Dr. Gruber's most productive planning/change/organizational transformation client relationships were initiated with a Scoping Study that in itself produces high value, as well as a realistic informed goal of the issues and processes in the next stage in the timeline of continuous massive progress in solutions to the now badly broken United States health system.


Disruptive innovation to enable competitive advantage is replacing now largely older medical practices that under new 21st century situational conditions favorable to a new vision with feasibility tested by exemplars. Internal and external forces that affect the realization or are barriers to positive innovation are identified in Dr. Gruber's scoping studies -- setting priority for positive adaptation to forces that enable competence to invest in positive -- and control negative forces that limit organizational performance.


Given Dr. Gruber's wide experience in assignments to achieve remarkable improvement in the delivery of healthcare, a Scoping Study to guide an action plan will be useful for a huge leap in competence that now challenges the United States health system.


Scoping Studies that launched on-going consulting are listed below.


1. Pfizer Pharmaceuticals: Dr. Gruber worked with Pfizer in an on-going consulting relationship for 25 years, a time of a rapid increase in Pfizer’s market share from a mid-range pharmaceutical firm to the largest in the United States. This Pfizer relationship was initiated when the Pfizer vice president of research attended Dr. Gruber's MIT Sloan School week-long workshop on the contribution of R&D to corporate goals in 1965. He invited Dr. Gruber to give a talk to his medical scientists in their research facility in Groton (CT). Dr. Gruber consulted with Pfizer research until his client was promoted to president of Pfizer and his CIO, Dr. G.M.K. Hughes, and Dr. Gruber then consulted in the Pfizer New York City headquarters.


2. NEW MEDICO with Charles Brenick: Dr. Gruber managed the development of the first NEW MEDICO computer system, which included requirements to meet government regulation for staffing by the level of care.


3. Lotus: In 1983 Lotus expanded from a start-up to more than a billion dollars in sales based upon the early use of the IBM PC with the Lotus 1-2-3 spreadsheet. Lotus controllers, highly skilled in Lotus 1-2-3 spreadsheet, programmed accounting reports without corporate accounting standards. A Scoping Study of what was then chaos in Lotus accounting provided the plan for professional accounting standards, which my consulting firm programmed and I lectured to the Lotus controllers and accountants on their new system.


4. Phillips Plastics, a mid-western automobile parts supplier, was forced to respond when auto manufacturers innovated with “Just-In-Time” manufacturing. Phillips had ten plants and often a given part was manufactured in more than one plant. The auto manufacturers required the coordination to enable delivery of a part to a conveyer from a truck to deliver to the assembly line. Phillips contracted with Prime Computer with the specification of electronic integration among multiple plants to produce a final part ready for the assembly line. Prime lacked this very new electronic network capability. My consulting there was initiated with a Scoping Study of requirements of the auto manufacturers with the production process in multiple Phillips plants. This is one of a number of assignments in which external pressure forced a major innovation in internal competence.