Creating Space for Strategic Thinking in Business and Life

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Clients often engage us to help them think differently, often more expansively. All come in with a desire, idea, or plan – could be for a next gen product or better user experience, tapping into a new market, developing a go-to-market launch campaign, improving their brand strategy, or something else.

They generally believe the essence of their idea or plan is good, but have a niggling feeling that their idea or plan may somehow be “off” or missing something, but can’t really put their finger on what’s going on or why.

It’s kind of like, on a personal level, when you start to do something and some deep knowing inside says “wait!” or “think again” or “there’s more here.” We’ve all experienced this uncertainty in business and life, countless times. You might notice it as tightness in your gut, or cloudiness in your mind, or a drop in your energy. At that point, you have to choose – you can just keep going anyway and ignore that internal guidance system; or you can stop, step back, and think strategically about your idea or plan from a much larger perspective.

In business and life, stepping back to think from a larger perspective is what I mean by “creating space” for strategic thinking. Now I recognize that to some of you this may sound “woo woo” and very California (hey I live in San Diego!). But hang in there with me.

Because when you do create a bigger space for strategic thinking, all kinds of new possibilities emerge. The result may be a major pivot, a slight adjustment, or no change at all. The other really important outcome is your acceptance at a deep level and without reservation that you are on the right track and doing the right thing.

Here’s what happens: By creating space to think strategically from a much larger perspective, you are letting go of the how (for the moment) to focus on the what. You become aware of any self-justifying but discomfiting loop you were in. You see where your creative exploration of possibilities and strategic thinking was constrained in non-productive ways.

What very quickly becomes clear is whether your desire, idea, or plan is in alignment with the mission and purpose of your company or business unit. In other words, you will know if, from your internal perspective, your what delivers on your why. Then as a next step, you might choose to do research with your stakeholders and customers to see how they perceive the alignment between your desire, idea, or plan, what they expect of your company, and what they want and will buy and use.

Most importantly when you create a bigger space for strategic thinking, you are demonstrating to yourself and others in your company to trust and act upon the inner guidance we all have. Which is very different than deferring to the critical voice we all have as well. You can tell the difference because when you move business decisions into a more expansive space though your inner guidance system, there is no judgment involved. The higher level of strategic thinking emerges naturally and with little effort. When your critical voice is the driver, the experience is full of judgment and diminishment. Not fun, not productive.

Next time you are faced with making a decision on a desire, idea, or plan, and some deep knowing inside says “wait!” or “think again,”… then listen. Do it. Give yourself and your team the opportunity to step back, make space for fresh, strategic thinking. Emerge knowing with clarity the right next steps.

Acknowledgement: Thanks to author Jim Case for inspiring this post.

What The Smash Broadway Hit Hamilton Teaches Healthcare About Marketing

Describing the Broadway play Hamilton as a smash hit is a huge understatement. Nonstop media coverage, standing room only, tickets being scalped for thousands of dollars — demand vastly outstrips supply.


If you happened to see the Tony Awards the other night, you saw Hamilton front and center, sweeping the night with 11 awards. Even the President and First Lady did a pitch about Hamilton during the awards show, with Obama touting, “a civics lesson kids can’t get enough of!”

Hamilton is a great example of how popular entertainment can get people engaged and excited about what otherwise may seem uninteresting. How popular entertainment call sell powerful ideas.

Hamilton is selling a great history lesson about the founding of America. As Obama put it, “in this telling, rap is the language of revolution.  Hip-hop is the backbeat.” Who would have thought it??

Well, why not?! And why not apply that same open-minded thinking to selling healthcare, insurance, medical devices, and health IT?

Bottom line, your products and services exist to restore and promote health – that’s really important. Some promise small improvements, others revolutionary changes. Challenge your marketing minds to think outside-the-box (even if Legal makes you reign things in later!) and create a Hamilton level of buzz and demand about the improvements your offerings make.

Whether your campaign is powered by rap or rock, whether it uses humor or tragedy, whether it looks backwards or far into the future, you can stand out. You can get people excited about a technology or product that may otherwise seem uninteresting. Harness your creativity and imagination to deeply engage your customers and patients. Use research to make sure it works.

As Barbra Streisand put it when introducing the final Tony Award for the best musical: “Celebrate the beauty that artistry can bring into the world.”

Help your customers and the world see the beauty and artistry in  the value your company provides.

Siemens Healthineers: New Name, New Promise

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When I was a teenager back in 1986, Disney brilliantly dubbed its design and development arm “Imagineering.” With the unique blend of imagination and engineering denoted by the name, the group developed Disney’s theme parks, resorts, and other entertainment venues. Perhaps more than any other entertainment company, Disney has consistently provided imaginative engineering that creates one-of-a-kind experiences for guests. They have delivered on the promise of Imagineering.

