Skip to main content


Showing posts from 2009

Computational Thinking

Improving Competitiveness For Less Than $100 Million

Does $100 million secure your competitive future? Maybe. A hospital I know quite well just announced a $100 million expansion driven by the need for more private rooms, all in the quest to "remain competitive."

I don't doubt that "remaining competitive" is important. It should be. The alternative is a long, slow slide into irrelevance. And this hospital is far from alone in leveraging-up its balance sheet to eliminate the anachronism of semi-private rooms.

And, yes, facilities have finite life spans. A former boss of mine was fond of saying "Never miss an opportunity to tear down an old building!" Sometimes it has to be done.

But what if that kind of "build a better box and they'll come" thinking is terminally flawed?

Flawed by health care's thundering herd?
"Are we doing this because everybody else is so we must do it too or suffer the consequences?"
Flawed by the behavioral limits of "bounded rationality" - i.e…

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 c…

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 &q…

"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…

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,, 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 m…

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 yes…

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)

"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 beg…

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 unins…

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 cl…

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)

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 sm…

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.

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…

"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.

Change By Design

From, 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..."

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, …

"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;…

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…

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 or 714-465-2087.

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 organization…

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 starvin…

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…

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 …

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.

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. …

Thanks For Reading and Lurking

'Thanks for reading' to organizations showing up here in the last day or so:
Episcopal Health ServicesApple ComputerFlorida HospitalThomson FinancialUniversity of PhoenixLoma Linda University Medical CenterAuburn UniversityKaiser PermanenteVisible TechnologiesFleishman HillardBristol Myers SquibbJohns HopkinsUniversity of Nebraska Medical CenterCourtesy 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 record…

"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's a complicated issue...lots of things to worry, privacy, cost, support..." All true. And all misle…

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, 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…

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

From 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, functiona…

"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 …

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, cl…