Winning the Right Game with Ron Adner, Ph.D.
This interview with Ron Adner, Ph.D. was conducted on September 29, 2021 by Gary Bisbee, Ph.D., MBA.
The full interview appears on The Gary Bisbee Show, and it can be viewed on YouTube or heard on your favorite podcast platform including Apple Podcasts, Google Podcasts, Stitcher and Spotify.
Can you define what you mean by ‘ecosystem’?
The way I think about ecosystems is that it's not just about interdependence. What makes the ecosystem construct matter is that it's the structure of interdependence among a multiplicity of partners, there's a multilateral game being played. The way to think about that structure is rooted in the notion of the new value that you're trying to create. An ecosystem is defined by the structure to which partners interact, to deliver a value proposition to the end consumer. And if you unpack that, what's changing as I'm trying to deliver a new value proposition and that's how you surface the structure of the ecosystem. It's once you have that idea of structure that you can begin to build strategies for alignment, for offense, for defense. Structure is at the heart of it.
How does the idea of value within healthcare fit into an ecosystem model?
One of the greatest challenges in healthcare is this debate about what is value. Value-based healthcare, for example, at a superficial level is moving away from fee-for-service to delivering a longer version of care. If that was all, it would be pretty straightforward. The issue is, the activities and the partnerships required to support this go way beyond the walls of the hospital. Not only do they create new interactions within the hospitals between primary care, specialists, and prevention, but now you're going into the community. Suddenly, you need to think about nutrition and access to healthy food. There are healthcare systems that have gone into the renovation business. It's cheaper to tear out carpeting than deal with the consequences of mold on asthma. This is a totally new structure of relationships. Unpacking those relationships allow you to create the strategy for how you deliver value.
How can innovation get a foothold when there’s so many established players in healthcare?
In healthcare you're selling something that is between a privilege and a right, and that border is being renegotiated. That renegotiation creates complexity, but it also creates opportunity for finding new configurations. For example, if one state is unhelpful in driving telehealth, that's not a veto on telehealth. We're seeing different states change their mandates. I think that healthcare from the provider side has massively underplayed their influence in their ability to shape alignment in the ecosystem. Healthcare systems are some of the prime employers in whatever geography they're in. And that's separate from their contribution to health in the community that they're in. There are all kinds of levers that can be pulled to put forward a clear vision and drive alignment.
How do you develop and recruit the right leaders from an ecosystem perspective?
When we're in an ecosystem setting, a setting where we're re-drawing connections, the kind of leader you need is not a better leader, but a different leader. When things are stable you need an execution minded leader, someone who puts their organizations ahead of themselves, the sort of thing that we usually celebrate. But if you're trying to align others into a new configuration, someone who puts their organization ahead of everything else doesn't sound good to any of those other partners. What you need is not an execution mindset leader, you need an alignment mindset. And that requires a different way of thinking that requires a different set of trade-offs. And from a governance perspective, it requires an appreciation that the right leader is sacrificing something in the near term to drive alignment that will create returns in the longer term.
What advice do you have for up-and-coming leaders?
The biggest challenge in healthcare systems today is not that we don't have enough ideas, it's that we're drowning in ideas. Healthcare systems are really good at launching ideas, so we're drowning in pilots. A lot of these pilots are successful, but most of them tend to go nowhere. If you're early in your career, you want to figure out not which is the exciting pilot rather, which of these pilots will go to scale. When you put promising people on a pilot, it gets a lot of attention and resources. A successful pilot teaches you that something is possible. To see if something is scalable, you need your most mediocre people. If that works, now you can scale. Projects need to think about alignment right up front, to make sure that the scale can make impact. That's how you make a difference in the world and in your career.