Microsoft Doesn't 'Get' Consumers (But It's Not Alone)

Back in October, I mocked Microsoft's Steve Ballmer for saying he wanted his company to "...invent everything that's important on the planet."

They'd better get busy, as writer and tech forecaster Mark Anderson notes in Strategic News Service (via the New York Times BITS blog):

"Except for gaming, it is 'game over' for Microsoft in the consumer market. It's time to declare Microsoft a loser in phones. Just get out of Dodge."
...

"Walk the halls at Microsoft and you can see it is not a place that gets consumers."

Walking the halls - a deceptively simple research strategy yet still capable of producing occasional flashes of insight. Try it yourself. Next time you're walking the halls of your local hospital, see if you can figure out what it is they 'get.'

The Bigger They Are...

Interesting juxtaposition of marketing impressions during today's travels. First, a billboard from a large health system (full disclosure: a prior place of employment) advertising robotic surgery. I formed several opinions during the 1.64 seconds the billboard was in view.

From least-worst to most:

Questionable: a marketing tactic based on the theory (if the word 'theory' isn't granting too much credit) that motorists speeding down one of Chicago's busiest expressways really care about having their prostate reamed robotically. Personally, I'm not persuaded.

Worse: the billboard's profusion of words, typefaces, fonts, logos and images. So many as to be confusing and, ultimately, ineffective.

Utterly wretched: the copy's light yellow colors on a white background. Hard to read in the daylight and nearly invisible under sodium vapor lights at night. Who does yellow on white billboards anyway?

All in all, a nice way to waste $100k plus the agency's commission.

Next was a meeting with a prospective client, a health care professional who truly values marketing as an investment in growing his practice. Great ideas and a willingness to try new things, all with a clear ROI focus. A decent budget but not enough to invest in "shoot yourself in the foot" tactics. No money wasted. Every dollar pulls its weight. And nary a hint of "I'll let my agency do my thinking for me."

Ever notice how the correlation between marketing acumen and organizational size is frequently inverse?

Job Available: Physician Sales Manager, St. Louis, MO

Mike Krivich, blogging at Healthcare Marketing Matters posted a search for a Physician Sales Manager for a St. Louis-based hospital organization. Christine Moors from Clonch & Associates is handling the search.

What Do Baby Boomers Want From Technology?

Futurist Michael Rogers thinks he knows. In a research project funded by AARP and Microsoft, Rogers gathered baby boomers in four cities for discussions about their "attitudes toward, use of and expectations for technology." Rogers' intent was to elicit some so-called "weak signals" - new and revealing insights about future trends in technology use and adoption.

From the NY Times BITS Blog, there are some interesting implications for health care:

"Boomers, Mr. Rogers predicted, are also going to be the driving force behind the use of information technology in health care. The dinner attendees who had access to electronic health records, he said, were “just ecstatic” about the benefits of setting up appointments online, e-mailing doctors and reviewing their records over the Web. As they age themselves, the incentive for using technology tools to manage health and wellness programs grows as well."

Let's hope the health care industry's level of "IT ecstasy" one day matches that of its customers.

"If You Could Ask Any Question About Your Population..."

Imagine having masses of real-time data at your fingertips - medications, treatments, diagnoses, outcomes - all knitted together with "Google-esque" technology, available anytime, anywhere to improve care and outcomes.

From Cleveland, Ohio via MedCity News:

"Steve McHale and Charlie Lougheed want to help medical researchers and physicians get together to make sense of burgeoning patient data, leading to innovations in health care.
...

"Now, McHale and Lougheed are creating Explorys Medical Inc. to develop a Google-esque technology that enables researchers and physicians to noodle questions by querying databases of medical information in real time, leading to their next discoveries."

Venture capitalists and physicians from The Cleveland Clinic are providing start-up capital.

As a health care planner, I've always been frustrated by rigidly-structured databases and canned reports. Much more enlightening is the ability to "cruise" the data, asking spur of the moment questions and making unexpected connections. Structure is necessary but often leads to thinking like everyone else. "Noodling" is what leads to breakthroughs in thinking and in strategy.

What If: Quarterly Stakeholder Meetings?

Thanks to the web, organizations have unparalleled access to new ideas and diverse viewpoints. Technology makes it easy to listen, learn and form new connections. And social media, including blogs, Twitter, Facebook, et.al., amplify customer voices to the point where anyone - not just the loudest or most important - can be heard.

A good thing? Well, that depends on how interested you are in what your customers have to say.

CEOs of publicly traded companies host annual shareholder meetings and regular conference calls to update anyone interested in the company's performance. Hospital CEOs aren't under the same legal obligation, but nothing prevents them from hosting regular "community meetings" to engage stakeholders in new and insightful ways.

What if...

• You organized a community relations & outreach blog to invite dialogue and spread your message of community engagement?
• You scheduled regular meetings, maybe smaller meetings every quarter and a large annual meeting, and used the blog to solicit stakeholder questions?
• You broadcast those meetings over the web, allowing those watching from afar to participate and submit additional questions?
• Your marketing team beamed live web and Twitter updates from the meetings, including the questions and answers?
• You posted meeting summaries as widely as possible - podcasts, YouTube, blogs, etc.?
• And finally, you posted accountability scorecards as part of the meeting follow-up? Who is accountable? What's the plan and the budget? When are we reporting back?

I'm sure a few hospitals do a version of this. I'd like to hear from them. More typical, I fear, is those hospitals acting on an oldie-but-goodie quote from Jack Welch:

"It's not that bureaucracies dislike customers. They don't. They just don't find them as interesting as they do themselves."

Andy Grove's Prescription For Health Care

From the NY Times, Intel's Andy Grove has a prescription for health care;

"Mr. Grove is focusing on the shortcomings in the medical innovation pipeline. “Why doesn’t technology give us medical treatments,” he asked, “that are better, faster, cheaper? A system that works, heaven forbid, like the chip world.”

"An answer, Mr. Grove says, lies in a concept called “translational medicine.” For years, the National Institutes of Health has been funding research projects into translational medicine, and definitions seem to vary. Mr. Grove, characteristically, offers a crisp one. “It’s the art of taking laboratory, one-off discoveries and putting them into mass production — in higher volume and at lower cost than previous treatments.”

Health care needs more people like Andy Groves asking "What if...? Why not...?" and could stand to jettison most of the "Yes, but..." crowd.

Hospital Marketers Are In Deep Trouble Unless...

...they secure a permanent place at the leadership table.

Health marketing blogger Mike Krivich blogs about a recent interview with an unusually clueless hospital CEO. Said CEO was taken aback by Mike's insistence that marketing is more about strategy and measurable results than ads and newsletters.

Unfortunately there's a lot of that going around, making it tough to disagree with Mike's conclusion that hospital marketers are swimming upstream. Better, though, to find that out BEFORE you take the job!

So how does one obtain a place at the table, given that acting 'entitled' is unlikely to work?

How about not telling people what you can't or won't do for them? Instead, be positive and solutions-oriented - the go-to person for finding the opportunities lurking in every difficulty.

Appreciate effort as important, but understand that it's results that matter. Produce documentable, repeatable results. Share them widely, then remember that if what you did yesterday still looks good, you haven't done much today.

Be future oriented, letting go of the past's debates. Learn what you can, make the necessary improvements and move on.

As an industry, health care's inward focus borders on narcissism. Someone needs to be the customer's voice. You, maybe? Ask "what's in it for our customers?" Keep asking. Back up your thoughts and recommendations with actionable data.

And now you've made a start. You may not yet be at the table, but at least you know where the conference room is.

The Reason So Many People Get Lost In Thought?

It's unfamiliar territory, of course.

Today's NY Times reports that the health reform-related statements of many lawmakers were ghost-written by lobbyists and lawyers working for biotech firm Genentech. Oops.

