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Constraints and Health IT Innovation

Even in Health IT, constraints can prevent or propel your innovation efforts. Often the framing of a situation is the key to guide your focus.

Article Jul 01, 2022

Rob Keefer

It seems passé to say that the healthcare industry is in flux. While the industry is learning to adapt to change, many IT executives attempt to innovate within a culture of massive constraints: government regulations, budget constraints, quality mandates, and constantly evolving populations and technologies. Unfortunately, one of the most significant constraints in the healthcare industry is the people. Often the people hired to follow processes are now being asked to change and be innovative.

Alex (not his real name), an executive in IT at a hospital system, recently related the following story to me. His institution hired a Director of Innovation who had invited Alex and a few others throughout the organization to a meeting to discuss innovation initiatives. The meeting was productive due to the new relationships forged and the ideas shared. It was a first step in the long journey toward making the hospital more innovative.

A few days later, Alex made a passing comment about the meeting to the CIO, his boss. When the CIO heard that a conversation about innovation had taken place, she was visibly disturbed. The CIO quickly grabbed a piece of paper and pen, and, in a controlled voice, asked, “Who was in the meeting?” She took names of the people interested in innovation as though she wanted to squash such craziness.

Unfortunately, this attitude can permeate an organization and advance a culture of scarcity. According to Brene Brown, we live in a culture of perceived scarcity. In her book, Daring Greatly, Brown refers to this as a “culture of ‘never enough.’”

According to Brown, the culture begins with personal attitudes, starting first thing in the morning when we don’t get enough sleep and finish our day thinking we didn’t get enough done. As we go through the day, we have limited time and try to handle issues without enough money, constrained by so many regulations, too little quality, and too much change.

As I interact with Health IT executives, three common constraint themes have emerged: Time and Money, People, and an Innovation Vision.

Time and Money

Large institutions can learn from startups when managing time and money constraints. When Basecamp (www.basecamp.com) was in its infancy, the same team that delivered for their existing clients, also built their core product and did not have a budget to make mistakes. The founders embraced their constraints and claimed they forced them to develop creative solutions. Their attitude was that constraints were advantages in disguise and determined how to work with what they had.

The Right People

Another story Alex mentioned was that he began to introduce innovative ideas in small ways. In particular, for one project, he sought out people who wanted to be a part of the change. One of his first-level managers is known to advocate for the status quo, so Alex reached out to two people in her group and asked them to do a special project for him ‘on the side.’ The people worked some magic, and the project was a success. One member of the team went to Alex a week after the project completion and thanked him for the opportunity to do something different, and offered to be a part of other special projects.

Lack of Vision

Sometimes we think we need a solid vision, but we need to just get going. Twitter is an excellent example of one vision changing into something completely different. The company began as Odeo, a social network to help people find and subscribe to podcasts. After Apple started to grow its presence in the podcast management niche, Odeo jumped out of that market and developed the micro-blogging platform that is now Twitter.

Benefits of Constraints

Constraints shape and focus problems; they provide clear challenges to overcome and inspire creativity. Creativity loves constraints, but the constraints must also be balanced with a healthy disregard for the impossible.


For those who aren’t sure of their constraints, use self-imposed limitations. For example, Jeff Bezos, founder of Amazon, made his teams as small as possible. He believed that if a group could be fed with two pizzas, it was too big.

The reality is that we have an abundance of resources, and our perceived scarcity is just that - perceived. It isn’t real. Indeed, we may not have what we would like, but we can focus on our resources to propel an idea forward. The constraints help with focus.

Start today. Embrace the chaos before you reach the calm. Define an MVP or the minimum requirements required to finish the first step. Keep moving forward.

Are constraints preventing or propelling your innovation efforts?

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