• Ruth Amos RN JD

Pigs, Wolves and Digital Healthcare Strategy


Strategy. It’s one of my favorite words in the English dictionary. Everything sounds better somehow with that word attached- as in, “I don’t just have a vision, I have a strategic vision.” But alas, successful strategies are often difficult to achieve in real life. I read an article this week written by some insightful leaders at McKinsey & Company and thought it would be helpful to share perspectives as relates to meeting some of the specific challenges inherent in digital healthcare decision making. The article is called Strategy to Beat the Odds.

The following scenario described in the article looks all too familiar when it comes to digital health- time and again, leaders go into periodic strategy meetings to present and discuss lofty goals and initiatives, then…

“…reality intrudes. By the time they get to the strategy room, they find it is already crowded with egos and competing agendas. Jobs—even careers—are on the line, so caution reigns. The budget process intervenes, too. You may be discussing a five-year strategy, but everyone knows that what really matters is the first-year budget. So, many managers try to secure resources for the coming year while deferring other tough choices as far as possible into the future.”

Perhaps it was after attending one of these types of meetings that former US President George W. Bush coined the now infamous term, “strategery”- looks and sounds like strategy, but it’s really not.


These dysfunctional conversations lead to a great denial of sorts- described as “successive hockey sticks,” depicted in the graph below- where aspirations perpetuate over the years as actual performance declines.




The McKinsey article focuses on economic profitability and market competition as the main goals for strategic thinking and looks at external benchmarking data to help leaders overcome biases and other decision inhibiting behaviors when looking to make bold strategic moves. Healthcare adds a critical dimension that needs to be kept top of mind in all discussions- deferred decisions resulting in diminished performance can very well place in danger the lives of those we are hoping to protect and serve.

In examining the odds of strategic success, the article points out that industry is key:

“The role of industry in a company’s position on the power curve is so substantial that it’s better to be an average company in a great industry than a great company in an average industry.”

The good news is, digital healthcare looks to be at the top of the great industry category these days. Statista has estimated the following global projections:

“The global digital health market was valued at 80 billion U.S. dollars in 2015 and is expected to increase to over 200 billion U.S. dollars by 2020.”

Yeah, all great so far, but what in the world does this have to do with pigs and wolves?

The humorous storytelling cartoon at the top of the page outlines the recurrent dynamics at play- the pigs are the strategic leaders (metaphorically of course), and the wolf symbolizes market and industry uncertainties that threaten the strategic plan, and failures that can pose a threat to the entire enterprise. In healthcare, digital strategy initiatives are fraught with budget silos, competing priorities and misaligned objectives. Even the terms used to describe a plan are likely to differ considerably from one impacted department to another. And with healthcare in particular, the wolf is always huffing and puffing at the door, heightening anxieties all around. To add even more pressure, failure of a digital strategy can potentially risk the lives of vulnerable patients.

So, what’s a pig to do to keep the wolf (or wolves) at bay? The McKinsey article outlines a few practical shifts that can be made to transform what happens in the strategy room:

·      Change the annual strategy-planning exercise into a continual strategy journey,

·      Replace base-case scenarios with momentum cases that extend the past trajectory into the future

·      Make strong bets on a few breakout opportunities rather than spreading resources across your divisions

The above shifts, combined with objective benchmarks that help define the quality of the initiative independent from the inevitable biases in the strategy room, will change the conversation at the top. This can improve overall chances of your strategy succeeding. When you can properly examine your most important business and quality levers, you can make better choices and mitigate the negative impact of fear, ambition, rivalry, and bias. Great strategies are notoriously tough to navigate, but it helps to have a decent map.


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