"Genentech, a subsidiary of the Swiss drug giant Roche, estimates that 42 House members picked up some of its talking points — 22 Republicans and 20 Democrats, an unusual bipartisan coup (!!) for lobbyists."

Of course Genentech sees "nothing nefarious" about their success, explaining that it happens all the time. They're right. It does happen all the time - over-reaching and stupidity trashing a message, I mean.

It's never been a good idea to let your hired guns do your thinking for you. And in today's environment of radical transparency - where such activity has no place to hide - it's downright embarrassing. At worst, it does your cause irreparable harm. And that's no "coup," bipartisan or otherwise.

If Your Service Was Great...

...please ring the bell. Talk about immediate feedback.

Hospitals need an "If your MEETING was great, please ring the bell!" sign in all conference rooms. Somehow, I doubt there'd be cause to worry about noise pollution.

(Sign seen in Arbys, Bolingbrook, IL)

Words To Live By

"Because things are the way they are, things will not stay the way they are." (Bertolt Brecht)

"Raise Your Hand If You Love Your Cable Company"

Ha Ha. A question asked and answered, from David Houle's Evolution Shift blog. No hands raised but lots of laughter.

Yes, the cable industry is ripe for disintermediation, with its inexplicable, customer-unfriendly processes. The way it forces us to buy lots when all we want is a little. Good riddance. It would have happened a long time ago were the industry's franchises not protected by cadres of dimwitted local regulators.

But let's rephrase: "Raise your hand if you love your HOSPITAL." How many hands raised now? Maybe a few, but not many.

"They love us! They need us! We're irreplaceable!" Umm-hmm.

Hospital leaders had better start confronting the Napster generation's eagerness to junk business models unable (or unwilling) to offer immediate, just-in-time information, radical openness and transparency, and services bundled (or un-bundled as the case may be) in new and creative ways.

Disintermediation in health care? It's already begun. Measure it by the sum total of all the revenue streams given up by hospitals as they declare after the fact, "Oh well. It wasn't really a core competency anyway." Huge revenue streams, even entire service lines, all gone after a half-hearted fight.

Measure it by all the nimble industry newcomers who, not mired in some "edifice complex," get busy creating one customer-pleasing innovation after another.

Hospitals could do all that. Just like the cable companies, they choose not to, at their own peril.

Health Care Reform and Medical Innovation

Tune in on November 20th for The Cato Institute's Policy Forum "Bending the Productivity Curve: How Would Health Care "Reform" Affect Medical Innovation?"

"Featuring Raymond Raad, New York Presbyterian Hospital / Weill Cornell Medical Center, and Coauthor, "Bending the Productivity Curve: Why America Leads the World in Medical Innovation"; Gerard Anderson, Director, Center for Hospital Finance and Management, Johns Hopkins University Bloomberg School of Public Health; and John E. Calfee, Resident Scholar, American Enterprise Institute. Moderated by Michael F. Cannon, Director of Health Policy Studies, Cato Institute, Coauthor of Healthy Competition: What's Holding Back Health Care and How to Free It."

"New research by the Cato Institute shows that America generates more medical innovations than any other country, and in some cases, more than all other countries combined. Medical innovation may be more important than covering the uninsured or controlling health care spending, inasmuch as a treatment must first be invented before its costs can be reduced and its use extended to everyone. The Democrats' health care legislation focuses on expanding health insurance coverage, which should encourage innovation—yet it does so by expanding price controls, government purchasing, and health insurance regulation, which reduce innovation. What would be the net effect? What are the alternatives?"

The event is free of charge and can be watched on-line at the link above.

5 Marketing Megatrends

Coming to a brand near you, from Adam Kleinberg at iMedia Connection, here are "5 marketing megatrends you can't ignore."

• Mass collaboration...
• Constant connectivity...
• Globalization...
• Pervasive distrust in big corporations...
• A global sense of urgency...

#4 is, I think, under-appreciated in health care. Doctors and hospitals like to think of themselves as the last of the white hat-wearing good guys, and maybe they are. But trust is a funny thing - built over decades and lost overnight. Screw it up and watch the laser beam of populist rage move from Wall Street to Medical Avenue.

Dumb Luck: A Poor Substitute For Sound Strategy

And so the maddeningly mediocre Chicago Bears beat the woeful Cleveland Browns last Sunday. Big deal. Neither team could beat USC.

What's more interesting than the final score is Bears coach Lovie Smith's reaction to fan frustration with "da team's" performance. Paraphrasing Lovie, a win is a win is a win, no matter what.

He's wrong.

Sometimes it matters more HOW you win. Despite playing DOWN to the level of arguably the league's worst team, the Bears achieved victory when, in some mysterious combination, dumb luck met a mistake-prone opposition. Fine. It happens that way occasionally. Call it winning by drifting into it.

But drift shouldn't be confused with possessing some basic competence, or creating and executing an intelligent plan, game after game, against good teams and bad. Call it winning by design.

Just like changes in your own organization's opportunities and threats, the Bears' opposition changes next week - to a team with a clue and a quarterback. I'm betting drift and dumb luck will be exposed for what they are.

Words To Live By

"If you have always done it that way, it's probably wrong." (Charles Kettering)

"If you don't like change, you're going to like irrelevance even less. (General Eric Shinseki, Chief of Staff, U. S. Army)

Customer Service 'Nevers' and 'Always'

From the NY Times, restaurant owner Bruce Buschel publishes a list of 100 Things Restaurant Staffers Should Never Do (Part 1).

I wonder how many hospital CEOs have a similar list for their staff? And how many are personally involved in the coaching, mentoring and rewarding activities necessary to transform the list beyond simply good intentions?

If Wishing and Hoping Could Make It True...

In a quote that makes me question his understanding of innovation, from the NY Times, here's Microsoft's Steve Ballmer, on software: "I want us to invent everything that's important on the planet."

Really? Everything? He'd better get busy, since Microsoft's NEXT invention will be their FIRST. And it's borderline comical to think that a single company can invent everything important, even in a single industry sector like software.

An Innovation Video From C.K. Prahalad

What if...? Why not...? Medically indigent or market opportunities?

What if everything you knew about the world's poor was wrong? What if you re-framed the issue instead of thinking about them as 'someone else's problem' (assuming you thought of them at all?) What if you cast off old notions about global poverty and discarded shop-worn solutions? What if everywhere you looked, you saw, not problems, but challenges to innovate?

Here's a short Fast Company video featuring C.K. Prahalad discussing GE's development of a new, lighter, cheaper EKG machine...

Why not apply the same thinking to YOUR community's indigent care 'problem?' Why not take a blank sheet of paper, cast off everything you know about health care as 'big business' and unlearn all you know about spider webs of regulation and strangling systems of guilds and castes?

Why not, for a moment, ignore that thick binder of policies and procedures, the attitude of 'we're so smart we must know best...'? Why not design something centered around human beings...something that might turn YOUR indigent care 'problem' into a new market 'opportunity?'

4 billion people around the world are considered 'poor.' GE went to rural India and found innovation-driven new markets. You may just need to go around the block.

(P.S. The video opens with a Comcast commercial. Ignore it. I hate them.)

Sg2 Forecasts Decline In Hospitals' CV Volumes

From Sg2's Edward Winslow:

"(Cardiovascular) remains the largest service line, but it is the only major service line for which Sg2 forecasts an inpatient (IP) decline. Sg2 projects modest inpatient growth in other major service lines from 2009 to 2019, and the net effect will be a scant 1.7% increase in IP volumes over the decade."

I expect we'll hear that old, familiar quote trotted out as hospitals plan CV strategy. You know, the one about not having to outrun the bear, just your hiking buddy.

