The model

Three stages. Two threads.

Transformation means deciding what to change, delivering it, and getting people to adopt it. Data measures every step, and AI speeds each one up. This is the model behind every Scale Street engagement, and the proof behind each part of it.

  1. 01 · Stage

    Strategy

    Decide

    Decide what to change and why.

  2. 02 · Stage

    Execution

    Deliver

    Turn priorities into a governed portfolio that ships.

  3. 03 · Stage

    Change

    Adopt

    Get 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.

The Scale Street transformation model: three stages, in order, with two threads under all three. Select a part to jump to its proof.

Why all five matter

Most firms cover one stage.

Strategy firms decide. Project managers deliver. Trainers handle adoption. When those are three different firms, each handoff loses something: the reason behind a priority, the budget behind a project, the training behind a launch.

Tyler Wallace has led all three stages, measured each with data, and deployed AI himself, at health system scale and in rural settings. One leader can keep the thread from decision to adoption.

01 · Stage

Strategy: decide what to change and why.

Choose what to change, set priorities, and agree on how you’ll measure them. A strategy is finished when people can say what they are not doing.

Proof
  • Co-lead author of USAID’s Blueprint for Global Health Resilience.
  • Built MD Anderson Cancer Center’s strategy execution framework: strategies, operational priorities, cornerstones, and enterprise risk management.

Background: Senior Advisor in the front office of USAID’s Global Health Bureau (GS-15), reporting to the Assistant Administrator.

02 · Stage

Execution: turn priorities into a governed portfolio that ships.

A priority without an owner, a budget, and a status report is a wish. Execution turns the strategy into a portfolio with governance, funding decisions, and regular reporting to the people who sponsor it.

Proof
  • Designed the funding, governance, and implementation framework for a $17M portfolio at MD Anderson.
  • Built implementation infrastructure for MD Anderson’s institutional 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.

Background: Director, Strategic Management, MD Anderson Cancer Center. Portfolio Management Professional (PfMP).

03 · Stage

Change: get people to use the new thing, and make it stick.

A project can go live on schedule and still fail, if people work around the new system. Change is the work of training, redesigning workflows, and measuring use until the new way is the normal way.

Proof
  • Took 50+ rural hospitals through the ICD-10 transition.
  • Directed ambient AI adoption across 200+ emergency department providers: training, workflow redesign, governance, and utilization measurement.
  • Trained 2,500+ people since 2023.
  • Coordinated surge staffing for USAID’s Global VAX effort across eleven priority missions.

Background: Six Sigma Black Belt (ASQ CSSBB).

Thread

Data: measure every stage.

Data tells you where you stand before you decide, whether delivery is on track, and whether the change actually held. Without it, every stage runs on opinion.

Proof
  • Executive milestone reporting across 65 projects at MD Anderson.
  • Analytics for a multi-site FQHC network: Power BI dashboards, scheduling and no-show analysis, telehealth capacity modeling, and multi-year budget analysis.
  • A national security audit of rural hospital websites: 1,382 critical access hospitals, 45 states, 44,524 pages.

Background: Ph.D., Public Health (Healthcare Management and Policy), UTHealth Houston. Microsoft Certified: Power BI Data Analyst Associate (PL-300).

Thread

AI: accelerate every stage, and lead AI adoption itself.

AI plays two roles. It can speed up the work at every stage. And when AI is the change, it has to be governed and adopted like any other change, with extra attention to safety.

Proof
  • Directed ambient AI adoption for 200+ emergency department providers.
  • Launched the first cohort-based AI readiness program for rural hospitals.
  • Built the nation’s first AI certification for rural health practitioners: AI Practitioner in Rural Health (AI-PRH), for HomeTown Health University.
  • Wrote, produced, and presented Microsoft’s AI Learning Path for Rural and Community Healthcare.
  • Designed and led generative AI training for 700+ USAID acquisition and assistance professionals.
  • Security-tested a voice AI scheduling agent, found prompt injection and persona bypass vulnerabilities, and recommended pausing the pilot.
  • Builds working tools with Claude and Claude Code.

Background: Microsoft Certified: Agentic AI Business Solutions Architect (AB-100, Expert); Azure AI Apps and Agents Developer Associate (AI-103); AI Business Professional (AB-730); Copilot and Agent Administration Fundamentals (AB-900). Microsoft Certified Trainer. 22 talks on AI since 2025.

Where is your organization stuck?

Most organizations are strong in one stage and stuck in another. A first conversation usually finds which one.

Start a conversation