We use data, systems thinking, and change management techniques to help hospitals improve their organizational effectiveness.

Introduction: Big Data’s Big Problem

Technology is dominated by two types of people: those who understand what they do not manage, and those who manage what they do not understand.” ‐ Archibald Putt

The greatest irony of the modern age is that the very technology that would allow just a few to control very large organizations has rendered those very large organizations obsolete.


The organizational templates used in business and government were formed before and during the industrial age. Today’s national governments, great multinational corporations, and very large health systems and hospitals were modeled on the same shared template. Top down control, lots of mass, and economies of scale formed the template’s outlines. Time and technology have rendered the old templates no longer competitively efficient.

Thanks to technology a few people working out of a small office can accomplish what only yesterday would have required scores of people and a national organization to achieve. Unfortunately, the power of that technology and attempts to harness it to deliver health care to the masses leads inevitably to the “treatment” of statistical abstractions instead of the provision of care for human beings.

Because the ACA sees people as coded database records, physicians are transformed into clerks whose compensation depends upon their willingness to subordinate professional judgment to statistically determined centrally‐administered rules. Each patient becomes a dehumanized aggregation of codes and treatment is permitted or withheld based on those codes. Physicians and hospitals are perversely incentivized to avoid providing care to the most ill, those patients whose conditions are more likely to produce an unfavorable outcome.

The ACA is a dehumanizing, amoral, and incompetent rationing scheme that grants to faceless bureaucrats the power to decide not only who may receive health care but what the course of that care must be. The financial interest of the State is being placed above the value of human life.