Hospitals and Social Media: More Stories of Luck and Pluck

"How Hospitals Are Quietly Leading the Way With Social Media" is the headline from Rohit Bhargava, writing in Ogilvy's Fresh Influence blog. Interesting that the article's first example of a hospital "leading the way" is really nothing of the sort. Rather, the hospital appears to be the passive beneficiary of a patient, acting on her own, sharing her cancer story via YouTube.

Sometimes you get lucky, but don't call that leadership.

Cisco Systems Announces I-Prize Competition

From the Wall Street Journal: Networking giant Cisco Systems announced a repeat of last year's successful I-Prize competition. Winners take home $250,000 and years of Cisco's support - in-house development, funding and staff - as Cisco hopes to turn the idea into a concrete business initiative.

Last year's winning idea, chosen from more than 2,500 submissions, was aimed at improving energy efficiency in the home. This year, Cisco has identified video, clean tech, education and health care as priorities. Business plans are due over the winter, with a selection named by spring 2010.

Deadheads Wanted!

"What Brands and Social Media Players Can Learn From The Grateful Dead" from SocialSteve's Blog.

The LCR model: Listening...Conversations...Relationships.

Minimally Invasive Prostate Surgery: Not Always Better

Today's NY Times reports on a JAMA article comparing outcomes from various types of prostate surgeries. The study found that increasingly-popular minimally invasive techniques have more of the complications men worry most about: impotence and incontinence.

“People intuitively think that a minimally invasive approach has fewer complications, even in the absence of data,” said Dr. Jim C. Hu, the study’s lead author, who is director of urologic robotic and minimally invasive surgery at Brigham and Women’s Hospital in Boston. “Men who were well educated and had higher incomes were actually more likely to embrace this approach, often due to aggressive marketing by hospitals that had spent $1.5 million to acquire the robots. I think the technology has been oversold.”
...

Dr. Peter Scardino, chief of surgery at Memorial Sloan-Kettering, said the study was important because it reported on data that did not come just from one medical center or one region.

“At the end of the day,” Dr. Scardino said, “what all the studies will show is that it’s not the tools the doctor uses, but the experience and skill of the surgeon. There’s nothing magical about the laparoscopic or robotic.”

How many hospital marketers are truly honest about a surgeon's skill? You don't see many ads saying "We've got this shiny new robot and our prostate surgeon just attended a seminar on how to use it so y'all come on in now!" There's truth in advertising and then there's TRUTH in advertising.

And, in a normally-distributed world, not everybody can be above average.

"Connected Care" Telehealth Program Comes To Rural Colorado

UnitedHealthcare and Centura Health have announced pilot locations for the Connected Care program in Colorado, giving patients in three rural communities expanded access to specialists using advanced teleconferencing capabilities.

"The Colorado program is among the first in UnitedHealthcare`s work to build a national telehealth network. Connected Care links patients with physicians and medical specialists located hundreds of miles away, using advanced audio and
video technologies and health resources to create an experience remarkably
similar to an in-person doctor visit."

Something you ought to be thinking about if you're an academic medical center in a state with a large swath of rural areas populated with Critical Access hospitals.

Chrysalis Ventures - Betting On Lowering Costs While Helping Patients

Where are the investors from venture capital firm Chrysalis Ventures putting money to work these days? They're searching "...for health care start-ups that make treatments more productive or make information about health care more cost-effective and accessible to patients." according to Claire Cain Miller, writing in the NY Times BITS blog.

Recent investments include Achieve, a company helping "...people who are struggling to pay their medical bills create a personalized budget that incorporates their credit card bills and other debt." Down goes bad debt.

And CerviLenz, a device that "...helps determine the likelihood that a pregnant woman will have a preterm birth." Up goes early diagnosis and prevention.

Chrysalis isn't trying to predict health reform's final shape but, rather, betting that simple, cost-saving technologies will be in demand regardless. I'd make that bet, too.

On My Reading Shelf: Value Innovation

New book: "Leveraging Health - Opening the door to improved health and reduced financial trends through value-based designs." from Cyndy Nayer, Jack Mahoney, M.D., Jan Berger, M.D. and the Center for Health Value Innovation. Looks interesting.

Business and Web 2.0

From McKinsey, an interactive feature on business and Web 2.0. Find out who is doing what, why, the results they're getting and plans for future investment.

Change By Design

From NPR.org, Renee Montagne interviews Tim Brown, CEO of innovation and design firm IDEO.

Brown points the way to design-driven improvements in health care:

"One of the problems I think we have in health care is that we tend to be thinking about how do we select from the existing choices that we already have, the existing approaches that we already have? The role of design thinking is to help create new alternatives, new choices, things that we haven't had before, ideas that we haven't had before. And it starts with focusing on people, which is the same thing whether you're designing a computer mouse or you're interested in childhood obesity; it starts with people and then applies creative tools to deliver the solution."

Starting "...with focusing on people" requires an observational, open mind and an acute willingness to see what's been right in front of you all along. Or as someone once said, "Walk a mile in my shoes..."

Connecting People and Devices For Better Health Outcomes

The future of health care is...social, from Fast Company.com and frog design.

A Value-Based Insurance Model From SeeChange Health

From Health Plan Week (via AIS's Health Business Daily) comes word of a "startup health insurer aiming to incentivize behavior change for both healthy and chronically ill members (beginning to market) its products to small employers in Fresno, CA this fall."

One observer calls SeeChange's model "...the next logical iteration in plan design."

Several interesting things:

• Small employers (fewer than 50 employees) are the target market here, a segment more used to being over-looked, over-charged and under-served by larger insurers.
  
• Behavior change is incentivized. Members receive richer benefits if they're screened for - and actively managing - a chronic condition.
  
• Not only does the plan accept the chronically ill and those at risk for developing a chronic condition, but it appears to embrace the possibilities of a new model based on prevention, active management and customer engagement through PHRs (offered through Health Insight), delivered through a narrow, focused provider network.

Venture capital firm Psilos Group provided $40 million in startup funding.

"Obama Administration’s Message to Health Care Start-Ups."

From Claire Cain Miller at the NY Times, the Obama administration's message to health care entrepreneurs is...GET BUSY! The message, delivered at Tuesday's Health 2.0 conference in San Francisco by Aneesh Chopra, the nation's chief technology officer, is that as the administration seeks to "...create the market conditions that would inspire game-changing innovations...", entrepreneurs should focus on broader issues than just what's in the current stimulus package.

Chopra says he fully expects to see the next generation of Fortune 500 companies born in this era, as innovative solutions are brought to bear on some of health care's most intractable problems.

Exploring the Patient Experience At Gel Health 2009

The Gel (Good Experience Live) conference series, a seven-year-old event curated by Mark Hurst, is launching a new healthcare event - Gel Health - a conference focused on the patient experience.

Speakers from Johns Hopkins, Beth Israel Deaconess and The Cleveland Clinic, among others, will offer their insights into the patient experience - how to improve it, and who's doing it, in a variety of organizations and companies.

Gel Health will be held on Thursday and Friday, October 22 and 23, 2009 at Scandinavia House, Park Avenue and 38th Street in Manhattan. Tickets are available at for $499.

Confirmed GEL Health 2009 speakers (so far):

* Dr. Bridget Duffy, Chief Experience Officer, Cleveland Clinic
* Dr. Robert Martensen, Author, A Life Worth Living; lecturer, Dept. of Global Health and Social Medicine, Harvard Medical School
* Cathy Salit, Working with Johns Hopkins oncology nurses via Performance of a Lifetime
* Dan Ford, Patient advocate
* Dr. Javette Orgain, Family physician; Chairperson, Illinois State Board of Health
* Dr. John La Puma, Author, ChefMD's Big Book of Culinary Medicine
* Dr. Jim Withers, Founder, Operation Safety Net
* Dr. Mark Pochapin, Director, Jay Monahan Center for Gastrointestinal Health
* Michael Christensen, Co-Founder and Creative Director of the Big Apple Circus and founder of Clown Care
* Olie Westheimer, Founder, Brooklyn Parkinson Group; cofounder, "Dance for PD" with Mark Morris Dance Group
* Dr. Sharon Krumm, Director of Nursing, Johns Hopkins Kimmel Cancer Center
* Dr. Sigall Bell, Beth Israel Deaconess Medical Center
* Bill Brownstein, Founder, Kids RX

It looks like an interesting two days on a topic deserving more attention and focus.

