Innovation Autoimmune Disorder is killing your organization’s innovation strategy

“No.” Photo by Gemma Evans on Unsplash

And why a heretofore taboo approach to organizational problem solving — vendors — may now be part and parcel to the solution


Every day, almost every employee in your organization is saying no to innovation. They don’t mean to, of course. But it’s happening. And the thing of it is: you are absolutely encouraging it.

That’s because your organization’s structures and systems have been optimized to be profitable and efficient and reliable at carrying out the day-to-day operations of delivering healthcare services.

That’s unquestionably good.

It’s also bad.

Those same structures and systems the organization relies on for normal day-to-day operation are also very much preventing innovation. On purpose.

An organization’s structures and systems can be thought of as an immune system, a defense mechanism against variation — the scourge of profitability, efficiency, and reliability.

That has produced a crushing paradox: at a time when innovation is needed most, most organizations don’t have the capability to innovate.

This paradox is called Innovation Autoimmune Disorder and it’s killing your innovation strategy.

Diagnosing Innovation Autoimmune Disorder

There’s a notion in technology circles that a company produces products in the image of how the work gets done in that organization.

In other words, a company’s products or services come with similar properties and capabilities as the organization’s structures and systems.

The phenomenon even has a name: Conway’s law. The adage goes, “Organizations which design systems…are constrained to produce designs which are copies of the communication structures of these organizations.”

It makes sense: organizational structures and systems necessarily influence the way the work is delivered because structures and systems are what an organization uses to communicate.

This idea, however, isn’t only present in technology companies. All companies design systems. So all companies are constrained by the structures and systems of their organizations, including healthcare delivery organizations.

How does a healthcare delivery organization launch a new service? By designing a system.

The process of launching, creating, starting, building, embarking, initiating, and any other effort of commencement in a healthcare delivery organization follows a similar path: an approach almost always governed by time-tested methods of planning, direction, and control. That’s because accepted methods of planning, direction, and control have consistently produced profitability, efficiency, and reliability.

A business plan is created. Funding is approved. Space is acquired, built out, and outfitted. Staff is hired and trained. Technology is installed and connected. Marketing and internal communication plans are created. All stakeholders are given the opportunity to provide input, concerns are stated and addressed, the project is scoped, a project schedule and budget are established, and the service opens for business according to plan.

Innovation is designing new systems too, of course, and healthcare delivery organizations that attempt to apply traditional planning, direction, and control methods to make it happen often find it doesn’t.

That’s Innovation Autoimmune Disorder: the implicit and explicit rejection of potential innovation caused by an organization’s structures and systems. It is the ultimate statement of “that’s not the way we do it around here.”

Support departments say no to — or fail to make exceptions for — a new idea, a new approach, a new vendor partnership, or some other request because of traditional planning, direction, and control reasons.



Brick Walls by by David Pisnoy, Shoot N’ Design, Michał Grosicki on Unsplash

IT, HR, vendor management, project management, and every other centralized function are all governed by previously established processes. Policies and procedures have been honed over the course of decades. Management practices — for all things: employees, interdepartmental relations, budgeting, performance management, etc. — have been optimized to serve large bureaucracies.

Innovation fails to materialize as a result.

New ideas go unpursued because project charter, scoping, and committee-approval requirements are burdensome. Procurement procedures prevent the purchase of anything outside what the bureaucracy deems acceptable. Administrators concentrate on budgets and efficiency because performance management focuses on short-term deliverables.

So while C-suite survey results continue to indicate that innovation remains an important strategic priority for healthcare providers, desiring innovation is rarely enough to make it so. Organizations that rely on the same structures and systems to innovate that they do for planned, directed, and controlled change are systematically rejecting innovation every day.

Treating Innovation Autoimmune Disorder

The healthcare delivery organization is organized and operated purposely so that each day is unremarkable from any other.

The problem for organizations is that the industry in the midst of remarkable days. The operating environment is changing faster than any organization’s current ability to respond. The challenges are arriving on multiple fronts — regulatory, operational, reimbursement, consumerism, workforce.

Industry norms are shifting. Tactical paths forward are relatively unclear. A dramatic technology conversion beyond the electronic health record is underway.

These are the reasons innovation is so urgently desired in healthcare provider organizations. But Innovation Autoimmune Disorder too often gets in the way. Shifting an organization’s structures and systems to incorporate innovation as an accepted exception is the required long-term approach.

Overcoming Innovation Autoimmune Disorder will require healthcare delivery organizations to craft structures and systems that explicitly support innovation.

While those structures and systems will be unique to each organization’s specific objectives and distinct characteristics, there are three essential objectives every organization must pursue to explicitly support innovation.

