Creating a problem by solving a problem


An interesting article was recently published by the Washington Post – If this was a pill, you’d do anything to get it – that shows how solving a problem so often throws up a new one

Medical research has taken amazing steps towards curing or immunising people against infectious diseases – acute illnesses responsible for high mortality rates. The results are shown in the image below:

Graph: death rate for infectious diseases

The outcome is people living longer. When we live longer, we are more likely to suffer from a chronic condition – an illness that develops slowly over time and often cannot be cured but can be managed through early detection and ongoing medication or lifestyle changes.

And so healthcare is being disrupted by its own success.

In the US (as reported in the article), one healthcare program adopted a new approach. They targeted individuals based on their medical history (had a chronic condition and had been hospitalised in the past year) and instead of waiting for potential patients to phone when they get sick, they arranged for a nurse to visit the patient’s home on a regular schedule (weekly or monthly depending on the severity of the condition).

The results: Reduced hospitalisations by 33% and reduced Medicare costs by 22%.

You should read the article for what happens next. Not quite a happy ending and the clue is in the title of the article. Perfoming house calls is assumed to be expensive and inefficient, despite the success of the program. If the same results had been achieved by giving the patients a pill…

It’s a great demonstration of the need to think differently when solving one problem creates another.


What is the CIO’s mandate?

The following presentation is a condensed version modified for display on Slideshare. It is based on a workshop I run for organisations to help define a digital strategy, by understanding and aligning with current business priorities. I’m considering expanding it out into a book format to include templates and exercises from the workshop.  The content is based on a range of materials I’ve gathered over the years from studies into achieving business value from IT. This version has been recently updated to include statistics from IBM’s 2011 Global CIO Study.

One of the most hotly debated exercises is to take the business benefits diagram and apply it to an industry to identify the differences between market leaders, those struggling to survive and a sample in between. Or alternatively, plot how a company has changed its position over time.

 An easy example is Apple. At the start of the century, the company was not in the greatest shape. There was little focus on customers, products were expensive to buy partly because they were expensive to produce, and the quality had deteriorated from being an early market leader. In the following 12 years, they moved all three axis into dominant positions

  • The opening of the Apple retail stores, staffed by ‘geniuses’ changed the customer relationship for consumers. iTunes provides a treasure trove of data about purchasing decisions. One are that remains weak is the customer relationship in the enterprise space.
  • Operations were completely transformed under Tim Cook, enabling products to be manufactured far more efficiently and at lower costs.  Whilst the Macbook range is still more expensive than the average personal computer, the gap has reduced significantly when comparing like-for-like specifications. And Apple makes much higher profit margins compared competitors, making it harder for others to compete on price.
  • Product quality has returned to a strong position, with most other manufacturers seeking to imitate many of the design concepts introduced in Apple products over the past 6 years since the launch of the iPhone
  • …and the fourth axis – redefining the market. In barely 6 years, Apple’s revenues and profits from mobile devices surpassed their computer sales and turned them into the most valuable company in the world. Nobody expected the oil companies to be toppled just yet.

If you were a competitor to Apple, which axis do you focus on to improve performance?  The fourth is always still there – Apple has yet to dominate the enterprise market outside of a focus on education…

Align your project dependencies

Causal Loop

I recently presented at the International SharePoint conference in London. This year, the conference held a new business-focused track and I was asked to present a session titled ‘From Business Requirements to Technical Scope’.  It was third in a series of connected presentations. A modified version of the talk is embedded below. (As usual, the original contained media animations and not many words so doesn’t really stand on its own.  Soundbite notes have been added into the slide deck.)

I confess, I was convinced I would be presenting to an audience of about 5 people as I had always assumed this to be a very technical-focused conference. I was wrong. The room was packed and the feedback received was great.

The emphasis of the session was on how to tease out the dependencies that should be aligned and prioritised as part of any SharePoint project, to help ensure that desired outcomes can be achieved. It is always about much more than just the technology. To visualise, I used a very simplified causal loop diagram. I may do a follow-up with the more detailed original from which it was taken.