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On December 14, 2015, Gorale commented on Iora Health: Improving Health While Cutting Costs :

Interesting piece, Iora has received lots of attention in health care, and for good reason. One question I have though, you often hear about new models like Iora being better because they allow for same-day scheduling and other similar fast services; what in the Iora model allows such quick patient responsiveness to occur that doesn’t happen in other PCP settings? Is it that physicians have more scheduled down-time during the day when they aren’t seeing patients? If so, some may argue that that’s not efficient use of the physician’s time. Where is the flexibility in scheduling and provider resources built in to see patients on a same-day basis? Also, interesting that the value-based-payment model works as well here as it does given that PCPs won’t necessarily see the increased costs of an admission to a hospital (unless their already in an ACO-type model).

On December 14, 2015, Gorale commented on Shouldice Hospital: Standardized, Specialized Clinical Processes :

Eloquently said! Yeah, I think standardization has a huge role to play in improving health care efficiency in general in the future. I would love to speak more with surgeons who have actually worked in such hospitals though to get their take on the very high throughput and lack of variation in their day. While it makes for extremely well-practiced surgeons, I wonder if they feel that their careers become mundane at all without a greater variety in their case load.

On December 14, 2015, Gorale commented on Rebuilding LEGO :

Jeremy, awesome post; as a kid, I had converted our entire attic into a sprawling Lego town (with a statue of liberty, soccer stadium, train, etc.), spent many many hours there (all to say, I loved Legos). Interesting to think about the role of customer feedback in product development and innovation. What do you think is they key to good customer feedback? I imagine that there are more or less effective ways to get customers involved in the process. Do you think it’s better to get customers involved in creating actual product prototypes, or is it better to solicit their feedback once prototypes are already created, or both? I guess that’s all to say, do you envision scenarios in which customer feedback could not be as beneficial as Lego would hope, and what is the best way to maximize return on feedback?

On December 14, 2015, Gorale commented on The Dana-Farber Successfully Sutures the Surgical Efficiency Gap :

Tehsina, really interesting piece; I did my gen surg sub-i at BCH, absolutely inspiring place and awesome surgical care of patients, but also totally appreciate the importance of having separate facilities and teams for lower acuity procedures. Do you think this solution would work as well if some of the ORs in BCH were just designated as sedation suites, or is there an advantage to having these suites over at DFCI instead? With that sentiment as well, what do you think are the primary obstacles preventing the adoption of this model at other centers? Seems like a fairly common sense solution, but the implementation is definitely easier said than done.

On December 14, 2015, Gorale commented on To Infinity and Beyond :

Roxy, awesome post, really interesting piece, especially how some scenes are actually changed depending on cultural context. I am curious more about your thoughts on the “matching not ranking” thought. While I see a huge benefit to equality in spurring creativity, I worry that having no hierarchy would reduce accountability. How does Pixar try to maintain accountability and order in decision-making with absolutely no hierarchy? Thanks!