Shining light on a different approach. Photo by Crown Agency on Unsplash

Make it okay to try new ideas. Innovation requires trying ideas. Innovation activities will produce unsuccessful outputs, but many can’t be labeled failures until experimentation has occurred. Choosing the right idea to develop further is surprisingly difficult in a planning-oriented environment. It can be made easier by testing in real-world environments. That requires experimenting with ideas which will occasionally lead nowhere but may serve as a building block to something better. It’s impossible to know the extent to which a new idea will improve value, increase revenue, and grow market share until it is tried.

Incentivize working together in new ways. Innovation requires business units, departments, and service lines to collaborate in new ways and be open to the possibility that a predefined outcome may not always be a basis for participation. Traditional interaction patterns should be set aside to explore something different. Take support departments and the operation, for example — instead of being perceived as gatekeepers of resources, departments like IT, HR, and project management can become partners in solving business problems with no predetermined approaches.

Make technology available to support new ideas. Innovation requires making technology available and accessible. While technology is only part of a solution — every innovation project utilizes a combination of people, process, and technology resources to create an output — even prototypes increasingly rely on technology for initial demonstration. Traditionally, administrators have had decision-making authority over elements of people and process decisions, but technology choices have remained the domain of IT. A budget is vital, but to innovate administrators must have access to all resources and, more importantly, agency in using them.

Finding Support Along the Way

Of course innovation-focused structures and systems are a long-term shift — and potentially longer than what organizations may be comfortable with given the pace of industry transformation. That reality is giving way to the realization that a heretofore sacred belief may be open to reexamination.

“More than 75% of leader respondents,” to a recent innovation survey from the American Hospital Association and AVIA, “believe that innovation must include partnering with other innovative organizations.”

Partners can help. Photo by Todd Diemer on Unsplash

The previously taboo approach to organizational problem solving — vendors — may now be part and parcel to the solution. Outside help may not only be needed, but required.

Healthcare delivery organizations have traditionally addressed strategic challenges with a mix of internal subject matter knowledge, technical proficiency, and industry best practice. The limits of that approach are evidenced by the survey results above. This version of healthcare transformation requires organizational capabilities not currently found in most contemporary provider organizations.

The shifting operating environment requires new organizational expertise in digital technology, emerging operating domains, and efficient implementation methods. Vendors, or in this new paradigm, partners — with their products, services, subject matter expertise, industry expertise, technical skill, and ability to execute with urgency — are the most reliable method to immediately leverage required know-how that doesn’t exist in most organizations.

There is no quicker way to overcome Innovation Autoimmune Disorder than to involve partners. Partners offer a plethora of opportunities to operationalize innovation across the organization.

Some organizations are starting to realize a partner approach may prove strategically beneficial for these reasons. GE Healthcare has launched partnerships with several organizations including Jefferson Health in Philadelphia and Partners Healthcare in Boston, AVIA’s innovation network business model is built on the idea, and industry integrator Catalyst HTI is opening a building in Denver explicitly for this purpose.

These partnerships are a good start at the executive level. But the strategy must diffuse deep into the organization if it is to find its full potential. Perhaps partners — of all types and sizes — can help the middle of the organization innovate right now if they were made available.

Industry partners will play an increasingly larger role in the transformation of healthcare delivery given the dramatic shifts on all fronts. To that end, organizations must become comfortable with new people, new concepts, and new ideas coming into the organization.

An organization’s structures and systems will adjust in time. Because just as structures and systems ensure profitable, efficient, and reliable operation, they also adjust as organizations realize the necessity of adapting and evolving.

And until then, partners can help.

As they always have, the competitive, regulatory, and operating environments are shifting. This time, however, the traditional model of adapting and evolving is preventing healthcare delivery organizations from doing just that.

Innovation Autoimmune Disorder is killing your organization’s innovation strategy. Do something about it now that you know: call a partner.

The Missing Ingredient from Healthcare Transformation

And How to Get Your Hands on Some Magic


As a healthcare administrator, you know there’s a missing ingredient from the proclamations about the Future of Healthcare Delivery™ emanating from conference stages, press releases, and white papers.

The magic to make it all happen.

Until now.

Introducing: Healthcare Transformation Magic Crystals


I was once a let’s-make-this-better, imagine-the-possibilities, nobody-can-stop-us real-life healthcare administrator.

It’s that perspective that gives me levitating excitement for the future of healthcare delivery — the future predicted by the technologists, consultants, and thought leaders: an innovative, data-driven, value-based, machine-learned, digital nirvana.

But there’s a secret every healthcare administrator knows and every disruptor is learning: changing healthcare delivery requires work. A lot of it.

It’s that perspective that makes me think magic is the missing ingredient preventing the promised future from being pulled out of a hat like the promises that come with it.

So I know we’re solving a wide array of healthcare provider execution challenges with a product perfect for boards of directors, executives, and administrators wishing to make healthcare transformation appear in their organizations: Healthcare Transformation Magic Crystals.

Your mileage may vary.

Mined from the deepest, richest, and most magical gem source in the world, Healthcare Transformation Magic Crystals can make any strategy appear out of thin air — no matter where the strategy originates including, but not limited to, conference stages, consultant deliverables, technology vendor promises, and even the hopes, dreams, and wishes of an internal planning session.

