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What Hospital Silo Do You Work and Play In?

February 11,2016

The healthcare industry is uniquely the land of silos. Within just one hospital there are service line silos, a marketing silo, a community outreach silo, a quality silo, an IT silo, an operations silo, a blah, blah, blah silo. You get the point. And the way the healthcare industry is going we will only see an exacerbation of this problem. Let me explain.

What you find is that communication within an individual silo is usually pretty good. Take the marketing silo for example. For each fiscal year a marketing plan and budget needs to be developed and submitted for approval. Individual marketing team members will develop components of the plan for their functional area such as PR, print advertising, digital and social media marketing, etc. to promote the hospital and then they're rolled up into an overall plan. Everyone in the marketing silo LOVES the plan. Once they've gotten the green light from the hospital budget committee silo, the marketing team silo will have their game plan for the year. They're all on the same page, drinking the same Kool-Aid, patting each other on the back over the great plan they developed.

But woops! The marketing silo that resides next to several other silos didn't talk to other silos about their needs (what a crazy idea). So the ‘golden plan’, using cardiology as an example, calls for promoting the heck out of the women's heart program but the cardiovascular service line silo wants to market minimally-invasive valve repair and replacement. The radiology silo wants to promote a new MRI while the plan calls for marketing digital mammography. Each interested party makes their case about changing the focus but the marketing silo won't budge. “Sorry, that's not in the plan that was approved”. Does this sound familiar?

I refer to this as inter-silo dysfunction. The reality is that in healthcare, silos rarely talk to each other and when they do, the communication is laborious and time-consuming because each side is worried about protecting their respective turf (i.e. silo). Consensus building sounds so right but the nature of healthcare makes this process arduous and decision making for hospitals seems impossible. And it's only going to get worse.

Hospital Consolidation Creates More Silos


In 2014, mergers and acquisitions (M&A) in healthcare reached record highs with the value of the transactions hitting $438 billion, or about 14% of all business M&A activity. One in five U.S. hospitals will seek a merger by 2020 as for- profit chains and large health systems swallow up independents. (1)

So what that means is there will be more silos within a system that don't talk to each other. There will be a lack of communication on a single campus and even poorer communication across other system campuses. Consolidation will cause slow-moving decision processes today to move at a snail’s pace in the future.

Mergers are an enormous undertaking, taking months and sometimes years to accomplish. With so many functions, people, policies, etc. to be integrated, there's little likelihood that evaluating new, integrative technology is even on the radar.  And that's a shame.

Silos used to hold grain. Now they hold power and it gets in the way of progress.


Dana Allison

Chief Operating Officer

IM Your Doc


(1) Fierce Healthcare, Aug. 19, 2015, “How Healthcare Merger-Mania Hurts Competition, Care Access”