Thursday, November 14, 2019


Without change, we continue to do the same things over and over. Allow us to partner with you to make sure your future truly reflects your Vision. It is never to late to start and the first step will always be the hardest.

RemTecH Associates LLC


Saturday, July 6, 2019

Uncharted Territorial Leadership

Many wait on others to lead the way, hoping they will develop pathways that are without risk. This is not leadership – it is merely running-with-the-pack. True change is only possible when you can accurately identify your core values (cultural DNA) and then develop pathways that will actually sustain your unique future (short and long-term). To do so, you need to be a leader, not follow! You need to seek new pathways that are original and uncharted: taking the necessary risk, knowing and understanding that you may fail, but realizing that without risk, change is impossible

Health Care today requires risk takers, but challenges faced today (risk) cannot be solved without a well-developed-partnership that can apply supplementary knowledge and skills to bridge-the-gap. It requires people willing to help you change, shift and grow your values, expectations, visions, attitudes, and behavioral norms (habits). Universal solutions will not offer you an authentic pathway. It requires transformational thinkers that can create pathways that go beyond territories that remain uncharted. Making hard and sustainable decisions will always remain difficult for some, but true explorers confront and embrace such conditions and still proceed off-road into the unknown. The world is weary of tried-and-true-solutions that simply don’t work. 

The definition of Institutional Isomorphism is: any organization that characteristically mimics the structure of another, thus accepting and executing the same concepts blindly without questioning the intelligibility offered within the suggested resolution. Star Trek puts it this way – “We are the Borg, you will be assimilated … resistance is futile.” To manage a facility you cannot be assimilated into the norm; if so you become the Borg. Best Practices and other suggested design solutions do not offer enough sustainable conditions that the future demands; thus you become a victim of the status quo, (i.e. we have always done it this way, so we will continue using the same pathway to manage our departmental functions). It is time to break out of the mode! True leadership begins when you travel down pathways that are uncharted and risky, but still remain open to seek out and obtain the necessary help to minimize those risks.

Don Quixote was a romantic dreamer; an aging gentleman who set out from his village of La Mancha, for the sole purpose of executing acts of chivalry. Riding throughout the countryside on his trusted steed named Rocinante, accompanied only with his faithful companion Sacho Panza, his lace and shield, his quest was to help others above his own self-interest. Dreamers come in countless shapes and forms; some even from the business world. Although labeled by many as crazy or simply an aging buffoon; such servant leaders turn blinds-eye to risk to empower others to change. Regrettably, those who bellow the loudest get heard, overpowering those having that still small voice of reasoning allowing change happen. We all need change makers; be a Don Quixo (as we are), who will make health care work to meet the demands yet on the horizon. Uncharted territory will always need those who are willing to step out. Call us so we may help you turn your visions into reality. Don’t become the status quo, thus sit on the sidelines.

Albert Einstein stated: “There are only two ways to live. One is as thought nothing is a miracle and the other is as if everything is.” When you do the common things is life, in an uncommon way, you will command the attention of the world. Begin a change maker.


Wednesday, April 17, 2019



It would be an understatement to say that the health care industry will not continue to undergo a transformation over the next few years. 

Both economic and governmental interventions have not made it easy on many facilities to deliver optimal services with diminishing cash flow. The Patient Protection and Affordable Care Act only raised the stakes, thus shifting the focus from thinking about reform to demanding it.

If we lived in a perfect world, those controlling the outcome would spend their time designing a better means of care to patients, regardless of the cost and manpower; thus placing the patient first when considering design-service-development procedures. But we don't like in a perfect world. Health care organizations are being forced to find new ways to cut costs, improve efficiencies, but at the same time reallocate critical and expensive resources to achieve optimal patient care. Realigning priorities is a difficult task; choosing the right strategies is not easy. And having enough insight to make the correct decisions that will sustain and transform health care takes an analysis that may not be in-house. With more than 32 million new patients coming into the U.S. health care system based on forced governmental reform, health care organizations will need as much agility as they can get. What will it take to make that final leap in Health Care Patient Services?

Certainly doing business as usual will not make it happen; believing that if we continue to move in the direction set before, we will eventually get there. Albert Einstein suggests: "The definition of insanity is doing the same thing over and over again and expecting a different results."

