Health Innovators
Health Innovators

Episode · 2 years ago

Why Waterfall Doesn't Work & How to Manage Strategy


Healthcare innovators are usually in such a rush to get to market that they don’t take the time to create the correct framework for decision making and develop the right strategies. Usually, they employ a waterfall strategy, which makes them susceptible to failure.

How can we implement incrementally, instead of taking a static approach? Why is it a huge mistake to lock down our strategy without making it flexible, iterative, and data-centric? How do we connect the insights between the disparate parts of the commercialization process?

On this episode, we talk about why the waterfall strategy doesn’t suit the healthcare commercialization process, and why a “set-and-forget” approach is a costly mistake.


Success in healthcare commercialization starts with slowing down to wrestle with our assumptions. -Dr. Roxie Mooney


3 Takeaways

  • The strategy for successful innovation is not meant to be static. We need an agile, iterative methodology that keeps up with the dynamic nature of healthcare. 


  • The waterfall method is not flexible enough. Consumer needs, market trends, and competitors aren’t fixed. Our strategies have to account for that level of constant change. 


  • Set a strategy that leaves options open. Just like Napoleon, one of the greatest strategists in history, we should be setting strategies that give us options and maneuverability. There’s no sense in sticking with a strategy even in the face of conflicting data.

The decisions we make in healthcare don’t function in a vacuum. Because of this, healthcare innovators are up against a lot of challenges that can affect the commercialization process. The first step healthcare innovators can take to beat the odds is to have a framework for those commercialization decisions, from concept to launch and beyond. 


Our strategy needs to reflect the dynamic and complex nature of the healthcare industry; and if we make decisions in the right sequence, we will avoid market failure, use our organizational resources well, and increase the profits of our innovations.

Welcome to Coiq, at first ofits kind video program about health innovators, early adoptors and influencers and their storiesabout writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy,founder of Legacy DNA marketing group, and it's time to raise our COIQ. Welcome back to IQ listeners. On today show we're cutting another solo episodewith Matt Johnson, our executive producer for the video and podcast show. Thankyou so much for joining us, Roxy, pleasure was always awesome, and youhave your own podcast show. I do, I do and and enjoy, enjoy having kinds of deep conversation. So on my own podcast we talka lot about strategy in the area that I operate in. So when Ishow up to these I know I'm going to have a really end up reallygood conversation and I'll end up pulling things out of this that I can goapply into my own business, which is a blast for me. But we'regoing to talk about strategy on the fly.

You know, strategy being kind ofstatic and there's this idea, and I think a lot of people have, it doesn't matter what fields you're in, but especially, it seems like inhealthcare that, hey, you do, just get the strategy right once andthen just let's hit the ground running, let's get to market, let's getout let you know, get in front of system get in front ofusers. Like, let's just get out there and do it right and thenthat that will, that will take care of itself. And it kind ofgoes back to the thing we've talked about before, which is that, hey, as long as you have the best solution, it's going to win out, which we've dealt with before. We know that that's not true. Solet's talk about strategy a little bit. What's what's you're feeling? Well,and I think that it's, you know, all entrepreneurs is. I've never metan entrepreneur that didn't really operate fast and furious, right, and sothe idea of leap frogging over strategy and getting into the tactics just makes,you know, entrepreneurs feel good. They're making progress and they're that much closerto success. You know so. But but that can be a losing strategywithout even realizing it, right or some well, yeah, because there's otherpeople involved. We've talked about this on...

...previous episodes, that it's not upto us. We can think we have the most awesome thing, but they'reespecially in healthcare, with it being multisided, there's so many things to consider.Even just one element, which you mentioned on a previous episode, thefact that sometimes the people who use a product or an innovation are not thepeople who pay for that alone introduces so much complexity and the decision of whoare you selling to and who's buying it and who are you marketing it to? That's just one element of a strategy that can have all sorts of implicationsup and down our our entire business. So anyway, let's jump into likeif you had kind of, I guess, the when you look around at themarket and you see what people are doing, both the innovators themselves whoare leading the companies and developing new solutions, and the people that they pay tohelp them with their strategy, essentially you're seeing kind of the same problem. What does that problem? So most of the time there isn't a frameworkfor that decision making to take place, so it's a little bit more WillyNilly, the kind of add hoc and...