They’re easy to use. No wand required. Previous experience with magic isn’t necessary.

Just combine a copy of a shredded project plan document with an ounce of the Healthcare Transformation Magic Crystals into a 9×12 manila envelope. Seal. Place on a shelf. Wait.

Abracadabra.

You could be amazed with the results.

Ignoring the Required Work

Healthcare transformation is real. It’s happening. It will continue to happen. We’re complete believers.

But without magic it’s not arriving via moonshots, grandiose op-ed think pieces, or generality-plagued conference talks. Because without magic those pronouncements, platitudes, and prognostications are going to require a lot of work.

And, from the back of the theater, it seems the future is arriving much too quickly for anyone to be bothered with real, actual work.

That reality is completely irrationally understandable.

Just think about the sheer amount of work that must be accomplished to operationalize a single transformation strategy in a single healthcare provider organization. It’s striking!

This Harvard Business Review article about a completely logical way of involving clinicians in managing the cost of care is a great example.

How long would an initiative like that take in your organization? Think about how much work — how many projects — are required to actually make it happen. It’s a lot. Like a lot a lot.

But at least the thinking is manageable. Ask the same question for this completely sensible way to transform an entire healthcare delivery organization, also in the Harvard Business Review, and you’re likely to struggle just figuring out where to start.

It’s obvious why ignoring the work is such a tempting detail to overlook: it gets in the way of overpromise, hype, and illusion.

The Fine Print and Some Free Advice

It’s here that I must inform prospective buyers that the Healthcare Transformation Magic Crystals come with no product guarantees.

But they do come with this piece of rock-solid advice: Get started and do the work.


It may not be as immediate, it may not be as sexy, and the projects may not be as fun as the promised near-future would lead us to believe.

But it will be successful.

In fact, it’s the only way transformation happens. Project by project.

Of course, looking back, it will have arrived in part through those pronouncements, platitudes, and prognostications, too. But the journey is likely to be much longer than the future-is-coming-sooner-than-you think dogmatists would lead us to believe.

It’s okay to be realistic about making change happen. It’s okay to be content with the day-to-day activities of doing the work. Not only do we think it’s okay not to subscribe to a dramatic vision of the future, we believe it’s pragmatic and practical and the path to real progress.

However, if you’re looking for a shortcut, definitely give these Healthcare Transformation Magic Crystals a try. We’ll send you a free sample if you’re interested. Fill out this form and we’ll drop them in the mail.

They’re real.

Well, as real as magic can be.

But if they seem to have lost their magical powers before you can use them: call us.

We’re ready to work.

With you.

And we know where to start.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can improve operations, execute strategies, and try new ideas. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

Transformation on your plate? Pick a project. Start. Execute. Repeat.

Photo by Ross Findon on Unsplash

Healthcare delivery organizations, and departments or service lines in particular, need an approach to adaptation that matches the volume of change within the industry.

The refrain “It’s coming at us all at once” is echoed in organization after organization after organization. The demands of transformation are constant and unrelenting.


Since projects are how organizations change, and change is constant, projects should be constant, too.

Start. Finish. Repeat. It’s the only way to transform.

Constant projects? But how?

Keep it short. Limit the scope of any project to a timeframe that is manageable, keeps participants engaged, and quickly produces an outcome. A twelve-week timeline is a respectable benchmark. Is the initiative larger than the single project? Do another one! More than that? Do another project! What’s that old project management adage — when’s the best time to start another project? Right after you finished the last one! (Oh, maybe that came from sales…)

Ditch the meetings. Instead of using meeting time to update project status or badger slowpokes for the work they promised or manage pending risks or etc., use that time to work on the project. Limited scope projects have timelines that demand constant action. Project participants will actually show up and participate if you get actual work done during a reoccurring calendar block. Save the weekly status updates for the end-of-the-project celebration!

Think real time and show progress. Try new functionality — changes in people, process, and technology — first in the meetings-where-work-is-done and then in the real world. Review it! Validate it! Encourage participants to provide input — “yes, I like this;” “no, I don’t like that” — and make decisions to adjust or move forward — “yes, thanks for your opinion and that’s a great addition;” “yes, thanks for your opinion and we’ll save that for a future phase.”

Enhance! Enhance! Now it’s time to improve. To iterate. No project is ever, ahem, finished. Of course it will be introduced into the world and become the new way of doing but that doesn’t mean it can’t be improved or altered or added to. A solution should be adjusted as the project outcome meets the real world and feedback is received. Add small things. Add big things. Try new things.

Believe in temporary. Maybe something drastic changed and the project outcome needs to be eliminated just a year later — that’s okay!, it was such a short project and great utilization of resources that the project outcome did what was needed. It was the bridge from there to here. And if we really go macro on it: every solution ever has been temporary. Things change. All the time. Projects that help departments move from one state to another are successes. Time to get started on the next project.

