a complete stop. I am a big advocate for thinking time. You can call it solitude, meditation or whatever; but it’s time where you can process information mentally. What I’ve discovered in the past two years is unprecedented. 

Unlike my high energy, overbooked past, I took a radical turn to huge margin. It has given me a freedom unlike anything I’ve experienced. The two areas were money and time. I took major steps in each to cut the spend/activity in half. 

It was tough at first, of course. It felt highly restrictive and like I was doing anything. However, like the highway at rush hour, my mind–as creative as it is–was being held captive. I didn’t even realize it. Cutting back paid dividends. The added capacity supercharged my life. 

It allowed me to invest time and money not just in the now, but more critically for the future. My innovation productivity took a major leap upward. I thought at a higher and more strategic level than ever before. 

It’s not popular and people think it’s counter-intuitive but margin can help you before more productive than you’ve ever been. We don’t need to continue to advance to get less and less productive. We need to advance and be more productive. We should be able to get the most out of life, not have life take the most out of us. 

Margin. Make some. 

Market Always Wins – Figure Out What It Needs

There is a quote in capitalism that says “The market always wins.” It does. I was trained as a mechanical engineer. For 12 years I had design responsibilities. I used CAD. I knew how to design parts that had to be molded in plastic, cast for metal, stamped, assembled with clips, screws or adhesive, extruded and coated. For years, I took the styling inputs, our testing requirements, and manufacturing requests and then balanced those with cost, weight, investment, performance and packaging to design the optimal parts worthy of being on a Honda. I didn’t question what I worked on. I didn’t know why. I simply designed. 

Then I became curious. Why did we design specific things and not others. How did we make trade offs? What did our customer want? I went back to grad school, not for engineering, but for business. How could I know what we should be working on? During my MBA program, I took every elective related to defining and understanding the market. 

I was exposed to our own market research process while in b-school. During development for the Model X, our code name for the project, I participated in focus groups as we sought feedback on several concepts for this all-new vehicle. We were targeting the college and young adult population so we visited several college campuses with our sketches and mock ups. We had three concepts: Lifeguard, Triathlete and Adventure Sport. 

Despite generating the most conversation, attention and approval, Triathlete, a CRX on steroids, our marketing team pushed for the least-discussed model, Lifeguard. I couldn’t understand why. There were clearly no Gen Xers, male or female, that wanted it. The team pushed forward anyway, studying surfers, skiers and other outdoor sports fanatics to create this segment buster. With a price of $16k, youth would flock to the dealers to get it. 

Executives were unsure. It was quite different than anything we had done. Our team was small and we had several other vehicles competing for resources. It wasn’t convincing enough. The work was shelved for several months and then suddenly development was restarted and accelerated.  Toyota presented a similar concept at the ’99 Tokyo Auto Show. We had to beat them to market. 

We did beat them, launching the Honda Element at the 2002 New York Auto Show before the Scion xB (which was a full year later). The Element was not a raving success. Teenagers and twenty-somethings did not flood the showroom floors. There was no clamoring for keys by the much-needed younger generation. Outdoor sports enthusiasts, dog owners and small businesses bought it, most older. 

(The entire Scion brand, birthed out of Toyota’s ’99 Project Genesis, also failed to connect meaningfully with the younger generation, eventually succumbing to business pressure, was shut down in ’16.)

Element sales only hit the annual target for two years, dropping to less than 20% of the original target by its last model year. The Element never hit its intended audience and never saw a redesign. It was canceled after a single, albeit extended, lifecycle. (This product launch was my first and hopefully last major mistake with the press–see article here.) 

I left the small world of Honda and the global automotive market. Since then, my job has exposed me to one industry after another: medical device, financial, education, industrial, military, government and healthcare. For over ten years, I’ve been a consultant on new product/service development. Clients pay me to improve their development output and the corresponding contribution to corporate profitability. 

I always start with understanding the market. There’s nothing worse than improving a development team’s process just to have them release stuff that misses the mark. It just makes the corporate financial problem get bigger faster. The Element was my real world lesson on this. 

If you’re going to invest money, time and limited resources on developing a new product or service, make sure you know what the customers are really wanting. Nothing screams waste more than giving them something they don’t want. 

Sure, the Element made money. Many products and services I’ve seen launched fail to do that. But what could have been in its place? The Acura MDX, Acura TL and Honda Pilot are three vehicles that were and continue to be huge successes, also launched as brand new when I worked on them. When you have limited development resources, your company needs Pilots, not Elements. 