What Gets Measured Gets Improved

Yesterday's Wall Street Journal featured an article on how Pennsylvania's health care has gotten better and cheaper in the twenty years since the state began publishing outcomes data. Further proof (if more was needed) that what gets measured gets improved, I guess.

As I read the article, I searched in vain for an expression of embarrassment from a physician or hospital administrator...

...embarrassment that Pennsylvania's system was forced on a recalcitrant industry by frustrated customers.

...embarrassment that, if it weren't for those customers forcing the issue, undoubtedly health care quality would STILL be pronounced too amorphous to measure, and...

...embarrassment that, twenty years after the fact and despite all the evidence to the contrary, the article is replete with examples of doctors and hospitals still questioning the program's data collection and reporting methodologies.

"You don't understand! Our patients are (a) sicker, (b) older, (c) poorer, (d) different, (e) more co-morbid, (f) all of the above, (g) none of the above...ah heck we're artists and we just don't like being measured!"

And that, my friends, is further proof of health care's extended side trip through the weeds of leadership and brand adolescence.

Read What I've Written Lately

To my Omaha reader who returns to this page nearly every day: if you want to see what I've written lately, click HERE. Thanks for reading!

Job Available - Experienced Health Care Architect & Facility Planner

A world-renowned Chicago-area health care organization is recruiting for a seasoned, stellar architect and facilities planner. Ideally a licensed architect with 10+ years in facilities planning and development, this individual will be comfortable working at all levels of the organization including C-suite and Board of Directors. S/he will see projects through all phases, from design through construction, providing strong capital budgeting and project management direction, while building a capable in-house staff of designers and project managers. Candidates should exhibit strong knowledge of health care engineering systems, urban planning and land use development, from either/both owner and consulting viewpoints.

Renee Banchiere of Hanna & Associates is coordinating the search. Contact her at renee@ahanna.com or 714-465-2087.

Healthcare & Social Media: 2009 Trends & Strategy

Good SlideShare Presentation on health care's expanding use of social media:

Healthcare & Social Media: 2009 Trends & Strategy

View more presentations from Scott Meis.

Tips For Adding Facebook To Your Marketing Efforts

From Hospital Online Marketing Education, here's an example of a hospital system augmenting its marketing efforts with a Facebook presence.

Watch the video as blogger Christopher Boyer interviews Steve Leibforth, Sr. Web Developer for 6-hospital Provena Health.

McDonalds and Culinary Innovation

As I've said many times here on Health Care Strategist, I define a "brand" as that which an organization is WILLING to deliver, and actually CAPABLE of delivering, no more, no less. Within that context, it's interesting to see brands testing themselves and the marketplace on what they WANT TO and CAN deliver without straying from their essential "brand-ness."

Now Business Week magazine publishes a story on the struggles of being McDonalds' "Director of Culinary Innovation." What? McDonalds? Culinary innovation? Am I alone in finding the association somewhat jarring?

Talk about an uphill battle. Dan Coudreaut obviously "relishes" a challenge! (I know, I know...)

I might actually drive through for a late-night order of red curry eggplant. Hold the fries.

How Should We View A Leader Who Can't Make Work More Compelling Than Bowling?

Here's an assignment for all you hospital leaders: stand by your employee entrance in the morning, the door where most employees arrive at work. Observe facial expressions, tone of voice and body language.

What do you see? All too often it's the drudgery of coming to work made visible.

Now do the same exercise at the same door as employees leave work. Compare facial expressions, tone of voice and body language to what you observed that morning.

At this hour, I'm betting you'll see the excitement of LEAVING work made visible. The excitement of leaving a job that doesn't fulfill, on behalf of an organization not trusted, in the service of a strategy not understood. The happiness and engagement of leaving all that because something better awaits. Bowling, maybe.

Why is it that employees show far more passion for their hobbies and sporting activities than their work - where they spend the majority of their energy and waking hours? How is it that so many organizations utterly fail to engage their employees' hearts and minds, their passions and longings, in the essential pursuit of MEANING - something beyond a paycheck?

And what does it say about a leader who can't make WORK more compelling than BOWLING?

Are you KIDDING me?

How To REALLY Reform Health Care

Reform health care not by giving people infinite choices, but by figuring out what they want and delivering it, seamlessly, elegantly and consistently. Making a reformed health care system operate more like Apple and less (WAY less) like Windows, from Davis Liu, M.D.

A Modest Speculation About Health Insurance Reform

For a moment, let's assume the passage of some sort of health insurance reform. If, as seems a likely outcome, millions of people become newly-insured, health care's providers may need an entirely new phraseology and strategic playbook.

Out the window: pervasive, demeaning codewords for the poor, like "medically indigent," "charity cases" or, worse, "deadbeats" and "GOMERs." Suddenly au courant: unfamiliar labels like "paying customers," underserved new markets" and "growth opportunities."

Who will those newly-insured reward with their loyalty and spending power? Think about it.

Will it be those providers (and you know who you are) who've spent professional lifetimes studiously avoiding any contact, closing services while de-marketing others, and de-camping to the wealthy suburbs whenever feasible?

I hope not, frankly. Somehow that'd be like well-fed banquet-goers heading back for seconds while starving servants watch through the windows. No, this provider segment has exhausted most other growth opportunities and now the biggest undiscovered pot of gold in decades is about to slip through their hands.

Because I'm rooting for the beneficiaries to be those who stuck it out through thick and thin - usually more thin than thick. Those who every day, and quite miraculously, turned a few loaves and fishes into a modest health care repast for the left-behind masses. Those who, though the waiting times may have been long, never turned anyone away.

Actions have consequences.

Taking Customer Loyalty To the Bank

Joe Inguanzo, President & CEO of Professional Research Consultants, Inc., commenting in the April, 2009 H&HN:

"It's fair to say that loyal customers are the only constant in today's rapidly changing health care environment. And, when every dollar counts, keeping loyal customers in your court is a sound strategy that can be taken to the bank."

Inguanzo told me this afternoon that his research firmly establishes a relationship between those clients MOST focused on customer loyalty and those LEAST affected by the economic downturn. For one survey-leading client, a recent quarter's financial results were the best ever.

Take THAT to the bank!

Southwest Airlines' Brand Promise Goes 'Pfffth!"

In a desperate search for new revenues, Southwest Airlines is now charging passengers $10 for so-called EarlyBird Check-in.

"Southwest officials say that by paying the extra $10, you'll probably be among the first 30 people to board — the "A" group — although they won't promise it." (Emphasis mine.)

Analysts forecast the new charges adding $75 million - and possibly as much as $250 million - to Southwest's annual revenues. It's an interesting case study in pricing power and brand performance. If Southwest's fares are more than $10 cheaper compared to alternatives (which they are not, at least on the routes I fly most often) consumers may not care all that much.

But I care. And yes, it's partly about the money. For years I've gone out of my way to avoid Southwest, due mainly to their chaotic ticketing and boarding processes. There are better-organized bus companies plying back roads in the rural Third World. (Plus I hate Chicago's Midway Airport.)

You buy your ticket with no confirmed seat but must return to the very same web site 24 hours before your flight to reserve a place in some line unless you pay $10 more which may or may not get you a better place in line. WHAT? Are you kidding me? They MUST'VE modeled that process after something they found in a hospital somewhere.

Maybe I'd put up with it if I saved LOTSA money along the way. But I haven't saved money and the chances I ever will just got slimmer by $10.

