The Assets Nobody Could See
As interim VP, I found roughly $30M of home dialysis machines sitting idle in clinics across the country — paid for, depreciating, and quietly billing monthly service fees, because home therapy had no asset management system that worked. I built one, and got the software approved in a year when almost nothing was.
All figures drawn from the public record; where results remain internal, they are described directionally. Visuals recreated as abstractions — no client artifacts or confidential data appear on this page.
Paying twice for machines nobody was using
When I stepped into the interim VP seat, home therapy was under the same pressure as the rest of the enterprise: hold the line on cost, and justify every dollar. What almost no one could see was that some of the largest dollars were already spent — and going to waste. Across clinics nationwide sat roughly $30 million of home hemodialysis machines that had been purchased, deployed to sites, and were not being utilized presently. Idle inventory, on the books as assets, quietly depreciating. And because no one could see across sites, the blindness drove fresh spending: one clinic might sit on several unused machines while another, with no way to know, ordered new ones instead of moving an idle unit over. The enterprise was buying equipment it already owned.
The waste compounded monthly. Each machine carried a recurring service and maintenance plan that billed whether or not a single treatment ran on it. So the enterprise was paying for these units three ways at once — the capital cost, the depreciation, and a monthly service fee on equipment doing nothing. Multiply that across the country and the leak was enormous.
Not a spending problem. A visibility problem.
The instinct in a cost control year is to stop buying, but the machines were already bought and more units were being purchased everyday. The real failure was that home therapy had no asset management system that met its requirements — no single source of truth for what equipment existed, where it sat, whether it was deployed, and what it was costing to keep. Without that, idle units were invisible, service plans renewed on autopilot, and no one could redeploy an asset they could not see.
That reframed the whole problem. This wasn't a procurement decision or a budget cut — it was an infrastructure gap. Build the system that makes every asset visible, and the savings aren't a one time recovery; they become a permanent capability: idle machines get redeployed instead of repurchased, service plans get switched off the moment a unit goes dormant, and every future dollar of home capital equipment is tracked from the day it ships.
Three ways to stop the leak
Getting a “yes” in a year of “no”
This was a year when capital approvals had all but stopped — and I took a net new software purchase into that environment and got it approved. The reason it cleared was the return: the recoverable asset value and the recurring service fees the platform would eliminate dwarfed the cost of the software many times over, on a payback measured against waste we were already absorbing. When the ROI is that stark, a spending freeze becomes the argument for the investment, not against it.
My team and I owned it end to end. I secured the approval and purchased the platform, and we stood up the build with a global implementation partner across the full year of my interim tenure — a development plan, the configuration to home therapy's requirements, a full process transformation plan, the rollout sequencing, and the education layer so the field and corporate teams could actually run it. Ownership that ran from the business case to the classroom.
An asset system home therapy never had
- ✓The approval nobody expected to clearA net new ServiceNow purchase approved during an enterprise capital freeze — carried on an ROI too large to defer, and owned from business case to sign-off.
- ✓A purpose built asset management platformServiceNow configured to home therapy's actual requirements — the single source of truth for what equipment exists, where it sits, whether it's deployed, and what it costs to keep.
- ✓Idle capital made visible and recoverableThe ~$30M of dormant home hemodialysis units surfaced for redeployment instead of re-purchase, with dormant service plans exposed for cancellation.
- ✓A full year build with a global partnerDevelopment plan, configuration, rollout sequencing, and a field and corporate education layer — delivered across the interim VP year with a global implementation partner.
- ✓A permanent capability, not a one time recoveryEvery future home capital asset tracked from the day it ships — turning a one off cleanup into an enduring governance system.
What visibility returned
The headline was the roughly $30M of idle equipment the system made recoverable, but the durable win was the recurring waste it switched off: monthly service fees on dormant machines, ended, and future capital tracked from day one. Approved in a year almost nothing was, on an ROI stark enough to make the freeze irrelevant (specific enterprise figures remain internal and confidential).
You can't manage what you can't see and you can't save what you can't manage.
What this page doesn't show
The operating playbook — how the approval was won in a freeze, how the build was sequenced, and how the system was made to stick. That part isn't a storyboard. It's a conversation.