HMS Essette Blog

//Why can’t Care Coordination be as simple as making spaghetti sauce?

Why can’t Care Coordination be as simple as making spaghetti sauce?

By Andy Gaudette, CEO

Although, as Essette’s CEO I am highly involved in directing the vision of our software company, at heart, I am still a Process Engineer. Solution thinking runs through my veins like spaghetti sauce. Yes, you read that correctly! But before you search out a new ICD-10 code for my odd condition, let me explain:

Prior to my unwitting (and somewhat, unwilling) entrance into the world of healthcare, I ran a successful consulting business. My aeronautical engineering degree, coupled with a strong entrepreneurial spirit, led to a career that sent me around the globe. I provided engineering services for a gamut of industries and, amongst other things, developed an expertise in engineered automation for food processing and manufacturing plants.

Those twenty eight years taught me invaluable lessons about leadership and teamwork, but the overshadowing take-away was this: it takes honest evaluation and genuine collaboration to create solutions that truly connect people with technology.

No doubt, Essette’s staff have heard numerous stories about my travels, some that seem to have become almost mythical in their re-telling. Although we joke about our beginnings (writing software for milk plants and even a traveling circus!), our background in connecting people, technology, and disparate ‘islands’ of information has been foundational to Essette’s way of doing business. And, ultimately, it has greatly contributed to our success in healthcare.

Why? Because besides providing me with personal life lessons, the key strategies we adopted for the production of national brand spaghetti sauces, ice cream bars, pizza crusts (and other crazy things like kid’s juices packaged solely for the convenience of soccer moms!) taught me the power of collaboration.

Not just amongst my team, but between the varieties of disciplines represented in the engineering world. Each, with individual specialties—whether they be motors, conveyors, piping, thermocouples (devices that measure heat), valves, ingredient dispensers; the list goes on.

Producing spaghetti sauce for national distribution meant we had to make a flavorful, high quality, and consistent product. Most importantly, all of the vendors that were involved had to work together collaboratively to make sure the final product was safe. We shared a joint goal, and if we failed, people would get seriously ill and potentially die. We had a responsibility to be successful as a team.

Every vendor knew their niche and every vendor respected the other’s expertise.

Quite the contrast to some of the vendors involved in today’s healthcare industry, right?

With all sincerity, I am constantly disappointed to see the proprietary and un-collaborative approach taken by many healthcare vendors. Especially when the health and wellness of others is at stake.

Why is it that, when we have the opportunity to build bridges, there is such hesitancy—and sometimes outright aversion—to openly share information, especially in real time. Is it because so many vendors are answering to investors, and investors are demanding that vendors be everything to everyone? Is it a ‘fear of lack,’ meaning we fear there is not enough business for all of us? Or, is it greed?

To effect change in healthcare, we must be the change. But stories abound about the lack of cooperation between vendors. If we had exercised this mentality in food processing, it would have seemed absurd. Imagine if the conveyor engineer wanted to be the filler pipe engineer someday and, in the meantime, refused to communicate with the existing filler pipe engineer! One thing is for sure, we would all be waiting for the tomato sauce.

Instead, and for the most part, manufacturers and food processors only hire vendors and engineers who adopt a collaborative approach. Their common goal: to improve quality and reduce costs on every project.

Why can’t we do the same in healthcare? Time is ticking and costs are still going up.

I know much has been written lately about interoperability – healthcare’s latest buzz word. CMS and other governing bodies are working on initiatives such as “Connecting Health and Care for the Nation, A Shared Nationwide Interoperability Roadmap,” (PDF). Will it take forced collaboration and layers of bureaucracy and legislation before vendors take the initiative to “interoperate”?

The thought of it makes my spaghetti sauce boil!



  1. Nag Reddy June 14, 2016 at 1:58 pm

    ‘Continuously reinventing our selves will keep us ahead and distinct among the vendor population. Then, it’s not the matter of competing, but it becomes matter of being self-sufficient. The key is to generate the drive and energy from within to get that disrupting/innovation ongoing. Very nice observation!!

  2. Rajeev Rawat April 19, 2016 at 8:17 pm

    It is role modeling of leaders like you that will build meaningful and necessary bridges. When you can show logical progress in the areas you highlight, integration of vision, technology, and processes to improve effectiveness and efficiency it will catch investors’ interest. When you can show increased customer satisfaction and higher profits, it will transform the industry’s culture from greed to service. Thanks for being a visionary leader.

  3. Robert Beltran, M.D., M.B.A. April 19, 2016 at 4:30 pm

    Health Care is unfortunately a different animal than being a spaghetti maker. Usually there are recipes that create the great sauces for this delightful meal.

    We are in a disruptive phase in health care where “breaking all the rules first” and having a “contrarian” leadership style are the key ingredients to making a great health care “sauce.”

    I agree the 3 C’s are all important- Communication, Collaboration, Cooperation. But we shouldn’t leave out the # E’s- Educate, Engage and Empower. :

    • essette April 20, 2016 at 8:56 am

      All great points. Similar to favorite recipes of past generations, a healthier “sauce” requires we make adjustments to healthcare’s previously favored ingredients, replacing them with fresh or even, unexpected options. It’s time we disrupt the disruptors. Education, Engagement and Empowerment are certainly key elements for improving today’s “recipe” for care coordination.


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