Increase the execution rate. Do projects. Lots of them. All the time. Finish projects. Keep going. It’s been said many different ways but the only known way to succeed is to try lots of things. Embrace the 10,000 Experiment Rule.

Train. Train. Train. Train. Train. Train. Projects go off the rails at this most important juncture: the translation of the new project into a live environment (and this advice isn’t only for technology projects). Resource-constrained organizations, most all of them, find that training is a convenient place to trim costs. Trimming costs is a fine objective — but don’t skimp on training time and resources. All that hard work of making a project happen shouldn’t go down the drain at the climax of execution.

Big transformation on your plate?

Pick a project.

Start.

Execute.

Repeat and keep going.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can improve operations, execute strategies, and try new ideas. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.


This originally appeared over here.

An ode to projects

Photo by Clem Onojeghuo on Unsplash

Projects are how organizations change.

A project is a temporary endeavor to produce something. Something that produces a tangible change in the way an organization does something.

The more projects an organization starts and finishes, the more change that is produced.


Demands on today’s healthcare delivery providers are marked by shifting external forces, rapid technology adoption, required cross-function collaboration, pursuit of new competencies, known knowns, unknown knowns, yes — even unknown unknowns, and probably a few others.

It’s a foggy future. Projects are how organizations navigate to it.

Projects are how an organization creates, how an organization adapts, how an organization eliminates. David Cleland, hailed as the father of project management, said it well, “Projects provide an organizational focus for conceptualizing, designing, and creating new or improving products, services, and organizational processes.”

Yep.

Projects are how an organization gets things done. Projects are how an organization executes. Projects are how an organization transforms.

Projects are the most important pursuit of every healthcare delivery organization.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can improve operations, execute strategies, and try new ideas. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.


This originally appeared over here.

The “Now What?” moment is a moment of action


Four days into a department reorganization and my new boss called me in for a conversation that concluded with, “Do you want to be the contact center manager?”

“NO!,” I silently shouted. I had been looking forward to focusing on building the population health program I was originally hired for and I didn’t have the slightest clue of what was required to manage a contact center.

“I think you have the capacity and capability,” the senior vice president ask-told, “Why don’t you take a few days to think about it and let me know.”

There really wasn’t any answer to give except “Yes.” So I did.

Now what?

The healthcare delivery operating environment is regularly producing “Now what?” moments — a moment when an administrator has beed told, asked, or discovered they now “own” a business problem that must be solved and find themselves in a moment of reflection asking, “Now what?”

Often the question is in silence to one’s self. Occasionally, people are more fortunate and get to ask it a little louder to a committee or an executive team. But even that can get tricky because topical expertise is a fleeting attribute in a fast-paced operating environment.

We’ve seen “Now what?” come in a variety of a flavors, but some seem to be more common, including the ask-tell flavor told above.

Another frequent variety is the execution imperative. There is a moment that arrives after the strategic planning activities of analysis, thought, and discussion when the new strategy must be operationalized and there isn’t a clear path forward. “Now what?”

Or our favorite, the innovation mandate. Someone, high from above, declares, “We need to be more innovative!” And proclaims to all in attendance that they must come up with three innovative ideas by the next meeting. “Now what?”

The last, which we cheekily call the oh-shi!, is when it becomes apparent to an administrator that the operation is facing a significant business problem — brought about by internal or external forces — that will impact the department, service line, or organization in some influential way. “Now what?”

“Now What?” moments often come from a place of fear, inexperience, or the unknown.

But the “Now What?” moment is a moment of action.

It means it’s time to do something. It’s time to shift attention to making something happen. Go.

There’s a long list of available actions. Do some research. Phone a colleague. Meet with IT or HR or project management. Plan a pilot. Discuss with your boss. Call a partner.

But the moment is now.

Don’t wait for permission, for more information, or for someone with more expertise to appear like I did in the contact center. Those weeks and months is a valuable time for doing. Because there is a moment that follows “Now what?” when no action is taken.

We won’t talk about that one. That moment is much more painful with much less individual agency. And, crucially, avoidable.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

The Ultimate Measure of Workplace Trust: You Decide What to Work On


It’s a panic-striking emotional state: I’m not contributing! I’m not on the career trajectory I need to be on! I’m not learning the skills I need to be learning!

That “I’m not a contributing member of this organization” feeling can be vicious.

My first healthcare job was as an administrative fellow, a sort-of management training program intended to provide exposure to the breadth of administrative positions throughout an integrated delivery system. It was a terrific experience and the people I worked for and with get credit for creating the foundations of my management style.

But there was a point early on, maybe a month or two in, when I felt exceptionally useless. The program wasn’t particularly organized — which turned out to be a great thing over two years — and resulted in open days with little to do early in my tenure.

I was gripped by the feeling of uselessness for months and didn’t know what to do about it.

Somewhere, somehow the thought struck me to find projects to work on.