Fast forward 30 years, Siemens just this month rolled out its new brand name “Siemens Healthineers” for their healthcare business. They explained it this way: “The new brand underlines Siemens Healthcare’s pioneering spirit and its engineering expertise in the healthcare industry.”

Of course, the greatest power of a brand name is in the promise it makes. Here’s the promise that CEO Bernd Montag made in relation to the new name: “Going forward as Siemens Healthineers, we will leverage this expertise to provide a wider range of customized clinical solutions that support our customers business holistically. We are confident in our capability to become their inspiring partner on our customers’ journey to success.”

Other industry leaders have made similar moves. In 2014, Philips pivoted their focus to become a HealthTech company. The strategy combined their professional healthcare business and consumer business (and still trying to spin off the lighting business) so that “health professionals and consumers will engage on their health journey in a more continuous manner, instead of waiting for acute episodes where disease may hit the patient.” Several years prior, GE launched Healthymagination as their “commitment to invest in innovations that bring better health to more people.”

I think the challenge for Siemens Healthineers will be to focus not on engineering health products but on actually engineering better health, and in a way that is meaningfully different than their competitors.

It’s a subtle but significant difference. Engineering health products is about what they make. Engineering better health is about why. And it is the “why” that can fulfill Montag’s promise to become an “inspiring partner on our customers’ journey to success.”

So it is for all companies: The inspiration is always in your “why.” Which in medtech, ultimately comes down to reducing suffering, improving wellbeing, and saving lives.

Healthcare Trends: What Customers Want – and Don’t Want – From Insurers vs. Providers

There are three significant and interrelated trends we are seeing from our research with health insurers and their members, providers and patients, and payer-provider systems. Taken together, these trends point to specific directions for health plans and healthcare provider organizations to take in order to better engage and satisfy their customers.

Improving Health: 3 Trends in What People Want

  1. More people want personalized health advice on what’s right for them.
  2. They expect doctors to provide them advice on their physical health and medications. But for lifestyle issues like stress management, weight loss, sleep–they seek solutions elsewhere.
  3. For lifestyle changes, they are open to advice from insurers–as long as it’s tied to how to use their health plan to stay healthy.

One key driver of the differences in what people want from their health plan vs. from their providers is mindset. Generally, people take on a “patient” mindset when they are sick and actively needing care from providers. They take on a “consumer” mindset when making lifestyle choices for chronic conditions and when dealing with their insurance company. These different mindsets lead them to want, expect, and accept different things from insurers than from providers. Understanding these two mindsets is critical for insurers and providers to develop the right programs and services people want and will use.

What People Want From Providers: The Patient Mindset

When a person has an acute illness or injury, they are in patient mode. What do patients want, and from whom? Patients want advice from their provider on their condition, symptoms, medication, treatment, and prognosis. Patients believe providers have the training and expertise to help them and should have their best interest in mind. After all, that’s what doctors, nurses, and other providers are meant to do.

Patients do not want advice from their insurance company about what care is appropriate for acute illness or injury. Right or wrong, patients often see insurers as obstacles to optimal care, not enablers. In the heat of the moment, they may lose sight of the fact that their health plan provides them with significant benefits and instead they focus on what they don’t get.

For many health conditions, patients sort of have to trust. As my friend and lifetime health educator, the late Dr. Shimon Camiel, said: “Sure, if I have high blood pressure, I want to be empowered and involved. But if I have an ax in my head, I just want the ER doc to take it out and save my life!”

So in the traditional patient/provider acute care relationship, the “contract” is this: patients trust, providers fix.

What People Want From Payers: The Consumer Mindset

When a person is dealing with coverage or benefits, they are in consumer mode. They expect to go to their insurance company – not their provider – about coverage decisions, or determining what providers they can see, or where to get their prescription filled. Similarly, they are open to getting advice about how to improve their lifestyle or better manage a chronic condition from their insurance company, as long as the advice is tied to using their benefits better. Consumers are not particularly wanting or expecting health improvement advice from their insurance company if it is not tied to benefits. To consumers, it makes sense and is reasonable that their insurance company will help them do things that both improve health for the individual and save money for the payer. That’s the heart of the win-win.

Consumers do not expect advice from their providers about benefits utilization or coverage. And many don’t turn to providers for help with health habits and lifestyle management unless it is tied to particular conditions like high blood pressure, obesity, or diabetes. Note that when dealing with long-term chronic conditions, people tend to be more in a consumer mindset than a patient mindset– even when interacting with their providers. I’ll cover this complexity in a separate post.

