1. The Passion of the Journey
Starting a new business and a new field
John Abele
MEDEDGE SUMMIT
York Region
June 20, 2013

2. The bigger the house,
the longer it takes to answer the door.
“I cut this out and hung it over my desk in 1972”

3. I always valued talking directly to the docs. AHA, 1974

4. Dr. Andres Gruntzig, holding our steerable catheter, AHA, 1976

5. BSC partners, Pete Nicholas, John Abele, 1979

6. BSC think tank, “Greek Diner” , Watertown, Mass.

7. History of BSC from the 70’s to 2001

8. Pioneering book on the power of culture on business success, 1982

9. One of the best selling business book in history…also on culture.

10. “In Search of Excellence”, 1982
8 Principles,
• A bias for action, active decision making - 'getting on with it'. Facilitate quick decision making &
problem solving tends to avoid bureaucratic control
• Close to the customer - learning from the people served by the business.
• Autonomy and entrepreneurship - fostering innovation and nurturing 'champions'.
• Productivity through people- treating rank and file employees as a source of quality.
• Hands-on, value-driven - management philosophy that guides everyday practice - management
showing its commitment.
• Stick to the knitting - stay with the business that you know.
• Simple form, lean staff - some of the best companies have minimal HQ staff.
• Simultaneous loose-tight properties - autonomy in shop-floor activities plus centralized values.
Still relevant in 2013

11. November,
1995
One of the most successful new business magazines, by the former
editors of the Harvard Business Review. They broke the rules.

12. }
Pete and John were charter investors and thanked in the masthead for
many years.

13. What are the differences between
big and small companies?

14. Big
Pro Con
____________________________
• Money
• People
• Experience
• Connections
• Diverse resources
• Market power
• Can go to scale
• Bureaucratic
• Slow
• Political
• Risk averse
• Cost inefficient
development
• Requires detailed plans
and budget
• Don’t know what they
know
• Unfriendly to inventors

15. Small
Pro Con
____________________________
• Fast
• Resourceful
• Risk taking
• Apolitical
• Works around the clock
• Can change quickly
• Always optimistic
• Undercapitalized
• Never enough people
• Never enough tools
• No reputation
• Lack of depth
• Lack connections
• Don’t know that they
don’t know
• Always optimistic

16. How do you balance the difference?

17. Leverage Assets
• Intellectual
• Geographical
• Technological
• Information
• Financial
• Marketing
• Strategic
Internally, externally, within, between

18. Orbiting the Giant Hairball: A corporate Fool’s Guide to Surviving with
Grace

22. Too Much Innovation?

23. Cleveland Clinic

24. Mayo Clinic

25. Health Systems

26. University of Pennsylvania

27. Cities Everywhere

30. Small can be BIG

31. And BIG can be Small

32. Technology enhances
Convergence
• Terabyte/exobyte memories...SmartPhone sensors/virtual
doctors.
• Personal medical search engines know who you are, where
you are, what’s wrong.
• Data gets bigger, more accessible faster.
• Wikis, blogs, collaboration software enhance collective
intelligence.
• Decision making software/computers… “Watson will see you
now”.
• Integrated imaging/diagnosis/therapy

33. CONVERGENCE
in many areas
• Disciplines: Cardiology, EP, Neuroscience, Radiology, Surgery,
GI, Urology
• Science: Biology, Chemistry, Physics, Nanotechnology
• Business: Pharma, Biotech, Devices
• Diagnostics and therapeutics
• Fusion imaging
• Technology: IT with everything, bioinformatics,
nanotechnology

34. The Arab Spring comes to Health Care
Democratization of Knowledge
Democratization of Power

35. Bottoms Up Health Reform: Some Examples
More TransparencyMore Transparency
More Participation by Patients
More choice

36. Crowdsourcing as a powerful business tool

37. Network science, the ultimate disrupter

38. Design Thinking
Systems Thinking
Integrated Thinking
Eco Thinking
Big Picture Thinking

39. www.kingbridgecentre.com
My conference center in King City, Ontario. New experiments in collaboration

40. The Kingbridge Mission
The Design of Meetings
Organizations are most productive when there is great
communication. Great communication can occur
when people are stimulated, provoked and challenged
in an atmosphere of trust, respect and accountability.

42. iPod versus iTunes
We need more systems solutions so we can use our
wonderful technology

43. Big or Small,
Innovation Starts with
Leadership

44. Leadership starts
with values.

45. Leaders invest in what
they believe.
-It’s not a job. It’s a religion.
Pseudo leaders focus on
image, not substance.

46. Leaders have
unshakable integrity.
• They care about what’s right
• They aren’t afraid to speak out.
Pseudo leaders
want results at any cost.

47. Leaders want to create
something of value.
Pseudo leaders
want to be rich.

48. Leaders don’t follow a formula.
• They do zero based thinking every day
• They question assumptions
• They question authority
• They question themselves
(true confidence)
• They provoke, challenge, test, play
Pseudo leaders do what they think
will please the boss.

49. Leaders are proactive.
Pseudo leaders react.

50. Leaders are self-
critical.
• They want the best solution
• They are open to the best
advice.
Pseudo leaders
“don’t make mistakes.”
• They kill the messenger
• Criticism is unpatriotic

52. Be willing to test yourself

53. How Do We Rate?
• Trust
• Communication
• Coordination
• Collaboration
• Sense of urgency
• Transparency
• Freedom from fear of failure
• Willingness to kill projects
• Organization-wide optimization

54. People have been trying to collaborate
since the beginning of people

55. The Babel Collaboration Center. Didn’t work too well.

56. When I asked the editors whether I could collaborate with
the other authors, I was told “we don’t do things that way”.

57. Building an organization is a continuous process.
Evolve or die.

58. “No one owns the industry.
It belongs only to the best - to those
who keep it growing, producing, alive.
We’re in it today, but tomorrow it
belongs to whoever does it better.”
Unknown

59. Invention is everywhere. This open source one could be
the foundation of many devices and applications.