Category Archives: Business

Creating Space for Strategic Thinking in Business and Life

space blog post image

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.

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!

Hot at HIMSS 2016: Interoperability, Population Health, Telehealth, Patient Engagement

I just got back from a jam-packed few days in Vegas for HIMSS 2016. Just me and 40,000 of my closest HIT friends.himss16

The mix was 2/3 vendors, 1/3 healthcare systems, I heard. Lots of excitement, lots of energy, lots of promise. Lots of walking.

As I step back, I see four main themes jump out: Interoperability, population health, telehealth, patient engagement. Here’s my quick take on each.

Interoperability: Getting devices to talk to each other, share data, and play nicely together for the higher good- better care, better outcomes. Along with improving mediating outcomes like workflow and reducing errors. Kudos to device and IT companies for sharing and letting go of turf. It’s certainly time.

Population health: All about prediction to figure out whom to provide what services to. Seems to be a modern version of managed care in terms of bottom line purpose, but driven by predictive analytics and with far more tailoring of care. The key piece still under-estimated is how hard it can be to get people to change health behaviors.

Telehealth: Keeps evolving to let more and more care and monitoring happen remotely (or “out-of-person” vs. “in-person”). Now it’s not just connecting provider and patient, it covers connecting providers and providers, providers, payers, and patients, etc. This will challenge our paradigm about what monitoring, diagnosing, and treating can only be done in-person. I think the litmus test for clinical care is empathy – to what extent can a provider truly empathize and thereby deeply understand a patient through mediating technology.

Patient engagement: Though it’s been around since the earliest days of healthcare, it now means all kinds of things and is catalyzing a wide variety of new products and services. Key issues here are about defining what it is and isn’t, developing objective metrics, and making it not a separate “thing,” but an integral and unavoidable part of every healthcare interaction.

Better interoperability behind the scenes, plus telehealth to enhance and extend relationships, combined with population health to focus resources, improves patient engagement to make it all matter.

Let’s Stop Confusing Strategy and Tactics in Healthcare

strategyI can’t tell you how many times we’ve seen very smart healthcare companies – med tech companies, payers, provider organizations, etc., confuse strategy and tactics. And it reduces their effectiveness every time.

Why do strategy and tactics get confused? First, sometimes there is not clarity about what the real objective is and why. This subjects companies to the paradox Lewis Carroll described this way: “If you don’t know where you’re going, any road will get you there.”  Without a clear end point in mind, develop meaningful strategy to get there is very difficult.

Second, there is so much pressure to get new things to market, it makes it hard to carve out time and think strategically. There’s only time to “do” — even if what is being done doesn’t make good sense.

So what’s the difference? Strategy determines how you will achieve your goal. It represents which map you will use to get where you are going. Tactics are the map details and are all about the doing.

Let’s start with a couple military examples: 1) Divide and conquer is a strategy. Sending half the troops in a frontal assault and half on flanking maneuvers are the tactics that executes on the strategy. 2) Go big, go long, or go home, were the three strategies being considered in the Iraq war. How many troops would be where and when were the tactics, and that’s what got all the media coverage.

Marketing examples: 1) Be first to market is a strategy. Be a fast follower is an alternative strategy. The specific products or services you take to market, the resources you allocate, and the timing are all tactics. 2) First get prospects in the door with a low barrier to entry, then engage them to be customers is a strategy. How you will go about getting them in the door and converting them into customers are the tactics.

 

Don’t be one of the many companies that spend millions of dollars and years of effort on something only because their competitors are doing it. Have a good compelling reason. That way you know where you’re going and why.

Next be clear about what your strategy is, and why. Make sure your strategy is really strategy — and not tactics with the word  strategy attached. Then get into the tactics that execute on the strategy.

Lastly, make sure your team knows the difference between strategy and tactics and why it matters.

