RED HOT Contributors


Episode 43 – Why Time is on HIS Side


Today’s hospitals have increasing pressure on delivering care. This comes from high patient demand, more chronic disease, and the shift to risk-bearing payments as we move into value based care.  

The constant pressure to do MORE with LESS has led to limited resources, tremendous inefficiency and waste, coupled with physician burnout and long patient wait times. This also shows up as challenges to growth and integration from what is often over-investment, resulting in poor mergers, acquisition, and the resulting integration.

I’ve met some intelligent thinkers and medical mavericks – and my recent healthcare leader guest wears both hats. Like Mick Jagger once sang…for this innovative polymath, TIME really IS on his side.


In this episode, Dr. Steve engages one of the smartest leaders on improving healthcare delivery operations and efficiency, Mohan Giridharadas of LeanTaaS 

An engaging interview, with deep-dives into the following :

  • The ‘secret sauce’ allowing his company’s products to be in more than half of the top cancer centers…and quickly moving into many other segments.
  • A philosophy and technology around appointment scheduling that is lowering patient waiting times by 50%
  • Smart technology in operating rooms, that will save health systems up to tens of millions per dollars each year 
  • Why 80% of all nurses can now HAVE lunch – and what that means to their culture and patient care
  • Why most scheduling technology is built upon a mathematical foundation of Jell-O
  • Why many home run efforts of A.I. have missed the easy singles and doubles

Here’s a valuable audio snippet from the show. The complete podcast show is available for listening, by clicking on play button at the top player in this article:

DR. STEVE: “One of the things I noticed in doing my review of both of the products your company has, is that they hone in on the component of TIME. Especially interesting is that you take a sample patient appointment, and divide it into two parts…the hands on (value) treatment, and the non-value added time, which is where the patient is often waiting.

The non-value time in a typical appointment, I believe you said, makes up 70-80% of the time, per your estimates. I find it a unique approach, and how time plays such a unique role in your value proposition for your products. Perhaps you could explain that further.”

MOHAN: “If you go back to First Principles on what makes a service process excellent, whether it’s delivering a bank loan or treating a patient, any service process can be categorized by time, process, and quality.

The classic way to go after services is to go after costs or quality first – that’s a problem. When you start with those two, it actually makes the overall situation worse.

Let me take cost for example.

Service processes are labor-intensive processes. So if you’re trying to reduce cost, you’re taking people out of the equation. When you do this, the workload goes up and the expertise disappears – and therefore you make more errors, quality goes worse – and time goes in the wrong direction.

Similarly with quality. If you try to make the quality better in the same existing process setting, you’re forced to inspect quality. So you have checkers, and checkers checking the checkers – and it adds layers of complexity, which adds costs, and takes longer.

TIME is the only variable that when you pull it in and make it better, it FORCES YOU to get better at the other two.

An example would be taking 30 days to process a loan – when in fact the work content was only 10 hours of work (title check, credit check, payment check, building inspection, etc.) And if I have 30 days to do 10 hours of work, I have lots of time to make mistakes.

But if had to guarantee a 24 hour turnaround on all home mortgages, guess what? You have no time to make any more mistakes. And so time becomes the equivalent of lowering the water level in the bay, to see the rocks underneath the surface, and then attack the rocks.

So when we (LeanTaaS) take the end-to-end experience for patient experience for chemotherapy, operating rooms or any asset in a health system, we can look at the total elapsed time and find out what percent of it is value-adding. Sometimes its 10-15%…and sometimes it’s even less.

So rather than attacking the actual work steps of the process, we attack the waiting steps, make those go away…and that’s how we consistently increase the velocity and throughput.”


 I have had the privilege and pleasure of working with Steve Ambrose on a podcast that covered a range of topics in healthcare information technology. The podcast logistics – communications, interview questions, scheduling and production – were every well managed.
A great experience that I would do again in an instance.

Dr. John Glaser
SVP, Population Health at CERNER

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