It didn’t come from my boss — the last thing I wanted to share was that I wasn’t busy enough.

It didn’t come from colleagues — I wasn’t close enough with anyone at the time.

It didn’t come from friends or family — “this new job is great!”

I just started finding projects: some were participation only, some allowed me to make small contributions, and some allowed me to explore my interests in the organization. But nothing was particularly useless.

There was no one breathing down my neck. No one looking over my shoulder. No one assumed the burden of becoming my task finder. I was just trusted to find work to do.

[A quick aside.]

Don’t get me wrong, it’s entirely possible that no one gave a shit about me as my status hovered around the level of “intern,” but I take solace in maintained professional relationships with the people in that organization.

[Back to it.]

Trusted to find work. A novel concept.

By my second year I was finding projects to work on that were of strategic importance to the organization. More projects began to appear: from my boss, from the CEO, from managers throughout the system. The feeling of contribution! It’s a drug.

I’ve been coming back to that story lately because I recently started asking my employees to choose what they work on. Initially there was shock — a seemingly normal reaction to a different approach from any other previous school or job experience. After wading through initial resistance and a smidgeon of bewilderment, the experiment seems to have improved two persistent management problems left behind by industrial models of production.

The first is related to trust. We’ve been taught that employees must be managed. Create tasks. Fill their days. Ensure output. But management, in the traditional sense, left me with questions. What is an appropriate level of production in a workplace dominated by intangible things? How do you measure what someone should be producing when much of it is novel and creative thought? How do you trust that what employees do produce is the appropriate amount when no widgets are actually created? How much time should be spent in the office during the week?

The second is engagement. We’ve long abided by the idea that work must be cascaded down a hierarchy — that seems to be the secret to accountability: tell everyone what they work on and what the measure will be. Bosses know best. Do as I say. Why aren’t annual objectives being met? How do you rate an employee’s performance when the annual objectives set at the beginning of the year aren’t actually important any longer?

It turns out that everyone — me as a manager and they as an employee — benefits when employees get to choose what to work on. Here’s what we’ve found so far.

Employees choose work that interests them. We hire job candidates because of their experience and skills, which are manifested interests with documented results. The work that interests them is the work they are good at. It’s why they are working for the organization. It’s the work they want to get better at, too.

Employees choose work that helps the company. Employees deserve more credit for their instincts. They don’t need managers telling them what is the highest priority, although prioritization conversations can be helpful in figuring out what to work on first. Management, if anything, is creating the framework for knowing what is important and what isn’t. Employees know what needs to be created and improved because they work every day for the company. They see what the company needs.

Employees are engaged with the work. When employees lead the objective setting for the work they are demanding of themselves, highly accountable for results, and completely engaged in the work itself. Coaching becomes about helping each employee deliver the work. Reviews are about lessons learned and developed skills.

For managers it’s a win-win-win: trust comes easily, engagement happens naturally, and everyone is striving to move the company forward.

Engagement surveys continue to tell companies the same thing every year: employees aren’t. After years of failed engagement improvement initiatives, perhaps it’s time to point the finger at the organization’s structures and systems (i.e., how we do things around here…) as the culprit for low engagement. And perhaps it’s time to start experimenting with new structures and systems that create the workplaces we all desire. Maybe there are better ways.

Here’s to finding all of them.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

Rethinking the Role of IT in Strategy Execution for Healthcare Providers

Photo by Thomas Kvistholt on Unsplash

We were speaking with a customer recently who asked, “Does IT even matter anymore?”

And we stumbled over each other to be the first to exclaim, “Yes! More than ever!”

The entire organization is completely dependent on IT’s minute-to-minute successful management because the entire organization operates on technology.


And that’s important because, in many ways, the business has become technology — a major transition since the advent of mainframe computers in the 1960s. Where technology once supported healthcare delivery workflow, that same workflow has come to depend on technology. Nearly every process of the modern healthcare delivery organization has come to rely on technology.

So it’s no wonder that enterprise attention has shifted to strategic information technology concerns such as system uptime, enterprise deployments, network security, and the like. IT is rightfully focused on these very important — the business-stops-operating-if-any-of-it-goes-haywire — activities.

However, as a result, there has been a divergence in prioritization between strategic technology issues and operational technology realities. At the same time that strategic issues have been given increased attention, there has been an explosion in operational needs for additional technology — the specific technology needs required to carry out the work of healthcare delivery.

Organizations have long relied on the electronic health record and enterprise point solutions to address these emerging use cases. But we meet daily with individuals in healthcare delivery organizations whose needs are not being met by the technology currently available to them.

That is important because, at nearly every turn, there are business processes (services, projects, service lines) that struggle to deliver needed results because they are dependent on less than ideal technology deployments.