You will need to take some very bold steps to break the mold from where we have been to where we need to go. A rethinking of the Health Care Business Model is required and to do that, it will mean that many mind-sets will need to be changed in the fields of: Architecture, Supply Chain Management, Procurement, and most important Physician run facilities. Each group has their own specific interest; most being control, but over and above that power is income. If you have control you have the mean of convicting other groups that you know what you are talking about and deserve the funds requested to execute the work tasks at hand. True sustainability must go beyond guidelines now recommended by Lean and Green advocates when developing a Strategic Master Planning. Considerations to develop and accommodate departmental location, deliverables (process flow), and management of waste must be part of the overall design methodology if any facility is to survive. 

Since trends towards outpatient care and wellness venues are expected to continue, all the more reason to consider the need to fully develop an executable plan that takes into consideration: integration of material-traffic-flow in addition to facility aesthetics. Management cannot continue to do-what-we-have-always-done, for that will not change the outcome. If we leave true change to the lawyers and politicians to fix, the solution will look like it was made by lawyers and politicians and it is highly likely that we won't like it. 



Staying in Tough with Project Needs

  1. Recognizing and embracing the fact the change is a journey and not a destination. It will take time and investments to complete
  2. Adopting a comprehensive approach that provides organizational growth based on a common language that sets goals before acquiring additional tools to execute work
  3. Exhibit unequivocal leadership through consistency, that includes input from all relative parties to ensure the correct pathway
  4. Communicate regularly a clear message as it unfolds to empower team decisions. All information is critical
  5. Clearly defined roles and responsibilities to ensure measurable and proper execution
  6. Ensure ownership of tasks, recognizing phase completions by team players
  7. Do not avoid discussions that are needed to correct dysfunctional behaviors, be tough but fair
  8. Make sure all staff are heard and suggestions reviewed. No idea is too small as to its potental
  9. Never underestimate the success of change efforts and give honor to the ones who contributed
  10. Failure is not a option, but should be viewed as a learning process that leads to higher levels of accomplishments

Thursday, April 11, 2019


Albert Einstein once suggested: "Imagination is more important than knowledge." We believe they go hand-and-hand. True change begins with an imagination, needs someone knowledgeable to execute tasks, and then shed some light as to how to move vision into reality. And that takes a partner! Allow us to show you the way.

Thursday, February 14, 2019

Value-Based-Care vs. Fee-For-Service Policies

It is impossible to discuss the future of healthcare without hearing the phrase "value-based-care." While the traditional fee-for-service reimbursement model promotes quantity of services, federal officials have proposed several reimbursement programs that reward healthcare providers (presumptuously) to cover their costs and increase the quality of care at the same time, but costs continue to increase even with this attempted change.

As the healthcare industry transitions to this new way of delivering care, many healthcare providers continue to wonder how value-based-care is different, what programs will they support, and how successful it be long-term. Short-term, all it has developed was more stress for profitability.

What are the differences?
  • Fee-for-services model: healthcare providers were paid for the amount of services rendered. With this concept, providers ordered more tests and procedure as well as managed more patients in order to increase their billings. Costs were determined by what commercial payers would pay in the private market and a percentage of what Medicare would paid for similar services. Rates, typically were non-bundled, meaning each service was paid separately. Cost variations for procedures and tests rose based on what the local market could bare. Although testing and procedures increased, patient care and sanctification decreased do to costs. 
To drive down costs and improve patient outcomes, the Federal government designed value-based care; packaging it up with a pretty ribbon calling it Obama Care (Affordable Care Act). Their goal was straight forward and very ambitious, but soon reflected an underlined agenda (Socialized Medicine). 
  • Value-based-care: calculates based on numerous measures; some of which determined the need for a combined effort to share information (IT) through a centralized database, a different approach based on patient engagement to determine what processes where acceptable, a reduction of hospital readmission levels and or outpatient procedures verses lengthy hospital days for services, and cap-costs for service rendered. All this to ensure accountability of the provider to control costs and increase qualities given. Bundled payments rely on certain levels of risk. If the provider is able to decrease the cost of their services below the bundled payment price, then they can pocket the savings, but if costs are greater, there is a financial lost. Medicare has caps in place to protect those using its service. Costs continue to increase and with more using the service, providers are loosing ground financially. The first to go was the Rural Hospitals were volume was to key to remain operational.
Although both models have their good and bad points, the key is volume, costs, procedures, and available technology has been a problem for smaller facilities. Much like the "New Green Deal" suggested for 2020 Democrats, details are not well defined as to execution. The Medicare was originally designed to take care of our seniors, but to open the same capped conditions - Medicare for All - would only further place undo stress on care and not truly address true costs which continue to increase.

