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Showing posts from January, 2009

What I See Ain't What I Remember

These days it's difficult to go far without passing empty strip malls and vacant storefronts. And as if we needed it, those dark windows staring back just reinforce a sense of economic malaise. It happened to me last night.

"I wonder what that store was?" I mused. I couldn't remember. I couldn't remember the next one either, or the next. I'm sure they were someone's livelihood, likely a dream fulfilled and a labor of love, certainly a quest for financial independence. Employers. Taxpayers. Contributors to our national economic fabric and local softball teams. But these days more than any, that's not enough.

The world doesn't need yet another undistinguished clothing store chain or a tanning salon on every corner or one more burger & pizza joint. It doesn't need them now and probably never did, though it was hard to see that from the perilous heights of an economic bubble.

Regardless of industry or location, no matter if you're…

Patients Can't Identify Their Physicians...

...and maybe they're happier that way, says a study released by The University of Chicago and reported in today's New York Times.
"Some 75 percent of the patients were unable to name a single doctor assigned to their care. Of the 25 percent who responded with a name, only 40 percent were correct. Those patients who claimed to understand the roles of their doctors were more likely to correctly identify at least one of their physicians."It may be more important that the family know who the physician is, said one expert in response. Another rationalized that understanding care processes is more important than knowing your physician's name. And of course we were reminded that "...well, hospitals are busy, bustling places..." as if excuses were explanations.

Interestingly, patients who could name their physician were also more likely to be unhappy with their care. "Ignorance (may be) bliss" was the response. "...and maybe we put a little too…

A $5 Million Technology Grant To Enhance Home And Community-Based Care For Seniors

Established with a $5 million grant from The SCAN Foundation, the National Center For Technology and Aging is devoted "exclusively to advancing the use of technologies that dramatically enhance home and community-based care for seniors."
"The center will focus on technologies such as remote patient management and monitoring, medication management, cognitive assessment, assistive technologies, disease management, family caregiver communication, and sensors."The Center hopes to accelerate the adoption of these technologies, with a long-term goal of enhancing seniors' ability to maintain their independence and avoid stays in hospitals and nursing homes.

Said hospitals have the skills and knowledge to develop the technologies. Certainly they have an incentive to participate in the equation. It remains to be seen whether they have the adaptability and foresight.

Things Are Great! They're Not? Really?

I wonder if there's more than a coincidental link between this story and this one. Getting CEOs off their private jets and back into the smog of commercial aviation might just improve things for the rest of us.

The best organizations I know are those where the CEO is also a CMS - Chief Mystery Shopper, something that's hard to do from a private jet or a corner office. And that's a good lesson for marketers trying to rewire their organization's customer service DNA only to find the CEO lacks a customer's-eye view of the organization's fundamental weaknesses.

Microtargeting Comes To Politics

Having the best data doesn't guarantee success, but add some fresh thinking and a dose of creativity to that data and you may be on to something. Just ask President Obama.
"The data-based techniques..., similar to those used to target supermarket shoppers and even to hunt for terrorists, are turning politics into the sophisticated calculations typically associated with Google (GOOG) and its ilk. In a fraction of a second, computers sort us into segments and then calculate the potential that each of us has to swing from red or purple to blue."Think differently. Segment your market. Gather public data; supplement it with your own insights. Figure out who your customers and supporters are, and who they are not.

Of that latter group, determine who is persuadable and what message appeals to them.Locate them geographically, socioeconomically, emotionally. Learn how they live, behave, respond, spend, act and react. Try some things. Learn some lessons. Refine. Repeat.

Competitor Research and Anticipation

Understanding your competitors' moves, from The McKinsey Quarterly.(subscription required.)

I found it effective to have my H-R function alert me when we'd hired away a competitor's employee. I'd buy that new employee a cup of coffee and ask a few simple questions: What was it like to work there? What are they doing better than us? What should we learn from them? What's the buzz about their future?

You'd be amazed what I learned, though most employees were initially convinced they had no valuable information to offer.Was it anecdotal? Sure. Was it always actionable or decisional? No, not always. But put it together with more-traditional primary and secondary research and the competitor landscape makes a little more sense.

And you meet some nice people along the way.

Align Your Foresight With Venture Capital

Health care strategists interested in an early peek at where their industry may be heading should monitor trends in venture capital funding. Those start-up and early phase companies are the future of health care technology, pharma, informatics and treatment modalities.

Your skills at predicting which ideas will make it big don't have to be perfect. But train yourself to ask lots of scenario-type questions: What if this idea becomes mainstream? What is our organization doing - and relying upon - that might be replaced or made obsolete? What would be the impact on us if that happened? How do we mitigate that impact? Are there new skills and/or knowledge that we must gain to take advantage of the idea?