For example:

  • The case manager that begged and pleaded for six months for a change in the Epic interface, finally got it, and 30 days later is making due with workarounds because a new business requirement came along.
  • The call center manager wholly dependent on outdated telephony and customer database that makes it difficult to report any measure of value.
  • The marketing director that knows they need CRM help, doesn’t know exactly what marketing programs they want to deploy, and knows that whatever does get approved is going to require a lengthy solution selection process.
  • And the population health manager that relies on spreadsheets, email, documents, post-its, home-grown reports, etc., and spends the first week of every month creating reports.

These are small business problems and pale in importance to any strategic IT need.

But they are significant and they are everywhere in the organization. And as such, the sum of these technology needs is actually quite large and has become a barrier for organizations seeking to execute on their growth, revenue, and value strategies.

Given IT’s appropriate focus on strategic imperatives, healthcare leaders are now turning to external assistance to enhance or create their technology deployments.

These leaders are seeking support in solving explicit business problems that are dependent on technology. They desire urgent, affordable, and personalized solutions.

But they also must be secure, supportable, and integrated.

Some of our customers come to us as a result of pent-up frustration with their IT departments. And we understand why. They’ve been told — or ignored — that their idea, their department, or their project which is deeply in need of technology support doesn’t rise to the level of being a priority for IT.

It becomes tempting for business leaders to exclude IT as a result of that frustration. But urgent, affordable, and personalized solutions can turn into problems when that happens. It is the definition of Shadow IT.

Yes, IT is busy. But it’s better for all involved when IT knows all technology deployed throughout the organization. Avoiding Shadow IT should be as high a priority for the business as it is for IT.


The most successful projects require an organizational partnership between strategy, IT, and the business leaders doing the implementing. During this time of urgency, a period that is melding strategy, business, and technology problems like never before, strong alignment between all three has become a competitive advantage.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

A planning tool to help healthcare organizations get started on the next project


Healthcare delivery’s competitive, regulatory, and operating environments are in constant transition. The result is constant change to how the work of healthcare delivery gets done. So it’s no wonder that leaders in these organizations are identifying project needs to keep up with change of continuing industry transformation.

Knowing that progress in today’s organizations requires crossing boundaries, navigating bureaucracy, and collaborating with multiple partners, it can be difficult to even get needed projects started, let alone implemented.

We’ve heard the frustration. It sounds like this: “We need to break down silos.” “We need to be innovative.” “We need to move faster.” “We need to make better decisions.”

And: “How can we get started quickly?”

That’s why we created the Project Building Blocks framework. Click here to download.


Over the past five years, Status:Go has developed the Project Building Blocks framework to help clients navigate answers to these difficult questions.

Healthcare leaders require a way to capture the complexity of a project while simultaneously identifying a path toward execution. An approach that embraces the value of planning while acknowledging urgent timelines require faster responses than organizations have become accustomed to.

Our customers use the Project Building Blocks framework to launch new programs, improve departmental operations, and deploy innovative technology solutions — all while relying on projects.

The Project Building Blocks uses the details of a proposed project to tell a story. That story captures the vision of the project while illuminating the details necessary for successful implementation.

A completed Project Building Blocks framework creates a broad, shared understanding for those involved in the project; serving as a map to execute any project.

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Strategy Execution Platform: the future of enterprise healthcare technology


The EMR falls short. IT is preoccupied and cost constrained. Middle managers need access to software. And widespread experimentation is key to transformation.

Strategy Execution Platform: Enterprise healthcare technology designed-for-the-user, won’t-bust-the-budget, and especially-for-your-need.


This is the most exciting time to be effecting change in the history of healthcare delivery. Healthcare transformation is continuously creating new operational requirements for healthcare delivery firms. Executives respond to the shifting operational requirements within healthcare delivery — both problems and opportunities — with strategies.

This is the most exciting time to be effecting change in the history of healthcare delivery.

As they have always been, middle managers are tasked with executing identified strategies. And as they have always had, middle managers use three resources to implement and execute: people, process, and technology.

Middle managers use three resources to implement and execute: people, process, and technology.

Decisions of whom to hire and promote have long been the agency of middle managers. The same goes for determining how employees do the work and customers experience the service.

Historically, however, technology decisions have been left to the IT department. Continuing this paradigm will only impede progress by creating barriers and causing frustration.

While not every problem is solved with technology, nor does every opportunity require technology, increasingly solutions are dependent upon technology. This makes it imperative to empower middle managers with it.

The responsive healthcare delivery firm provides middle managers the capability to act by empowering them with agency over people, process, and technology decisions. Responsive healthcare delivery firms allow middle managers to quickly solve problems and take advantage of opportunities by piloting as many ideas as possible.

Empowered middle managers create responsive healthcare delivery firms. Responsive healthcare delivery firms empower middle managers.

The rigidity of the EMR and existing industry IT ideals are combining to prevent middle managers from being empowered with technology in the same fashion as they have been with people and process decisions. Fortunately, there is a solution.

The Strategy Execution Platform.

