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Interview with Ryan Tarzy about Digital Health

Ryan Tarzy received his B.A. in Economics and Applied Mathematics from Northwestern University. Early in his career, he realized that his talents involved combining the role of an entrepreneur with that of an advisor. Since then, Ryan has been passionately working on moving healthcare forward and has founded or led several digital health startups. In 2003, he co-founded MediKeeper, one of the earliest digital health startups. He later served as CEO of Personal Health Labs, a lab focused on R&D in areas such as health gaming and interoperability.  He now serves as Director of the Incubation Studio at CoverMyMeds. Prior to CoverMyMeds, he served as Co-Founder of Playful Bee and SVP of Business Development for PokitDok. He has recently begun to angel invest in digital health startups.


1) Many have attributed the impressive evolution and expansion of digital health to a move towards human-centered design, suggesting that a lot of previous health technology was engineered in a such a way that user experience was an afterthought. In your opinion, to be a success in digital health is user experience more important than utility? And why?

I think it is absolutely accurate that in the past, user-centered design has arguably been an afterthought. However, as we evolve into this next wave of digital health beyond Health 2.0, I think it is unfortunately still true that neither utility nor user-centered design is the most important factor of success. I would say at this point, success relies primarily on a solid business model. You can have fantastic user-centered design, you can have some utility, but if you have not figured out the way you’re going to get reimbursed, the way you’re going to get paid, or have a compelling value proposition for the direct consumer, then you are still going to struggle to be successful in digital health.

That said, I do believe user-centered design is driving some really exciting things coming out of the new wave of companies in digital health. I’m really encouraged by that, and I hope that it continues. I think that it does become a differentiating factor when you compare multiple companies, all of which have the reimbursement model and/or revenue model figured out.

2) As an investor in digital health startups, what do you look for in early stage companies trying to make it in health tech? And, what is a common flaw of new entrants that you feel could be easily avoided?

First and foremost, I look at the founders. Founders, to me, are the No. 1 determinant for success. I look for founders that, if they haven’t done this before, have deep domain expertise. They have dealt with the business problem before, they understand it, and they’re now trying to solve it through their own company.

I also look for founders that have a combination of passion and hustle that makes me confident that they’re going to be able to get past the inevitable roadblocks and hiccups that are going to take place when you’re trying to tackle an industry like health care. Those are the top two things I look for.

Lastly, I look for companies that I feel like I can provide an unfair advantage (while advising them). I want to feel like I can bring a lot more to the table than just monetary value as an investor.

In terms of things that I think are common mistakes … ultimately the sales cycles in health care are just really long. What I see is most new entrants will come in vastly underestimating the sale cycle and struggle. When you have these long sales cycles, what kills you is waiting on those maybes. You really have to aggressively develop process to manage the pipeline and be able to move beyond that first LOI, or unpaid pilot, and get yourself more quickly to a proven revenue model — a robust pipeline that is bringing in recurring revenue.

Another common mistake is a great idea, with a lack of domain expertise. It sounds self-serving as a healthcare investor with deep domain expertise to say this, but it is always good to have someone with healthcare expertise as an investor and/or advisor in the group. You need an advisor with specific knowledge in the area that you’re trying to tackle.

For example, a lot of people lump life science investors in with health IT and digital health investors — these are completely different businesses. One is dealing with long development cycles and a completely different type of regulation. The other is more about reimbursement cycles and enterprise sales and understanding the intricate players in the space. They are just different animals. You need someone, depending on which area you’re tackling, with that specific type of healthcare domain expertise. Very few can do both.

3) In 2014, Robert Szczerba wrote an interesting article: If Google Health Failed, Why Will Your Health Portal Company Succeed? We still have not seen a true runaway success in this area. What will it take to finally get there?

This is very personal to me because the first company I co-founded was one of the early personal health record companies. My co-founders and I built the company on the premise that there is this need, this obvious need, for a more central place for individuals to manage their health information. Back then we called it personal health records (PHRs), now you might call it a health portal. It just still feels like something that should exist but, I agree, at this point there has not been a huge success in this space yet.

What’s really interesting about this is there’s information leaking out that both Google and Apple are now attacking this space with new technologies. The ubiquity of smartphones, or even now through smartwatches, might potentially be a new opportunity for this to take hold.

I’ve always believed that the ideal health information exchange is the “HIE of One,” where the individual is the conduit of their own health information. The panacea of interoperability to create a universal portal, whether it’s Google Health or Microsoft HealthVault, is the wrong way to think about it. We need the ability for an individual to easily be able to take control of their health information and have control of the back and forth. Then, consume their data in whatever portal they want. I hope this is where things are going and I’m excited to see Apple coming into the market and Google seemingly retrying to attack this market. I’m really intrigued to see what they come up with.

4) What is your take on the longevity of today’s wearables? There are numerous articles with click-bait titles indicating the smartphone is dead within five years. One could argue that might be the same fate for most wearables today. Where do you see the puck heading for wearables?

I feel like five years is too aggressive to say the smartphone will die, but I may be wrong. I think that I’m much more pessimistic about the future of wearables as they exist today. We are seeing the early stages of these devices; they have passionate followers; they literally have millions of users out there. If you believe that wearables are going to become a more ubiquitous thing — I will say today’s wearables will likely be starkly different five years from now. Looks at Apple’s AirPods, those will change the smartphone and are technically a wearable. Wearables will evolve in ways we cannot predict.

It comes down to, what do you define as a wearable? Staying with the AirPods example, this is a sign that we’ll be utilizing voice for data entry … speech will be integrated into our car, which is integrated into our watch and into our AirPods. And really, the cloud becomes more and more the world we live in versus having our nose in our smartphone.

So although I am pessimistic that devices like the Fitbit will have legs five years from now, I am optimist about the future of computing being more integrated into all parts of our life in a, hopefully, more user-centric way without having to have our nose buried in our smartphone all the time. As voice gets more and more compelling, we will not need to physical interact with devices, limiting the need to “wear” anything.

5) In your opinion, what are two underrated and/or little-known companies right now in digital health that you believe are positioned to make a huge impact (in the future) and why?

1) LeapCure: This is a company that has really cracked the code on recruiting patients for clinical trials. It is fascinating to me that over 60 percent of clinical trials fail due to patient recruitment issues. That’s just staggering to me and just seems like such a big problem that we haven’t been able to crack.

This company has been able to use techniques that have been utilized in other non-health care markets to micro-target individuals — even for very rare diseases. One of their customers specifically specializes in rare diseases for children. So, truly the needle in the haystack kind of problem: how do you find the less than 20 patients in the country that would qualify for this clinic trial?

They are able to do that, and will likely make a huge impact. They are reducing the cost of patient recruitment and increasing the success rate of clinical trials. That could have a far-reaching impact on the industry. So, I’m really bullish on that and what they’re doing and excited to work with their team as an investor and board observer.

2) Paubox:  Sometimes seemingly boring companies on the surface are in the best position to make an impact. Paubox operates in the area of email and disaster recovery. Sounds incredibly boring for healthcare but, what they’ve done is, they have cracked the code of how to deliver HIPAA-secure email — and they do that in a way that is user-friendly. You can finally simply use your Gmail account as a doctor, and they’re able to make that HIPAA secure for communication with patients. All the friction created by email alerts that push you to a portal, only to hassle with additional passwords and clunky communication channels. Paubox solves all that. Finally, you can simply email your doctor … like you email the rest of the world.

 

Interview with Cathy Presland about Tracking Progress

Cathy Presland, a former economist, runs the program World-Changers’ Circle that takes five action-takers on a 6-month journey of transformation. She is an expert on leadership, both personal and professional, and inspires people to look beyond themselves when they make their life and business decisions. Cathy draws her knowledge from over twenty years of experience working with governments and international organizations on different public policies, programs and regulations. Cathy is a respected motivational speaker, teacher, mentor, facilitator and an author. Her book, Write! Stop Waiting, Start Writing. A Step-by-step Guide to Turn What You Know into a Book, is an international bestseller and is just one of the ways Cathy is supporting people who feel they have an idea that they want to share with the world.


1) If someone is looking to create a system to track their process towards some sort of desired change and/or personal improvement, how would you coach them through building this architecture so they can successfully develop a measuring protocol that assists them with meaningful metrics that assist with experimentation and continual improvement?

I think that at the core of any kind of monitoring is the question: is the process serving the end goal? Sometimes this is just a feeling, and sometimes, it is some kind of a quantified measuring protocol. I’m not so interested in numbers; I’m interested in where we are trying to get — How can we make the process more joyful, therefore, making it easier to get to the goal, regardless of the number? In my experience, if we put a measurement around a goal too early, the number becomes more important than the result we’re aiming for and there is no scope for creativity. We’re then quick to jump to self-criticism about not hitting some made-up target which sets off a cycle of demotivation. Measurements are especially not helpful in the early stages when we are just setting up doing something. Sometimes, you first need to do something to test your theory without having to deal with the danger of negative feedback that can come from creating your own metrics. If you want quantification, do a two-week experiment and see how you feel. You can put some measurement around it later if you feel you want to move it forward. So, very rarely would I rush into measurement from the outset.

I’ve got a client at the moment, for example, who’s applied for a number of jobs, and she’s not getting the results she wants. So, we had a conversation about what else could she be spending that time doing? It transpired that it wasn’t working for her because she wasn’t really inspired by the jobs she was applying for. This was the start of an honest conversation. I’m interested in what is going on in our minds that is creating good or bad feelings. When my client has an insight, and she realizes that she wants to be doing something differently, she should just be able to go off and do it. She doesn’t necessarily need to monitor things. Too much measurement can strain your results I think. It may be just about how honest we’re being with ourselves about the things we are doing, whether the things that we’re doing are going to give us the results that we want.

2) When someone is faced with assessing a life change where the present state/status quo is comfortable and satisfactory, and the future state being evaluated is high risk but high reward (i.e. the change requires deviating from an existing desirable state) — what effective strategies, processes and/or frameworks have you found useful for individuals to use to increase the likelihood of making a successful decision?

Life is never a low-risk, high-risk situation in my experience. The future is always unknown. None of us literally knows what we’re going to be hit with personally, professionally, so to me, that is never what it’s about. The actual situation is less important. The only thing that really matters is how we’re thinking about the current situation and what moves we’re making.

I don’t have a framework I could prescribe. What I do have is a philosophy. I do think there is a place that we can come from, because, as individuals, we’re so tiny and meaningless. And, the less consideration I give to me, the more contribution I’ve got to make to one person, to my children, to my family. I try to have a discussion around what is important to the person in that coaching conversation. What is it that they feel in this moment is the right thing for them to do? It’s about removing your personality and your ego as much as possible, so you can analyze your decision in terms of these questions:

  • Am I doing this because I think I’m going to be happier in some way, which is a red flag because our feelings don’t come from our circumstances?
  • What is the greater good in this situation? What feels ‘right’?

