Influence Of Organizational History

In healthcare, what’s often hailed as new is, in fact, old. More often than not, we’re simply renaming long-standing ideas with fresh terminology. Take social determinants of health, for example. Many in the industry believe we’ve only recently begun to consider social factors in healthcare. Not true. Back in the 1980s, organizations like SCAN participated in the pioneering Social HMO demonstration project, which integrated social services to improve health outcomes. The benefits? Homemaker services, personal care, adult day care, respite care, and medical transportation. Sound familiar? Another example: value-based care. It’s often pitched as a revolutionary approach to healthcare payment. Again—not new. For decades, organizations have operated under full-risk and global capitation models. Think Kaiser Permanente, Atrius Health, Healthcare Partners, CareMore, and Heritage. These groups assumed full financial risk for patient populations long before the term “value-based care” entered the lexicon. The principles haven’t changed—only the branding has. And what about ethnic-focused health plans? Some view them as a recent innovation. But they’re not. Plans like Chinese Community Health Plan, Central Health Plan, and Brand New Day have long catered to specific ethnic communities, designing benefits tailored to their unique needs. These models didn’t just appear—they were built over time with intentionality and cultural insight. The takeaway? History matters. We should study it. Learn from it. Build on it. Understanding the past helps us avoid repeating its mistakes—and helps us build a better, more effective system. Yet in today’s healthcare innovation economy, history is often erased in favor of a shinier narrative. Claims of being “first,” “best,” or “most innovative” drown out the real story. But progress doesn’t come from pretending we’re starting from scratch—it comes from standing on the shoulders of those who came before us. Those who ignore history are doomed to repeat it. It’s one reason healthcare can feel like it’s stuck in a loop: too often, what’s marketed as innovation is just a reboot of old ideas. Respecting history isn’t nostalgic. It’s strategic. What truly matters is execution—and a relentless drive to improve on what came before. But that improvement begins with knowing and respecting all that came before us.