It may be easy to say “Adam, you have to have failures. Fail fast.” After market launch isn’t the time to fail, especially with physical products, the tooling ramp up is too long and expensive, especially in regulated industries. Software can do that, doing simple A/B testing on a portion of their user base. 

Fail before launch. I saw the rejection signs years before the Element launched–when it was still a foam core cutout–that it wasn’t going to be what product managers expected. The Acura RDX was in danger of the same fate before it was fixed for Gen 2. The Acura ZDX was an utter failure as well. Honda was pushing product to market not responding to pull. 

(Still, Honda remains one of the premier mobility companies in terms of profit. I only pick on them because of my familiarity with them. Where is Pontiac or its hideous Aztec, Saturn and their plastic-bodied cars, Fiskar, the Tesla Roadster or any other of many auto brands and cars that failed to deliver, losing billions of dollars.)

My advice, from seeing this over and over again is simple, take some time, maybe a lot of time, and deeply understand what the market needs. Your future depends on it, whether it’s a product or a service. Customers can’t always articulate what they need, but their pain points become obvious after close observation. I’ve never seen a thoroughly researched segment that was well executed fail.

Think Outside of the Box? Ugh…

Think. You’ve seen them. I recently saw another post on LinkedIn that was centered around business jargon. It is funny to read the phrases and colloquialisms used in the professional world. This particular one had 25 listed and was asking to comment on which phrase was our pet peeve. After reading through all of them and reminiscing about the most memorable times I’ve heard each of them used, I narrowed down my finalists. They included ones like “synergy,” “apples to apples,” and “bandwidth.” 

However, as an innovation consultant, there was one clear winner for me. I added my phrase to the comment section: “think outside of the box.” It’s not that I don’t agree with the concept, I actually live in it most of the time; it’s the fact that I don’t think people actually mean it. 

According to Wikipedia editors, it means “is a metaphor that means to think differently, unconventionally, or from a new perspective.” A new perspective. New. That’s the tricky part. 

While I believe that people saying the phrase actually believe they want a new perspective, I don’t think they actually want one. In practice, for those that actually do want a new perspective, there are even fewer that appreciate the new perspective. Then, there is an even smaller percentage that will take the idea and “execute” on it. 

The reason “thinking outside of the box” is so disturbing to me is because it is my modus operandi. I love it. I thrive in it. If you present a problem statement to me, my brain goes into overdrive to imagine a novel solution. Operating within imagined constraints, I modify and update the idea to be a practical, if difficult one, to deliver. There are people who operate this way naturally. (See my post on brainstorming.)

With novel solutions, the biggest issue is that it feels impossible to implement. It takes more “out of the box” thinking to make it a reality. This means effort. Sometimes lots and lots of effort. By definition it also means change. It.means.NEW. 

Difficulty and change are not things that most people like to do. Out-of-the-box thinking demands a penchant for personal adaptation and hard work. That makes it off limits for the masses, but it’s where innovators reside. It’s where the best ideas come from. It’s where disruption and revolution are birthed. It’s a challenging path that yields incredible results. It’s not for everyone. 

The next time you hear the words “think outside of the box,” your immediate replies should be “do you really want this” and “are you willing to stick with the idea until it’s done.” If not, it frustrates everyone and doesn’t “move the needle” at all. If you say it, mean it and then work the ideas and enjoy the fruit of your labor. In the immortal words of Yoda, “Do. Or do not do. There is no try.”

Empower the Middle Manager!

You want innovation? You need the work environment for your innovators to thrive? You need a higher level of output to keep up with or exceed the market? You need to empower your middle managers. Why? They hold a critical key to innovation success: the mass of workers who report to them.

There are amazing companies that don’t need help with innovation. The leaders there are incredible. Financial performance is amazing. They represent to what most aspire; however, this is a very small percentage of businesses. Forbes does the Top 100. Fast Company publishes a list of the Top 50 Most Innovative Companies. That’s a very exclusive club. But not everyone gets press. Let’s say this performance is reserved for the top 10% of businesses. These have all levels of the organization working in lock step with each other. But that’s not where most people work.