And, at the same time, I also think that the right thing is something that we create in our imaginations. So, I don’t see that as a fixed thing; I see that as a drive, a movement, an action at this point in time.

3) In contrast to the previous question, it is my opinion (given the immense amount of advice currently available about improving performance) that people often get stuck consumed by integrating seemingly endless methods (e.g. life hacks, productivity approaches, etc.) that either act as distractions and/or worse — impede progress towards what really is desired. What is your opinion on this assertion and do you have a process with your clients on making strategic decisions on what not to do? Lastly, in this regard are there commonalities that lend themselves to general advice that would benefit most people about what not to do?

I certainly see life hacks as distractions. And, I think that they can impede progress when people give them an importance that they don’t deserve. A lot of life hacks, especially in the personal development world, are designed to try to create some kind of space. Meditation, or anything in that zone, is designed to try to create some space so we can get some clarity. But, the process often becomes an end in itself, like, “I’ve got to meditate”. And we forget that we have access to that space in our heads at any moment. Some people have found life hacks helpful, but the reality is that we don’t need them.

We’re very good at making up things that we think we want and then trying to think our way there.  We go into this cycle of over-thinking, whereas, if we actually just gave ourselves mental space, we’d probably already know what it is that we want to do. But, we just don’t accept it, or we don’t see it, or we don’t think this is it; we kind of don’t know what it looks like. So we spend a lot of time chasing things that we don’t really want to do, or things that other people have, which are completely pointless wastes of time.

People that have enough perspective to know that something is not real or is going to pass, do better in life. We need to distinguish between what’s real and what isn’t. Generally, there are some things that look more real than others to people. Money is a typical example here. Many of us think money will create a feeling of security but the security comes from within us, not from something external. Similarly, doing something because it’s going to lead to something else taking an action or a path “so that…” or because there is an ulterior motive beyond the immediate is generally a wrong decision, too, and you are fooling yourselves if you are taking intermediate steps to something. If there’s something that you want to create, there’s always a more direct way to do it. For instance, “If I make lots of money, then I can create a foundation to do good in the world.” It’s like, why not just do good in the world now?

The other kind of big general thing that I will comment on is that people seem to think there is somewhere to get to. However, there’s no forward motion. It’s a real trap to believe that there is forward motion because then we’re always trying to get somewhere that we’re never going to get to. It’s just motion, in all sorts of directions and, often, that can be hard for people to conceptualize because we are so conditioned that there is a timeline in life, a journey from A to B. That’s a myth, there is only where we are now.

4) What are good indicators that it might be time to give up on a big idea/plan/goal? Using my own goal as the example, the Boston Marathon has always been a stretch goal, albeit an achievable pursuit — until recently where I was advised never to run long distances again. The Web is cluttered with advice to never give up on your dream, but science suggests this “inspirational” messaging has had some significant negative consequences. What is a suitable gauge and process for determining a goal has realistically fallen out of reach?

For me, this comes down to removing the ego from the decisions that we make. It is about heading in a certain direction and making the most of the opportunities we have rather than regretting those that are not open to us right now. It’s kind of direction versus outcome. And what is important for me is the direction and coming from a higher self … it can be difficult for us to create that separation between what we feel and what we actually decide to do. So, the higher the perspective we get on this, the easier it is to take those clear decisions. That’s where I would work with somebody. We feel what we feel; it’s not for me to tell somebody that what they’re feeling isn’t valid, because that’s what’s coming up for them. But, I will work with them in a way to show them that this isn’t meaningful in the way that they think it might be.

When a big goal falls out of reach, it doesn’t take away from you that direction that you’re heading in. For you, for example, it’s not in the cards to do the Boston Marathon anymore. Or, maybe it is. Or, maybe you can explore something else and get another route for experimentation and/or exploration. But, if you stay attached to the Boston Marathon, you’re going to lose the creativity to try out lots of different things on route to getting there. The reality is that we have very little control over what happens. We don’t know what’s around the corner; we don’t know who we’re going to meet. And, the more open and positive we are to the possibilities that are in front of us, the more fantastic things happen.

5) You run a program called World-Changers Circle. Although daring big might not be for everyone, what are some of the undervalued intangible rewards you have witnessed from those that succeed at big things?

I think that it is human nature to want to do something that goes beyond ourselves. People come to me because they want to do something meaningful, and this doesn’t have to be grandiose. Amazing things can happen when we get our egos out of the way, and these things happen faster than we expect when we do this too. You take bigger actions and make bigger asks when you’re not coming from a place of ego. There are a lot of benefits from taking a different perspective and looking differently at the world: you get calmer, have better relationships. You realize that it is actually more about how you’re looking at things rather than anything that other people have done. You realize that the world is driven internally more than externally.

Interview with Chip Conley about Creating Joy

Chip Conley began his journey in creating “joy” by transforming a seedy motel in the Tenderloin District of San Francisco into the legendary Phoenix hotel. Under the umbrella Joie de Vivre (translated to mean: the exuberant enjoyment of life), the endeavor grew to 40 unique hotels spread across California. He has authored several books, including Emotional Equations, PEAK and The Rebel Rules. Currently Chip serves as the Head of Global Hospitality & Strategy at Airbnb and the Chief Strategy Officer of Everfest, a company that connects the festival community online.


1) Now that you have immersed yourself in the world of festivals, what are the commonalities that make these experiences so impactful and life changing? For instance, there are elements that distinguish the Rise Festival from say, an Outside Lands. What are the essential elements of exceptional festivals that set them apart from a run-of-the-mill collective experience?

There is a French sociologist named Émile Durkheim, and in 1912 he wrote about the nature of pilgrimages. He coined the expression “collective effervescence” that really describes what makes a festival different. He used this term in the context of religious pilgrimages, but I actually think a festival where you become part of the installation — in an environment where people are somewhat out of their customary social environment — that is where transformation tends to happen. When you go to a concert, generally you go there for the day and then you go somewhere else. Collective effervescence happens when your sense of ego almost evaporates and what it is replaced with is a sense of common mission, and a common connection, with other people — that’s the beauty of a festival. The more digital we get, the more ritual we need. In this context, ritual is the IRL experience vs. the URL experience. The URL experience is what we do online, IRL is “in real life,” and I think that the more we are possessed by our gadgets, the more we need to have opportunities for connection in real life. Furthermore, there is no doubt that habitat influences our behavior and what we are willing to accept. A particular festival may have a set of guiding principles (e.g. Burning Man’s 10 Principles). What is really great when a festival does have principles — and they are well-advertised and promoted — is as an attendee you know what you are getting yourself into and also what is expected of you to participate.

2) You are well known for creating physical space and visceral experiences that create joy. Like any good master, you have pulled elements from other disciplines ranging from positive psychology to physical art. What is one of the most profound lessons you have learned along the way? Perhaps one you found the most surprising about the craft of creating joy?

I have always loved throwing parties. I throw the grand opening parties for my hotels, and every five years I throw a party somewhere in the world for just my friends. I did this last year in Baja with 125 friends. It was great. I just threw a party for 20,000 people in Los Angeles for Airbnb. What would normally be considered a conference, we reimagined as a festival and broke conventional rules. This was the third event of this type for Airbnb, and this time we wanted the format to be a bit uncomfortable at first. Not uncomfortable physically, but more like the attendees did not know what they were getting themselves into. A level of curiosity like, “I do not feel like I am in a normal environment.” This level of stress can actually help people to find parts of themselves that they did not know exist. We had the event in a somewhat sketchy area of Los Angeles. There are historic, beautiful theaters that we used as part of the installation. We took over five historic theaters, we took over about seven different retail spaces, and at least three parking lots. We used this environment for workshop spaces, conversation spaces and creative spaces for people to connect. What I believe is that what is remarkable — what creates joy — is when something surprises you and then it delights you. There can be surprise and disappointment or there can be surprise and delight — when it is surprise and delight, it is unexpected. Unexpected delight is memorable. I think interesting juxtapositions do this very well. When juxtaposition is done well, our brain is literally going through a process of having to imagine two things together, for instance, art and spirituality. The blending of ideas can lead to illumination. You see something in a way you never thought of before. The best way to describe someone who is a great festival producer: they are a curator. So, you try to curate an experience, create a habitat for people to have peak experiences. When there is nice mix of unfamiliarity and you push through boundaries — joy comes with that feeling that some level of accomplishment, some level of progress, has taken place. This growth allows you to feel a sense of exhilaration.

3) In your book, The Rebel Rules, you talk about the benefit of sabbaticals to avoid burnout. For many, these opportunities will only manifest a handful of times in a lifetime. As such, in your experience examining both successful “rebels” and those with an affinity for wanderlust, have you identified any strategies for those who embark on soul-searching expeditions to help maximize their outcome?

Creating space (whatever space means in the context of some individual freedom) and seeing what emerges is pretty important. Now, you literally could do that on a weekend. You could say, “Okay, this weekend I am going to put an office message that just says: I’M NOT CHECKING EMAILS THIS WEEKEND.” You hide your phone. For two days you go digital free. You go through a digital detox and maybe you have nothing planned, you literally just allow spontaneity or serendipity to rule those two days. That process might actually start to bring some things up for you, including fear. A lot of us like structure, a lot of us like to have a calendar that is full because it lets us know, “Okay, this is what I accomplished today.” There are a lot of people that need to ‘accomplish’ things to feel alive. So, I think not everyone needs a six-month sabbatical — at least not as a first step. Even if you have the opportunity to take a sabbatical because your life has created a transition, it might be foolish to assume that you know what you are going to get out of a sabbatical. For me, my sabbatical was not really even a true sabbatical, but more along the lines of “what’s juicy for me right now?” For me it was festivals, and I started going on that path, and I went to five festivals in Asia in the winter of 2013 and came back starting Fest300. Then, all of a sudden, out of that emerged the founders of the Airbnb approaching me and saying, “we want to turn our little tech company into a hospitality company, will you help us do it?” I have been doing that for almost four years now. Sometimes you have to make space to grow; I might not have taken the call from Brian Chesky four years ago if I had not taken time for renewal. When you create space, you are in a better place to take the blinders off, which gives you the opportunity to see things you might not have seen otherwise. So making space is one strategy. A second strategy is meditation. I try to meditate twice a day if I can. That experience is my form of a daily sabbatical, because it allows me to decompress and disconnect. It does not have to be meditation — some people like taking afternoon naps, for others it is going for that four-mile run that they do every day. Whatever it is that helps you to break with the linear mind. However, there is not a prescription that is right for everybody. I think for me, knowing my tendencies, having a really open field is probably wise because if I am too prescriptive about what I want at the end of a six-month sabbatical, the end result will be a linear to-do list, which defeats the purpose. With that said, realize your sabbatical probably should be the opposite of what you normally have. For me, I need space to be open to new ideas. For someone else, they may need a sabbatical because they are so lost that the purpose of their sabbatical is more oriented around a mission or some level of achievement.