𝐒𝐢𝐱 𝐠𝐞𝐧𝐞𝐫𝐚𝐭𝐢𝐨𝐧𝐬. 𝐎𝐧𝐞 𝐰𝐨𝐫𝐤𝐟𝐨𝐫𝐜𝐞. 𝐔𝐧𝐢𝐟𝐢𝐞𝐝 𝐧𝐨𝐭 𝐛𝐲 𝐚𝐠𝐞—𝐛𝐮𝐭 𝐛𝐲 𝐩𝐮𝐫𝐩𝐨𝐬𝐞. I believed leadership meant setting direction and ensuring alignment. But over time—I’ve come to see that real leadership isn’t just about strategy. It’s about 𝘤𝘰𝘯𝘯𝘦𝘤𝘵𝘪𝘰𝘯. That truth has never been more relevant than it is today. For the first time in modern history, 𝐬𝐢𝐱 𝐠𝐞𝐧𝐞𝐫𝐚𝐭𝐢𝐨𝐧𝐬 𝐜𝐨𝐞𝐱𝐢𝐬𝐭 𝐢𝐧 𝐭𝐡𝐞 𝐰𝐨𝐫𝐤𝐟𝐨𝐫𝐜𝐞. It’s a leadership challenge few of us were trained for. 🔹 𝐒𝐢𝐥𝐞𝐧𝐭 𝐆𝐞𝐧𝐞𝐫𝐚𝐭𝐢𝐨𝐧 (pre-1946): Still serving on boards; shaped by duty and discipline. 🔹 𝐁𝐚𝐛𝐲 𝐁𝐨𝐨𝐦𝐞𝐫𝐬 (1946–1964): ~12% of today’s workforce; value stability, loyalty, and legacy. 🔹 𝐆𝐞𝐧 𝐗 (1965–1980): ~27%; independent, pragmatic, delivery-focused. 🔹 𝐌𝐢𝐥𝐥𝐞𝐧𝐧𝐢𝐚𝐥𝐬 (1981–1996): ~34%; purpose-driven, collaborative, growth-oriented. 🔹 𝐆𝐞𝐧 𝐙 (1997–2012): ~27%; inclusive, tech-native, values transparency. 🔹 𝐆𝐞𝐧 𝐀𝐥𝐩𝐡𝐚 (post-2012): The emerging workforce—digital-first, fast-learning, entrepreneurial. These differences show up in how we work: → Senior leaders value hierarchy; Gen Z favors flat structures. → Boomers seek recognition; Gen X wants autonomy; Millennials want meaning; Gen Z asks, “𝘞𝘩𝘺?” → Gen Alpha? They're learning, building, and questioning earlier than ever. What feels like friction is often just generational dissonance. In a recent HBR piece, put it well: “𝘠𝘰𝘶 𝘤𝘢𝘯’𝘵 𝘪𝘯𝘴𝘱𝘪𝘳𝘦 𝘢 𝘮𝘶𝘭𝘵𝘪𝘨𝘦𝘯𝘦𝘳𝘢𝘵𝘪𝘰𝘯𝘢𝘭 𝘸𝘰𝘳𝘬𝘧𝘰𝘳𝘤𝘦 𝘶𝘯𝘭𝘦𝘴𝘴 𝘺𝘰𝘶 𝘶𝘯𝘥𝘦𝘳𝘴𝘵𝘢𝘯𝘥 𝘸𝘩𝘢𝘵 𝘪𝘯𝘴𝘱𝘪𝘳𝘦𝘴 𝘵𝘩𝘦𝘮.” That’s the shift we need as leaders: From uniformity → to personalization From authority → to empathy From legacy leadership → to 𝘭𝘪𝘷𝘪𝘯𝘨 leadership I now ask myself not just, “Am I leading well?” but “Am I leading 𝘳𝘦𝘭𝘦𝘷𝘢𝘯𝘵𝘭𝘺?” Because when we adapt our style—not our standards—we help every generation contribute at their best. Great leadership today means adapting with intention and embracing what makes each generation thrive. 𝐏𝐮𝐫𝐩𝐨𝐬𝐞 𝐀𝐥𝐢𝐠𝐧𝐦𝐞𝐧𝐭: Connecting individual roles to a broader organizational mission fosters engagement across all generations. 𝐂𝐮𝐬𝐭𝐨𝐦𝐢𝐳𝐞𝐝 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧: Recognize and adapt to the preferred communication styles of each generation to enhance collaboration. 𝐅𝐥𝐞𝐱𝐢𝐛𝐥𝐞 𝐖𝐨𝐫𝐤 𝐀𝐫𝐫𝐚𝐧𝐠𝐞𝐦𝐞𝐧𝐭𝐬: Offering flexibility can address the diverse needs and expectations of a multigenerational team. 𝐂𝐨𝐧𝐭𝐢𝐧𝐮𝐨𝐮𝐬 𝐋𝐞𝐚𝐫𝐧𝐢𝐧𝐠 𝐎𝐩𝐩𝐨𝐫𝐭𝐮𝐧𝐢𝐭𝐢𝐞𝐬: Promote a culture of lifelong learning to support professional development for all age groups. What shift have you made to better lead across generations? #HarveysLeadershipRhythms #ThoughtsWithHarvey #ExecutiveLeadership #TheLeadershipSignal #GenerationalLeadership #LeadershipReflections #LeadWithIntention #MultigenerationalWorkforce #LeadershipCue #Mentorship

The erasure or distortion of history can have symbolic effects that reverberate throughout society. Here are some ways in which erasing or distorting history can have symbolic effects: 1. Loss of Cultural Identity: History is deeply intertwined with cultural identity, serving as a repository of shared experiences, values, and traditions. Erasing or distorting historical events can undermine cultural identity by erasing important aspects of a community's past and disconnecting people from their cultural heritage. 2. Normalization of Injustice: By whitewashing or minimizing the history of past injustices, opposing groups normalize oppression and inequality. This sends a message that certain voices and experiences are less valid or worthy of acknowledgment, perpetuating marginalization and silencing marginalized communities. 3. Manipulation of Memory: Manipulating or erasing history distorts collective memory and shapes public consciousness. It creates a false narrative that reinforces existing power structures and serves the interests of those in positions of authority, often at the expense of marginalized groups. 4. Erosion of Trust in Institutions: When institutions or authorities engage in censorship or historical revisionism, it erodes trust in the integrity of those institutions. People may become disillusioned with official narratives and question the motives behind attempts to control or manipulate historical knowledge. 5. Resistance and Resilience: Despite attempts to erase or distort history, marginalized communities often demonstrate resilience and resistance by preserving their own narratives and reclaiming their historical voices. This resistance can take various forms, including oral traditions, cultural practices, and grassroots movements aimed at reclaiming and amplifying marginalized histories. Overall, the symbolic effects of erasing or distorting history are profound, shaping perceptions of identity, justice, and power within society. It is essential to recognize and confront attempts to manipulate historical narratives and uphold the integrity of historical knowledge as a cornerstone of cultural understanding and social justice. CS