Get a team together and facilitate a discussion. Develop a range of scenarios and possible responses, not because you're trying to be precisely right, but because shared insights and understanding improve your response - no matter which scenario ultimately proves correct…

What If...'Boomsday'?

Demographics, peak oil and the "rapid, 'sharp curve of decline.'"from Paul B. Farrell at MarketWatch.
"In short, within four decades human demands will easily double. That makes population growth the key variable in every economic equation ... impacting every other major issue facing world economies ... from peak oil to global warming ... from foreign policy to nuclear threats ... from religion to science ... everything. Population is the No. 1 variable in the economic equation."Health care strategists are well-advised to think beyond the arguably short-term benefits of the new administration's stimulus package, and consider a new range of longer-term threats and scenarios:so-called "peak oil", global scarcity-driven nuclear confrontations, the decline and collapse of societies...

It just keeps getting better, doesn't it?

Preventing Infections With PatientPak

Hospitals talk a good game when it comes to nosocomial infections but, as usual, they've been so focused on their own issues they've missed some obvious consumer opportunities. Now, Springwise brings word of a unique, branded B2C application for the worried well and those who would like to stay that way: PatientPak...
"Although hospital superbugs may be infamous, we haven’t yet seen a branded, integral B2C approach to their prevention. Sold and marketed to consumers instead of to health institutions, PatientPak is a collection of antimicrobial and other hygiene items for those planning a hospital visit. Its aim: to kill 99.99% of bugs, including nasties such as MRSA, salmonella and E. coli."
Buy several for the patient you love.Then, as a health care strategist, think of problems your organization struggles with that might also affect your customers. Why should the value from solving those problems accrete to someone else?Think B2C, not H2C or P2C or H2P2C.

How soon…

I Read, I Observe, I Blog

Proposed legislation targets physician-owned hospitals, says the Wall Street Journal.

And Apple Computer reported strong first quarter profits, surprising analysts and handily beating Wall Street's expectations. Timothy Cook, Apple's COO, said he leads 35,000 "wicked smart" employees who "...were put on the earth to make great products..."(Full disclosure: I'm writing this on one of those great products (MacBook Pro), downloading music from a great service (iTunes), listening to that music on another great product (iPod Nano) while planning to buy even more (an iPhone and a 24" iMac.))

Meanwhile, Microsoft announced plans to lay off 5,000 employees. In making the announcement, Steve Ballmer, Microsoft's CEO, engaged in typically opaque execu-speak, saying "...we'll manage expenses and continue to invest in long-term opportunities to deliver value to customers...and we'll emerge even stronger..." I doubt I'm alone in not …

Anybody Want To Rent A Teleporter?

"Who is our customer?" Health care strategists, particularly in the provider sphere, deal with that question interminably, and often to no great purpose. Is it the patient? The patient's physician? The payer? Some higher power? All of the above? None of the above?

Here's one way to think about it: imagine if you awoke tomorrow morning to find all your physicians mysteriously teleported to some distant planet. Would your hospital remain a going concern? It wouldn't be a pretty picture, but after a period of dislocation you'd still have lots of people needing your services, directing their managed care organizations to send you money, blazing new trails to get the care they need at your facility.

Alternatively, how would the picture look if tomorrow you awoke and found your service area entirely empty of prospective patients, leaving you and your physicians to gaze at each other across empty waiting rooms and vacant surgery suites? I suppose you could re…

Cross Their Palms With Green

Have critics you want to silence? Buy 'em off, says Jacob Hacker, writing in The New Republic.
" what all other countries did when creating their national health programs: buy off the opposition. Britain's health minister was once asked how he had gotten doctors on board for the National Health Service. His reply: "I stuffed their mouths with gold." Money may not change everything, but it does make it easier to win friends, or at least divide and placate them."Of course, what works for heads of state will get a hospital CEO tossed in jail. Better check with your compliance officer first.

"Doctors Going Alternative" says a headline in this morning's Chicago Tribune. As the article notes, patients lead the way, voting with their feet and wallets in favor of therapies like massage, acupuncture and meditation. Now physicians are getting on board:
"The future success of the holistic complementary and alternative medicine (CAM) movement in the U.S. hinges on the very people who once viewed alternative medicine with cold skepticism: mainstream, conventionally trained doctors. Though many...believe medical treatments should be backed by rigorous scientific data, they will not rule out adding into the treatment mix mind-body therapies that have been used for centuries in other cultures. (Doctors) might suggest relaxation techniques when...stress is a factor, acupuncture for pain or probiotics for acute diarrhea."Moreover, there may be sound economic and public policy reasons for pushing the trend along:
"Five chronic conditions—mood disorders, dia…

The Hearst Corp: A Hard Act To Follow?