4) There can be a bit of an underbelly to festival culture, where it is purported that some that identify with this lifestyle and chase experience, do so with hedonistic self-interest. A recent example are some of the complaints coming from Standing Rock (http://www.independent.co.uk/arts-entertainment/music/news/standing-rock-north-dakota-access-pipeline-burning-man-festival-a7443266.html). In consideration that this may exist, how does contribution, responsibility and ethics factor into organizing any collective experience?

I think hedonism in moderation is appropriate, self-interest is not necessarily a bad thing. However, festivals can become an addiction, just like so many other things in life. I think one of the things that Burning Man has done quite brilliantly is creating 10 principles that define this community. The main event and other events around the world that are sanctioned to be Burning Man affiliated help this community to hold ourselves accountable when we see people not living up to them. No one is perfect of course, and the Burning Man principles are not right for every festival. The problem with a lot of festivals is they lack principles. Often when you lack principles what you get is the lowest common denominator. Without an inherent culture, you get something that takes people to their basic instincts. Getting back to your first question, I think the part that is truly beautiful is when you see that collective effervescence happen. Collective effervescence means that people are losing their sense of ego and their sense of identity and, in the process, feeling connected to something bigger than themselves. I think that if principles are articulated well, and these principles are lived out in such a way that they help people move beyond their own selfish needs (in the process of experiencing the festival), then principles have the potential to create a better legacy for the event. If an event is something that is purely hedonistic — and it is important to note that there are festivals that survive and do quite well within that environment — you diminish the ability to somehow feel like there is something bigger than your own personal, hedonistic needs. Great festivals elevate people and help people to transcend their own petty grievances and desires. A great festival is a community of people experiencing something together. So, if it’s a collection of individuals as opposed to a community of like-minded people, the risk is, if you look at Maslow’s hierarchy, pretty low on the pyramid with regards to experience. At these type of events the moment that somebody else is attracting you as an individual to something over here, or a new shiny object there, whimsy just takes you over there because you don’t feel any connection to the purpose of the event. Festivals are at their best when they really do help people to feel connected to something bigger than themselves.

So the issue you have highlighted is not a festival problem — the definition of addiction is using something as a distraction, as a means of not feeling something. Festivals can play this role. If you just constantly go to festivals because you cannot live your normal life, or live in real life and/or you are searching for a utopian experience… festivals always come to an end. If you are going to festivals as a way to vacate in some manner, I think you need to ask yourself, “What could I do in my ‘normal’ life to make it better?”

5) If someone wanted to follow in your footsteps in the pursuit of creating joy, but was at the beginning of their journey and was looking for mentorship, what three pieces of advice would you impart on them to begin acquiring the mastery to be successful in this pursuit?

1) Understanding who you were as a little kid always helps, because weirdly there are clues in your childhood that help you understand what it is that gave you that sense of timeless wonder. Timeless wonder is usually a pretty healthy place to seek out in that Joseph Campbell “follow your bliss” approach to life. So, start by doing a personal archeology project about your childhood. Talk to your friends, talk to your brothers and sisters, your parents, whoever you spent time with as a child. Look at pictures of yourself at childhood and get a sense of what it was that gave you bliss. How can you manifest that in your adult life? I was always fascinated about Walt Disney and how he created Disneyland. I was fascinated by creating experiences for kids in the neighborhood, so… I would do just that. I would create a restaurant in my mom’s dining room for instance. There are clues there — find them.

2) Look at who you admire. Who are the people out there in the world as adults who are living their life in such a way that they could be a model for you? Who is actually having joy in how they experience their life? Who is doing it in a way that gives them a sense that they are living their calling? This does not have to be just in the work world; you could live your calling as a political activist, you could live your calling as an Ironman athlete, you could live your calling as a grandmother. Figuring out what it is that gives you that sense of passion in life and seeing it in other people — this helps you develop a better picture of what life might look like for you.

3) The way to bring joy to people is helping them to feel like they are a kid again. The Celebrity Pool Toss has been going on for 25 years now — a fundraiser we do at my first hotel, The Phoenix. It is a fundraiser for TNDC’s afterschool program for kids. We have created a fundraiser based upon the high bidder getting to toss a celebrity in the swimming pool of the hotel. The reason that it has lived for 25 years now — raising over $7 million for afterschool programs — is because it allows people to act like a kid. Auctions are a bit fun too, but the process of actually throwing someone in the pool is very childlike. I think providing people that sense of being able to break out of their normal formality — helping people feel less contained. Burning Man is a somewhat extreme example. Getting the chance to toss people in the pool is a very simple example, but still effective of reconnecting with a sense of freedom that might have gotten lost in adulthood.

A word of caution for those looking to create an event. Some people find joy in being spectators, others in being participants. Some events are better suited for everybody to be a participant, some are suited for some people to be participants and some to spectate. I think a key to success is to make sure people know what they are opting in for. So, if you are creating an event with the aim of creating joy — if your idea centers around everybody participating, you better make sure the attendees know that in advance.

Interview at the Motionsoft Technology Summit about Big Data

This quarter’s Business, Innovation and Entrepreneurship interview is the compilation of getting to discuss “big data” analytics with four exceptional thought leaders at the Motionsoft Technology Summit this year (2016). These four gentlemen in no particular order are: Jafar Adibi, Ph.D., the President, Co-founder, and CTO of re|unify; Jeffrey Cooper, the Senior Manager of Business Development at Samsung; Mark Newman, the President of Heads Up Analytics, and Keith Catanzano, a Partner at 2River Consulting Group. The answers below are summations of their respective answers, as such they are not represented as verbatim but edited for readability and context.


1) When a company is either building a data model (or working with a third party for this type of service), what considerations should an operator have regarding the crossroad of complexity and usability?  There are scenarios where too many disparate and incomplete data sets can make it difficult to find the signal from the noise; what are the trade-offs as the amount of available business intelligence information continues to increase? And what considerations should we take into account to maximize any investment in mining data?

[Jafar Adibi]: You need to figure out what problem you are trying to solve. Clients will come to me with data, rich sets of data, and say, “Jafar, now go figure out something to do. Find something interesting.” Generally, this is a waste of time. People believe finding correlations (any correlations) are going to help their business, but that is often not the case. When you identify your problem, we are better set up to solve it. There are different analytic methods for classification problems, association problems, and other questions that are not necessarily answered through correlative means. Getting to the right question will help you establish what data sets are important.

Then you need to figure out your budget. There will always be noise in your data, especially data from business intelligence. We can build a model to take the noise into consideration. However, using more data is obviously expensive, so that goes back to what are you trying to solve for. We can exclude data that will not answer your question, which saves you time and money. As such, you want to keep return on investment (ROI) in mind as you think about the question you are asking. Ask yourself, “If I answer this question, how much money with I gain/save?” The answer to the ROI question gives you a ballpark on what it might be worth regarding your investment in a data model.

2) It seems to me that a lot of ad hoc advice about using data for business intelligence is disseminated on broad-based assumptions derived from general population data. However, is this not one of the follies of “Big Data”? Companies are basing important decisions on arguably misleading benchmarks, rather than creating a narrative specific to their population (or at least a sample from their specific population); What are strategies to ensure we are making the best decision based on our company’s unique attributes?

[Mark Newman]: The most important thing is to trust your own expertise. You should intuitively know the customers you are trying to attract. You should have an idea of what strategies you are trying to pursue. You should already know what the important problems are you need to solve. What you don’t want to do is look to data to validate some preconceived answer to your problem. Instead, you want to devote your own educated guesses as to what to do — and then you want to use data to test those rigorously to keep yourself honest.

I think there are two ingredients to doing that. The first is to agree with your colleagues on the definitions of the terms that you are using in your data. If all the stakeholders do not agree on the definition of the numbers, then you all are not going to have an organized lexicon/narrative to work with. You have to agree on key metrics that you are going to use to allow for the monitoring of health and progress within your organization.

The second ingredient that you want to have is to follow an experimental approach that is constantly evolving. Your customers and prospects are going to react differently to your products and services over time. Reasons:

  • They might have more experience with you as your brand matures
  • As consumer groups mature, they change their goals
  • Your previous pitches are now stale, and customers react to them differently
  • Different competitors in the marketplace

What works today does not work tomorrow. Instead of some one-and-done, super solution to what you are trying to accomplish — instead you want to have some kind of innovative, incremental approach in the beginning. If you follow that, then over time, the data is going to have a narrative that reflects who you are, and what you are trying to do, and what works best for you.

3) Until recently, most data aggregation efforts have told a fairly unsophisticated narrative, and inspired relatively unremarkable initiatives in an effort to capitalize on data mining. How can we improve our use of data? And, how can companies do better at making data more actionable?

[Keith Catanzano]: What is the question the company is trying to answer? It is important to not just say, “How do you make data actionable?” We are probably all guilty at some point of looking at a data model and saying, “Look at the results, they’re awesome!” I think intriguing insights can be challenging in terms of making data actionable. There is a ton of data out there. Once you find ways to bring yours together, there is a lot you can see using data by way of insights. At some point you need to do something with the insights. In order to do that, obviously, it’s important to know who your customers are [assuming trying to influence their behavior is your goal], but also why are they customers. However, in this use case the why is more important than the who. The “why” is ultimately what you are going to try to make actionable, because to take action you are going to need to pull some type of lever to influence consumer behavior. There are lots of ways to work with communication or outreach in an attempt to accomplish this, but the effort requires the company to take a deliberate approach regarding how data is used to take action.

It is also important to note that making data actionable is generally not a one-shot deal, and architecting a campaign that changes an entire group’s behavior in some way probably will take a series of events that includes multiple levers I mentioned. So to make data more actionable, an organization should sit down and say, “What is the level of energy I want to put into solving or addressing this problem?” And that’s probably both a financial decision and a brand decision. For instance, a brand manager might ask, “Is this the kind of consumer group that we want to continue to attract? Yes; OK, well … indicators show we may be struggling with this particular group, so let’s double down because from a brand perspective, that’s how we want to be seen.” An alternative scenario here is the data suggests (to the brand manager) that too much effort is being spent focusing on the wrong group. Without asking the right questions, the data just suggests that marketing is ineffective. To finish, a company really needs shared responsibility to make data truly actionable. Ultimately, as an organization you determine what resources you want to put against data analytics, but knowing what question(s) you wanted answered first is important to making data actionable.