"I'm now free to move about the country?" Add 'free' to the growing list of words with indeterminate meanings.

"To date, Kaiser Permanente members have completed 6 million doctor’s visits without using one gallon of gasoline."

I'll Have A Double Decaf Latte And A New Strategy

Call it the Starbucks experiment, an idea sparked by a recent Business Week article on the re-making of Starbucks brand and growth trajectory. Take your half-dozen smartest employees, gave them some money to play with and charge the team with creating a brand-new organization able to effectively compete with your current organization. The results would look like...what? New ideas, new templates, new norms, new brands, new cultures, new processes?

What's the harm? You might learn something important before your strategic rivals.

Business Success Made Simple

(Driving home from Texas last week, I saw an Intercity van on the highway. It reminded me of this post, written several years ago for another blog.)

I'm a little skeptical of case studies being generalized into one-size-fits-all recommendations for success, and I have no idea if the company I'm about to discuss is "successful" in the traditional business sense (i.e. profitable.) But the company, Intercity Lines, Inc., provided a rather expensive service to my family, met all my expectations, secured my repeat business and did all of this with nice, service-oriented people and a set of very simple, low-cost business principles. I think it's worth talking about; read on if you do too.

Intercity bills themselves as "America's premier enclosed auto transport company." A year ago, my oldest daughter needed her prize possession, a brand new Nissan 350-Z, transported to California where she was beginning (another) year of college. A web search for auto transporters produced the usual bewildering list of results. We requested quotes from several companies that actually offered working web sites. (Simple Business Principle #1: build and maintain a web site that encourages people to do business with you.)

Intercity's response was prompt and clear. (Simple Business Principle #2: The appropriate thing to do when someone indicates they'd like to do business with you is...respond!) Note that Intercity was not the low bidder; we chose them because their service was superior up to that point.

We received a series of e-mail messages outlining next steps and timeframes. All arrangements were ultimately confirmed by phone. (Simple Business Principle #3: Unless you're Amazon.com, use technologies like e-mail effectively but close the deal with a live person.)

The arrangements included the date and time for picking up the car (no 5-hour windows like the cable company) and the driver's cell phone number. We were told to expect a call from the driver shortly before arrival. Indeed, the driver did confirm and, more impressively given Chicago traffic, the truck arrived right on time. (Simple Business Principles #4a and #4b: Keep your customers informed and show up as promised.)

The truck that pulled up was immaculate; the trailer's hardwood floors gleamed. The husband and wife driving team was personable and professional. In less than 10 minutes the car and its contents were inventoried, every surface was covered and it was carefully loaded into the trailer. Note that we've never met anyone from Intercity beyond the drivers. Not the owners, not the managers, no "customer service reps," nobody. To us, the drivers ARE Intercity. (Simple Business Principle #5: Your customers see your people and your facilities (or trucks in this case) AS your company. Pay attention to the details. It doesn't cost that much to keep a truck clean. It doesn't cost more to hire people with the right service attitude. It might even cost less.)

We were told that the Illinois-to-northern California trip would take several days, and that the drivers would check in the day before arrival and again several hours before delivery. Again, the system worked as promised; the truck arrived when and where promised and, most importantly, the car was in perfect condition. (Simple Business Principle #6: Sometimes it matters how you start; it always matters how you finish.)

Our experience with Intercity inspired sufficient trust that they were the automatic choice when we needed the car returned to Illinois the following spring. We experienced the same easy process, another polished, shiny rig, a different husband and wife driving crew but every bit as nice, and the same on-time delivery. (Simple Business Principle #7: Great service is repeatable. It's outstanding performance time after time, without excuses.)

Thinking about it, I'm sure there are other lessons to be learned. But I'm continually amazed by the sheer number of learning-disabled organizations out there, large and small, failing every day and not really knowing why. Our experience with Intercity proves once again that great service is no accident but it's no impenetrable mystery either. Communicate. Show up on time. Hire positive people. Manage the details. Use technology appropriately. Everything else is just somewhat helpful commentary.

The Illusion Of Control

Advertising gives you the illusion that you control the conversation. You're talking. Surely "they" are listening. And of course "they" are paying attention and dutifully acting as you wish.

Insight occurs when realization dawns:

• Most people live their lives happily ignoring you.

• Of those devoting part of their limited attention span to your message, most neither care very much nor remember very long.

• The select few who BOTH care AND remember apply their OWN interpretive filters which may (though usually not) match your own.
  

So give up the illusion that you're in control of the conversation. You aren't. You never were.

Let the learning begin.

Fresh Thinking For Healthcare

A health care branding and strategy blog debuts from Scott Regan of Anderson Healthcare.

Markets Are Conversations.

The Chicago Tribune on social networking and corporate marketing:

"What corporate marketers are discovering is that many of the strategies they've used for decades don't apply in the new social realm. For one thing, the companies have had to learn to let go of control. They can't be unnerved by an audience that talks back, often with brutal candor.

"Such dialogue is occurring anyway, said market researcher Josh Bernoff.

"You can ignore it or you can try to fix it," said Bernoff, co-author of "Groundswell: Winning in a World Transformed by Social Technologies."'

The key point there is that the dialogue is occurring anyway, with you or without you. Better to be part of the conversation.

And yes, it's difficult to predict what will work in social media, but the same thing could be said for most branding and advertising (who would have predicted a lizard could sell insurance?)

"United Breaks Guitars'

From Chicago News: United Airlines' employees smash a guitar while passengers watch from the plane. Guitar's owner writes a song and posts a YouTube video. Said video is viewed nearly 650,000 times. Airline apologizes and uses video for "employee training" purposes.

What does it say when an airline needs to train its employees not to break stuff? Think about it next time you hear an airline executive complain about the industry's poor growth prospects.

And speaking of poor growth prospects, if your hospital occupies the lower quartiles of patient satisfaction results, you might want to prepare for the day a similar video spotlights your ER waiting times and execrable customer service. I can just imagine the humor, the pathos, the embarrassment...the desperate search for someone in Patient Relations to "fix" the problem.

Potter: Health Plan Profits Matter More Than Patient Health

Testifying before the U.S. Senate Committee on Commerce, Science and Transportation, former CIGNA executive Wendell Potter "...testified that large health insurers routinely and intentionally drop high-risk members. They also make coverage exclusions difficult for policy holders to understand and dramatically boost premium rates for small employers that have high claim costs, he asserted."

Responding to Potter's accusations, CIGNA mentioned the company's long support (emphasis mine) for a health care system that mandates insurance coverage for everyone at the same rates “regardless of whether or not the person has a pre-existing illness.”

Who are they kidding? And since when does acknowledging some new post-election realities constitute "long support?"

Find a pdf of Potter's full testimony here.

NY Times: "A Doctor by Choice, a Businessman by Necessity"

In ways subtle and overt, medical professionals are encouraged act like businesses. And so they do, sometimes realizing too late the difficult bargain they've struck.

Writing in the NY Times, Dr. Sandeep Jauhar expresses the dilemma:

"...the consequences of this commercial consciousness are troubling. Among my colleagues I sense an emotional emptiness created by the relentless consideration of money. Most doctors went into medicine for intellectual stimulation or the desire to develop relationships with patients, not to maximize income. There is a palpable sense of grieving. We strove for so long, made so many sacrifices, and for what? In the end, for many, the job has become only that — a job."

Most problematic, I believe, is the fact that a sense of "commercial consciousness" is no longer optional if obligations like student loans and payrolls are to be met. It's now the price of admission, a necessary requisite for professional and financial survival. And I think we're all a little worse off.