Like sick patients do, consumers sort of have to trust in the system. What is and is not paid for is governed by what their health plan covers, or what they are willing to pay for out of pocket. So the “contract” between consumers and insurers is this: Consumers make good choices, insurers pay for them.

Acting on the Trends for Better Business

Leverage these three trends as a starting point when you think about what your organization can and should offer to your customers. Then do the research to make sure you’re solving meaningful problems that people want your organization to solve.

The result is happier and more engaged patients and consumers and a far better user experience. That translates into brand loyalty and ultimately improved health and reduced costs.

Beyond UX: How To Tap Customer Desire For Better Health IT Solutions

User experience research is really important in healthcare. You need those insights to optimize the user experience and make your technology as good as it can be. But how do you know what desires and expectations users/customers bring into the experience? And how do you go deeper and identify what will bring real value to users/customers?


As you know, user experience research in health IT typically focuses on likes and dislikes and problems and opportunities with the interface, which makes sense. After all, the interface is what users use and what feeds workflows. For some technologies, user experience research also includes how providers, patients, and the device all interact.

To understand value, it’s important to go beyond assessing how users/customers interact with the interface and beyond other aspects of the use case.

Before Use

Let’s start with what is involved with users becoming users; that is, how they get to the interaction and experience. This requires understanding and tapping into their desires and expectations.

Consider: Are users coming to the experience by choice? Are they wanting to accomplish what your technology accomplishes? Are they required to use your solution? What are their expectations? What are their desires? How does using your solution fit into the bigger picture of their workflow and priorities?

These attitudinal precursors to use can dramatically affect the user experience. Decades of research show know how powerfully expectations shape experience. So be sure you know the answers before you test usability and the user experience. Do the research to get answers to these questions. A quick and dirty approach is to talk with users just prior to using your software or technology. Alternatively, you can bring them into a focus group facility, and with appropriate props, have them imagine they’ll be using your technology and find out what’s going through their minds and hearts. Just be sure to ask the right questions and without bias.

Observing Value

Another great complement to user experience research within is in-situ/ethnographic research at clinical practices to understand what will truly bring value to healthcare workflows within a broader context than your technology.

Watch at first. Just watch. Then ask questions to understand. Really focus on understanding problems, not coming up with solutions (yet!).

Ask them what they’re thinking as their waiting for data to be processed or for the next prompt. Identify what matters to them emotionally and pragmatically. Doing so will give you tremendous insight into what they desire and value, which in turn will affect what solutions you make and what user experiences you offer to help them fulfill their desires and get done what they need to get done.

This kind of deep observational research reveals what aspects of their workflow providers and administrators find most frustrating, what wastes the most time, what desires are unfulfilled, and ultimately what interferes with better patient care.

As my friend and mentor Don Norman, a noted author and leading Design Thinker summarizes: Observe/Think/Make. This is the critical “observe” step. If it’s done with an eye toward understanding the broader context within which your technology may be used, it will provide you with far more valuable insights.

Do observational ethnographic research in clinical practices whenever you can. If access is a problem, find other ways to observe workflow. Create mock workstations or procedure rooms and invite administrators and clinicians in. Again, you can use focus groups as a place for crudely emulating workflow. As long as the setup puts users into the right mindspace, it can get you valuable insights.

Bottom line, going deeper to tap into customer desire and understand what motivates users and what will bring them real value will make your UX work far more gratifying and effective and lead to better Health IT solutions.

Make Medical Devices & IT Solutions Customers Want & Buy

In medtech, you encounter unique challenges to making devices and solutions customers want and will buy. External forces, like downward cost pressures, reimbursement challenges, and regulatory requirements make it tough. Plus a lot of device and IT companies impose relentless pressure to get the next big thing to market – and to do it now.

In light of all these pressures, how do you increase your effectiveness at making devices customers want and buy? Keep customers first in how you think and all you do.

I know, I know. It’s easy to say. It can be hard to do. And it’s not a panacea to counter all the marketplace challenges you face. But it can ground your thinking, guide your decisions, and help you get the best possible results.

In a recent article published in Device Talk, the med device industry blog from MD+DI, I outlined four keys to making devices customers want and will buy, from a customer-centric perspective.

The 4 keys:

  1. Start with the right business mindset
  2. Get customer input – the right way
  3. Decide between MVP and alternatives
  4. Recognize your work saves lives

This approach will lead you to think differently, engage with customers differently, and design and market your devices differently. You really can increase your effectiveness by keeping customers first in how you think and all you do.