Emerging Departments: How AI is Transforming Organizations Transformation in light of AI isn't just about digital change—it's strategic, cultural, and organizational. Early results of organizational optimization with AI reveal that traditional structures are evolving into new, combined departments that break down silos and enhance collaboration. Here are some emerging trends: 1. Human Experience Department (Led by the CXO) Combines marketing, HR, and customer service to create a unified experience approach. Focuses on customer and employee experience as a seamless continuum. Example: Airbnb and Starbucks blending internal and external engagement for holistic experience design. 2. The Intelligence Function (Led by Chief Data & Intelligence Officer (CDIO)) Merges IT, data analytics, and AI strategy into a unified intelligence function. Enhances decision-making with data-driven insights and technology integration. Example: Microsoft and Amazon use intelligence functions to support strategy and innovation. 3. Integrated Growth Department (Led by the CGO) Combines Marketing, Sales, and Customer Success to create cohesive client journeys. Prioritizes growth by aligning customer interactions across all touchpoints. Example: HubSpot and Salesforce driving client experience continuity. 4. Strategic Innovation & Transformation Office (Led by Chief Strategy Officer or Chief Transformation Officer) Combines strategy, innovation, and transformation initiatives for continuous evolution. Fosters agility by integrating foresight and innovation into long-term strategy. Example: Tesla blending innovation with strategic growth planning. 5. Technology and Digital Transformation Department (Led by the Chief Technology & Transformation Officer) Integrates IT, digital transformation, and cybersecurity under one strategic role. Embeds technology into workflows while ensuring security and compliance. Example: Cisco and IBM streamlining their digital transformation efforts. 6. Resilience and Continuity Department (Led by the Chief Risk Officer) Oversees Risk Management, Business Continuity, and Strategic Foresight. Ensures organizational resilience in an increasingly FLUX world. Example: JP Morgan building resilience to mitigate risks and ensure continuity. 7. Ethics and Responsible AI Office (Led by the CEAO) Ensures ethical AI use and compliance with regulatory standards. Maintains trust and integrity as AI becomes central to business strategy. Example: Microsoft and IBM proactively building ethics frameworks for responsible AI. In sum, AI is driving fundamental shifts in how we structure our organizations. To thrive, leaders must think beyond digital transformation and focus on strategic, cultural, and organizational evolution. The companies that succeed will be those that break down silos, integrate their functions, and embrace transformation as a continuous journey.

The Persian Royal Road: The First “Internet” of the Ancient World At the height of the Achaemenid Empire, the Persians built one of the most impressive infrastructures of antiquity: the Royal Road, a network stretching over 2,500 kilometres, linking Susa (in present-day Iran) to Sardis (in modern-day Turkey). Established by Darius I in the 5th century BCE, this road was not merely a trade route but a revolutionary communication system. In an age without technology, the Persians developed an astonishingly efficient postal service, with mounted couriers changing horses at relay stations along the way, enabling messages to traverse the empire in under a week — an unimaginable feat for that time. The Royal Road faced formidable challenges: it crossed deserts, mountains and rivers, requiring the construction of bridges, tunnels and constant maintenance. Yet the Persians kept it operational, using it to dispatch royal decrees, news, and even spies. The Greek historian Herodotus was so impressed that he wrote: “Neither snow nor rain nor heat nor darkness of night prevents these couriers from the swift completion of their appointed rounds.” This system was so advanced that it later inspired modern postal networks, such as the Pony Express in the United States. The story of the Royal Road reveals the brilliance of Persian ingenuity in transforming vast distances into opportunities for connection, uniting a diverse empire through a communication network that defied the limits of its age.

Every legacy system is a crash course in how the business really works. They’re seen as outdated, bloated, and ready for the trash bin. But here’s the truth: • They’ve handled real users, traffic, and edge cases. • They’ve survived years of business changes and still deliver value. • They’ve been battle-tested in ways shiny new systems haven’t. My take: 1- “Rewrite” is often a seductive trap. You want clean slates, but that’s rarely what the business needs. The cost of a rewrite is underestimated; the risk of losing hidden logic is ignored. 2- Smart refactoring wins. Replace the tires, not the whole car, unless you’re willing to delay product work for quarters. 3- Stability is undervalued until it’s gone. The most “boring” systems are often the most critical. Don’t underestimate a system just because it’s old. -> Stability is a feature. One week in the legacy codebase > three months of onboarding docs. Do you believe in “rewrite from scratch” or “refactor in place”? Why? P.S. You are not a Senior Engineer until you have worked on legacy code.