Thanks For Reading and Lurking

'Thanks for reading' to organizations showing up here in the last day or so:

• Episcopal Health Services
• Apple Computer
• Florida Hospital
• Thomson Financial
• University of Phoenix
• Loma Linda University Medical Center
• Auburn University
• Kaiser Permanente
• Visible Technologies
• Fleishman Hillard
• Bristol Myers Squibb
• Johns Hopkins
• University of Nebraska Medical Center

Courtesy of Statcounter's domain tracking stats, I know I've got readers and lurkers. Now what I'd like is commenters. Argue with me. Tell me I'm full of it. It's certainly not out of the question.

Regional Innovation Conference Addresses Economic Recovery Issues

Last Friday, I attended a conference sponsored by Purdue University on using innovation and regional partnerships to drive regional economic development. Richard C. Longworth, author of "Caught in the Middle: America's Heartland in the Age of Globalization" delivered the keynote address.

Longworth's basic message is '...the old days are gone and they're not coming back. So get on with the business of economic reinvention.' Tough to hear sometimes, but a necessary message for regions, organizations and individuals all to grasp.

Yours truly was interviewed for the South Bend Tribune's event coverage;

"Making this huge attitude change will require more than politicians working together, said conference attendee Steve Davis, an entrepreneur based in (Michigan.) It will require attracting young workers and venture capital to the Midwest, he said.

"Davis has two start-up businesses — one for individuals to gain online access to their medical records, and another offering guides to triathlons around the world.

"Davis said Michiana would benefit from gatherings that provide ways for entrepreneurs such as himself to network and share ideas."

For me, the conference's most thought-provoking session was "New Tools for Regional Development: Open Source Economic Development & Strategic Doing" from Scott Hutcheson, Assistant Program Leader at the Purdue Extension & Purdue Center for Regional Development.

I'm checking with Scott to see if I can post his presentation here. Open source strategy is a powerful tool for getting lots done with many, small ideas and initiatives, making it easy for strategists to tap into the power of the collective.

And as I always say, hospitals don't have an uncompensated care problem, they have a "failure of economic development vision" problem. Stay tuned for a future post on the subject.

"We Just Discovered The Internet and Want The Whole World To Know!"

Glendale (CA) Adventist Medical Center offers its patients in-room web access and e-mail and finds the occasion worthy of a press release.

The hospital believes the service helps it "...stand out from competitors." They may be right, more's the pity.

In a connected world, consumers long-ago learned to expect "anytime, anywhere" connectivity. Even the lowliest coffee shops have been wired for years. So I fail to see how a hospital's quest for strategic separation is aided by ANNOUNCING such a belated entry to the modern world. More likely, they embarrass themselves with further proof (as if more proof was needed) of exactly how far behind the times they'd fallen.

What's next? A press release saying "...all rooms are now air conditioned?"

Yeah I know. I can hear the excuses. "You don't understand...it's a complicated issue...lots of things to worry about...security, privacy, cost, support..." All true. And all misleading from the real headline which should read "We shoulda done this 10 years ago. We weren't paying attention to trends in consumer expectations and didn't understand how important the wired world has become. Now we're having to play catch-up."

Eh, it's difficult admission for a narcissistic industry and probably a bit long for a headline.

Your Personal Brand: Not What YOU Say It Is...

...it's what THEY say it is. Blogger Joseph Higginbotham offers some timely advice to those of us creating our own social media-driven brand. Be generous, empathetic, civil, cooperative, pay it forward, all the things that pay off in real life work here too.

My personal favorite is "The No A**hole Rule." Life is too darn short...

EMRs and "Meaningful Use."

Health care providers showing "meaningful EMR use" by 2011 are eligible for incentive payments from the $20 billion EMR stimulus package. Writing in netdoc.com, Patricia King, JD outlines the details for physicians:

"To be a "meaningful EHR user", the physician must satisfy three criteria:

* The physician must use "certified EHR technology" in a meaningful manner, including electronic prescribing.
* The physician must demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.
* The physician must submit information on clinical quality measures specified by HHS.

HHS will designate the way in which a physician is recognized as a meaningful user (through attestation, submission of claims with codes indicating that a patient encounter was documented using certified EHR technology, survey responses, submission of quality reports, or other means)."

I know this is HHS's ball game and they're entitled to make the rules. Play by their rules, buy an approved system, use it for e-prescribing and care coordination, report the right data in the correct format and the incentives rain down, I guess.

Hopefully, somewhere in all those indicators, are measures of the direct benefit to those same consumers from the EMR investments being encouraged on their behalf. I get that e-prescribing and coordinating care are wonderful things to do, and certainly agree that more - and better - quality reporting is long overdue.

Typical, though, of an inward-focused industry, the direct benefits to consumers are more implied than obvious, at least so far. OK, EMRs will facilitate more e-prescribing. Great. And more e-prescribing will lead to...what? What's all the fuss wrapping up to? What's in it for me as consumer and patient? Maybe THAT ultimate outcome is what Medicare ought to be incenting.

It seems to me that the road-map to "meaningful use" in the purest sense begins with a desired consumer benefit and then drives the technical issues and processes to achieve that benefit. I'm sure I'll get a comment or two referencing research proving the merits of e-prescribing (improved health, better medication compliance, fewer errors, etc.) Fine, incent the ultimate delivery of those benefits, not the process's mere presence or absence.

The takeaway: Incent benefits and outcomes, not processes. Or as I always say: effort is appreciated. Results are required.

It's The Idaho/Wharton/Phoenix/Colorado/Mayo Innovation Mashup

From IdahoStatesman.com: Officials launched THE CORE, an enterprise zone for health care, education and technology enterprises. St. Luke's Meridian Medical Center is on board along with dozens of other public and private enterprises. The trend continues of health care providers playing leading roles in their community's economic development.

From Knowledge@Wharton, sometimes innovation takes a village. It's a thought-provoking article on the benefits of opening up innovation processes to thought leaders and partners outside your organization's walls. What if you created an extranet and posted your innovation priorities for all to see? Let's say you wanted to improve a discharge planning process. How many more good ideas would you get if you asked thousands of people instead of just a few?

From Medical News Today, a Health Leaders-Interstudy report trends in the Phoenix market of EMR "de-installation" or contract cancellation due to training, functionality and/or affordability issues. Possibly an ominous sign for a broader, national rollout.

From the Craig (CO) Daily Press, the VA brings tele-health innovation to veterans in rural Colorado. High-intensity cameras, otoscopes, "smart" stethoscopes and other technologies integrate care with physicians 150 miles away, improving convenience and saving time and travel on often-snowy roads.

The Mayo Clinic Center for Innovation will host Transform, a collaborative symposium on innovations in health care experience and delivery, Sept. 13-15. The symposium requires registration and is open to the public. It will feature nationally recognized speakers on topics focused on innovation methodology and innovations in health care delivery models, including Web-based tools.

Social Meda Measurement by Visible Technologies

Some interesting social media measurement and tracking methodologies in this presentation.

Social Meda Measurement by Visible Technologies

View more documents from Gravity Summit.

"UAB Health System Announces Inaugural Innovation Award Winners."

While many health systems find it difficult to expand their focus much beyond day-to-day survival, a few recognize the power of teams with innovative ideas to drive measurable, long-term improvements in key strategic indicators. Example: the UAB Health System...

"The UAB Health System has announced the winners of its inaugural Innovation Awards, which acknowledge novel and inventive programs, policies, ideas and processes implemented in the last two years that have led to significant, measurable improvements in patient care and/or operational efficiency.

"The awards recognize best practices in UAB Health System entities and affiliates, with a goal of promoting widespread adoption of exceptional programs and ideas. Montgomery-based Baptist Health took first place in this first year of the program after the Health System CEO Council reviewed 36 nominations and selected three winners in each of two categories: Impact, for programs that have had the greatest positive effects on patient care or operations, and Creativity, for programs that demonstrate exceptional vision and imagination."

The ideas are out there to take your organization to the next level too. They're within your walls...locked up in your team's fearful heads, maybe?