Read the full MD+DI Device Talk article here.

Let me know what you think.

Hope for the Future of Health IT Marketing!

hopeI just got back from the Health IT Marketing Conference (HITMC). It gets better and stronger every year, building incredible community, thanks in large part to the vision of its founders John Lynn and Shahid Shah.

I was fortunate to present on how to win internal support for better customer-centric marketing, and to lead a workshop – one that both delighted and humbled me. Here’s why.

The half-day workshop, Using the Voice of the Customer to Develop Winning Health IT Marketing, showed how to develop game-changing customer knowledge and translate it into winning marketing strategy.

The workshop participants – mostly marketing directors and managers – were incredible. It was my experience with them that was equal parts delightful and humbling. What stood out was their openness and candor, their desire to improve, their appreciation of the customer voice, and their willingness to challenge their own thinking and mine. And most of all, their commitment to deeply understanding and serving their customers.
Continue reading Hope for the Future of Health IT Marketing!

Getting Clearer on Patient Engagement: What You Said

In a recent post on patient engagement, I made the point that as a field, we really need to clearly define what patient engagement is and isn’t. After all, how can we improve it, if we’re not clear what “it” is?

Accordingly, I proposed a definition for patient engagement along with a rationale, and invited you to comment and add your definition. Many of you did, providing interesting ideas and much food for thought. Thank you all.

We aggregated what you said (only slightly edited for grammar) and are sharing it here to further the conversation. Let me know what stands out for you, and any new ideas or definitions that come to you.

Joeri GredigWe see patient engagement as the most valuable driver at maximal low costs to achieve faster recovery. Technology developed with focus on patient perceived value will boost caregivers effectiveness.

Leslie Rees: Hard to define with different attitudes of both patient and clinician and often determined by circumstance funding and time.

Marian BondPatient engagement is very different from listening to a patient worry about their health or takes action to improve their condition. Patient engagement is about giving your time to actually hear what is being said and acting as a conduit for that patient to grow in knowledge and spirit. Engagement is the illusion of time for that patient – making them feel like they are the only one in the universe and making them feel fully heard. Care and comfort is a lost art in medicine. It is something that a lot of facilities are trying to teach, but best taught by example.

William Hannon: You can never replace Empathy. Doctors, Nurses, Device Designers, Architects all need to embrace a sense of EMPATHY with the patient. It is a sad state of affairs when a whole new profession UX ‘User Experience appears out of nowhere.

Rafael Goeting: Engagement happens when we give our patients a greater sense of control over treatment, care, and outcome. This type of engagement is not limited to just the patient but also includes their loved ones.

Mahendra Bhandari MD,MBA: Patient engagement is a perpetual support to a patient, outside the period of ‘in person’ contact with the healthcare provider. Wireless medicine and technology is poised to play a major role. This engagement has to continue beyond the treatment of illness to wellness.

Dawn Stewart: In my opinion patient engagement comes in different forms and at different levels. This can consist of a patient taking interest in their condition, seeking out information around treatment and management, understanding their medications…rather than just letting the healthcare professionals treat them. It’s about taking some kind of active role in the disease, condition and therapy.

Sk Ray: I think patient engagement is the tool to share the information which are beneficial for any individual who is suffering due to illness or who is health conscious.

Thomas Calloway MBA: Great topic, Mr. Engelberg. I have always considered “patient engagement” the attitudinal decision that stimulates a commitment to modify deleterious health behavior. If you like, when patient and doctor decide to work together.


Note that to some of you, patient engagement is about patient attitudes toward their health. For others, it’s about tools, or interaction between providers and patients. A couple of you highlight empathy as the critical ingredient. And several focus on behaviors or actions patients take to improve their health or healthcare.

I’ll keep working on refining the definition of patient engagement so we can move to an industry standard. I welcome your ongoing feedback and input.

Once defined, the next question becomes… how do we measure patient engagement? The fun continues!

Happiness as Competitive Advantage? A Challenge for Health Companies

company_happinessYou may be familiar with the Kingdom of Bhutan’s Gross National Happiness (GNH) index. This small Himalayan nation is the only country in the world that measures and aims for national happiness as its most important objective. The intent is to build an economy and culture based on spiritual values more than on material wealth. It prioritizes GNH over GDP. Bhutan’s commitment inspired the United Nations to pass a resolution that placed “happiness” on the global development agenda.

What does this have to do with you and the success of your company that’s in the business of health?? Potentially, a lot. As you read what follows, consider the notion of balancing both profitability and happiness as guiding values and major indicators of success.