That leaves 90% of organizations that don’t have ideal conditions for innovation. I spend the bulk of my time consulting with this group of organizations to help them improve their development capabilities. This post is extremely practical and is not meant to be all inclusive. There is plenty I won’t discuss here. I won’t be talking about the best leaders or the best innovation practices. I will be talking about the 90% and what I see there.

Let’s recognize the three tiers of employees: the executives, middle management and the doers. The sole responsibility of executives responsible for innovation is to create a culture that enables success; that means enabling middle managers, who actually supervise the work being done by the doers.

As you can expect, it’s very different talking to each tier of employee. For the most part, executives seem to be optimistic, middle managers seem to be negative about shifting towards more innovation, and the doers are just trying to get their impossible list of work done.

In bureaucratic companies whose career path forces corporate ladder climbing tactics, the gap between each tier is the widest and the performance is inversely proportional to the gap. I have found the highest level of performance occurs when the gap from middle management to executive narrows. This will empower.

Among the 90%, here is what I have found middle managers think about each tier:

Our Executives

  • Won’t understand the issue
  • Can’t fix the problem
  • Will view me as incompetent

My Employees 

  • Already doing as much as possible
  • Have too many projects to manage
  • At high risk of attrition

Me, the Middle Manager

  • Utterly swamped and hopeless
  • Feeling impact outside of office
  • Proud of work team has done

Middle managers, there actually is hope! Most executives can understand the issue, you just have to present the information in a way that matters to them. What metrics are they measured on? Sell them your proposal based on those. Don’t sugar coat the problem. Tell the whole story, not just your piece of it. Look at the impact to the whole value chain and organization, not your department. Appeal to their strategic initiatives and what makes them look good if your idea is successful. Push them to make a tough decision and don’t let up. Don’t make them look stupid in front of their peers. Talk privately for tougher conversations. This will cause them to empower you more.

Executives, you have to push your managers but you can’t bury your head in the sand and hang out in the ivory tower of the executive offices. You have to get to where the work is being done. You should be communicating with every level of the organization. That means going to the innovation shop floor. Do it regularly. Don’t act entitled or superior. Be one of them. Remove the barriers they share with you, not create new ones. This will empower.

The doers will follow their manager (unless they lose trust in their competency), not the executive. Among the 90%, there is more distrust and animosity toward the executives than there is their manager. The manager holds the keys to their performance. If managers are talking pejoratively about the executives, the executives lose and the company loses. If the manager-executive relationship is amenable, the gap closes and the doer performance is more aligned. 

Try these strategies. It is tough but extremely fulfilling. However managers, if after multiple attempts, your executives are unwilling to get their hands dirty, switch companies. The world is massive. There are firms out their that will appreciate your skills and will give you the opportunity to shine. Innovation demands new thinking and middle managers hold the key to releasing that power.

Different [Than Everyone Else] but Need Help

How different are you?

Your business isn’t keeping up with the marketNot everyone on the executive team believes it.

You need to do something to turn it around. You desperately need to introduce something new.

You need innovation but you need guidance. You need an expert’s opinion so you call one.

“But we’re unique.” No you’re not.

“Our situation is different.” No, it’s not.

“Our industry isn’t the same.” Yeah, it is.

In fact, there’s very little that’s different. You’re almost completely identical. It doesn’t matter you’re military, healthcare, education, financial, high tech, industrial, publicly traded or non-profit.

Let me see if I get this right…

CEO “We’re under tremendous pressure to deliver results now. I can’t worry about next year’s’ products, I need this year’s. We’re just too slow. It takes forever to launch something.”

CFO “I don’t know what’s happening to our margin. It’s just not there anymore. Our sales are soft. We can’t keep lowering price. We need that new project to launch now. The business case has been built into our projections for a while.”

Chief Strategy Officer “The market is changing fast. We just need to form a joint venture with _______ or buy _______. The synergies will benefit both of us. The ROI is great and we can realize revenue quickly.”

VP Engineering “The leadership team can’t make up their mind. Just when I think we’ve set a direction, I hear something else. I have a great team. They just need to make a decision and stick with it.”

VP Sales “We can’t get new products out fast enough. Our customers are asking for features we don’t have. We can’t sell our old stuff anymore. We’re behind our competitors. We just need (insert cool tech here).”

  • “We’re siloed.”
  • “We’re behind in the market.”
  • “Leadership can’t prioritize.”
  • “I can do this or that, but not both.”
  • “Our software team is Agile.”
  • “We know what our customers want.”
  • “We have to increase EBITDA.”