Doesn't matter how big or how small your organization is, urban or rural, teaching or non-teaching. But here's the problem: ideas can be tough to recognize when they don't just show up on their own at the executive suite's oak-paneled doors. They need finding, nurturing, recognizing, supporting, funding and, yes, a little risk-taking. They need a process and a culture that values improvement and inquiry.

But they're out there, as long as you have teams of people asking What if...? Why not...?

What was first on the agenda at your most recent leadership meeting? Budget cutting or innovative problem-solving? I'll bet I know where UAB started.

Top 50 Customer Service Blogs

The Top 50 customer service blogs. If you can't find a few new ideas somewhere on the list, you're not trying very hard. What's not to like about a blog titled "Constructive Grumpiness" anyway?

There's More To A Name Than Just A Name

It's no accident that the best-branded health care organizations are those with physicians tightly integrated into the cultural and decision-making fabric. Mayo, Cleveland Clinic, Kaiser, Geisinger, Virginia Mason, to name a few, have a decided advantage over the more traditional private practice model where physicians are, at best, an arms length away and, at worst, strong competitors.

I remember making a site visit to one of the above-named organizations, and hearing the CEO (a physician) say very clearly "Our customer is the patient. Period. Anybody not agreeing doesn't work here!" Wow, now THERE'S the platform for an enduring competitive advantage.

Everything in that organization - the people, the processes, the planning, the facility, the scheduling, everything - is all directed toward acting on that "patient as customer" premise. I'm sure there's internal debate about a great many things, maybe even an argument or two, but the basic, clarifying premise cuts rather quickly through the murk.

Importantly, there's minimal lip service, maximal forthrightness. "This is us. This is how we do business. If you don't like it you won't fit here."

Legions of consultants and seminars promise to deliver "the secret roadmap" to physician integration. I'll offer a modest, hard-won observation for free: no model, regardless of how elaborate or expensive, will work until freed from the scourge of lip-service, A.K.A. execu-speak for "We don't really want physicians involved and don't intend to communicate. In the meantime, we'll do our best to make sure they don't figure that out until it's too late..."

The Takeaway: Becoming "The Mayo Clinic of (Your Town)" takes more than consultants, lawyers and a new tax ID number. Create all the new legal structures you want. Along the way, recognize that the old models made certain toxic behaviors necessary for survival. Find them. Root them out. Unlearn them. Stop rewarding them.

The new models require new ways of thinking, of communicating and of implementing. New voices engaged in honest, sometimes difficult conversations. And, an understanding that "physicians at the table" doesn't mean creating another committee.

A Twitter How-To in Seven Easy Steps

A great SlideShare Presentation on Twitter.

A Twitter How-To in Seven Easy Steps

View more PDF documents from mhomann.

"New iPhone Application Offers Instant Access to Health Cost Information."

From AIS's Health Business Daily, here's Managing Editor Michael E. Carbine discussing a creative new iPhone application for consumer-directed health plan enrollees.

"Canopy Financial's Mobile Consumer Directed Healthcare (CDH) Software Application, the only such one, allows iPhone and iPod Touch users to search medical procedures using keywords to determine if they are eligible for payment using their spending accounts, a valuable capability in its own right. But when the user identifies a specific procedure, the application not only maps the location of local providers offering the procedure but also pulls up the customary cost of the procedure based on the consumer's ZIP code.

...

"The medical expense locator feature combines Canopy data on procedure rates with the iPhone's integrated mapping application to match procedures with providers in the user's ZIP code. Contact information for all identified providers also is displayed. A Procedure Cost Analyzer then retrieves customary prices that insurers and employers typically pay for the procedure, again by ZIP code. This...enables consumers to contact providers to evaluate and negotiate prices before agreeing to undergo and pay for a procedure."

The $4.99 download offers a lot of useful functionality to CDH members (full disclosure: including me.)

There's Hope For Me Yet!

Now that I've found these tips for succeeding as a late bloomer. Phew! My idea book is getting pretty full.

Check out Several Ways That Pharma Can Harness the Power of Social Media : Bio Job Blog

Take a look at: Several Ways That Pharma Can Harness the Power of Social Media : Bio Job Blog

From Seth Godin: "This Industry Deserves To Die."

Of course he's talking about the textbook-publishing industry, and as the father of 4 daughters, college age and older, I wish the death would've occurred, oh, about 8 years ago.

Why is death deserved? Let's see...too expensive, resistant to change, uninspiring, impractical. Says Godin,

"The solution seems simple to me. Professors should be spending their time devising pages or chapterettes or even entire chapters on topics that matter to them, then publishing them for free online. (it's part of their job, remember?) When you have a class to teach, assemble 100 of the best pieces, put them in a pdf or on a kindle or a website (or even in a looseleaf notebook) and there, you're done. You just saved your intro marketing class about $15,000. Every semester. Any professor of intro marketing who is assigning a basic old-school textbook is guilty of theft or laziness."

I hope some health care leaders are paying attention. As adjectives, "expensive, resistant to change, uninspiring and impractical" apply to their industry too.

Putting Patients In Charge Of Health Care, From the NY Times

A former boss once referred to health care providers' endless, inward-focused bureaucratic narcissism as "navel-gazing." Jack Welch framed it slightly more elegantly when he said something along the lines of "It's not that bureaucracies dislike customers. They don't. They just don't find them as interesting as they do themselves."

Now, Dr. Pauline Chen, writing in the New York Times, discusses Dr. Donald Berwick's philosophy of "patient centeredness" and its provocative implications that health care would work better if control was transferred from physicians to the patients themselves. According to Dr. Berwick, we face a system...

"...built...around clinicians that makes it impossible to customize care the way it needs to be. We don’t have a standard of services or processes that are comfortable for patients. We have built a technocratic castle, and when people come into it, they are intimidated.

"Patients keep having to repeat their name because the system has no memory. We dress them in silly-looking gowns. We give them the food we make instead of the food they want. We don’t let them look into their medical records unless they have permission. Health care keeps telling patients the rules instead of asking patients about their individual needs. What is said is, “This is how we do things here,” not “How would you like things done?”

"People get accustomed to this. They are trained to be passive, and passivity is not a good idea..."

I once had a physician Board member speak against a proposal to create an on-line portal through which patients could review their medical records. His argument? That patients, upon gaining direct access to their own clinical data, would "...just waste my time, barraging my office with stupid questions."

Even sadder, nobody on the board disagreed, not the administrators nor his physician colleagues, not the laypersons nor the business leaders. But Berwick's clarion call for a new way of thinking about health care may be turning a few heads and changing a few minds, perhaps even on THAT Board.

The new model is all about re-structured power relationships and financial incentives. I'm betting the latter is more amenable to fixing than the former.

"Some examples of this new model of care? Shared decision-making would be mandatory in all areas of care, with patient preference occasionally putting evidence-based care “in the back seat.” Patients and families would participate in the design of health care processes and services and would be a part of daily rounds. Medical records would belong not to clinicians but to patients, who would no longer have to get permission to look at them or call the doctor for lab results.

"Even the word “compliance” would become obsolete.

"As Dr. Berwick writes in his piece, '[We] would all be far better off if we professsionals recalibrated our work such that we behaved with patients and families not as hosts in the care system, but as guests in their lives.'"

That sound you hear is not the gearbox on a '53 Studebaker. It's a few rusty paradigms being shifted.

Chen's interview with Berwick concludes with this:

"...the burden to change the system falls on the leaders, the stewards, the people who create the organizations where the workforce works. Doctors want to do their work in a patient-centered way; they really do. We have to fix the health care system so that it gives doctors the time to do the job they want to do."

Yes, health care needs to be fixed. Yes, compensation systems and incentives are a huge part of that "fixing." But I'm less confident than Berwick that physicians, universally, want to be more patient centered, especially when that implies giving up the power to tell "compliant" patients what to do because, well, "I'm the expert and you're not!"

