Almost always great new ideas don't emerge from within a single person or function, but at the intersection of functions or people that have never met before.

When the functionality of a product or service overshoots what customers can use, it changes the way companies have to compete. When the product isn't yet good enough, the way you compete is by making better products. In order to make better products, the architecture of the product has to be interdependent and proprietary in character.

There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well.

It is when the product is not good enough that proprietary integration gives you a competitive edge. You cannot outsource and be competitively successful in this situation. But at the other end, where standard components assembled in standard ways can yield acceptable performance, you must outsource.

The whole enterprise of teaching managers is steeped in the ethic of data-driven analytical support. The problem is, the data is only available about the past. So the way weve taught managers to make decisions and consultants to analyze problems condemns them to taking action when its too late.

There are direct paths to a successful career. But there are plenty of indirect paths, too.

There needs to be conviction and action behind rules.