Bhutan’s young King Khesar put it this way in his coronation address: Yet we must always remember that as our country, in these changing times finds immense new challenges and opportunities, whatever work we do, whatever goals we have – and no matter how these may change in this changing world – ultimately without peace, security and happiness we have nothing. That is the essence of the philosophy of Gross National Happiness. Our most important goal is the peace and happiness of our people and the security and sovereignty of the nation.

Most companies in the health industry base major business decisions on financial metrics like ROI to shareholders, quarterly numbers, and EBIDTA. Which makes sense. You need to be successfully financially and deliver a return to investors to be a going concern.

Money matters, no matter how dedicated your company is to improving health and saving lives. “No margin, no mission,” as the late Sister Irene Kraus, former CEO of the $3 billion Daughters of Charity National Health System, is credited as saying.

And, and… maybe happiness can matter just as much as money, and measurably contribute to your company’s financial success.  Especially since you’re in the business of health. Many start with employee happiness and well-being. Kaiser, Genentech, Mayo Clinic are a few of the health companies that have a reputation for really investing in the well-being –  and thereby the happiness – of their employees.  And there’s much further to go.

Let’s do a thought experiment: What would if happiness of your employees was a measure of your organization’s well-being? What about delivering  happiness to your customers?  Can you imagine happiness as part of your brand promise? Part of your unchanging core values? A key differentiator in highly competitive market? A metric you proudly talk about to shareholders and investors?

Be happy??

Companies in Healthcare: What Could Make You Disappear??

The healthcare industry is changing at an incredible pace. That means winners and losers. New companies emerging and existing companies going away. What could make your company disappear?

To be clear, by “make your company disappear” I don’t mean some super-powered ray gun or a natural disaster that would ‘poof!’ make your company suddenly vanish, dissolve, or fade away.  I’m asking seriously what could make your products, services, or company irrelevant, obsolete, or undesirable?

And I apologize. I know disappearing can be an unpleasant thing to think about. But it’s really important to think about, especially when you’re doing well. As you know, there is a plethora of products, services, and companies that were once great, and then succumbed to forces that made them disappear.

In today’s healthcare environment, just consider the impact of Meaningful Use or the MEDTECH Act; the shift toward value-based reimbursement or growing influence of GPOs; the proliferation of wearables and monitoring devices; and the health plays of leading tech companies like Apple and Google.

Any of these forces can position a few as market leaders, necessitate radical restructuring for many, make other companies disappear, and launch countless new startups to replace them. You want to stay strong. Be proactive. Don’t be one of the disappearing companies or a victim of circumstances.

First consider your company’s relationship with the market and healthcare business environment. Start with these five questions:

  1. What change in the market can make my products or services irrelevant, obsolete, or undesirable?
  2. What technological innovation can make my products or services irrelevant, obsolete, or undesirable?
  3. What shift in consumer behavior can make my products or services irrelevant, obsolete, or undesirable?
  4. What policy or regulation can make my products or services irrelevant, obsolete, or undesirable?
  5. What competitor can make my products or services irrelevant, obsolete, or undesirable?

Your answers should help you look beyond the present, see threats to your long-term viability, and proactively make plans to preserve your company’s existence and well-being. Think big picture, not just about what might replace your offerings, but what might integrate your technology into something bigger, like smartphones have integrated the functions of MP3 players. Consider too getting input from KOLs and customers to give you a more well-rounded perspective and greater certainty in your conclusions.

Now take a look at your own internal practices and beliefs, that if unchecked, can prevent you from being agile and responsive, and ultimately make you disappear. But don’t do this assessment unilaterally, get feedback from your team. Drawing on the innovation work of Dartmouth professor Vijay Govindarajan, think about these three traps that can make even highly successful companies flop. Do any apply to you?

  1. Major investments in systems or technologies can make it prohibitively expensive for you to move to newer and better tools. But the longer you stay with what you have, the harder it is to switch. Some call this the “sunk costs” fallacy.
  2. Fixation on what brought you success blinds you to new things that can threaten or displace you. You don’t see it until it’s too late. Then you respond with desperation. Sometimes “if it ain’t broken, don’t fix it” just does not apply.
  3. Hyperfocus on today’s marketplace can lead you to ignore new trends and market forces, and future opportunities and threats. You may be too wrapped up in the business to focus on the business. You’re all about today, and lose out on forward thinking.

Combine your answers to the first set of questions about your company’s relationship with the market and external environment, with your assessment of traps based on internal practices and beliefs. Be honest.

Stay strong. Don’t disappear!

by Moshe Engelberg, Ph.D.