People adopt new tech… but inside their existing silos. Using old workflows. Following old boundaries. New tech promises an end‑to‑end solution. It spans silos. It unifies data. It requires painful organizational change. But it doesn’t replace the legacy overnight.  For years, both systems coexist. The old system still dominates communication, roles, incentives, and thinking. People are trained on the interface, but not on how their jobs must evolve. The “end‑to‑end” solution? It’s adopted piece by piece, pulled back into silos, until it mirrors the fragmented organization it was meant to transform. Conway’s Law wins. The system still reflects the organization’s communication patterns, even when the tech is new. Transformation doesn’t move at the speed of technology. It moves at the speed of organizational change. ---------

Every organization says its values matter. But the real question is whether anyone can see them. This visual captures a truth leaders often overlook. Values do not live in posters or documents. They live in the everyday cultural practices that surround people long before they read a single sentence about what the organization stands for. ↳ Symbols show up in the way you brand your work, the stories you celebrate, even the small signals people receive when they walk into a room. ↳ Heroes reveal themselves in who gets acknowledged, who is admired, and whose behavior becomes the informal standard. ↳ Rituals are the repeated moments that shape how people feel when they gather, decide, reflect, or close a year together. ↳ Practices are the actions that quietly reinforce what is truly acceptable and what is not. When these layers align, values become tangible. People experience them without needing explanations. When they do not, values start dissolving into aspiration rather than reality. This time, so close to the end of the year is a natural moment to notice the rituals that hold your culture together. The way teams close projects, express gratitude, celebrate progress, or take a pause before stepping into a new season. These small moments often reveal more about your actual values than any formal statement ever could. So if you want stronger values next year, do not start with rewriting them. Start with understanding the cultural practices that already shape how your people think, feel, and behave. That is where values either live or fade.

AI field note: Modernization is one of the most underappreciated forces for innovation (Southwest Airlines shows us why). When legacy systems finally get updated, two big things happen: 1️⃣ You can start improving services that were effectively frozen in time. 2️⃣ The cost and complexity of running those services drops—freeing up time, money, and focus for what’s next. But for a long time, modernization just wasn’t worth it. The juice wasn’t worth the squeeze. Projects kicked off with long planning cycles, manual analysis, and a lot of upfront investment—often without a clear path to value. That’s starting to change. AI is shifting what’s possible. It can help teams understand legacy code faster, accelerate planning, and reduce the rework that usually slows things down. With that, modernization becomes more viable, more targeted, and more focused on outcomes. It’s not just about updating systems—it’s about unlocking capacity, reducing friction, and making space for the next wave of innovation. Take Southwest Airlines. They needed to modernize their crew leave management system—a critical platform for scheduling, time off, and operations. Over time, the system had become harder to update. Technical debt made it difficult to plan changes, and documentation was limited. Each update required hours of manual analysis just to understand what the system was doing—slowing delivery and tying up valuable resources. But the pressure to modernize was growing. As operations evolved and employee needs changed, the system needed to be more flexible, more reliable, and easier to maintain. PwC partnered with Southwest to take a different approach. Using GenAI, we analyzed the legacy code and generated user stories—effectively mapping the system’s behavior and identifying what needed to change. That work: ⚡️ Cut backlog creation time by 50% 🌟 Produced user stories accepted 90% of the time without major rework 💫 Freed up 200+ hours across teams More importantly, it gave the team clarity and momentum—turning a slow, manual planning process into a faster, more focused path forward. Less time untangling the past. More time building what’s next—for their teams and their travelers. There’s never been a better time to modernize.

When I started Fifth Wall, PropTech didn't really exist. No major exits. No pattern recognition. Just a lot of intuition and not a lot of data. Nine years later, the picture is very different. With dozens of outcomes to look back on, we now have real visibility into the patterns that shaped our own performance: ✓ Our most significant outcomes came from early, high-conviction investments where we were willing to move before the broader market had full certainty. ✓ We concentrated meaningfully in the companies where we had the strongest belief in their long-term trajectory, rather than spreading capital evenly. ✓ The data shows clear power-law dynamics not only across companies but across investors. The strongest outcomes came from investors who were willing to take early, concentrated risk, and our historical results now reflect that pattern. ✓ Our strongest decisions came from tight, in-office teams moving quickly together. For the first time, we have the data to validate the factors that influenced Fifth Wall's historical outcomes in PropTech, and these insights now shape how we think about our own investment process moving forward. We will be sharing more on this data with the ecosystem. Here's a quick look at a few of them ⬇️