Most would agree, we have yet to fully leverage the value-based-care model. Going into the future, there are certain realities which must be addressed in order to see meaningful progress toward advancements in patient care while bending the proverbial cost curve of services rendered. What has been seen so far is to - reduce costs using unproven big promises to increase patient care sanctification levels, which remain in decline. Healthcare is very complex and certainly there are numerous areas that are jointly connected (threads that affect one another). You cannot look or even try to fix one area without disrupting another. WE NEED TO LOOK AT THE LARGER PICTURE. 

We are RemTecH Associates believes there is an item that continues to go unanswered. The area of Inventory Management Design to be not considered during design-development phasing. This oversight costs facilities 30-40% in annual revenue based on poorly conceived design policies and procedures. IT IS TIME FOR A CHANGE...


Wednesday, January 23, 2019


During the month of March, RemTecH Associates will be launching a brand-new website. 

Since our launch date of June 2013, we have offered services to specifically address the many conflicts that arise during phasing design-development in the arena of Materials Management, Materials Handling, and Supply Chain Management. Working with Architectural Firms, Owners, and Management Groups within Healthcare, Commercial, and Industrial marketplaces, we analyze and develop alternatives to ensure you increase your sustainability. We have linked with more than 1,500 individuals throughout United States, Middle-East, and China; offering fresh ideas to solve existing concerns associated with Inventory Management. Inventory must be viewed an asset not simply an overhead liability; therefore, additional consideration is required during design phasing.

Our primary desire has always been to partner with each client served. That has never changed. As we look to this newer site we add several newer offers in addition to the concept of FAVOR.

FAVOR - as much as we put offers out, it is critical that we receive favor. That task requires two things (a) a fair offer that meets and or exceeds the need present, and (b) the desire for those receiving believe change is critical for their future growth.

Offer - we have offered several ways to meet your needs, both from the stand point of completing an assessment document to benchmark current conditions without cost. Second, offering specific insight to tomorrow's technological break through as to ensure sustainability once executed. Even with these offers and many others favor is your side of the fence to accept our suggested path forward.

RemTecH Associates is different than any other consulting firm that you have or have not used in the past. Our success is only possible when you have been giving enough information to turn your vision into reality. That is the main purpose of launching our newer site. 

We hope you feel the same and "together" we will accomplish the necessary steps to allow you to meet future demands.

John Hensman
President / CEO
RemTecH Associates LLC



Tomorrow Need Clear Thinking Today!
Our Health Care System is broken and we are fast approaching the "point of no return." 

To continue to operate with the mind-set “business as usual” or “we really cannot change the system, so why try” - our ability to meet future patient care needs will not succeed. 

According to recent studies, Chapter 11 filings have decreased by 53% nationwide since 2010. In healthcare, during that same window has increased by 305%. 

With operational costs continue to escalate (seemly unchecked in patient care, drugs, and other services) and no "government-driven-agenda" offered will repair it especially when they are one of the primary contributors and manage how others conduct business. 

First: Rural Hospitals, unlike large facilities, have certainly felt the impact of ACA based on increased closure rate.  Any offered solution will require “boots-on-the-ground” to develop reasoning that reflects true innovation. 64 million (rural) Americans depend on the small community hospital environment (25-100 beds) for their primary source in care. Since 2010, there has been some 1,800+ closures, forcing most to travel great distances for care. Staffing, technology, profit margins, burn-out, etc. has been noted as factors that started after ACA's launching. Larger facilities are not exempt, but certainly have the ability to adapt better by simply charging more to the patient.