The Takeaway: Many hospitals talk a good "patient-centered" game. You see a few systems adding "Chief Experience Officers" to their executive ranks or adopting a hotel-like "room service" approach to patient meals. Some offer less-revealing patient gowns. But it's all window-dressing (pun intended) until those power-based relationships change fundamentally and permanently.

GM Will Rue the Day It Converted Roger Penske From Partner To Competitor

Enduring another endless spasm of "Pursue scale! Eliminate overhead!! Damn the torpedoes!!!" a PPE (that's Prior Place of Employment to you newer readers) closed a nearby primary care practice in favor of a larger practice two towns over.

To the extent there was ANY rationality behind the decision, several theories appeared to apply: (1) solo practice is an expensive, uncompetitive model of organizing a medical practice, and (2) consumers would happily do what they're told even if it meant driving 30 minutes through grinding suburban traffic to see another PPE-branded doctor.

Both theories were quickly proved wrong. What was proven right (again) is the notion that markets are local - one service provider, one customer, a loyal dyad.

Some physicians prefer practicing solo, are good at it and don't mind the drawbacks, which can be substantial. So it was with this doc. He left us, established another solo practice nearby, joined our competitor's medical staff and prospered. Oops. The PPE hadn't seen that coming.

And only a few patients transferred to the new, larger practice. The PPE watched and fretted as their market share in several key zip codes dropped off a cliff. Yikes. Didn't expect that either.

I'm not resurrecting an old debate here just to say "Nyah Nyah I was right!" (Even though I was...) No, I wonder how many of the same mistakes are being repeated by GM and Chrysler right now, as dealers and brands are sacrificed on the alter of overhead reduction.

Today, GM announced the sale of the Saturn brand to the Penske dealership chain. Roger Penske hasn't done much in life - from racing cars to running large companies - that hasn't worked out. He knows cars, he's well-respected, smart and tough - everything GM ought to fear in a competitor.

According to today's New York Times:

"'Saturn was kind of an unpolished gem at GM,'' said Brad Coulter, director at the Bloomfield Hills, Mich., turnaround firm O'Keefe and Associates. ''They had never really fully exploited what they developed. Saturn is known for having some of the best-run dealerships. The brand is highly rated. It's a top-notch sales organization.'''

So Penske's buying "...best run" dealerships, a "highly rated" brand and a "top-notch" sales organization. Sounds like those are the assets GM should be keeping, not selling.

I'll make a prediction: after three years under Penske's leadership, Saturn will be outperforming GM on most measures of corporate success. And the investment bankers on President Obama's auto task force will say "Gee, we never saw THAT coming!"

The Takeaway: Any idiot can slash overhead, and every day another idiot proves my point. Seeing beyond Wall Street's spreadsheet models and MBA mantras requires a rare degree of strategic subtlety, a finely-attuned ear for consumer feedback, a restless mind - a mind open to other scenarios and possibilities and, finally, an awareness of the post-slashing end game.

More of my ramblings about remaking the auto industry, here.

What If...

As I write this, in the aftermath of the Air France tragedy, the so-called black boxes' recovery from an unknown resting place thousands of feet under the waves is not certain. What if, I mused, a plane's vital operating statistics were streamed to a secure server somewhere, dry and on-shore?

Apparently it's not a new idea, in fact it's old enough to have come to Katie Couric's attention. Of all people, she covered it on the CBS news this evening, where I learned that, as with most things, the obstacles are not technical as much as financial (lots of planes, lots of data, lots of bandwidth, lots of servers) and organizational (pilots look at it as 'big brother' watching their every move in real-time.)

That's most often the case; new ideas are technically possible long before all the inertial barriers to implementation come down. I guess those arguing against the idea aren't paying the salvage team's salaries or braving mid-Atlantic storms, looking for a tiny breadbox in a great big ocean, all to find a cause for the decade's worst airline disaster.

Ah well. It's still a good idea.

Behind Every Resume Is A Potential Customer

Been job hunting lately? If not, consider yourself blessed. Out there, it's a big black hole of utter rudeness and callous non-responsiveness. From today's New York Times comes a modest proposal: treat job-hunters like, well, customers!

"...in the whirlwind of daily activity, a business can lose sight that there are real people behind all those résumés. And how the company treats those people, well before any of them become employees, says a lot about it, its brand and its values.

"In the current labor market, where there is a glut of supply, perhaps some companies think they have the upper hand and can afford to skimp on the niceties. They are mistaken, though, because every economic cycle eventually turns, and there is always competition for the best talent, regardless of economic conditions.

"It’s for this reason that human-resources professionals and company leaders need to treat job candidates like customers."

Pay attention to job-hunters? Treat candidates like customers? They're a dime a dozen, so where's the benefit in that, you ask? "Oh but we're terribly busy HR professionals..." you say? Sure, go ahead and kiss that brand promise goodbye, along with the last remaining thimble-full of your business model's growth potential.

"A Stanford Business School case study found that some companies get (the concept of treating job hunters like customers) and capitalize on it. Southwest Airlines, for one, recognizes that employment candidates are not only career customers — but that they could also be, or become, customers of the airline.

"Southwest’s core principles of respect permeate its recruiting, where there is a focus on making sure that no applicant feels inferior or rejected. Many Southwest job applicants have a better experience being rejected by Southwest than they have being hired by other companies. As a result, Southwest gets the best people, and it shows in its superior financial results.

"Another example comes from the food industry, where I recently heard a story about a manager from Nabisco who was attending a human-resources industry conference. When he declared that his company responded to every résumé it received — solicited and unsolicited — he was met with incredulous stares from his peers.

'“Why respond to every résumé when that’s clearly not necessary?” someone asked.

"The Nabisco manager smiled and replied, “ Because — everyone eats cookies."

I love that: "...because everyone eats cookies." And they always remember how you made them feel.

The Takeaway: Has your growth trajectory flattened out? Nosedived? Check how your organization treats job-seekers. Go online and try out your HR Department's "application engine." Investigate how (or, if) you communicate with applicants. Undoubtedly, it's no better than how you treat customers...more's the pity. How can your organization surpass HR's performance when it's THEM supplying the talent? Wouldn't they be the lowest common denominator?

Regrettably, I don't foresee it changing until a generation of HR "professionals" and recruiters spend a few months themselves searching for a new job, sending resumes into the black hole, dealing with recalcitrant web sites. At that point they may figure it out. Until then, as Depeche Mode might have said it, Enjoy the Silence.

More on my feelings about HR, here.

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd.

Most important, in my opinion, is this:

"...electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems.

"Finally, consumers must become much more involved in their health and health care. Unless patients comply with care and take responsibility for their health, even the best doctor or team will fail. Simply forcing consumers to pay more for their care is not the answer. New integrated care delivery structures, together with bundled reimbursement for full care cycles, will enable vast improvements in patient engagement, as will the availability of good outcome data.

It's nice to hear, finally, somebody (a) link the current EMR mania to antecedent process improvement and (b) remind us that it's fundamentally about value delivered to consumers (a.k.a CUSTOMERS!) What a concept. How rare it is to hear "consumer" and "EMR" used in adjacent paragraphs.

Yes, consumers matter, despite the bureaucratic, collectivist approach of most IT vendors and health providers. You'd think it was really about them and their lives and problems! Trust me, it's not and those who think it is suffer from acute strategic cluelessness.

Putting my meager funds where my large mouth is, I'm working on a start-up provisionally described as "Consumer-Controlled Access To Medical Information." Sort of Google Health meets credit card-style merchant processing. And, yes, I have a vested interest in the debate, though - vested interest or not - the more twaddle I hear from health care providers about their EMR strategy, the more convinced I am that consumers are merely afterthoughts and I'm on the right track.