A Strategy Execution Platform provides diverse functionality, allows a sustainable support model, and is inexpensive to implement. It possesses the privacy and security features demanded by the healthcare industry. It allows IT to facilitate technology diffusion throughout an organization by focusing on governance rather than managing a project request queue. Instead of a single-record keeping system that promises everything to everyone with a single usability framework, it allows for many projects to be built upon a single framework promoting usability to match the workflow needs of the user.

Most important, a Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation. Finally empowered with all three resources — people, process, and technology — middle managers are now truly enabled to implement the strategies of healthcare transformation.

A Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation.

As continuing healthcare evolution has required us to inventory technology, question processes, and challenge our people, one thing has become clear: It will be the summation of many efforts that will allow healthcare to transform. With the aid of a Strategy Execution Platform, those middle managers able to pilot projects by marshaling their resources, innovating their processes, and taking advantage of new technology will be the leaders to get us there.


The Electronic Medical Record is a Brick Wall

The EMR is a necessary piece of technology. It’s the workhorse technology of healthcare delivery. It ensures stringent adherence to process. But the inherent rigidity and weight mean functionality, existing or promised, hasn’t adapted well to the requirements of an evolving operating environment. The EMR has not adapted to the flexible requirements of healthcare transformation.




Usability is terrible. It’s cumbersome for entering information and navigating existing information. The data is poorly organized. It doesn’t have a longitudinal view of information making it difficult to capture a snapshot of a patient’s context.

Speaking of data, it’s nearly impossible to get out for enterprise purposes. Creating or extracting reports, analytics, and dashboards requires an analyst, usually one that reports up through the IT function.

Customization of anything requires the consensus of a committee, is impossible at worst, and completed on a lengthy timeline at best.

The EMR controls workflow and process, rather than process and workflow being built into the technology. It offers no insight into productivity or performance. Automation, business logic, and workflow support are maddeningly absent. It recognizes no opportunities for process improvement.

Integrations are difficult or impossible. It lacks any effort to allow patients to enter information. And it doesn’t help market services, monitor health, or promote engagement.

Healthcare delivery requires a better way to become responsive to problem-solving and responding to opportunities brought about by transformation. It requires a flexible, complementary software solution that can be implemented anywhere, connect with anything, and is perpetually customizable.


The IT Department Has Become a Roadblock

The information technology department has been the most important department in healthcare delivery over the last forty years.


But IT has unintentionally become a roadblock. Technology now touches almost every aspect of healthcare delivery. Given this growth and new requests that come along with it, IT leaders have been forced to create a bureaucracy that allows only the most important and pressing needs to be addressed. This bottleneck prevents progress in an environment that is demanding more and more technology to support organizational initiatives.

The same cost-cutting and value-improving pressures facing operational departments are facing IT, too. With pressure to reduce headcount, a growing number of projects, and rising support requests, increasing needs from operational departments become more difficult to fulfill.

Technology needs of operational entities are viewed as a lower priority because IT’s focus is on other strategic priorities and enterprise initiatives like ICD-10, Meaningful Use, privacy and security, EMR replacements, technology issues related to mergers and acquisitions, clinical data integrations, etc.

Data analysis resides as a department, often within IT, instead of as a function embedded within each department. The necessary bureaucracy of the centrally managed IT function does not promote scope, scale, nor speed in new projects.

Given its support department status, IT is too far from the patient experience. Technology should be making it easier to use and consume healthcare services, not making it a more frustrating experience.

Creative technology solutions are viewed as a risk. No CIO has recently been fired for implementing Oracle or Cisco or IBM or Epic. This mentality leaves inexpensive and effective solutions to a wide variety of problems on the table.

IT must transition into a role as technology facilitator, helping to diffuse technology-supported solutions as quickly as possible. This mentality will allow organizations to take advantage of new competitive priorities and improvement opportunities. The IT department should be promoting care coordination, patient experience, team-based care, interoperability, and data sharing at every turn. IT must help other departments become more functional, not stand in the way of being functional.


This is the Golden Age of Middle Management

Where is healthcare transformation occurring?

The answer, clearly, is where healthcare is being delivered: in places like the clinic, the radiology department, the contact center, and the case management department.

Who is responsible for implementing healthcare transformation?

The answer, undoubtedly, is middle managers. The individuals charged with leading the clinics, the radiology departments, the contact centers, and the case management departments.




While executives have the enjoyable task of intellectualizing and philosophizing for the pursuit of creating strategy, it is middle management that has the responsibility to make the strategy happen. The ideas — yes, important — are the easy part. Bringing the ideas to life is difficult.

Peter Drucker, the famed management consultant, relayed it best when he wrote, “… the man who focuses on contributions and who takes responsibility for results, no matter how junior, is in the most literal sense of the phrase, ‘top management.’ He holds himself responsible for the performance of the whole.”

Perhaps a bit more succinctly but equally prescient, Herb Kelleher, the founder and CEO of Southwest Airlines put it this way: “We have a strategic plan, it’s called ‘doing things.’”

