Can great companies transform healthcare?

A reference to the book Good to Great popped up during some of my research this summer. Interestingly, it was mentioned by a Google employee as one of the greatest business books.

I had the audio book in my car for years and listened to it on repeat during long commutes to the South Bay. Regardless I decided to read it again and was surprised to discover that the lessons has been somewhat ingrained.

With so many people chalking Google Health up as a failure, it’s a good book to read or revisit now. I don’t buy into the narrative that healthcare is too hard for big tech. Let me explain why.

Good to Great

If you haven’t read Good to Great or have forgotten it, the book is based on Stanford research of companies that were able to outperform their competitors over a fifteen year period and explains the factors that contributed to the success of the great companies.

Google 

Google is a great company that was founded to organize the world’s information. If you search “best search engine”, Google tops the list of search engines and has outperformed Microsoft. Microsoft’s search engine Bing is the second most popular search engine.

The healthcare industry has an abundance of data that is not easily accessible or readily available as useable information. The best use of Google’s expertise is to help organize all that data so that it can be readily used by whoever needs it.

Google Health

Looking at some of their existing investments in digital health [Fitbit and iRhythm Tech] and genomics [23andMe and Verily], Google is accessing large amounts of consumer lifestyle, patient and genomic data. 

The de-identified data will provide meaningful information to advance medical research, give healthcare payers [governments, insurers and employers] new insights for structuring benefits and payments and give consumers more information to manage their health. All of which will radically transform the healthcare industry.

Keeping Google Health as a separate business unit likely didn’t make sense given their investments in established operating companies. The operating companies may act similar to a service line function used by healthcare organizations, with Google providing functional expertise to those organizations as needed.

Healthcare

Years ago, I posed the question, “when is good, good enough?” because I had discovered that many healthcare organizations were content with good. If the organization was not publicly traded, contentment set in when they could pay the bills and make a bit of money. Healthcare executives were hesitant to rock the boat if they didn’t need to do it.

Good is not good enough for healthcare consumers which is likely one of the main reasons people describe healthcare as broken. It’s hard to hear such a negative assessment and hard not to take a defensive position.

It is also not good enough for those who want to advance their career, earn more money or pursue their greater purpose in life. The industry is at risk for loosing a lot of clinical talent at a time when more is needed. Healthcare leaders need to muster the courage to rock their boats. Defensive strategies are not going to work going forward.

Do we have any great healthcare organizations?

No one really knows because the current ratings don’t provide the full picture. Healthcare companies are not comparable because there is so much variation in the structure, services provided and financial reporting. We can’t ignore those difference or adjust for all the anomalies without a deep understanding of the business practices and financial systems of each organization.

The companies chosen for the Good to Great research were all publicly traded companies because the consistency in the rules and the rigor in the reporting made similar companies comparable.

Technology in healthcare

Technology was not one of the factors that made good companies great and it’s not going to make healthcare companies great either. 

Technology enables people to do their jobs well and that in turn improves business performance. It is time well invested to do right.

Given the amount of grumbling about electronic health records, organizations have not invested enough time and effort to refine their processes and the technology. Some organizations have found ways to relieve pressure and extend clinical resources in the interim but it’s not enough.

Greatness 

Greatness requires discipline. The great companies like Google understand what they can do best and focus their efforts accordingly. It’s referred to as a hedgehog strategy.

That level of organizational discipline has been lacking in healthcare but may emerge with the new companies engaged in the industry. 

Getting the alignment right to address the broken feeling may take time. There are competing interests and conflicting initiatives that need to be resolved for the industry to feel like a system.