4) How will health club and health club member data evolve over the next several years — what will prove to be important signals for our industry in addition to financial, transactional and activity data?

[Jeffery Cooper]: So besides activity data from wearables, there will be a lot of contextual data the health clubs can now potentially get. With corporate wellness taking off you are going to see deep integration with insurance companies and insurance data. I believe, along those lines, health clubs will also be integrated more with the medical industry. As prevention becomes more associated with a basic level of fitness, I believe you will see medical data become relevant.

In that regard, I think prevention of chronic diseases is eventually going to drive a lot of people toward health clubs from the medical side of things. Right now, in most cases, doctors cannot write a prescription for a health club, but that could change as more complex sensors begin to validate the efficacy of fitness interventions.

Genomics data is another revolutionary area. You already have things like 23andMe, but there is a company Helix, which has been recently funded. Their idea is to sequence your genes, and license this data back through health care providers and fitness applications. With genomic data, consumers can make better choices (and health clubs can cater to them better). With this data, people can ask:

  • Am I suited for bodybuilding?
  • Am I suited for endurance?
  • From the limited time I have, where am I going to see the best results?

As science becomes more advanced, these companies will snapshot your genome once, and then as the science learns more and more about the genome — health clubs can take preemptive, proactive actions from that data to keep their members healthier longer, keep them out of the hospital and improve their overall quality of life.

5) Why does “Big Data” often fall short on delivering on its value promise?

[Mark Newman]: Personally, I feel that part of the problem is the way output data get reported. I feel that in data science to deliver a static report, it is potentially a sign that we have not done our job properly. The reason for that is because when we deliver a page of numbers, there is often no context to the end-user. When you are able to create/refine a business question, you generally make the presumptive problem simpler than it first appeared. Before you set off looking to get value from data, your organization should come up with your desired thresholds and metrics. Then instead of looking at static reports that, at best, will give you trailing indicators — build a dashboard that gives you real-time intelligence based on the most important metrics for your business. This dashboard should be something that your employees can always go to — not just some report that gets delivered on your desk — but something that is readily available on an ongoing basis. You also need to evaluate and monitor the efficacy of this dashboard on an ongoing basis. For instance, if you have a forecasting dashboard and there is a forecast your company is trying to meet, is the dashboard valuable and helping you meet your forecast?

I believe both dashboards that monitor things that drive your business forward, as well as insights that are actionable, are at least two things that give you some evaluation of whether “Big Data” is helpful and valuable within the context of your own particular situation. The other thing is that you really want to be doing analyses all the time. You want your data strategy to evolve past sending out graphs and numbers — to actually be working to build a story of what’s going on in your organization — and back up your story with reliable and meaningful communication so every stakeholder is seeing the same thing and you can all agree that your chosen data model(s) is providing value and is meaningful within the context of your particular business.

Interview with John Gengarella about Fitness Technology

John Gengarella is known for his extensive experience in global operations, customer-centric design and application development. He has been connected with highly successful enterprise software businesses for over 25 years. However, John began his career in the fitness industry. Outside of the fitness industry, John has held executive roles including vice president of C3 Energy, Chief Revenue Officer for 24/7 Customer and CEO of Voxify. In 2015, John was appointed the CEO of Netpulse, a company that has been viewed as one of the market leaders in mobile technology for the fitness industry. In addition to his professional work, John is the lead mentor in the non-profit organization StartX, which focuses on the development of Stanford’s top entrepreneurs through experiential education. He is also an angel investor and advisor to various early stage technology ventures.


1) One thing that consistently surprises me is that it usually takes a while for emerging tech companies — ones that specifically focus on health clubs — to realize that the total addressable market (TAM) regarding health clubs is actually fairly modest. In this regard, what lessons can you pass down to anyone thinking about creating technology that caters to health clubs?

I do not agree that it is a small total addressable market. I actually believe it’s enormous.  I think if you look at what’s out there today, you’ve got a handful of groups doing over a billion dollars in sales. If you look at the spend over the entire industry, there are testaments of over a $70 billion TAM. Folks are investing serious money to engage their members. I believe there are 185,000 clubs globally, that’s an enormous market. MINDBODY got a $450 million evaluation, a company that’s focusing on a niche segment of the market — studios.

You can easily build a $100 million company in this space. But it depends on how you define the market. Thirty years ago or so, I had a few clubs. We had index cards that had member’s names on them and you stuffed envelopes with monthly invoices that looked like the things you get at Denny’s. So, if you were assessing the fitness market at that time as an entrepreneur, did you say, “Hey, I’m going to make money on index cards and envelopes,” or did you say, “Hey, I can build a CRM solution, or automated billing system, and completely change the dynamics in a new set of investments in that segment?” I think you have got to look at the market overall and how we’re solving problems. I think if you look at IT spend, for example, that might be a small number. That might only be a billion dollars. But what does an average club spend on marketing? It’s 10x that spend. I bet worldwide clubs spend close to 10 billion annually on member acquisition. I think there is an enormous opportunity for the right entrepreneur in this space. The challenge is you have to go solve a problem. What do I do to engage members? What do I do to attract new members? What do I do to increase my retention? …the same core tenets exist from 30 years ago.

So my assessment is I think the market’s huge. And then, where do you draw the line? Is it Fitbit? Is it Under Armour? I mean the lines are blurring every day, there are tens of billions invested annually in fitness. As a software guy, I’m not as interested in treadmills and those kind of things. The Precors and the Matrixes will make their money selling equipment. 30 years ago, we talked about what was inside our four walls. Today, now we are talking about engagement with members outside of those four walls, as well. The club brand is still alive and well… on your app… on your T-shirt — but the market is changing. It is no longer necessarily simply what is happening in those three hours a week inside the club anymore.

2) As the head of a company that makes a great fitness mobile app — specifically regarding fitness — what is the role of activity trackers as they exist today, when the modern smartphone often rivals the internal hardware of commercial fitness devices?

That’s interesting. There is no question that the Apples and the Samsungs are going to be battling the Fitbits of the world very soon in terms of tracking. You have a few pieces that you’re solving for in this space:

  1. You need a form factor that works
  2. You want as complete of a data set as possible
  3. You want accuracy

I think the biggest challenge for smartphones is form factor. Especially since phones are getting bigger as they also are turning into mini entertainment centers. Also, women often leave their phone in their purse, so it is not constantly tracking activity. I think form factor is a challenge for phones today. What this means is you are also not getting a complete data set. For those who want all their activity tracked, you need to have your phone glued to you 24/7. Accuracy is also an issue. Without separate peripherals you are not going to get heartrate information, at least not accurately. There is still skepticism, even if smartwatches take, that they can accurately track heartrate. 

Phones do have a phenomenal advantage in that they are ubiquitous, and adoption is exceptional. I don’t know anybody that does not have a smartphone today. But what do I get out of that? Do I get the accuracy of my heart rate? Do I get other capabilities that I want to see… capabilities I can get from a wearable that I am in touch with the entire time. Given what we are trying to solve for, it will prove to be an interesting battle.

3) Looking past current wearables on the market today, where do you see digital health taking the health club industry five years from now?

That’s a really interesting question because the potential has become enormous, but just as it has been for the last 30 years, the next five will still be about relationships. What’s the relationship that I have today with my club (as a member)? What’s the relationship that I have with the other members? What’s the relationship that I have with my employer? What’s the relationship I have with my healthcare provider? My doctor? My coach? My team? I think when you look at the evolving way we engage in relationships through technology, you’ll see the digital aspect of that becoming more pervasive. I am not addressing just the customer relations concerns here, but also the relationship an employee has with their employer —  a financial relationship that plays a role in the person’s well-being. The big challenge is going to be the exchange of value. To me, there is a two-way value exchange. For instance, I (employee) let you see my steps on a daily basis, you (employer) give me $300 towards my monthly insurance bill. People love to discuss privacy concerns, but quickly forget it was only a few years ago they were hesitant to store credit card information with Amazon.com. Privacy issues aside, annual healthcare spend is the largest line item on our country’s P & L! Follow the money — over the next five years there will be enormous energy around a digital understanding of each consumer, each member, each employee. I see this evolving into some greater level of personalization that simply does not exist today. How do I get to know a specific person in a meaningful way and understand their needs, provide them value for that exchange, and capitalize on the value associated with that understanding in an ethical way? We’ll answer that question.

4) There is a modern-day narrative that fitness delivery is well-positioned, better than ever, to be on the forefront of the continuum of health care. However, this discussion has been going on for a few years now (e.g. Exercise is Medicine, Exercise is a Vital Sign, etc). In your opinion, do you believe technology has helped, or hindered, progress in this area? 

The challenge is the complexity around data privacy. What are the responsibilities around those that are in charge of the data? How do I protect the consumers’ willingness to share? What level of privacy should I expect in terms of dealing with any manufactured insight, i.e. new personal information generated about me that could effect my livelihood (e.g. credit score)? This problem doesn’t get solved with one “ah-ha” moment. There are going to be step-changes that go along with this because we are a cautious nation when it comes to privacy. There are credit card breaches all the time with little consequence. But, if I let somebody know what your blood pressure is, I can still go to jail. So, I think that we are cautious as a society about health data, but I believe you will see that loosen over time. What are the true risks if I share this information? Truth is, you probably have a great interaction with your doctor and she becomes wonderfully more insightful about your health.

There are valid, historic concerns about the consequences of having a preexisting condition. There’s a scare about how that data can be used and possible negative impacts that could come as a result of someone having that information. Again, fair value exchange becomes important. I’m willing to share, if there is limited risk and I get something in return. Few are going to share data for the fun of it. If people get better care, get a lower rate on insurance, get more personalized programs that are really consistent with their health, they will come around. You can see that today, in the volume of opt-in consumer apps that are out in the market. There will be dissection among the population: those that are willing to share health data and those that are not. There is always a sub-segment that’s going to believe in some conspiracy theory that, “data will always be used against me.” They are not going to participate willingly. Luckily there are many that have a willingness to take that risk. I think the more challenging issues are not around, “Can I collect data and generate insights around this woman’s health and well-being?” The challenges are more going to be around policies and protections that allow the consumers of that information to use it appropriately and ethically. To me it’s not technology that has hindered us so much… people have.  

5) The last couple of questions I have asked you what you think might be different in the future regarding fitness technology, a harder question might be the one I will conclude with: what is going to remain the same five years from now?

