Scale Street Solutions · Athens, GA · Nationwide
Too much change. Too many priorities. Not enough time to lead it.
Scale Street gives health systems, and the rural and community organizations they serve, a senior leader who decides what to change, gets it delivered, and makes it stick, measured with data and accelerated by AI.
01 · Sound familiar?
The problems we’re hired to fix.
Health systems and rural and community organizations call us when the change outruns the capacity to lead it. Pick the one that sounds like your week.
Everything is changing at once.
New technology, new requirements, new funding, and a workforce that’s already stretched. The change doesn’t wait until you’re ready.
We help you decide which changes matter now, which can wait, and which to say no to, with clear priorities and the measures that tell you it worked.
- Built MD Anderson Cancer Center’s strategy execution framework: strategies, operational priorities, cornerstones, and enterprise risk management.
- Co-lead author of USAID’s Blueprint for Global Health Resilience.
We don’t have the systems to keep up.
No portfolio, no governance, and no single place to see what’s in flight. Projects live in inboxes and spreadsheets, and status meetings replace progress.
We stand up the execution system (portfolio governance, stage gates, dashboards, and executive reporting), run it with you, and hand it to your team.
- Built implementation infrastructure for MD Anderson’s strategic plan: 65 projects, 500+ team members, a web-based project management tool, and executive milestone reporting.
- Built project management infrastructure for the nation’s largest rural ICD-10 initiative: 50+ hospitals in five states.
Too many priorities. Nothing gets done.
Every initiative is urgent, so none of them finish. The same few people sit on every project team.
We cut the list to what matters, put an owner, a budget, and a status report on each priority, and track it to done.
- Designed the funding, governance, and implementation framework for a $17M portfolio at MD Anderson.
- Portfolio Management Professional (PfMP).
I know it matters. I can’t find the time.
The CEO owns the agenda but spends the week on operations. Strategy happens in the margins, if it happens at all.
A Fractional Chief Transformation Officer carries the agenda day to day, so you make the decisions without running the logistics. Smaller organizations can start with a Transformation Coach.
- Senior Advisor in the front office of USAID’s Global Health Bureau (GS-15), reporting to the Assistant Administrator.
- Director, Strategic Management, MD Anderson Cancer Center.
We bought it. Nobody’s using it.
The system went live and the licenses are paid for, but people found workarounds and the old way is still the normal way.
We run adoption: training, workflow redesign, governance, and utilization measurement until the new way sticks.
- Directed ambient AI adoption for 200+ emergency department providers.
- Took 50+ rural hospitals through the ICD-10 transition.
Everyone’s asking about AI.
Vendors are pitching, staff are experimenting, and the board wants a plan. There’s no policy, no intake process, and no one who owns it.
We set up AI governance a small team can actually run, vet the tools worth trying, and lead adoption of the ones worth keeping.
- Security-tested a voice AI scheduling agent, found prompt injection and persona bypass vulnerabilities, and recommended pausing the pilot.
- Built the nation’s first AI certification for rural health practitioners (AI-PRH).
The board wants proof it’s working.
You’ve made changes. You can’t show what they returned, or whether they held.
We set a baseline in the first 30 days, then measure every stage with dashboards and executive reporting your board can read.
- Analytics for a multi-site FQHC network: Power BI dashboards, scheduling and no-show analysis, telehealth capacity modeling, and multi-year budget analysis.
- Executive milestone reporting across 65 projects at MD Anderson.
02 · How we fix it
Three stages, two threads, one leader.
Every fix above comes from the same model. The stages happen in order; data and AI run through all of them.
- 01 · Stage
Strategy
DecideDecide what to change and why.
- 02 · Stage
Execution
DeliverTurn priorities into a governed portfolio that ships.
- 03 · Stage
Change
AdoptGet people to use the new thing, and make it stick.
- Thread
Data
Measure every stage.
- Thread
AI
Accelerate every stage, and lead AI adoption when AI is the change.
Most firms cover one stage. Strategy firms decide, project managers deliver, and trainers handle adoption. Tyler Wallace has led all three, measures with data throughout, and has deployed AI himself, at health system scale and in rural settings.
03 · The difference
Health system scale. Rural depth.
Most consultants who serve large systems don’t know critical access hospitals. Most rural consultants haven’t operated at system scale. Tyler has done both.
At system scaleAcademic medical center, federal agency, health systems
- Ran strategy execution at MD Anderson Cancer Center: a $17M portfolio, and 65 projects with 500+ team members on one project management system.
- Directed ambient AI adoption for 200+ emergency department providers.
- Co-lead author of USAID’s Blueprint for Global Health Resilience.
In rural healthCritical access hospitals and the networks that serve them
- Built project management infrastructure for the nation’s largest rural ICD-10 initiative: 50+ hospitals in five states.
- Launched the first cohort-based AI readiness program for rural hospitals.
- Built the nation’s first AI certification for rural health practitioners (AI-PRH).
04 · Fractional Chief Transformation Officer
Senior transformation leadership, without the full-time hire.
Your teams know your organization. Tyler adds senior transformation leadership for your agenda, or for one program, and hands it off to your team.
Hire the full role, or start with one focus area and expand. Every engagement begins with a 30-day diagnostic of your portfolio, your data, and your AI readiness.
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Focus area · Full scope
The whole transformation agenda
For a CEO or COO without a transformation leader. Tyler leads the whole agenda: all three stages, both threads.
-
Focus area
Ambient AI
Provider training, workflow redesign, governance, and utilization measurement for an ambient documentation rollout.
Proof200+ ED providers
-
Focus area
AI Adoption & Governance
Governance, intake and vetting, an adoption plan, and adoption metrics, so a new Chief AI Officer can deliver before the team is hired.
ProofAmbient AI for 200+ ED providers; a voice AI security test that led to a recommendation to pause the pilot
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Focus area
Transformation Office / Enterprise PMO
A strategy execution framework, portfolio governance, stage gates, dashboards, and executive reporting, then a handoff to your staff.
ProofMD Anderson: a $17M portfolio and 500+ team members
-
Focus area
Rural Strategy & RHTP
Rural portfolio strategy, delivery and reporting for Rural Health Transformation Program initiatives, and technology adoption across rural sites.
Proof50+ rural hospitals through ICD-10
05 · Rural & community health
One leader, shared across many hospitals.
Associations and networks can share one Fractional Chief Transformation Officer across their members or hospitals, so each organization pays a fraction of the cost.
Smaller rural hospitals and FQHCs can start smaller. Both entry options cover every stage of the model, and either can grow into the full role.
- Start
Transformation Coach
Works with one leader.
- Grow
Transformation Advisor
Works with the leadership team.
- Full role
Fractional Chief Transformation Officer
Owns outcomes alongside leadership.
06 · By the numbers
The proof, in numbers.
07 · Clients & partners
Organizations we’ve worked with.
Which one is keeping you up?
Tell us which problem sounds most like your week. We’ll tell you plainly whether Scale Street can help.