Second: Best Practice, Lean Design, and Reduction of Carbon Footprint have been the norm in design-development for some time. Its effectiveness is different based on facility usage. We are not opposed to such norms, but such concepts have often become the acceptable standard based on those having the loudness of voice or having the most impressive title. Such norms, however, simply do not look at other critical areas that can reduce annual operational costs, thus continue to offer cookie-cutter-designs. In addition - limitations built-in to hospital budgets force Architectural firms to cut-corners just to be competitive; hence, supporting the need to further such practices as SOP. The best way to considered the affects of these norms is - look at how they interact within other industries. Health care has been very slow to accept advancements in technologies for controlling inventory levels. Questions must be asked and methodologies accepted that have had proven results. The best approach to include these norms into any given design is - attack the problem by stripping away all the assumptions, breaking problems down to their common points, and solve them as if for the time time (i.e. uniqueness approach). Analyze the conditions and not accept common pathways that may or may not add cost to a project. FRAM once stated: "Pay me now or pay me later." Renovations cost more after you go live then changing it on paper now. That is why these norms should be only guidelines, not mandates for acceptable design.   

Third: Inventory Management Levels has long been considered simply an "over-head costs;" therefore, the need for Asset Management Design considerations are not typically included in Pre-schematic Phasing or any phasing development. To understand the ramifications and long-term affects to your campus sustainability, proper consideration is required and or outside help needed through a consulting firm who wants to partner with you. Based on inadequately designed Inventory Asset Design Policies, many facilities experience an annual lost in revenue around 30-40%. Such lost contributes to hospitals ineffectiveness to meet patient needs, patient satisfaction levels, and a wide-range of other conditions (i.e. Inability to become a Profit Center, JIT-PAR Inventory Levels, GPO Controls, Cost to Purchase Critical Items, Inaccuracies in Inventory, Lost to Outdated Usage; not to mention Staffing issues associated with increased operating stress and burnout). The success of your facility hinges on inventory control management design-development.

Fourth: To achieve True Transformation Change, you need to first look beyond budget constraints to design our facilities; looking at true inventory needs from an asset perspective, not just an overhead. From software, to the selection of equipment, and space programming, to the mismatch placement of departmental locations all contribute to poor growth potential (building it right the first time). Simply – new facility designs or renovations merely copy previous acceptable ideas, which will not support true sustainability. Without addressing these critical needs, especially in a rural health care setting, many will die do to the lack of proper care and health care as we know it will fail. 

Fifth: Hospitals represent the very underpinning of our society; therefore, they need to lead the charge verses being forced to follow the norm. Unanswered questions today will predict the future you have tomorrow! Change must begin and it must begin today.

Summary: We who serve health care must design each facility based on their unique needs. Creative innovations are not the enemy (thinking-outside-the-box), but to sit still and accept the norms will not change tomorrow's results. Those who work daily to make us healthier must ask the questions to get the right answers. Our job is to offer the right answers, but partnering (team work) will achieve a better and brighter tomorrow.

Albert Einstein suggests - "The definition of insanity is doing the same thing over and over again and expecting different results." 


Friday, January 11, 2019


Many facilities today have a number of major questions that go unanswered. They ask different organizations to help, but only receive lip-service and corporate jargon that adds to their confusion about the direction to take.

RemTecH Associates LLC is different than those who believe they are serving the industry; we freely share answers that are important to you

Over the next few months we will freely offer advise to any questions that you may have without strings and certainly without conditions. Our only desire is to answer your problems and offer logical / executable tasks in hope of partnering with you through our suggested exercise. 

Call us and let us prove to you that we want to be there to assist you to achieve your goals. Vision is only transformed into Reality when those involved want to help. 


Tuesday, January 1, 2019


RemTecH Associates has always looked for new ways to advance our services. 

We are currently in the process of redesigning a NEW WEBSITE that will be launching in the next few months. The primary purpose of our new site is to address the many technologies currently offered in today's marketplace, to determine if they will effectively meet future demands. Some technologies will not make the cut; yet others will require some additional modifications to ensure they will grow accordingly as demands increase. 

Our approach will be bold and out spoken to some; one that will look at many unanswered questions associated with Inventory Asset Management Design Development and what it will take to decrease operational costs, but at the same time increase efficiencies. Certainly many subjects will not sit well with certain companies; for it will question their motives for meeting market needs against design hindering limitations of your budgets.

Our approach will also require input from you. We want to first listen to your needs and then suggest some unique alternatives that can make a difference. Feedback will be critical to our efforts; therefore, we are offering a free survive that will start a process for meeting your future challenges.