Five years from now, mobile will still be the center of our lives. It is the communication mechanism for any audience, whether you are talking about a health club member, you are a member of an airline, a hotel guest, or an Uber rider. Mobile will remain the primary platform for customer interaction in the near future. This bears repeating from my previous answer… thirty years ago, I used to have a few health clubs and the same mandates exist today: a need to acquire new members, a need to retain those members, and a desire to increase the contribution/benefit made to the member base. That’ll be the same in five years… probably for as long as health clubs exist.

With the pervasiveness of availability of information available to the consumer, the fitness industry, like any other mature industry, is becoming more and more competitive. So, the drivers of asset performance will be the same in five years. Mechanisms for personalization will evolve. There will be this quest for personalization. Whether I have a big box or a small box, I will be able to use technology to have the capability to differentiate my offering with personalization, but that is only filling the need that has always been there …building a meaningful connection with your member. 

Interview with Edgar Schein about Organizational Culture

Dr. Edgar Schein is one of the most prominent organizational development figureheads alive. He earned his Ph.D. in social psychology from Harvard University and went on to teach at the MIT Sloan School of Management reaching Professor Emeritus distinction. Along with numerous academic publications, Dr. Schein has a long list of books that cover various organizational topics such as group process consultation, career development, and of course, organizational culture. His titles include Organizational Culture and Leadership, Helping, Career Anchors and Humble Inquiry.


1) You have stated recently that the concepts of organizational culture that are often disseminated from your original work on culture need to now be viewed differently. What is one of the biggest misconceptions — regarding the way your work is used today — that you would like to see better aligned with our current understanding of organizational culture?

From the beginning, I have argued that culture covers everything a group learns in its evolution. That includes external understanding of the environment so that you can survive and grow. Internally, that includes figuring out how to get along. I think today’s usage of the word culture is almost exclusively number two. It’s discussed in terms of workplace culture and how to get better engagement; how to get people to work in teams; how to be more service oriented. People use the word, culture, as almost exclusively geared at how to make employees happier and behave differently according to some notion of what management thinks might be better. What gets ignored is the role of culture in defining strategy, and mission, and how we’re going to get organized. All these concepts are also part of culture, and they are almost never really referred to now in most of the current, popular managerial literature.

2) Few (if any) would question the merit of your ideas around leaders needing to be more helpful and the concepts of humble inquiry. In environments that are inherently fast-paced (ex. medicine) what are a couple useful strategies to utilize these methods where time is scarce? 

One misconception is that humble inquiry is a slow, tedious and long-running process. I can see how it could easily be interpreted that way. But, my experience has been that, if a leader — whether it’s a doctor or whoever — who has time constraints, still wants to be a humble inquirer, you can do that by being more personal. So, my best example is, I’ve recently talked to several doctors and they complained bitterly about the degree to which they only have a few minutes with a patient because of all the other stuff they have to do. So, recently, whenever I’ve been with a doctor and we get into this discussion I coach them to lean over, touch the patient on the shoulder, and say in effect to this person, “As you may know, in the present system, I only have ten minutes. So, let’s make those ten minutes count.” My hunch is that, if you say something like that, it would immediately relieve some of the pressure and would enable both of them to be more open and personal — saying what’s really on their mind. So, it’s use of time, rather than the absolute amount of time that I think makes the difference. What I want to teach leaders is to see how they can very quickly personalize their relationship with their subordinate, or client. When successful, what then transpires is good, open communication rather than a formal dance of do I trust the other person, etc., etc. That may take a lot of time in some instances, but there’s nothing arbitrary that says it’s got to take at least an hour, or a day, or whatever. It’s really how you do it that matters.

3) Previewing my own research a bit, I have found during the process of my dissertation — contrary to popular advice that effective workplace wellness requires leadership actively architect “positive” company culture — successful wellness programs in small to mid-size businesses flourish when leadership is not evolved. Successful programs instead seemingly share the commonality of beginning as an internal well-being movement, spearheaded by (what is perceived as) a neutral advocate. You have discussed previously that “concepts” do not have cultures, groups do. A working theory of mine (in this context) is that well-being is better supported by an organization when employees do not feel coerced by tactics pushing them towards a preconceived definition of “wellness.” If that’s true, are there any tactics leadership can use to inspire a healthy culture other than giving this cohort autonomy?

The leader doesn’t have to participate, but they have to believe that whatever is going on at that middle level is worthy of support. So the distinction you have to make is not that leaders have to be involved, but that leaders have to be aware of what’s going on and be supportive. I can give you lots of examples of that. An interesting example (in regards to your question) would be, if you found some middle-level-generated programs that succeed where the leader is indifferent.

There are a lot of touch-feely programs out there. The leader comes in and discovers for the first time you are engaging in one of these type of programs and says, “What? You’re meeting in this group? No more of that.” There are plenty of examples where good programs are being killed that way. The problem is that middle managers and/or their staff do not explain well enough to leaders what they were actually doing. If they learn that the employees really like this stuff, they are generally not going to kill it — unless it really violates some of their own assumptions about what employees should be doing. The programs that I’ve seen killed, for example, are where employees will get into a T-group program sponsored by HR, and then an executive takes notice and sees them engaging in various kinds of emotionally charged feedback activities. The executive gets horrified, and says, “Who launched this program? I’m not going to have any more of that in my company.” That’s the kind of thing that can happen if leaders aren’t well-oriented to what the program will actually involve.

4) In your extensive look at the role culture plays within organizations, what are your thoughts on the impact culture can have on influencing and/or impacting personal well-being (outside of what we discuss above)?

My basic view is that culture covers everything that goes on in the organization unless it’s a brand-new organization and no culture is yet formed. But, assuming that the group or the company has some history, the culture will determine both what people regard to be the right way to work and how to feel about it. So, you can have a culture, which we used to have a lot of in the auto industry and so on, where what the person expects is a fair day’s work for a fair day’s pay. As long as I get my pay and I have reasonable working conditions, I don’t expect my company to make me happy. I expect my company to give me a living. And, if that’s the cultural norm, as it was in many organizations in the past, then you can’t say this is a bad culture because employees aren’t happy. It is what it is and employees have accepted it. Now, what seems to have happened is, in the last 25 years, is employees are beginning to say, “A fair day’s work for a fair day’s pay isn’t good enough for me. If I spend all this time at work, I want to feel better.” That spawned organizations like Great Place to Work. Organizations like Great Place to Work make their money because a lot of employees think this stuff makes a difference. They believe, “How I feel at work is important.” If the boss gets concerned and says, “Gee, I want to be an organization that makes my employees happy because there’s some evidence, at least in some industries, that safety and quality actually is better if employees feel healthier and happier.” There’s enough research now that bosses are beginning to believe that this is real. So, suddenly, they want to change their culture. But, if they’ve spent 25 years building a fair day’s pay for a fair day’s work kind of culture, you can’t just now say, “OK. I’m going to bring in a couple of consultants and we’ll create a healthy culture.” It doesn’t work that way because you’ve trained all your supervisors and all your managers to be impersonal, and bureaucratic, and that’s the way the place has worked forever. So, now suddenly, you discover the employees aren’t happy… so what are you doing to do? Well, you might from the very top have to start treating your own subordinates differently because your own subordinates are also part of that cultural system. So, when people say, “I now want healthy and happy employees,” they generally don’t realize that whether or not they can get there depends very much on the culture that’s already there, the culture they have built over however many generations. Therefore, they can slowly begin to evolve their culture in a new direction, but that also means changing your reward system, changing the way people are managed, changing all the fundamentals of the organization.

5) You have recently focused some of your work around humble consulting looking at intimacy as it applies to working relationships. Sheryl Sandberg has discussed that it is the fear of perceived intimacy that holds men back from creating strong professional bonds with female counterparts. Have you unearthed anything in your recent work that might mitigate this risk (other than common sense)?

When my Humble Consulting book comes out, which will be shortly, you will see that I make a big distinction between three levels of relationship. One is sort of the bureaucratic “stranger” relationship. Level two is what I’m calling a more “personal” relationship. Then, level three is what I’m calling “intimate” relationships. So, the question is, are we using intimate in the same way as Sheryl Sandberg? I’m arguing that level two relationships, which are always appropriate, is what you would call a personal relationship. I know you as a whole person… I am responding to you as a whole person. The question of what is appropriate in the workplace between men and women, I think it’s totally appropriate for both to get more personal around the tasks that they have to perform. But, that should not imply they need any more intimacy, sexual or otherwise.

The definition of intimate becomes crucial in this discussion. In U.S. culture, one might think that the word immediately implies this deeper male-female kind of stuff. And, that would certainly be a misuse of a working relationship. Therapists and lawyers aren’t supposed to be intimate with their patients and clients, but they can be very personal in how they structure the relationship so that good information and trust is built up. So, that’s the distinction, but I cannot specifically answer this question because I do not know how Sandberg has defined the word for her work.

The trick is to be aware that society’s rules always apply. What society decides as inappropriate intimacy applies across the board. You can’t say, “Well, in my company, we’re going to use different rules.” The key is for you, or me, or anybody to play by cultural rules because those rules apply to all these situations. Then, within that say, “Okay. I can’t be intimate, but as a boss I can sure have a better relationship with my subordinates by at least getting more personal.”

Interview with Kate Matsudaira about Productivity and Work

Kate Matsudaira is a startup founder and technology executive with a passion for productivity. She has extensive experience building and managing high performance teams and has held leadership positions in companies such as Decide (acquired by eBay), Moz and Amazon.com. In 2013, Kate started her own company Popforms with the mission of helping employees excel at work through innovative courseware. Popforns was acquired by O’Reilly Media in June 2014. In November 2014, Kate launched the Spark Notebook on Kickstarter after a decade-long journey trying to find “the perfect notebook.” Her goal was to raise $14,000, and she exceeded this by almost 10X raising almost a half-million dollars. Kate can be found musing about productivity, tech, leadership and life at: katemats.com.


1) Throughout your online authoring on goal setting, you discuss the importance of being mindful of your motive. I like that you move beyond the common Simon Sinek clichés of “start with why” and rather focus on the reality that people are going to be moved to action differently by different motivation. What are the best ways of overcoming being “lazy”?

Have you heard the word akrasia? The term means lacking command over one’s self. When someone acts against their better judgment, they kind of simply have this akrasia.  You know you should be doing something, but you don’t do it. I think most people’s lack of progress comes from this concept. Most people know what they should be doing at some level.

I believe there are two main ways people get stuck. The first way is, you know what you should be doing but you’re not sure how to make progress. For example, you know you really want to be a writer but you don’t know how to get a writing job. You have the skills of a writer, but you do not know how you actually make a living writing — or how to take those steps towards your goal. The challenge here is figuring out how to get started.