This is the golden age of middle management. An era when all the action of improving healthcare delivery is happening on the front lines under the supervision of the often maligned, but unnecessarily so, middle manager.

Middle managers are central to the success of healthcare transformation. As such, they are central to the success of healthcare delivery organizations. Maybe, just quite possibly, more important than the CEO.

But middle managers need to be empowered with the resources to make transformation happen. The job of the middle manager has become increasingly difficult: their plates are full, the velocity of industry change is increasing, and the constraints of the technology they and their staff are using are real.

Historically, with only supreme agency over people and process resources, it is time for healthcare organizations to empower middle managers with a third: technology.



Widespread Experimentation

As commonly held as the notion that organizations must innovate to continue to create value is, healthcare delivery organizations continue to struggle to ensure that innovation is systematically part of their culture, part of the day-to-day approach of solving problems or taking advantage of opportunities.


Charles Darwin had it right when he wrote about biology. It appears the same holds true for the modern-day business entity, too: Adaptation is key to survival. How to adapt but one step at a time?

Some ideas pontificated following the passage of the Affordable Care Act are beginning to appear. For many, though, we are still maddeningly far from knowing what is going to be the secret to success in population health, value-based reimbursement, or care coordination, among the many other elements known or unknown of healthcare reform.

Innovation is not a board room strategy, it’s a way of doing. A way of operating. Innovation only happens through experimentation with ideas. Many ideas.

While great headway has been made in finding new ways to deliver healthcare, there is truly only one way to continue to figure it out: try more ideas.

Tom Peters, the management consultant, puts it best: Whoever Tries the Most Stuff Wins.

Successful innovation is simple: widespread experimentation. That doesn’t make it easy.

Admirably, healthcare delivery has long been experimenting. It’s the essence of the scientific method, pilot projects, trial and error, Plan-Do-Check-Act cycles, Kaizen, process improvement, etc. Whatever the organization calls it, it’s imperative to do more of it.

As Malcolm Gladwell relays in his “Creation Myth” essay, psychologist Dean Simonton notes, “Quality is a probabilistic function of quantity. The more successes there are, the more failures there are as well.”

If innovation is the way into the future, and it most certainly seems to be, healthcare delivery firms must embrace widespread experimentation and make the tools, both tangible and intangible, acceptable, available, and accessible.


Strategy Execution Platform


Arthur C. Clarke, the acclaimed futurist, wrote: “Any sufficiently advanced technology is indistinguishable from magic.” That notion has been canonized as the third of Clarke’s Three Laws.

“Any sufficiently advanced technology is indistinguishable from magic.”

How does an organization empower middle managers with technology?

With the magic of a Strategy Execution Platform.

A Strategy Execution Platform provides diverse functionality, allows a sustainable support model, and is inexpensive to implement. It possesses the privacy and security features demanded by the healthcare industry. It allows IT to facilitate technology diffusion throughout an organization by focusing on governance rather than managing a project request queue. Instead of a single-record keeping system that promises everything to everyone with a single usability framework, it allows for many projects to be built upon a single framework promoting usability to match the workflow needs of the user.

Most important, a Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation. Finally empowered with all three resources — people, process, and technology — middle managers are now truly enabled to implement the strategies of healthcare transformation. The ability to pilot ideas, as many as possible, in response to arising problems and opportunities and then iterating, expanding, or ending the idea is a paradigm changer for healthcare delivery.

As a flexible, complementary solution, a Strategy Execution Platform can be a standalone software system allowing software to be created for any need. It can be an overlay, a way to make existing technology more functional. It can be a way to connect technology with new or existing systems, making integrations the default and not an exception. And it can even be a solution that stands between two other solutions, drawing data from each and recombining to create something new for a related function.

A Strategy Execution Platform is the easiest answer to a problem facing more and more departments and cross-functional initiatives: information management. As organizational efforts take notice of the reality that what happens outside the hospital or clinic is as important as what happens inside, the patient journey continuum becomes a necessary concern. The four activities — acquire, connect, retain, and improve — some pursued collectively, others independently, become important considerations for a firm’s activities as a system of record.

As a platform strategy, a Strategy Execution Platform meets the goals of exponential distribution (scale), widespread experimentation (scope), and expedient implementation (speed). It can be programmed, tailored, and adapted to a department’s needs. It removes the need for IT to conduct a scoping exercise every time a technology request is made. Governance is possible but doesn’t stand in the way of progress. The system is dependable but doesn’t require excessive support. It is a multi-sided technology solution addressing the requirements of a diverse set of stakeholders.

The velocity of industry change requires an approach to solving problems and taking advantage of opportunities where there is a bias for action and an expectation of widespread experimentation. It requires a new commitment to speed and scale and scope. This notion becomes a reality only with empowered middle managers. Agency over people process, and technology decisions is their new domain.

A Strategy Execution Platform makes it possible.