Connectivity and Interoperability: Advance the Frontier… But Don’t Overdo It!

big_data_waveJames is a senior product manager in a med device company. He had a pretty typical business day last Thursday. Besides meetings and desk work, he was communicating online for about three hours on and off. During that time, James sent 34 emails and 15 texts and received 29 emails and 18 texts. He got 5 messages from LinkedIn, 3 Skype notifications, and over a dozen updates from various professional groups. He booked 4 customer meetings via his CRM and scheduled 17 tasks with his team on BaseCamp. He got invited to 11 events and was pinged with 14 calendar reminders.

Some of these things were really important to James, some mundane. However, all these activities went to the cloud, then to all his connected devices – cell phone, tablet, and watch. There was no discrimination as to what specific content was worth sharing, so virtually everything got distributed and was accessible on all his devices. When James saw 83 of the things he did online earlier in the day also show up on his phone, then on his watch, he growled: “Why are they telling me all this?!”

And whenever he was on his laptop and interrupted by text messages popping up on his screen, he felt intruded upon: “Why are they assuming I want this??” he shouted in his head. “Let me choose!”

Switch gears to healthcare. Connectivity and interoperability continue to be really hot topics throughout the industry. Health IT and med device companies are offering more and more connectivity and interoperability in their systems and solutions. GE describes the sharing of information between medical devices and information systems as “fundamental to GE’s healthymagination objectives of lowering cost, increasing access and improving quality.”

The core purpose underlying connectivity and interoperability is collaboration that improves care. HIMSS defines three levels of interoperability. The highest level is “semantic” interoperability, which requires that data is not just exchanged between systems (both IT and devices), but made available in a way that can interpreted and used by the clinician.

Done right, the technologies that enable connectivity and interoperability can help transform the industry by facilitating better health care and improved health outcomes at lower costs. That’s good for the healthcare industry overall and good for patients. Whether driven by Meaningful Use requirements, competitive pressures, or clinician needs, fundamentally, connectivity and interoperability are customer-centric ideas.

However, like with James above, be careful not to go overboard with connectivity and interoperability. This can happen when what is possible, i.e. what technology can do, trumps what is desirable, i.e. what customers want, need, and will use. Sometimes less is more. Sometimes it’s the discernment  of what information really matters that makes connectivity and interoperability so powerful.

Be sure you know what data (and in what form) your customers want, can interpret, and will use; and what data is just frustrating or confusing clutter. Do your homework, don’t assume. Just because all the data can be shared collaboratively doesn’t mean it all should be shared.

 

Gratitude in the Med Tech World

Thanksgiving.

In America, the holiday wakes up a lot of people to the good in their lives and they feel thankful.gratitude

I believe that for those of us whose work results in preventing disease, allaying pain and suffering, or restoring health, we have something to be thankful for everyday. That includes every person involved in med tech, healthcare, life sciences, health insurance, etc.

You have chosen to work in a field that inherently has meaning and purpose. Of course, it’s easy to lose sight of that, with the relentless pressure to come up with the next big thing, to be fast to market, to hit your numbers no matter what. And if your work is far from the front lines of patient care, it can become harder to connect what you do with the ultimate outcome of better health.

Stay motivated by connecting your work with its higher purpose – improving health and well-being. Here’s a story that brings to life how you can imbue meaning in what you do everyday, by repositioning your own thinking.

Sir Christopher Wren was a renowned astronomer, writer, and most notably an architect – a real renaissance man. He designed many of the most famous churches in England in the late 1600s. One day when Sir Christopher was inspecting the work on his masterpiece St. Paul’s Cathedral, he walked up to one stonemason and asked, “What are you doing?” The worker said “I’m laying stone.” Sir Christopher thinks about it, nods his head and keeps walking. He turns the corner of the building and walks up to another stonemason. He walks over to him, and once again says, “What are you doing?” This man looks at him, looks up, smiles, and says: “Sir, I am building a monument to God!”

He was doing the exact same work as the first mason, but the second mason connected his actions with a powerful vision and greater meaning. You can imagine this second mason was far more driven, focused, and committed to the results of his work. Why? He imbued his work with a higher purpose. It was no longer about the stones he laid.  It was about building a monument to God. His recognition that he was contributing to a significant purpose was the source of his focus and clarity.

