Happy New Year !!! Will you Innovate at the Edges in 2019?


The ONTOADAPTIVE (OA) team wish all a productive year with Innovation at the Edges in 2019. What do I mean by that?

Lean Culture Hacking - A Replay. In May 2018, I wrote about Lean Culture Hacking targeting problems in Digital Health. A number of colleagues asked - Why is this idea important? How does it relate to Innovation within the Enterprise? How can I get started internally? Before I answer in detail, let me share a simpler story.

H1, H2, and H3 walk into a bar. H1, H2 work together. H3 agrees to meet H1 and H2 out for drinks after work and start to talk shop. H3 says - “I have got this awesome idea ABC - if you join me we could start a new company and …”. H1 retorts - “It will never work. I have over X years of industry experience and it is dead on arrival (DOA) - plus we got too much we have to get done now. H2 intercedes - “Hold on H1, let’s hear H3 out, I wonder how that maps to our current business - maybe we can start small and get an internal champion to sponsor us.”

Innovation at the Edges. You may have been some part of similar conversations - maybe even succeeded or failed after an attempt. You may even relate to either H1, H2, or H3, maybe even all together - and you should. Here is why.

The cast of H1, H2, and H3 represents the classic Mckinsey - 3 Horizons of Growth (Baghi, Coley, White) model as shown below. This model helps visualize how companies approach value creation in markets they serve over time.

Mckinsey 3 Horizons (Baghi, Coley, White)

Mckinsey 3 Horizons (Baghi, Coley, White)

More recently, Blank has adapted the “3 Horizons” model to emphasize that industry leaders differentiate by fostering cultures that can both: 1) execute proven business models and 2) search and validate new ones continuously in parallel. H1 represents your core business models while H2 and H3 represent incremental and disruptive innovation respectively.

What changed so much from the classic perspectives to now? H1 no longer guarantees a 5 to 10 year comfortable horizon. Being good at H2 and H3 is no longer optional. As shown below, organizations must raise their awareness on where the edges are and all the H1, H2 and H3 overlaps. More importantly, the edges are dynamic - constantly changing how H1, H2 and H3 intersect with more accelerated timeframes.

Mckinsey 3 Horizons (Baghi, Coley, White) - Modified (Albarracin)

Mckinsey 3 Horizons (Baghi, Coley, White) - Modified (Albarracin)

As individuals, you may need new communication tools in order to facilitate conversations effectively between the H1, H2, and H3 edges. We all need to proactively seek those edges where H1 can meet H2 or H3. Innovation is not a department - it is habit. It is about cultures that foster those habits.

What about Digital Health? Within U.S. Healthcare, innovation is like oil and water. The industry is highly conservative, regulated, and risk averse. At times it can feel like there are 10x more barriers than there are opportunistic entry points.

Here is where Digital Health holds promise. Although many have claimed to have defined the term Digital Health, I personally align most with Topol’s original vision of Digital Medicine. Additionally, I align with Sanders (Health Catalyst, 2018) in that Digital Health Platforms (DHPs) may help disrupt current fragmented health systems approaches. DHPs improve our Digital Trajectory, with patients providing context beyond what ~3 clinical encounters per year can offer.

Digital Health and DHPs are a cultural transformation. The DHPs are diffusing faster than H1 incumbents may acknowledge. In 2018, Roche’s $1.8 B acquisition of Flatiron Health is providing oncologists exactly this DHP experience assisted with curated data, AI and machine learning to improve clinical decision support. Expect more of that in 2019.

The Digital giants are coming. Amazon, Microsoft, and others are eager to make disruptive plays in Healthcare.

Key Takeaways. So for 2019, will you Innovate At The Edges? Here are 3 Lean Culture Hacks you can take into the new year:

  1. Talk the talk. When discussing “Innovation” with others, try using “3 Horizons” model in your conversations and see what resonates. Read up on my Lean Innovation and Digital Health references above.

  2. Dog food it, Experiment. Define some problems to solve in Digital Health. Host a student innovation team to start with H2 or H3 ideas and experiment.

  3. Live it. Form a Digital Health innovation team or engage an innovation partner to get more H1, H2, and H3 culture hacking the real thing and at risk.

At ONTOADAPTIVE, LLC (OA), we are passionate about making a real-world impact where humans and cognitive technologies meet in Digital Health. Drop us a line.

Lean culture hacking with Blockchain via OA Digital Health boot camp

Congratulations to UIC undergraduate entrepreneurs - Gabriel Piekarek, Kerry Kurcz, Shay Gin, and Ja Goo - who recently completed our Digital Health boot camp and placed #1 in student team competition. 

Boot camp instructors were Narciso Albarracin, MS, CSM and Ephraim Caangay, MD. The team was tasked to explore how caregivers can effectively share patient-reported outcomes for seniors with cognitive disorders using Blockchain technology.


At ONTOADAPTIVE, LLC (OA), we are passionate about making a real-world impact where humans and cognitive technologies meet. As a UIC College of Business (COB) Capstone sponsor, we are proud to give back and run boot camps as part of our “Lean culture hacking” mindset. By Lean, we mean the “third way” or continual experimentation, taking risks and learning from failure; and understanding that repetition and practice is the prerequisite to mastery. By culture, we mean innovation is mainly a human process and not just about technology. By hacking, we mean our special blend of Lean thinking, Digital Health Design, and Agile product development from the trenches.

What were outcomes or key results? Within 15 weeks, the team delivered patient experience maps which guided the development of a minimum viable product (MVP). Specifically, they baked off two major Blockchain platform leaders: Microsoft Azure and IBM Cloud. Activities converged to a final “demo day”, a formal report, and finally, a team competition. All these learnings help manage risks and guide future investments with regard to a more informed technology direction with boots to the ground reconnaissance on Microsoft Azure Blockchain-as-service (i.e., Ethereum) versus IBM’s Hyperledger offerings.

Were there challenges?  Absolutely. For many undergraduates, this is their first exposure to real-world team-based immersion into stakeholder communication, problem-solving, critical thinking, and assessing bleeding-edge methods and technology. Accelerated exposure to human-centered design (HCD), Cloud, Blockchain, and Agile can be overwhelming. Explicit mentoring, direction, and guidance is required. Blockchain technology is moving rapidly that much platform learning was done on the fly.


No free lunch. For an effective boot camp, plan for about 150 to 200 hours of effort for directing, mentoring, scheduling the time of faculty, subject matter experts (SMEs), and technologists, and organizing for iterative and final “demo day” reviews.  Internally, your culture and processes will be challenged - How well can you describe your problems? Are they digestible? How are your onboarding processes? How do boot camp concepts align with other student learning objectives? What are the skill gaps?  Are your methods, technology platforms, and subscriptions ready? What methods or collaboration tools are most effective?

Co-create with us. As with our boot camps, we approach industry problems, engage clients, and build products with a “culture hacking” mindset. We tackle seemingly impossible problems into more digestible components with our customized approach to  and technology exploration. Curious on which Blockchain approach was selected and why? Or even how to approach your internal innovation? Drop us a line. Look for follow-up posts on the Blockchain in Healthcare event recently held in Chicago.