It’s Time: Shaping the Health Ecosystem for Systemic Impact

Updated on September 16, 2020
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By Ralph Welborn

We face a paradox within Public Health. We’re fantastic at insight, or surveillance, of outbreaks and rapid response. Look no further than the global public community’s accomplishment around Ebola and Zika a few years back, and Cholera and Diabetes in an ongoing manner. Sure, it took time to mobilize to scale for each of them. And, for all of them, many challenges were faced and lessons are still being learned. However, the point is that the global community responded. Companies now provide critical information for tourists to have a safe trip to foreign countries. As countries combat their outbreaks effectively and public health information is available the tourism industry can continue to prosper.

 Yet we’re not as good at building enduring systemic impact in the environments that required the mobilization. Again, look no further than the examples cited. We respond, then move on to the next significant health challenge — or “shiny object” as someone once put it — tackling the first hard problem, which is the response, but not the second, which is building local capabilities to lessen the likelihood of it occurring again. 

The challenge? Crossing the chasm between strategic intent (of responding quickly to a specific disease outbreak) and building enduring impact. The result? The chasm, in which lives are lost. 

A New Lens

Crossing the chasm requires a new perspective, or a new lens of insight. Much like the Hubble Telescope did for scientists who were looking at the same sky, but were rewarded with new vistas of insight and discovery, this new lens provides a way to see health programs systemically, and thereby begin to scale health innovations sustainably.

Improving health outcomes will be as successful as behavioral change is effective, and sustained, across all stakeholders. Health programs are complex — influenced and impacted by different types of people, organizations and markets. They’re embedded within ecosystems of engagement, requiring the orchestration of activities and capabilities across all of these actors if we want to make systemic impact. 

And here it gets exciting.

Why? Because there exist lessons to offer bold healthcare leaders — insights learned from other industries and explosive growth companies from around the world. How so? A simple reason: Every explosive growth company, whether Tesla or Tencent, Amazon or Alibaba, or so many others, shares a commonality despite their obvious differences in focus. Namely, they’re built on shaping ecosystems of engagement and orchestrating the activities and capabilities from the vast range of the stakeholders engaged in that ecosystem. Sound familiar? 

Let’s look at three lessons from explosive growth leaders related to crossing the chasm from initial rapid healthcare response to sustainable impact.

1. Clarify what and who makes up your ecosystem. 

A new strategic question underlies how today and tomorrow’s explosive growth leaders operate: Where is value being created — and destroyed — in the ecosystem in which you and your customers are embedded? This question reflects the reality that industry boundaries are blurring as technologies developed in one area become quickly adapted for others. Recognizing this immediately starts to help you think through the potential ripple effects of decisions you make and actions you take across a vast array of different types of stakeholders. 

2. Figure out how to motivate different stakeholders to change their behavior.

Different stakeholders are motivated by different types of value — what we call “currencies” — that matter to them. One key to orchestrating one’s ecosystem comes down to knowing how to create and execute on a shared value framework whereby everyone engaged realizes value.

3. Orchestrate around your critical 20 percent. 

The complexity of health programs means that no one firm can build sustainable health program impact by itself. The new Amazon-JPMorgan-Berkshire Hathaway announcement about their “ecosystem-centric model” to provide new models of care is but one of many examples occurring throughout the world that’s taking advantage of the new models underlying explosive impact. Each brings specific capabilities (defined as skill sets, behavioral patterns and technology assets) to the table — their own “20 percent” of capabilities critical to meeting the bold objective. This highlights how the one key to orchestrating ecosystems rests on a) knowing what is your 20 percent that you bring to the table, and b) orchestrating your partners around each of their 20 percents. 

Why does this matter now?

We’re at an inflection point to transform how we tackle health system challenges systemicallywith speed and scale. Lessons from explosive growth companies from other industries can help us cross the chasm from effective response to sustainable impact.

So, who’s in your ecosystem and what’s in your program to orchestrate them?

Ralph Welborn is author of Topple: The End of the Firm-Based Strategy and Rise of New Models for Explosive Growth. He is CEO of CapImpact, specializing in advisory and predictive analytics for new growth models, and is a former head of IBM’s strategy and transformation business in the Middle East and Africa. For more information, visit or

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The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.