An increasing number of the press releases about value-based care startup funding announcements have a Nashville dateline. Amy Goad, managing director in Sendero Consulting’s healthcare practice, has been impressed by what she has seen of the collaborative culture in Nashville that has helped it become a major health IT innovation hub. She recently spoke with Healthcare Innovation about why she thinks North Texas could be poised to become the next major healthcare innovation hub. 

In December 2024 I interviewed Goad along with Chad Jones, senior vice president of information systems at Texas-based heath system Baylor Scott & White Health, about a syndrome in which health systems test lots of new ideas and technologies that fail to scale up and end up in the dreaded “pilot graveyard.” 

HCI: Before we talk about the potential in the Dallas area, what do you see as some of the elements making Nashville successful as a health IT hub that could perhaps be replicated elsewhere?

Goad: As we have worked to open an office in Nashville, one of the things that struck me as the most interesting and unique about the city is what they call the HCA family tree. HCA is such a large health system in the community, and the way that it's been structured has really spun out a lot of leaders, a lot of startups, a lot of investments. 

On the Nashville Healthcare Council webpage, they actually have a published HCA family tree. It's not just lore. It is a well-regarded chain of leaders. People who are now in the ecosystem in different lanes were once in the same lane working  together. And that Nashville Healthcare Council has played an incredible role as a convener.

Also, that Southern culture of Nashville is different than the coasts, which can be a little bit cut-throat. With that Southern charm, you get really strong collaboration and people working together. 

HCI: Another thing is that Vanderbilt is there. In informatics research, they're one of the leaders in the country…

Goad: Yes, and when you think about it from a startup’s perspective, the city of Nashville has massive data access across the board. Vanderbilt has one of the largest genomic data sets. Then you've got these massive systems like HCA, Lifepoint, and CHS. If you are a startup that is wanting to build a technology or a service, it is great to have access to these organizations that have the data and are also willing to let you pilot things. I have been to presentations by startup leaders who have been able to partner with the health systems there to incubate their products. 

HCI: In Nashville, you also have Frist Cressey Ventures, co-founded by former Sen. Bill Frist, M.D., as well as Rubicon Founders started by Adam Boehler, who used to head up the Center for Medicare & Medicaid Innovation. They seem to have a good understanding of what might work in the value-based care space and can help steer startups so that they are more likely to succeed…

Goad: Yes, there are a lot of seasoned leaders there who are investing. It's not a lot of people who are new to the industry; it’s people who grew up in the industry and are now taking an entrepreneurial path. That is the opposite of an entrepreneur who's seeing opportunity in healthcare. You've got people who are intimately familiar with the industry, the complexities, the way things work, and they are solving real problems.

HCI: So what are you seeing in the Dallas area that gives you hope it could be the next Nashville? 

Goad: I work primarily in Dallas, and have very close relationships with leaders at SMU [Southern Methodist University]. I was invited to participate in a closed-door roundtable back in 2022 where SMU really put their stake in the ground to say we want to be a convener of healthcare in North Texas, not necessarily to add a new medical school, but more to look at the business of healthcare. And because North Texas is growing so rapidly, we do have a good number of healthcare headquarters, a good number of reputable health systems in the area. We need to be better about combining forces and pulling resources together to provide better healthcare for our communities, our state. So I've had the privilege of seeing Dallas work to generate momentum and then also benefited from seeing what they have established in Nashville. 

HCI: What are some things health systems in North Texas can work on together? 

Goad: For North Texas, it started with saying let's just look at quality improvement and how we work together. One of the early pushes toward this was the pandemic. That opened the gates to more collaboration versus competition in North Texas. I'll give a lot of credit to the DFW Hospital Council led by Steve Love. In that time of crisis, they were really the ones who were helping to organize and facilitate the collaboration across systems. It was a necessity to provide care for the community, share PPE supplies, and help to staff the surge. That opened people's eyes. We’ve been longtime competitors, but there actually is opportunity for us to work together better.

People are looking at how to keep that going in a positive way. In parallel, Dallas itself is just growing — there are a lot of financial services institutions, but healthcare is also becoming a bigger part of our ecosystem. With the healthy financial sector, people are looking to make strategic investments. The healthcare technology startup scene is starting to become bigger here. I believe that groups like Health Wildcatters and Pegasus Park are helping to create momentum in the technology space. We're not typically known for being a tech hub here in Dallas, especially healthcare tech, but we've got a diverse number of health systems. We've got investment. There's now a growing collaboration space there. 

HCI: You mentioned SMU being involved. Does it help a region if there's a strong academic partner involved? 

Goad: Absolutely. They bring thought leadership, but they're also just a lovely neutral party, and interested in finding options for their students and their alumni. It helps to take the competition piece out of the equation, so I do think groups like SMU make a big difference, and they can bring together new ways of thinking as well. 

HCI: Can Sendero play a role in helping North Texas identify some steps to take and pitfalls to avoid if they are trying to create this ecosystem? 

Goad: We’ve been able to see what is working in Nashville, and we’ve benefited from the structure that's there. We can see what’s working, what's not working, and where they are in their journey. A lot of what we do in day-to-day consulting with our clients applies when you set up governance systems, you set up leadership roles, you work to bring people together to solve real problems. I think a lot of that does translate.

In Dallas, I see our role is just being an active participant. Part of the challenge is identifying the problems to be solved; then people can rally around to build that momentum. As a consultant, that's what I work on with our SMU partners — what are the problems that we need to solve? Then leveraging our network of clients and peers to bring people together to solve those problems. I'm very optimistic. I have seen a lot of commitment from the executive leadership of the local health systems.