So you’re not just managing work streams, developing product specs, writing code, editing copy, or selling products. You are contributing to better health, to less pain and suffering, to hope for living a better life.

Remember – especially when you feel overwhelmed with details and deadlines: YOU are making the world a little better.

Thank you.

The Critical Step Before Business Model Innovation…First Things First!

ambiguityOnce upon a time there was a little division in a big med device diagnostic company that wanted to extend into the unfamiliar territory of disease prevention.

The division was trying to win internal support and significant funding. They knew they needed a strong business case but had not yet figured out the specifics of their offering. There were a lot of unspoken assumptions and hypotheses. Moving forward by simply saying “we think we can, we think we can!” might work for little engines, but was not a good business practice for this group.

In short, the group was at a fork in the road. Going to the left they could travel on “Ambiguity Lane.” Staying to the right, they could move forward on “Clarity Way.”

Ambiguity Lane
In some ways, Ambiguity Lane seemed easier in the short-term because it postponed figuring out the foundational stuff that really needed to be figured out. Ambiguity Lane involves jumping ahead into business model development and skipping over the work of first gaining sufficient clarification on the offering or identifying and validating key assumptions. In this context, people travel Ambiguity Lane with a passive and often unspoken ambiguity that serves to postpone commitment.

On one hand, getting a business model in place sounds concrete and has an element of CYA, which can have a certain appeal. On the other hand, this sequencing also means living and speaking in ambiguities that avoids real commitment.

Even those team members that felt the seductive pull of Ambiguity Lane also saw its risks: 1) Internal leadership could more easily ignore the project or refuse to support it since it was lacking in substance and focus, and 2) The business model would be weak and not very actionable because it was built prematurely and based on too many hypotheticals.

Clarity Way

Going down Clarity Way was a happy choice to some; and initially felt risky to others. Clarity Way requires an honest assessment of what the team knows (and doesn’t know) about their offer and how desirable it is to customers, how feasible it is technically, and how viable it is financially. This road exposes critical business assumptions and opens them up to verification or correction. Clarity Way gets key questions on the table and solved in order to move into business model innovation with a solid foundation and in the right sequence.

The team members that wanted to travel on Clarity Way felt it would be premature and risky to jump into business model innovation without conducting some due diligence first. They did not want to pretend they knew more then they actually knew or use ambiguity as a cover for not having worked things through. They felt that the other road, Ambiguity Lane, was actually the greater risk.

 

Making the Choice

Turns out that Clarity Way has lots of blue sky and sunshine. Its travelers believe that transparency gets the best results, in line with the famous statement by Louis Brandeis: “Sunlight is said to be the best of disinfectants.”

Ambiguity Lane is grey and misty. It’s easy to get lost or misled when it’s hard to see clearly. As common sense philosopher Thomas Reid said, “There is no greater impediment to the advancement of knowledge than the ambiguity of words.”

After some soul searching, the little division in the big med device diagnostic company choose Clarity Way. They knew how much was at stake for the company by extending into the unfamiliar territory of disease prevention.

The Clarity Way travelers also saw the value of first getting everyone’s ideas, concerns, and questions on the table, identifying which hypotheses needed to be tested, and getting initial input from customers. By doing so, they felt they’d be able to make informed decisions, understand and avoid internal roadblocks, and solidly move forward into developing their business model and business case to unlock investment.

Happy Ending!

Once the team came together on Clarity Way and shared what they knew and what they assumed, they immediately recognized that the appeal of their offering was predicated on three major hypotheses. They did a fast round of customer research and validated two of those mission-critical assumptions. One assumption however, related to how desirable their offer would be to customers, was way off. With egos aside and a quick pivot, they corrected their thinking and modified their offering substantially. Doing so called for a totally different business model than would have been developed had they not made the commitment to do first things first. The team got the investment they sought and solid support from the CEO.