The second way people get stuck is, you have the knowledge to move yourself forward… you have the capacity to build a plan… but you cannot establish momentum. Using the writing example, you know that you need to create sample work. You need a few paid opportunities through freelance work so you can build a portfolio. You need to build the needed momentum to reach your goal. So, in this scenario the challenge is not putting a plan into place, but rather actually executing on a plan. This category of being stuck is where my notebook really helps, by turning bigger goals into actionable steps.

To overcome being lazy you need a plan. You need action. I think this is one of the bigger lessons for me in my life. When I first started my career, one of the things I would struggle with was that my boss would give me these huge projects. So, I would always ask, “Where do I start?” The goals were so big, and I was so new at what I was doing, I didn’t even know where to begin. I think that’s something that happens with a lot of people. You have these really big goals and you’re so far from the finish line it becomes tough to continue. One of the biggest lessons I learned during that time was to start with small steps.

2) Last year you became a mother. My wife and I just added our second addition to the family. How has parenthood changed the way you approach being productive (now that time is not exclusively your own)?

One obvious change in approach is prioritization. By necessity, I have now learned to say no to a lot more stuff too. When I got pregnant, I became really sick. I had a tough pregnancy. There was simply a lot I could not do during that time. So, at that point in my life, I started taking things off my plate because I physically was not capable of working the way I had in the past. The experience was a good primer for the way I operate now; I was forced to be economical with my time and I became very disciplined.

I have also learned you have got to focus on the task at hand. I talk a lot online about being present. Whether I am on a call, playing with my child or I’m writing an article, that is all I’m doing when I am performing that task. Always quality over quantity (with respect to completing tasks). When I am with my son, I’m not checking my phone. I leave my phone in the kitchen so I am not tempted. I am mindful of maximizing the output from any time spent, whatever the desired outcome might look like of the activity I’m immersed in — if I believe I won’t get positive ROI from time spent on something… I simply don’t do it.

I am up at 5:30 a.m. with my child now. So, time is the thing I don’t have. I have become really disciplined. When I have 15 minutes free, I don’t waste it on things like Facebook, I’m not screwing around with my extra minutes. I’m using all time really effectively nowadays. I have a predetermined plan for those 15 minutes that advantageously pop up. One of the real secrets to time management is knowing what to do with the spare 15 minutes life gives you.

3) Working with Michael Gervais, as well as buying into some of the arguments made by Gary Keller in the book The One Thing, I believe “balance” is a fallacy for high achievers. In my opinion, high achievers find more time than others because there is always more that can be done. You highlight this in your post about making the most of small slices. That said, prevailing science suggests that making time for renewal, and turning down, allows us to be more productive. How does the concept of renewal fit into your productivity paradigm?

You have to schedule it unfortunately. For me, exercise is a release so I try to schedule time to work out regularly. Fortunately, I consider time with my child downtime. I carve out time to spend time with my child and that’s not mentally taxing for me. For me, the time with my family is renewal and I have been really deliberate with how I spend my days. I also make it a point to take vacations every year.

In my car, I listen to good audiobooks, things that make you a better person. I have a pretty long commute, 45 minutes each way, so that’s a good amount of time that I can just kind of unwind if I want. So, I think it just depends on what you need (personally) to unwind. But, for me, I get enough renewal in my life. I’ve built my life around these things because I understand they’re important.  

4) You have an amazing amount of personal systems: for staying on task, organizing yourself and managing incoming information. Personally I feel overwhelmed by the information I have amassed and at times can find it limiting. For example, each year Evernote becomes less useful for me because it contains so much content now. Considering your interests, your proclivity for knowledge and writing, as well as being a continual innovator, what are your strategies to isolate what is important and/or simplify when you need to?

I have this thing I call my Monday Ninja Planning Session and I do it religiously every Sunday night or Monday morning. I start my week with it. I have time on my calendar for it that’s always either 30 or 60 minutes. The sessions are about going over what are the most important priorities and/or things I need to do that week. By engaging in this activity, it really makes sure that I’m not just working on time sucks (e.g. tactical messages in my inbox) or whatever superfluously comes my way. It also means that — by design — I am checking back into my goals every week. I ask myself, “How are my yearly goals going? What is going on with my monthly goals? How does this all fit together?” I make sure that I am actually moving forward with what is important. This method makes you critically look at your productivity and refocuses you to make sure that you’re working on things that matter. Establish this ritual at the beginning of the week, and you find yourself managing your time more effectively.

Also, if you work for someone else, send a status email every week outlining what you are going to do for the week. Make sure what you are working on is mapped with you and your manager’s goals. When I was an employee, this process created an ongoing conversation with my manager and allowed me to track and share my progress in a very tangible and meaningful way.

These are not really ways of simplifying your work I suppose, but rather ways of focusing on what is important which is keystone to being productive.

5) You have now created a movement of people who are going to use your product to aid them in making 2016 their best year yet. What are your plans and goals for evolving the Spark Project and the Spark community in 2016?

That is a really good question and I wish I had a really good answer for you. I am still consistently surprised by the success of the various Spark projects. Frankly, it is awesome. However, when you have a lot of unplanned success — which has led to not being able to fulfill all the orders in time for the new year — I am just trying to do my best just to make sure everyone is happy.

What the future holds is evolving. I am hoping to expand into some complementary products. We already have launched the meeting notes notepad. I also look forward to building other tools to help people be successful, so stay tuned for that. That’s it in terms of physical products for now. In terms of the Spark community, I am hoping to continue delivering strategies and free worksheets that help people achieve their goals (by way of the Spark email newsletter). We will likely use Kickstarter again next year for the 2017 planner because that platform has really worked well for us so far for launching these projects.

 

Interview with Al Lewis about Workplace Wellness Programs

Al Lewis is an outspoken voice in health care and workplace wellness. He is the author of several books on these topics including Why Nobody Believes the Numbers: Distinguishing Fact from Fiction in Population Health. He has founded and held senior positions at a variety of health-related organizations including the Population Health Alliance. Al’s latest endeavor Quizzify is one of only a few population health companies to measure its outcomes validly and guarantee savings for the organizations it serves.


1) Your graduate focus at Harvard was law. Before you discovered that most health-care measurement methodology is flawed, what was the initial impetus that led you to the pursuit of exploring, examining and developing a career that revolves around health care and corporate wellness?

I went from Harvard Law School and I was going to become a lawyer. I stumbled into this recruiting session for a consulting firm and there was this guy giving a recruiting presentation and I was just mesmerized by it. The guy was a manager at Bain and Company by the name of Mitt Romney. I applied for a job at Bain and I didn’t become a lawyer.

I worked at Bain for eight years and toward the end Bain was imploding at the time. I jumped ship and went to work at a health-care company and that’s how I got into health care. Then, I stumbled into a job as a Chief Executive and Chairman of a NASDAQ health-care company called Peer Review Analysis in 1993. In 1995, we merged with another company and I had to find another job. Once again, I kind of stumbled in a new role, this time in disease management, but I figured out that there was an opportunity there, especially in the Medicare population. There was so much chronic disease and yet doctors were getting reimbursed very little. Primary care doctors were getting reimbursed very little and there was nobody watching patients between visits.

At the time, I thought there was an opportunity for disease management and I started the company Disease Management Purchasing Consortium. During that time health plans — and to some extent employers — just jumped onboard. I started basically putting these programs in place, and was doing that merrily until somebody came along and essentially said that my measurement was wrong and that, in fact, disease management saved much more money using something called “prospective identification,” some wacky methodology that their actuaries told them to use. The belief is that they were actually saving a lot more money. I thought, this doesn’t look right. So, I sat down with a spreadsheet and compared my methodology to theirs and, guess what? My methodology overstated the savings and so did theirs. In my book Why Nobody Believes the Numbers I compare prospective identifications, annual requalification, and it turns out both overstate savings and you have to do something different altogether.

When I went back and looked at all the numbers I’d put together for people, they were all wrong. The savings didn’t exist. So, apparently, it is perfectly fine with other people to do this, but it was not fine with me. What happened next is detailed in the 2007 blog post: A Founding Father of DM Astonishingly Declares: “My Kid is Ugly”.

Since then, after writing Why Nobody Believes the Numbers, I basically went rogue and started naming names, built They Said What?, I call out the liars, etc. But, it wasn’t my first choice. I was essentially forced into it. I mean Rachel Carson wrote to Monsanto and pointed out the hazards of DDT very nicely and they didn’t do anything. So, that’s when she went rogue. I basically did the same thing, except that in my case, it’s more [Silent Spring author] Rachel Carson meets Dave Barry.

2) In a recent article about the folly of content curation and the way information now gets disseminated, the author Katie Herzog argues that in the age of the Internet we often herald things that distort the bigger picture. Beyond the frustration you have publicly shared that Baicker’s seminal research is continually used to support the efficacy of employee wellness programs, how does an organization effectively find the signal within the noise? How do you believe organizations should define success?

First, let’s define wellness as two types of wellness, wellness done for employees and wellness done to employees. Now, wellness done for employees is basically not quantifiable. It is things that employees want to do, and you are making it easy for them to do it. Maybe they want fitness facilities. Maybe they want better food. Maybe they want flex-time. Whatever it is, it is not things that they have to be bribed to do or punished if they don’t do. And that’s the big difference between wellness for and wellness to employees. I don’t think there’s anyone who objects to wellness for employees. I’m a big fan. But, what the Affordable Care Act is about and what the controversy is about is wellness done to employees.

The thing about wellness done to employees is that the results have to be quantitative to justify the expense. Wellness done to employees, you have to either bribe employees or fine them into doing it. If somebody likes something, they’ll do it for free. Coercion damages morale. This is, by the way, is according to a Health Education Research Organization (HERO) report.

HERO are the ones who admitted the morale impact, but you don’t have to be a rocket scientist. Just look at the comments on essentially any article in the lay media about wellness and it is all negative. So, advocates of wellness done to employees have to justify it with math. Math is shockingly easy to do.

Regarding math, some people do it, but many people don’t. Consultants don’t like it because they can’t really charge that much for it. In this case, done right it also shows the opposite of what they expect. You can start with page 22 or 23 of the HERO report that lists a bunch of diagnoses which have corresponding ICD-9 codes. HERO didn’t list them, but anyone who wants them can get them from me. I’m happy to send them. The June posting on the Quizzify blog has a Wellness ROI template all ready to go that has the ICD-9s in it.

The HERO report did their own ROI analysis and they found $.99 in in savings per employee per month from reduced hospital admissions. That, by the way, was without adjusting for the fact that many of the costs at the population level are coming down anyway. So companies are actually turning out an entire wellness program to save $1.00.