Or something like that…

Good thing you called. We might be able to help.

3 Areas to Focus On To Successfully Launch New Product or Service

Portfolio vitality is required if a company is going to ensure future performance and survival. This is achieved through the continual launch of new products and services to the customer. Some organization are referring to a combination of products and services as solutions or offerings. I will use all of these terms interchangeably in this post.

As someone whose domain expertise lies between the idea and launch of a new product, I am frequently asked what the most important things to do when attempting to increase portfolio vitality. There are three areas that organizations of any size need to consider: the new product must fix a pain point, it must be repeatedly available on demand & you must be able tell and deliver it to the customer. Project teams are crucial to addressing these areas. Each area needs a representative on the team. That representative is responsible for their area being successfully done.

The first is fixing a pain point. This requires a deep understanding of what the end customer actually needs. Without giving the customer a differentiated product from what already exists, there is no reason for them to switch. Launching something to the market just because it does something cool doesn’t ensure success. In fact, the biggest mistake in new product development is creating something nobody wants

Take a look at Apple Watch. It hasn’t enjoyed widespread adoption, even after two years and two generations of being in the market. A small percentage of people own one. Why? The price is high, the capabilities are mediocre and it requires a paired iPhone. Apple had its chance but lost out with the proliferation of smart fitness trackers that more closely provided what customers wanted. In order to win, you have to address a pain point.

Understanding the pain points is just the beginning. You have to have a development team that can translate those needs into a workable form. This usually starts with a design that leads to a prototype. It needs to be rigorously tested and then a finalized design completed for launch. The final product is ultimately what must fix the pain point(s). The design inevitably gets watered down with trade-off related to cost, technology readiness, and other areas. Don’t lose the focus on fixing pain points when getting to the final design.

It’s not enough to have a final service ready, the second area for a successful launch is needed. An organization must be able to repeatedly provide that service to the customer. Customers are not very forgiving when they go to purchase your service and it isn’t available. Only in rare cases the customer will be patient. Depending on the ratio of the value added to the wait required, the customer will likely move to a competitor. Your organization must be able to provide your services at the rate of customer demand.

Each unit provided should be defect free, matching the design intent. Two popular methodologies for repeatedly providing defect-free are lean and six sigma. Lean is the industry best practice for establishing waste-free operations, minimizing cost of production. Six sigma focuses on reducing variation to the lowest possible level. A disciplined approach using these principles will ensure the organization meets repeatable provision to the customer.

The last area is that the new offering must get to the customer. This includes the trigger and delivery. Proper advertising and fulfillment after an “order” is placed leads to strong revenue and growth. The better presentation to the intended customer, the more demand will be. The shorter the wait, the happier the customer will be. Marketing in the social media age has its own rules now and the shift in retail due to the Amazon effect has reset the playing field. Companies must keep up with what the leaders in their market are doing.

Each of these areas are critical to launching a new solution to the market. Get one right, you have one right. That doesn’t mean you’ll win. You need more than a great offering. You need all three for a successful launch: fix those pain points, make it available when ordered and be able to get it to the customer. That will win and that will lead to portfolio vitality and the future success of your firm.

Adam’s Writes His HIMSS Part 2 Report


On the first day of HIMSS 2017 I stayed in our booth, so Day Two was my day to venture out. Where do I even start? The HIMSS community has literally taken over the area around the Orange County Convention Center. There are product launches, awards ceremonies, and press interviews galore. The twitter-verse is overflowing with #HIMSS17 and other associated tweets. I’m particularly amazed how every hotel, restaurant, Wi-Fi hotspot, pedi-cab, and Uber is crawling with formal and impromptu meetings between attendees and exhibitors.

I decided to take advantage of the hoopla and joined the #HCLDR meetup in the Hall D lobby. It was there I was approached by Nick Adkins, a kilt-wearing, healthcare MBA who welcomed me into the #pinksocks tribe by presenting me with a mustached-pair of pink socks.

The socks are intended to be a conversation starter. “It’s easy for us to get caught up with technology and get stuck behind a screen,” Nick said. “Sometimes we need to be reminded to talk face-to-face and show empathy looking into the actual eyes of another human.”

For me, that was the theme I pulled away on Day Two. The HIMSS show floor is filled with vendors that all claim to be “doing” population health, value based care, and data security. On the surface, there is little to no differentiation between vendors.