...and so you know, there's allsorts of inherent challenges to that I may be leaving some strategic decisions on thetable that I'm not even aware that I need to make, or I maybe overlooking some of the connections between those strategic decisions. And so, youknow, none of these decisions kind of function in a silo or kind ofIndependent. They're all in a related and so if I don't have a frameworkthat, mind you, is based upon some type of theoretical principle, right, so it has to have some type of backbone and credibility to it thatI'm I'm going to be more susceptible to failure. And, like we've talkedabout on some other episodes that you know the failure rate is really high.Ninety five percent of innovations that are brought to market fail. So what isone of the first steps that health innovators can do to kind of beat thoseodds is to have a framework for those commercialization decisions all the way from conceptto launch and beyond. Yeah, yeah,...

I agreed to it's if you mentionedthe typical entrepreneur being kind of the fast and the fury is we allhave that idea that, well, if ninety five percent of businesses fail,those are the dumb ones I'm in the five percent. That's not good.I am the five percent. Happening to me? Come on now, onehundred percent, we all think. Well, and that's you know, that's it. There's a lot of beauty in that, because that's why we are, that's why we're entrepreneurs, that's why we're creating things that don't exist,and it's that kind of optimism that really fuels us and helps us overcome allthose hurdles that we face in this journey. That is a hundred percent true.Everything is everything is a tradeoff in a balance. It's you Yang,all right. So so when we look at having a framework, so wetalked a little bit about, you know, like doing strategy on the fly,which most of us do, obviously, having having a framework basically lets youknow exactly what all the factors are that you should be taking into accountbefore you even sit down and make the...

...decision. So when I think aboutthat, to me that means having better a better idea, like a Romant, better vision, almost like taking the blinders off, but it also meansyou kind of know, if you know all the factors that go into it, you probably know. Okay, here are the five things I don't reallyknow and I've never really taken the time to even ask the market, andI know that's part of your strategic framework, is knowing who and when to goask to get the data that you need. Right. Yeah, yeah, absolutely. So it's it's really it's all of those decisions that collectively,you know, define that commercialization process and every decision that's being made. Yourbuilding confidence because you're taking the time to kind of wrestle with the research,wrestle with the data, kind of double check or play devil's advocate with someof your assumptions. There's so much biased that's just kind of inherent to thiswhole process. So a lot of times, you know, health innovators want tomove fast and furious and get to... because we're all, you know, trying to win in be first to market. But the reality is issuccess is slowing down just a little bit to wrestle with those assumptions, kindof think a little bit differently, think a little bit deeper about these decisions, because I guarantee you that when you have this, you know, provenframework, that this strategy that you have as an output is going to bevery different than if you didn't take the time to wrestle with some of thoseideas. I've seen it happen time and time again. Yeah, I readesomething really interesting. I think it was actually just yesterday. Stumbled across thislittle piece of information. I was working on some content for my own book, which I know you're working on yours as well. I think ours areactually going to come out around the same time, September, October Ish.Just awesome. Yeah, I know. So we're both in the kind ofa strategy in the deep thinking, good decision making business. So I stumbleacross a piece of information which was about Napoleon, which is, you know, widely considered like the greatest military thinker...

...and strategist of all time. Oneof the things that he was famous for was the the preceding, always proceedingwith two options, and other words, he never considered strategy to be somethingthat he did back at the palace and then you just kind of carry outon the ground. Strategy was just it was basically just like it's hey,this is how we make decisions, and it's always this kind of iterative process. So he learned how to set strategy in such a way that it gavehim options and maneuverability later on. That's one of the key things that ifyou're working with a good thinker, someone like you, if you're a healthinnovator, and they're working with you, I think you have the ability tokind of lead them through a process of setting strategy and making do good decisions. It's not about cutting yourself off from decisions. It's about creating options soyou can move with whatever the market wants, because that's always changing, and beingflexible because consumer needs aren't fixed, market trends aren't fixed, competitors aren'tfixed, so those things are continuously evolving...

...and changing, and so you know, you know the work that I do with folks is that we're developing thatemergent strategy that we're going to go to the market and test. Yes,even the work that we do together over this twelve week period is and we'renot saying that at the end of those twelve weeks that all those decisions arefixed and we're confident that this is the exact strategy for going to market.We're just saying that we believe that this is our most profitable strategy based uponthe data in the research and the framework that we've used and then we gointo the market and it's still errative, in an errative and flexible process becausewe're continuously infusing new learnings throughout that. Yeah, which is we alluded toit before we hit record, but I wanted to bring it into this conversation. You mentioned something that basically the waterfall doesn't work right that kind of projectmanagement decision style. Explain a little a about what you mean by that,because that is we think of it in...