A major paper - The Seattle Post-Intelligencer - is put up for sale as a last-ditch attempt to see if it has any future at all. I don't live in Seattle or read the P-I, but I can't imagine their situation is much different from other struggling media properties.Nor are the explanations unusal or creative: revenues are down, expenses are up, the internet is draining away readership.

Funny, I didn't see "failure of vision" on the list anywhere.

The P-I's owners (currently the Hearst Corp.) might want to read this post from Seth Godin. In just six concise recommendations, he outlines a strategy for the New York Times that could work on the left coast, too. Built around enabling users to spread messages, using accumulated influence in new ways, building permission assets, keeping score, using stringers by the thousands, and creating new platforms for advertising, it all sounds so easy and obvious when Godin says it.

In Godin's words,
"Lots of organizatio…

The Choice In Front Of You

Grow or die! Every business is a growth business! The growth imperative! To read these slogans, you'd think growth is squarely on everybody's mind, every day, all the time. You'd be wrong.

Especially in health care, there's frequently a missing, albeit crucial step: DECIDING to grow! What's that you say? Of course we've decided to grow! OK, let's think about that for a moment.

What was on the agenda at your last all-hands leadership meeting? More importantly, what was FIRST on that agenda? Budget? JCAHO? Compliance? HIPAA? Quality? Satisfaction? Policies and Procedures? All important topics, for sure. But where on that agenda was BUSINESS GROWTH?

When was the last time you identified someone who managed to grow her business in spite of all the usual organized resistance and inertial drift, pulled her out of the audience and made her a hero? You do that for leaders who hit their budgets, don't you? For those setting the patient satisfa…

The Future's Uncertain...

I think of myself as a futurist which, by its nature, means I'm comfortable making predictions about what the future holds and the actions successful organizations ought to be taking NOW to get ready. Perhaps you, dear reader, and I are both more comfortable making and relying on predictions than we should be.
Prognosticating is a dicey business, as this Business Week article points out.
My favorites: "Freddie Mac (FRE) and Fannie Mae (FNM) are fundamentally sound.... I think they are in good shape going forward." — Barney Frank (D-Mass.), House Financial Services Committee Chairman, July 14, 2008

"In today's regulatory environment, it's virtually impossible to violate rules." — Bernard Madoff, money manager, Oct. 20, 2007
Good lessons, both, in looking for the story BEHIND the forecast, and understanding how much context matters.
Frank's utterance is, I think, more wishful thinking than forecasting, a sign of a man knowing his goose is cooked but hop…

Desperate Times Call For Desperate Measures

Michigan's economy has hit rock-bottom and taken health care along for the ride.  But now some Detroit-area hospitals figure growing their business is about the only option left.
They're re-engineering processes, showing new respect for their patient's time, offering door-to-door shuttles, expanding evening and weekend hours, discounting care - "7 tests for $70" is a great concept - and enabling more patient-doctor contact using e-mail and Blackberrys.
"What we're learning is you just can't hang out a shingle" for a doctor's office, says Dr. Mark Kelley, chief medical officer of The Henry Ford Physician Group. "We may have to be like malls and staff like crazy on the weekends."

My Parents Went On Vacation and All I Got Is...

...a peek at their surgical scars!
I ruminated about medical tourism a few posts below.    For those of you still holding yourself in the "unpersuaded" camp, let me add this: I know of at least one large health system developing high-end hospital facilities near equally high-end Mexican and Caribbean resorts.  
They're planned to be JCAHO-accredited and staffed with American-trained physicians and nurses.  They'll be modern, clean, shiny and new...and with a resort next door for the family, all two hours away from the U.S. mainland.  And their prices are still a fraction of what mainland hospitals charge.
Don't think patients will go to Bangalore?  Maybe.  But I'll bet they'll go to Cabo.