Life and business requires enough ambiguity, and we definitely need skills to navigate through it. But don’t let passive ambiguity be an excuse for not diving in and doing what needs to be done. Please get clear on your offering and why customers want it and will pay for it. Then and only then should you work on your business model so you can really get it right.

First things first!

 

The Promise & Challenge of Customer Intimacy for Med Tech Companies

No, it’s not about low lights, mood music or negligees. Customer intimacy is a business philosophy that commits you to deeply connecting with your customers. The deeper you connect, the more you sell.

Fundamentally, there are two main aspects to customer intimacy: One is really understanding what customers want. The other is giving them what they want. And that makes for very loyal and profitable customers.

When you are customer intimate, you focus on specific customers and let go of others. You precisely tailor your offerings to what your customers want and need, and do (almost) whatever it takes to make them happy. That requires really tuning to customer desires, both stated and unstated. And it may mean using big data analytics to make optimal recommendations to customers – like Amazon does with products, Pandora does with songs, and LinkedIn does with business contacts.

As a result, your customers are thinking “How do they know me so well?!” And of course, if you are practicing customer intimacy, you also genuinely care about your customers.

Sounds good, right? Here’s the rub: Most every med tech executive will say they are committed to connecting with their customers. In thought, they are. But in practice, it’s often a different story. Customer intimacy is hard to achieve. It’s a long-term strategy that requires organizational commitment, a relentless “tuning-in” to customer problems and desires, and both responsiveness and creativity to solve those problems and fulfill those desires.

Customer intimacy also challenges and turns traditional revenue goals right-side up. How? Customer intimacy is about maximizing the lifetime value of a customer. It is absolutely not about about lowering prices to hit quarterly or end-of-year numbers. In terms of KPIs, long-term relationships trump short-term profit. This can be a tough sell in solely numbers-driven organizations.

On the other hand, because it is challenging for med tech companies to practice customer intimacy, those that do will: 1) gain a significant competitive advantage in a very tough market, 2) build a barrier to commodization of their products and services, and 3) create a unique and powerful brand promise that can be core to their very identity. And as Zappos, Southwest Airlines, and Nordtrom all attest, bottom line, customer intimacy can be highly lucrative.

The first step is to decide if you have what it takes to be customer intimate over the long run. Consider: Money aside, how deeply do you care about your customers? Do you commit resources to really understand them? How far will you go to satisfy them?

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Resources:

The HBR classic by Michael Treacy & Fred Wiersema: Customer Intimacy and Other Value Disciplines

Interesting Forbes magazine article by business technology expert Joe Weinman on how digital and big data is transforming customer intimacy into “collective intimacy”

Med Device Companies: Never Say “We Sell Boxes”

We know several medium and large med device companies that still claim, “we sell boxes.” They may not say exactly that to customers, but inside the company they use those words, and usually with a mixture of pride, arrogance, and I think fear. Unfortunately, that thinking insidiously infiltrates everything the company does, from new product innovation to downstream marketing.

But that’s how some med device execs, engineers, and product managers think about the business they’re in: Making and selling “boxes” with good medical technology inside. It’s an easy trap to slip into – especially if the company has had success. The reality is med device companies do make boxes. However, that’s not the business they’re in.

Every med device company is in the business of improving healthcare and saving lives. Solutions to meaningful problems is what they sell.

In 1960, Harvard Business School professor Theodore Levitt wrote a game-changing article called Marketing Myopia. He posited that businesses do better when they focus on meeting customers’ needs rather than on selling products.

His quintessential example of an industry that got it wrong was railroads. While the need for freight and passenger transportation grew, railroads shrank. They wrongly thought they were in the railroad business. They didn’t see they were really in the transportation business. Why? Because they were product-oriented, not customer-oriented. As a result, railroad companies let others take their customers away.

Though it was over 50 years ago that Levitt wrote about marketing myopia, I believe that product-centric thinking still dominates in healthcare. What do you think?