Now, you have to subtract the cost of the program. Let’s say the program is $1.50 an employee a month. Good luck finding a wellness program that cheap. Most start at $100 a year per employee. So, then you compare the cost of the program to the reduced claims cost, and that gives you your best-case scenario for savings. I say best case because you have other costs of wellness besides the vendors, consultants, and lost work time, and that kind of thing.

So to somewhat answer your question, you cannot define success by monetary savings. That’s why I’m offering a $1 million reward to anyone who can show that it does, because it doesn’t. My million dollars is very safe.

3) In a recent interview with James Pshock from Bravo Wellness, Pshock resurfaced something for me that I think is at its core, true. Organizations — when they begin as entrepreneurial endeavors — are not generally created to shoulder the burden of employee health care. This is a burden progressively being assigned to enterprise through policy — although few would disagree that a business should be concerned with the well-being of their employees. Based on your experience and opinion of workplace wellness, what do you believe is the obligation of an employer when it comes to employee well-being? 

As an entrepreneur, my job is basically to not put up roadblocks, to stay out of their way, and to be responsive if they have health or personal issues. The staff I have at Quizzify is dedicated, highly productive, motivated.

I don’t have an “obligation” to provide for their well-being per se. But, if I don’t provide for their well-being, either their productivity might suffer or they’ll go somewhere else. So, I don’t need to be told by the ACA, by Congress or the President what I can and can’t do with my employees. I’m going to do the best thing for my employees regardless.

The absolute, positive, last thing that I would ever do to my employees is institute a pry, poke, prod, and punish wellness program. It would cost me money. It wouldn’t save me any money. It would damage their morale. And it would drive a wedge between me and them.

Since you brought up Bravo Wellness, if you go to my expose of their previous website (which they bowdlerized following my exposé) they were essentially bragging about how they can save an organization money immediately by “fining” employees. They also spend a lot of time talking about their appeals process. I would not — in a thousand years — put in a wellness program where I fine my employees for things that have nothing to do with work, where a wellness program was so unpopular that I needed an appeals process to get out of it.  Not to mention the very questionable screens they want to run on your employees.

4) In some of the assertions you make regarding the folly of using motivational tools to promote wellness you’ve used Penn State as an example of how things can go wrong when an organization utilizes extrinsic incentives in an attempt to persuade employees towards better health.  In a recent WellSteps seminar, Dr. Steven Aldana said that after checking in with Cassandra Kitko, an adjustment was made at Penn State that merely repositioned the penalty as a reward? In other words, little has changed there although the remarketing of economic incentive has muffled the criticism. In your experience have extrinsic motivators ever been effective? Or, in your opinion, are economic incentives always going to be “forced wellness”? If yes, how? If no, why do you think that is?

Dr. Steven Aldana is not one for fact-checking. He has called me a liar before, but has never provided an example of where I have allegedly lied. I don’t mind. As you can tell, I love the fact that he’s calling me a liar. The truth is Penn State’s original program is gone. It’s done. There’s no spinning of that statement. His statement is incorrect and I’m pretty sure he knows that he is incorrect. If you look at Dr. Aldana’s website, he’s got a wellness ROI calculator. If you put in zero for “annual cost increase”, it doesn’t matter what other variables you put in, by the year 2020, you always save $1,359 an employee. So, he essentially made it up.

In terms of extrinsic motivation, I actually do find that there is a place for extrinsic motivation. The thing about extrinsic motivation is that it only works once. It works to get somebody to try something. And, after that, they have to like what they are doing … they have to want to do it on their own. Otherwise, you simply have to basically keep paying them, and paying them, and paying them to perform the desired behavior. I, myself, was extrinsically motivated to do something healthy once. In fact, ironically — and here’s the fun part. This is that NASDAQ company I was telling you about, Peer Review Analysis, and we were going to switch to self-insurance. I looked around, and we had a lot of nurses there. Nurses, ironically, have horrible health habits. So, I thought: well, if we are going to go to self-insurance anyway, I should have a fitness contest and give people $50 as a reward for participating in fitness activities. What happened is that, of the 100 people in the company, the same 20 who played on the office Frisbee team and the volleyball team were the same people who signed up for this program. The other 80 could have cared less. I, myself, signed up for the program. What I started doing was, out in the western suburbs here of Boston, is I started riding my bicycle to work in mid-town to collect the $50. Well, guess what? That was 1994 and, essentially, every trip I take from mid-town Boston that doesn’t involve snow, rain, or dead of night, I do on my bicycle today because I basically paid myself $50 to do it once and I loved it!

So, I think motivation has a role, but it’s a role of trial and it’s a role of doing something once. It’s not a role of continuing to raise incentives until you get someone to do what you want them to do. We don’t need to force people to do things that they just don’t want to. It is not good for companies, and it is certainly not good for employees.

5) One thing I have found challenging about the recent affinity the workplace wellness industry has had with BJ Fogg is that his popular behavioral model softens the importance of environment. It takes the work of Kurt Lewin and then glosses over the significance of external factors. As a layman of your work, I get the sense that you also advocate that wellness “wins” can be made through environmental design. Is my assumption correct? And in addition to this assumption, right or wrong, where else do you see organizations getting it right?

Yes, without question. I am far from an expert in this field. In my opinion, what you want to do as a company, and if you listen to the wellness industry they advocate this, too, it’s all about creating a supportive culture. As the leader of a company myself, what I’m trying to do is I’m trying to make my organization be as valuable as possible. Part of that is creating an environment where people want to come to work. But, ironically, wellness vendors have essentially nothing to do with creating a culture that makes people excited to go work. To the contrary, the evidence shows many of these types of programs create cultures that do the opposite.

Simply being mindful of environmental factors can have a huge impact. I have an excellent example of that in my book with Tom Emerick, Cracking Health Costs. Back to Peer Review Analysis — it’s going to sound silly — after employees complained about the conditions of our bathrooms I contacted the management of our office building we were in and asked, “How much extra would I have to pay you to clean the bathrooms twice a day?”

We came to an agreement and I paid them probably less than what would have financed a wellness program for probably 20 people. So, for the cost of the wellness program for 20 people, I had the restrooms cleaned twice a day and I don’t think there was an employee in the company who didn’t take notice and was grateful.

What did this accomplish? The organization was telling the employees they mattered. And you weren’t telling them by making some pronouncement that they mattered or by giving them lunch once a month. What you were telling them on a daily basis, doing something very unglamorous — I mean you can’t get more unglamorous than that — is that they matter.

Interview with Bill McBride about Fitness Delivery

Bill McBride is the co-founder and CEO of Active Sports Clubs. He is an industry veteran in the field of health and wellness, and has served as the Chairman of the Board of Directors for IHRSA, a Board Member on ACE’s Industry Advisory Panel, and currently serves as a Medical Wellness Advisor for the Medical Wellness Association. Bill also sits on the advisory board of several other companies including Fit3D, Club Solutions, Club Industry and previously has worked with Zuberance and MiGym. Bill has been a mentor of mine for several years. You can learn more about Bill at his personal website BMC3.com.


1) Given your vast experience in the wellness industry what are three universal truths in “getting it right” that apply to all fitness delivery (not just health clubs) that have surprised you in the sense that they are not industry standards?

  1. There is a lot of fitness delivery that is “contracted” on the assumption it is all homogeneous – a commodity. I need a clean “house”, so I hire a housekeeping company.  I need fitness, so I hire fitness people.  Fitness is very personal and people that are qualified and engaging are critical; but for a company, the brand delivery and standards that the brand represents are also critical.  Getting the right people on the bus, training, and “enrolling” fitness delivery professionals seems to be a constant challenge in all aspects of fitness delivery (regardless of distribution channel).  I am not surprised by this fact, but I am surprised by the slow progression in solving this problem on a broader scale.
  2. The true power of group fitness is often discussed and most people “get it”, but it hasn’t been truly leveraged as of yet. Think for example of “Debbie’s Class” – Debbie is a member.  Why not have a class just for Debbie and her friends?  Why not personalize group fitness further?  This could be done with school mom groups, civic groups (Girl Scouts), and neighborhood friends that walk together, etc.  Personalizing group fitness is rarely approached in this way. Approximately 44 percent of club members exercise with a friend. There is an opportunity there. 
  3. I’m surprised by how many health clubs look the same in regards to layout and offering. The lack of true differentiation and uniqueness in the space seems intriguing.  This is what Curves figured out earlier on.  We need different configurations and approaches to bring in new members. 

2) Why do you think the health club industry has not been more involved in the evolution of health technology? Only recently are you seeing health clubs really integrated with digital health devices, when the industry (as the experts in the area of wellness) could have had more of a hand in shaping these products?

Human nature seems to favor a scarcity mentality, instead of an abundance mentality.  I think club operators were (or in many cases are) afraid of outside “competition” that could cost them members.  Even my friends at MYZONE, whom I’m a big fan of, were reluctant to open their system for participants to download their data at home until recently.  I asked them over 4 years ago to open their system because I wanted our members to download and see their data in real time.  Their position back then was ‘no’, we want users to go to the club to download their data, this forces a club visit for our clients’ clubs/gyms. In their defense, they viewed their product as a club retention tool, not an activity increasing tool. While on the surface that may make some sense, just as scarcity mentality always seems to make sense in the short-term.  But long-term, an abundance mentality always wins out.  MYZONE came around and gave me some credit in their shift in thinking, but the world has already realized it’s a transparent, information-based reality now. Clubs have to realize this and embrace broader thinking as active lifestyles will always need professional human support.

3) You and I are both fans of Michael Porter. I just read Zero to One where Thiel builds off Porter’s ideas and suggests that the current entrepreneurial dogma of iterating off competitive ideas is a race to the bottom. In the book Thiel highlights using examples how perfect competition can destroy an industry. I believe a case could be made that is happening in the health clubs industry, especially anyone that goes up against the main chain operators. Where are people getting is right in the industry? Put another way, what are the common attributes of the players that are able to rise above the low cost health club model?

This is the million-dollar question.  The high-end that can’t be replicated with ease (cost of entry too high) will always serve a consumer need: Exclusive, lifestyle, family and prestige based. These companies create an emotional bond, evoke status and its members are brand connected and in many cases for generations (think Four Seasons, fine dining, etc.).  The low cost play will also have a steady stream (think fast food or Motel 6). It’s the accidental middle that are in the most trouble.  Middle price point players with a strong value proposition (reasonable but not low price) and a very controlled expense structure can do nicely if engineered properly.  Now for the current twist, we have the boutique offerings – not a high cost of entry, but a very high perceived service level.  In this modality, I think boutique hotel (Kimpton or Joie de Vivre).  These are high service offerings and very nice, but relatively small and some “nostalgically older”.  The concepts that are too trendy seem to be short-lived.  So anticipated trends versus modalities that stay around is another avenue of consideration worth thought. For example karate, yoga, Pilates and cycling have proven not to be trends. And how low can the low price point go? I heard recently of a $5 a month club.  At some point soon, I expect to see a “free” club model with all revenues and profits come from ancillary programming like retail, clothing lines and ads within the club. Free with premium offerings, or a play like Pact where you actually get paid to workout.  I agree with you that a large segment of the industry doesn’t appear to be working towards adaptation. 

