Three Common Oversights In Strategic Planning

When most leaders do strategic planning they focus on only one of the four key areas – Goals and how to achieve them. By spending minimal time discussing the other three critical areas, many strategic initiatives fail to reach their potential. Before setting strategic goals, leaders should cultivate a full dialogue on underlying assumptions, potential unintended consequences, and barriers to success.

The following is a case study to illustrate the importance of discussing Assumptions, Unintended Consequences and Barriers to Success during a strategic planning process. It highlights how dialogue in these three areas, in addition to Goal setting, leads to strategic planning that fosters alignment and results in a smooth execution of a strategic initiative. The case is from the fictional HITA Group, a regional health care information technology alliance comprised of doctors, hospitals, insurance companies, and government representatives.

The HITA Group needed a strategy to become financially self-sustaining as the American Recovery and Reinvestment Act (ARRA) funding was being phased out by the federal government. Long term funding is a significant issue facing similar non-profit organizations across the country. The HITA Group received revenue from three sources of funding: insurance companies, health care providers and grant funding. The strategic question on the table was how to increase the funding from each of these groups in light of the ARRA cuts.

Assumptions – By discussing assumptions two strong leaders in conflict over a stated strategy learned they had assumed different meanings for the word “payer.” When they began using the same definition a completely new solution and a new revenue stream emerged that they both endorsed.

The default solution to financial sustainability was being advocated by the Board Chair, a government official. He said the insurance companies should be mandated to pay more for the technology to exchange health care information. He reasoned that as payers they were getting most of the cost savings through information sharing because it led to the elimination of redundant and unnecessary medical tests for which they would no longer be paying. The insurance company CEO on the Board said, “NO Way!” to paying more. Through a dialogue on assumptions they discovered that the Board Chair considered insurance companies to be payers, but the insurance companies said that self-insured employers in the region were actually the majority of payers. As a result of this definitional alignment, The HITA Group had a shift in strategy. Rather than being in conflict with each other, the insurance company CEO and the Board Chair began to make presentations to the self-insured employers in the region. If large companies became paying members of the alliance their employees’ data could be included in the system, and they would realize cost savings by eliminating duplicative health care tests and procedures on their employees. The result was a new and significant revenue source from large companies in the region.

Unintended Consequences – After a dialogue on the potential unintended consequences of the stated goals, a staff member of The HITA Group generated a creative technology solution to reverse rising operational costs.

A strategic goal of The HITA Group was to access each and every grant available to fund the development of new technology. The Board had not previously discussed the unintended consequence of that goal, which was that grants paid for the development of capabilities but did not cover the ongoing maintenance of them. The maintenance costs of new features were causing The HITA Group’s expenses to increase exponentially without revenue to offset these costs. A point in the dialogue was that not all of the features required by the granting organizations were valued by The HITA Group members, yet they had to develop all of them to receive the grant. Listening to the conversation one of the technical staff members was able to generate a creative strategic solution. She suggested that The HITA Group develop all the features to meet the requirements of the grant, but if there was not enough member interest in specific features to pay for the ongoing maintenance, they would disable that feature.

Barriers to Success – By overcoming a group norm to stifle naysayers, a previously unknown barrier related to training preferences was surfaced.This discussion of barriers led to an improved training program as well as increasing a new product revenue stream.

The HITA Group had developed a web-based software application for office managers of physician practices, but it wasn’t selling as well as hoped. The Board heard that physician practices were “not getting value” from it. To provide context to this example, there was one HITA Group member who vocally disagreed with any new idea, providing a litany of all the reasons that it wouldn’t work. She was labeled a negative force in the group and was shunned in general.She was also shut down whenever she tried to bring up a potential barrier to success.By creating a situation where bringing up barriers was encouraged, the group learned that this woman had information directly from the office managers. When they said they were “not getting value” they meant that they were not able to attend the training sessions being offered to realize the value of the application. These training sessions had been held centrally at a hospital in the major city in the region, but most office managers couldn’t afford the time to travel and attend them. The office managers preferred webinar training in small increments over time. Although the strategy to develop this style of training increased the expenses, it added the revenue stream for the software application that had been dismissed as a failure.

These three examples from The HITA Group illustrate how intentional strategic planning that encourages the discussion of underlying Assumptions, potential Unintended Consequences of achieving goals, and an open discussion of Barriers to Success leads to better results than what most groups do in strategy sessions when they immediately jump to the Goals and how to achieve them.

Let Your Body Do The Talking Through Nutrition Response Testing

At its most basic definition, nutrition response testing is a professionally administered battery of tests in which answers to health questions and ailments are sought via the body’s central nervous system. By manipulating the body by way of individual positioning, movements, and other manipulation techniques, the practitioner can then record nervous responses and draw certain conclusions from them. Each response is associated with a particular problem or ailment within a particular part of the body and can thus be interpreted as actionable health suggestions and change.


Anyone can easily become concerned at the thought of tampering with the nervous system, but this type of test is quite simple and just requires the physical manipulation by the practitioner upon the patient. There are no machines, electrical currents, or adverse effects to then be concerned with. In fact, the patient is sure to be tougher on their body on a typical day than the test practitioner would ever come close to during these simple manipulations.

How, Why It Works

So, how exactly does it all work? To get down to the science of it, one must understand how the central nervous system works. When certain movements or actions take place in a limb or other body part, the nervous system immediately runs its myriad of reporting and communications relays throughout the system. These interactions take place by way of neurotransmitters, axons, neurons, and dendrites all working in tandem to assess and communicate the current events to the brain and body alike.

Essentially, the nutrition response testing practitioner will manipulate certain parts of the body, record the nervous responses that are noticed, and draw subsequent conclusions from that gleaned information. The test can be administered in a broad sense so as to provide a sort of whole-body check or in a more accurate area of focus or concern. The patient is then able to take this information and advice and apply it to their daily habits in nutrition and personal activities.

A Sample Outcome

To get a better picture of the process, let’s take a look at a hypothetical patient and health dilemma. Jack is a middle-aged man that is experiencing energy-drain and exhaustion like never before in his life. After checking some other areas to no avail, he consults with a Nutrition Response Testing Practitioner.

After going through the test, he is made aware of a specific trace mineral that his body is now lacking and needs more of than most others. He then goes on to try supplementing this mineral into his diet, and sure enough, the problem quickly diminishes. If not for this particular testing method, it’s unsure if Jack could have ever truly discovered this issue by other means, medical or personal.

Finding The Right Nutrition Response Testing Practitioner

The NRT practitioner should be a medical professional that is well-versed in nutrition, the nervous system, and physiological responses in general. When choosing the right practitioner, ask questions to be sure that they are a good fit for this new healthcare alliance being created. Most importantly, find out their level of experience in this area as well as their abilities as they pertain to your particular medical concern.