As a developer who believes deeply in ethnographically-based solutions, I have to ask, “Where is the human value of the product or service?” While my design engineering background gets excited about technical solutions and my business background relishes in financial implication, it’s my humanness that begs there be more than technology and net margin.

One attendee told me, “What I want [from AI] is the ability to talk with the patient and have AI listening to the conversation and [cognitively] pop up suggestions based on what we’re talking about.” That could be a game changer for doctors, but what about the nursing staff, care coordinators, coders, IT staff, and other front line staff?

Healthcare organizations need to be strategic about their technology investments. They can’t assume that purchasing one more software packages or devices will result in successful implementation and achievement of the IHI Triple Aim – improved quality outcomes, improved patient experience, and an overall reduction in the cost of care.

Too often, organizations inject new technologies before understanding the overall impact on the continuum of care. So, how can organizations successfully implement new technologies?

They can’t count on a vendor to know all of this information. At Simpler®, we believe healthcare systems need to orchestrate clear plans that take into consideration all systems that contribute to quality patient care. These plans are rooted in deep customer insights and bounded by properly set operational constraints. To develop and implement a new solution, healthcare systems need to determine what is important to their patients, what would help them run the business better, and what would position them for the competitive edge.

This brings me back to the #pinksocks. Every healthcare system feels compelled to differentiate themselves in this competitive market. While outfitting a healthcare system in pink socks won’t do the trick, a customer-first, development technique like Simpler’s can distinguish organizations from the sea of others. By optimizing work flows around the patient, clinicians, information, equipment, and quality, organizations can introduce winning, new services that set themselves apart. Thank you HIMSS.

You can find out more on how Simpler® is successfully guiding Lean transformation in the healthcare sector here:

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Adam’s Composes His HIMSS Part 1 Report

I’ve arrived in beautiful Orlando, Florida for the largest healthcare IT conference, HIMSS 2017. As an innovator, technology enthusiast and veteran of healthcare tradeshows, I was excited to finally get the opportunity to see and hear first-hand from some of the best and brightest thought leaders and innovators in our industry on how technology will impact healthcare in the year to come.

As eager as I was to meet some of the 40,000+ health IT professionals, executives and vendors exhibiting at the show, I was particularly excited to attend the inaugural keynote session.

This year’s opening keynote address for HIMSS was delivered by Ginni Rometty, Chairman, President and CEO of Simpler’s parent company, IBM. Rometty kicked off the conference by delivering a well-received speech on healthcare and the cognitive era. She discussed how cognitive technologies, such as artificial intelligence, are poised to profoundly impact medicine and value-based care, emphasizing that the healthcare industry needs to embrace and guide new technologies into the world in an ethical and enduring way.

Rometty also shared her concern over the fact that many healthcare organizations and leaders struggle to imagine the future. This point hit close to home as I’ve found that many of my clients aren’t putting enough thought into the future. Rometty’s remarks support my firm belief that healthcare delivery firms need to get serious about internal innovation to further support and bolster the outcome of patient care. They also must produce new and improved models of care for both patients and the healthcare system employees in preparation of the future, and that it is done in a strategic manner.

After a brilliant HIMSS keynote session, it was time to hit the exhibition hall floor. I was assigned to work the corporate booth for the bulk of the day to share Simpler’s vast array of offerings and discuss how Simpler, Truven, and Phytel & Explorys are contributing to the IBM Watson brand. It was great to meet so many fascinating people with interesting problems in their healthcare system.

As day one of the conference wound down, I found myself reflecting on the day’s events. Here are my takeaways:

  • We have to address innovations that reduce physician administrative burden, not increase it. Simpler Senior Advisor, Dr. Paul DeChant, gave a talk on his new book, “Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, A Handbook for Physicians and Health Care Leaders,” which specifically addresses this topic. DeChant shared how new innovations, processes and fixes should reduce the barriers and frustrations care givers encounter every day.
  • With so much uncertainty, healthcare organizations need to be even more flexible. To be effective for any period of time, healthcare organizations need to create adaptable environments that value continuous improvement, and don’t flinch at the notion of change. The Lean management model hardwires that adaptability. The ability to rapidly adapt to a changing environment is a critically important strategic advantage in this era of rapid and unpredictable change.

I’m looking forward to digging a little deeper in my next post.