4) Guessing that you do not think this question is an all or none proposition, how do you think the rapid expansion of workplace wellness programs, and the emergence of open access residential wellness solutions, will evolve how (and who) is providing fitness delivery today?

There are many corporate wellness companies in the space already.  The older ones are simply staffing agencies.  Nothing wrong with that, but there is an opportunity for the health club management providers to play a much bigger role than they do today.  Free fitness access is here in a lot of places and it will continue to grow.  Parks, trails, in hotels, on company campuses and residential complexes – access to activity and fitness is going to continue to rise.  Wellness is a nebulous term.  What does that mean?  Lifestyle engagement and promotion of activity through fitness, movement, sport and recreation will grow and prosper.  The industry (health club or health club/fitness center management) must realize the genie is getting out of the bottle..  Think abundant solutions and total well-being, not just fitness and not just what can accomplished in a single space.

5) I know you enjoy the guesses of futurists and are an inherent forward-thinker. Regarding fitness delivery, you wrote a great article for Club Insider (Are We Asking The Right Question?) where you answered the question, “what will be the same in ten years?” Your argument for taking this approach was it is a more compelling question than “what will be different in ten years?” This is probably true; however, it does leave me the opportunity open to ask it, “What will be different in how we will deliver fitness in ten years?”

I believe the industry will be forced to morph from sales and marketing with great facilities (as the current historic primary focus) and more towards programming, coaching, wellness/medical services in very engaging environments.  We will see different looking clubs (I hope) with much more holistic services and creative designs.  I envision it to Lifestyle Centers …not just rooms with equipment, as those rooms and outdoor spaces with equipment will be commonplace by then.  And not just studios to move around like we have today… It will be more about the “feeling” and “community”.  This is where technology and wellness/medical integration will be game changing.  I see more with wearables and digital health that support total well-being, disease management and prevention.  Technology that can help people form and maintain habits, make activity/exercise more “fun” or “tolerable” and support individuals utilizing wellness professionals to improve their quality of life.  A lot of people in our industry focus on results.  Results are a by-product of a great offering.  The focus should be on delivery and habits.  I do believe that great structural design, warm & friendly social activity and innovative programming will always be around …just as we will still have hotels for rooms away from home, and great restaurants for good meals on the go …but there will be disruption like hotels saw with the shared economy (Airbnb) and restaurants saw with social shopping (Groupon). There are big things on the horizon and I am excited for the future.

 

Interview with Dr. Chris Bingham about Fostering Innovation

Dr. Chris Bingham is an award-winning professor of Strategy and Entrepreneurship at the Kenan-Flager Business School at the University of North Carolina. Dr. Bingham received his undergraduate accounting degree and MBA from Brigham Young University, and received his PhD in strategy, organizations and entrepreneurship from Stanford University. Currently Dr. Bingham’s focus is the process of accelerated learning in the context of seed accelerators. Dr. Bingham’s complete biography can be found here.


1) You have presented how one can use the Nadler and Tushman’s Congruence Model to foster and/or improve innovation within an organization. Is this more a function of a healthy organization being more innovative, or are there certain aspects specific to the Congruence Model that lend itself to creating an innovative environment within an organization?

There are different components of the Congruence Model, right? You’ve got task, you’ve got structure, you have got people, and you have got culture. And, sometimes, people will tweak this model a little bit, but those are basically the four parts. The whole point is, if one of them is off-kilter, then you can have some problems.

So, I believe in the model. I believe in the congruence. If I were to look at one of the elements that I find the most intriguing, it’s probably structure and here is why: Because I believe the counter-intuitive insight when you’re trying to innovate is that when markets become more dynamic, more ambiguous, often the best strategies are the most simple. And that’s an insight that a lot of people don’t get because what happens over time in organizations is you build up more and more structure – that is, more policies, more rules, more manuals, more routines… what that ultimately does is create inertia. It creates bureaucracy. It makes it difficult to change. Organizations are trying to become more efficient and that’s what the structure does, organizations become efficient but at the expense of flexibility.

So, if you think about a spectrum, you’ve got efficiency on one end and you have got flexibility on the other. There is a natural force pushing firm imperceptibly towards efficiency at the expense of flexibility. And so I think, as leaders, what you have to do – if innovation is key for you – is you’ve got to deliberately pare back structure. I’ve been looking at innovative companies across many different industries, and what you see is they will provide a little bit of structure, but within that structure, there’s a lot of room to adapt. For example, Yahoo, in its early years had a few simple rules shaping their partnerships: (1) don’t do deals if it jeopardizes the user experience, (2) no exclusive deals, and (3) the product or service must be free.  Those rules provide some structure and guidance (securing some efficiency), but within those rules there was a lot of room to adapt.

2) You have also stated that there is evidence to suggest a diverse team dynamic promotes an innovative culture (highlighting Under Armour’s Board as an example of this). In addition to simply gaining expertise outside of an organization’s industry, are there other considerations or strategies one can use in building an effective team through diversity?

You can think about diversity from lots of different angles, right? Functional diversity, gender diversity, age diversity. But, I believe the key point here is trying to find people who disagree with you. And that’s a little non-obvious. You want to create task conflict (i.e. when people disagree with you) without creating affective or personal conflict. Task conflict often is helpful because an organization can avoid premature convergence on what might be a suboptimal plan. It keeps you from jumping into things too quickly. Also, studies show task conflict leads to improvement in team decision making effectiveness. And when this works, team decision making effectiveness improves not only satisfaction with the team, but also team performance.

The other question is, how can you find these sort of disagreements naturally occurring within organizations and what do you want to do about it? I think what you want to start looking for is internal disagreements that might come up when you are trying to develop a new service or a new product. Marketing and finance almost always are going to support the status quo because their incentives generally come from knowing the existing product. New innovation presents a risk to their livelihood.

Engineers and R&D folks are often the ones who will be pushing new and disruptive ideas. They are looking for what’s going to be best from a customer perspective and/or from a product perspective. This natural tension is good. Look for those natural disagreements to find balance.

Diversity is also key for brainstorming. A dictum at IDEO is, “Go for quantity” in its brainstorming sessions. So, it’s not untypical in an hour-long brainstorming session at IDEO for them to come up with ~100 different ideas for something. Without this practice guideline what will often happen is the power players in the room are going to get out their ideas first. And, then other players in the organization start conforming. They are going to start saying, “Oh, yeah, that’s a good idea.” Any idea they might have had gets stifled and factions start to form around the power people’s suggestions and you don’t get much further than that. And, then, it becomes just sort of a power game. In contrast, if you can just start saying, “Hey, look. Let’s get out 30 ideas in the next 30 minutes and let’s get 100 ideas in the next hour,” what happens is it quickly becomes more objective. So, you actually depersonalize it by getting high numbers of ideas out there from a diverse group maximizing the organization’s available choices.

3) One way an organization can successfully tap their market for ways to innovate is to ask themselves, “what job is our customers hiring us for?” What are some other key strategies an organization can use to tap their external market for ways to innovate, rather than simply continuing to iterate and improve?

There is an innovator’s series of books: Innovator’s Dilemma, Innovator’s Solution, Innovator’s DNA. There is now a new one out, Innovator’s Method. What I believe these books are missing is an understanding about the social innovator. Not social in the sense of social causes, but in the sense of innovators that tap community. Crowdsourcing is a great example. For example, Monopoly fans voted on Hasbro’s Facebook page to get rid of the old flat iron playing piece and adopt a new cat playing piece instead. Scrabble players vote on which new word to add to the Scrabble dictionary. It is a really powerful channel when an organization taps into its external constituents.

The other thing you’re starting to see, from a social perception, is innovation tournaments. Netflix did this a couple years ago to improve one of their predictive algorithms. My understanding is it was a very diverse team of academics and industry experts that came together for this. You are starting to see more of these innovation tournaments produce some really amazing ideas. Customers prove to be really helpful for insights. They can help you identify problems and solutions in ways that prove difficult for internal resources (for a variety of reasons).

4) It appears that health-related wearables are in the process of “crossing the chasm” and are here to stay. In your opinion, what is important to get right as we move on from early adopters, to catering to the early majority regarding these products?

So I think your question, simply put is, “how can you help the early majority?” In other words, how can you help cross the chasm, right? What do you need to do to help this new market? If you look at innovation diffusion theory, it’s actually a pretty old, well-established theory. We know early adopters are a fairly small group, where the early majority is a bigger category (more than double that of the early adopter group). If you look at differences between early adopters and the early majority, what you will see is the early majority is more pragmatic, a little more cautious, and want some proof of benefit. What they really want is the understanding that this is going to become a social norm, not just a benefit. They want refined technology to improve ease and convenience. They want a lot of stories of the innovation’s effectiveness. An interesting thing that builds on this diffusion model is actually looking at how adoptions occur. And what you’ll find – and this is actually pretty interesting – is in the early years adoption is generally based on mass media, but when you start hitting the early majority, what becomes really critical is adoptions occur more due to interpersonal communication. The social component therefore becomes really critical to get the early majority onboard.

5) The way people consume fitness is changing, especially with regards to modality, delivery, and provider. Michael Porter says a disruptive technology is, “one that would invalidate important competitive advantages.” Now that you have examined the health and wellness landscape, what are some of your predictions about how people will consumer fitness and wellness over the next five to ten years, and what does that mean for traditional health clubs?

I wish I could look into my crystal ball and get a more precise answer for you. There are broad trends that are affecting lots of different industries we can discuss. One key trend is mobility. If you look at the time spent in mobile apps in 2014, it’s gone up 50% from 2013. And that’s crazy, 50% in one year, and most of this is coming from just mobile apps. How does that exactly work for the fitness industry? I’m not quite sure. But, I think ignoring it or assuming that you don’t need to address it is not the right approach. So, I think that’s one very big influence that’s going to affect how people consume fitness and wellness over the next five to ten years.

Another trend is the idea of accessibility and simplicity. Some think of innovation as additive. I’m adding new features, new services, or whatever. Yet some companies like Google are innovating by subtracting things, and pulling things out, and making their product simpler, and more accessible. With Google Docs you don’t get all the features of Word, but you get the most essential ones. I think if you think about these three big trends of mobility, simplicity and accessibility; I think that’s going to really influence the way that people consume fitness and wellness over the coming years.