...terms of if you were to kindof lay out this this process of setting your strategy, that's probably what mostpeople would do. Okay, I'm going to make this set of decisions andthen lock those down, and that to make the next of decisions and thelock those down and show them the closet because they're made right. Yeah,that we by the waterfall method. Yeah, and you know, and to yourpoint about you know Napoleon, you know, when he's out on thefeel of the battle field, he's not like, oh well, you knowwhat the the opposing team, you know, did something differently and now our strategyis not effective, but we made that decision, so we're going forwardwith it anyway. Right there, adapting and changing and and so you know, the waterfall method can be successful in a lot of applications, but Ithink when it comes to developing your commercialization strategy that it's just really not flexibleenough. More of an agile methodology that we're using to build that commercialization strategybecause, like you said, it's not fixed where you're making decisions and it'sin this specific static sequence of events.

It's not like one thing happens andthen it ends and then another decision make is made and then that ends andso forth. It's IGERATIVE. It just continues of you know, build,test, iterate, build, test, iterate, and really that's sometimes it'shard for health innovators to kind of swallow, because we want to check it offthe list, we want to mark it as done, but this isreally a process that happens throughout the entire life of the company because it's allalways changing and so we never we you know, you they we will getto a point where we believe that we've got a deliberate strategy that we sayokay, we've identified product market fit and we believe that this is going tobe our scalable strategy for scaling the business and really growing. But even atthat point you're still analyzing the landscape, even if it's just insurance, youknow, again, like evaluating new competitors, evaluating the trend in your overall marketniche, you know, like you always need to be, you know, Eyes Open. That's aid. Yeah,...

I think one of the one ofthe things that entrepreneurs would love to be true, but it's not true, is that success comes from putting the blinders on and just working tailoff andthen everything will be fine. Yeah, I wish that was the case,because if every if the only thing that separated us from success is hard work, well then you know, there be a lot more successful people. Sadly, that's not the case. Yeah, I don't think we can really evertake the blinders and keep them on. We need to kind of always havethe blinders off. There's you know, we need to focus on what we'redoing, execute the strategy we've set, but still be consistently keeping our eyesopen and knowing what to look for, and that's where that strategy framework kindof helps. Even once we know what we're doing for the next ninety days, understanding and having that framework in place gives you a way to consistently reevaltyour your strategy without starting from scratch every time. You're just looking for thespecific factors that are important. Yeah, absolutely, and I think focus iskey, right. So, if you are a startup or an emergent company, I mean there's you know, you're...

...usually short on cash, you're usuallyshort on people and what you've got the most obvious things to do, andso how do you I? You know. So this kind of gives you aframework of what decisions do you need to make now that are going tohave the most impact to your success, and so it kind of gives youthis sequence of decisionmaking and then helping you kind of connect the dots between thatdecisionmaking so that way you are maximizing the use of your resources, both timeand money, and really knowing where to focus, because it's it's really Imean, I think that that's a big pitfall is that, as an entrepreneur, that I have so many things to do that I don't know what todo when, and so I'm spread too thin and and I'm just distracted andI'm not getting the results that I'm looking for. So, you know,having that framework really kind of gives us guard rails in that decision making process. Yeah, it's a good way to put it, almost like a bowlingwith bumper rails makes it a lot easier.

It's the only way. I boththree hundred it's the only way we don't end up in the gutter.All right. So you're doing a whole speaking of like the strategic process andgetting the right input and feedback. So you're doing this this workshop you've gotcoming up at a big healthcare event. So tell people just a little bitof briefly about the workshop and where they can learn more and connected yeah,absolutely. So we're going to be doing a workshop on patient cocrete patient productco creation at the Connected Health Conference in in Boston in October. Love tosee you there and you can get more information about it on the connected healthwebsite. Awesome. And then, besides, you know, kind of listening tothe podcast on Apple podcasts and spotify and stitcher in all the usual placesand leaving you a lovely five star review for all your glorious content and goodguests that you have. Besides that fun stuff, which people should do,where else can they go to kind of dive deeper into the framework and learnmore about the strategic work that you do? Yeah, absolutely. They can visitour website, legacy, hype and DNACOM. Very cool. You've gotall kinds of fun resources. They're awesome.

Roxy's a pleasure. I love talkingabout this stuff. It's always blast. Thanks, Matt. Appreciate it.But I what's the difference between launching and commercializing a healthcare in avation?Many people will launch a new product, few will commercialize it. To learnthe difference between launch and commercialization and to watch past episodes of the show,head to our video show page at Dr Roxycom. Thanks so much for watchingand listening to the show. You can subscribe to the latest episodes on yourfavorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes onour youtube channel. No matter the platform, just search coiq with DrRoxy. Until next time, LET'S RAISE OUR COIQ.

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