72 Million People Want To Know

The Wall Street Journal on what's new in health web sites;"The Internet has long drawn people seeking information about health care. Last year, health Web sites drew about 72 million unique visitors, up 14% from a year earlier, according to comScore Inc., an online-marketing research firm that tracks some 200 such sites. Such strong growth comes as sites increasingly focus on some of today's leading consumer health concerns, including prescription-drug safety, quality of care, and the ability to network with other patients facing similar health problems..."  (emphasis mine.) I think patient-to-patient networking is a powerful trend, feared by many practitioners but inevitable and, ultimately, empowering.
Here's the New York Times on PatientsLikeMe, an internet start-up that "may be a big step forward in medical science or just a MySpace for the afflicted."  Interesting.  Users seem relatively unconcerned about HIPAA or their physician's objections, vi…

WellPoint Invests In Medical Tourism

From the AIS Report on Blue Cross and Blue Shield Plans:"WellPoint's pilot program, called the Global Health Care Partnership, will allow employees of Serigraph to access benefits for certain common elective procedures at designated facilities in India starting in January 2009. Serigraph, a Wisconsin-based printing company, has 650 U.S. employees. The procedures include major joint replacement and upper and lower spinal fusion. "The U.S. retail price for knee replacement surgery is approximately $70,000, while the same procedure costs approximately $8,500 in India," says Razia Hashmi, M.D., chief medical officer for WellPoint's national accounts." (emphasis mine.) Providers ignore this trend at their own peril and, in my experience, most are paying scant attention.  Insurers like WellPoint are focusing these programs around the few high-margin services providers have left.  They're content to leave onshore all the unprofitable diagnoses - the sepsis and …

Good Candidates Needed!

I know times are tough for job-seekers out there.  In a modest attempt to help,  I've invited recruiters to forward opportunities to me for posting here on Health Care Strategist.  There's no charge to them or to you, dear reader.  And no expectations beyond paying it forward - connecting those looking for opportunities with those offering.  Good luck to us all; let me know if I can assist you in any way.
Please contact Gary Reynolds directly or forward the opportunity to a colleague:  
Recruiter looking for a strong, sales-driven individual with recruiting management experience for a senior-level position in southern California. Company is a travel nurse company; successful candidate will manage 6 recruiters and 2 remote sales people in other states. Compensation is open and a relocation package is available to the right individual. Contact Gary Reynolds at or 209-267-1115.

Nice Idea. Ten Years Late.

Preliminary reports paint a bleak picture for the recently-completed holiday shopping season. Yet, two retailers - Apple and - appear to have done reasonably well, considering.  
Among the many reasons given for their success, I'd spotlight the power of their brands, their unerring focus on making things easy and seamless for the customer, great design - products in Apple's case and an on-line shopping experience in Amazon's - and the consistent leadership of near-tyrannical CEOs who gleefully ignore Wall Street's slavering herds in favor of customer-centric innovation and rule-breaking.
As an aside, have you BEEN to an Apple retail store lately?  A retail strategy that wasn't supposed to work, couldn't work, shouldn't work...and then it did.

But the real, untold story of last month's performance is the YEARS Apple and Amazon spent relentlessly refining their visions, building their brands, connecting with customers, honing their services, inves…

Predictions for mHealth from David Doherty

Will mobile phones upset your thinking and upend your industry?  Maybe.  I'm working on a start-up idea for what I call "Consumer-controlled access to medical information" using Apple's iPhone as an authentication device.  David's forecast gives me some comfort I'm on the right track.
Some of the slides are hard to read, so here are the main predictions for how mobile phones will transform healthcare delivery in 2009
1.  mHealth will begin to supersede eHealth
2.  The Personal mHR will begin to replace eHR
3.  The Health Web Bubble won’t happen
4.  OLPC interest will shift to OMPC (One Mobile Per Child).
5.  SmartHome and Body Area Network initiatives will disappoint and focus will shift to mHome and Pervasive mTechnologies.
6.  A scientific paper will prove a mFitness application can offer greater Health benefits than regular gym use.
7.  Mobile Network Operators will start promoting Healthcare uses for Smartphones
8.  A 3G Video Calling service will be launched to s…

The Hyundai Assurance.

The Big 3 American automakers plead for government bailouts to fix an outdated business model.  I don't know; maybe hybrid and electric cars offer salvation from decades of strategic clumsiness, and maybe the bailout gives the Big 3 some breathing room to get there.  
But I do know the only true, long-term fix is a recovery in demand for new cars, a demand driven by consumers' confidence in their own economic future. No confidence?  No demand.
So it's interesting to see scrappy Hyundai tackling that problem head-on.  Hyundai says "Buy one of our cars.  If you lose your job or suffer some "life-altering circumstance" within the next year, bring the car back.   At minimum, it's an interesting experiment in shifting economic risk from the buyer to the seller, though exactly how much risk is transferred remains to be seen.
I'm not sure what the idea's immediate relevance is for health care.  Cars are 'goods' and health care is a 'service'…

Simplicity From Complexity

Health care planners typically juggle many different services and businesses, each with unique customers, competitors and prospects.  The complexity can be overwhelming.  So-called portfolio models for assessing industry attractiveness and competitive strength can be a good analytical jumping-off point, including the McKinsey-GE 9-box matrix. (Click on the "Launch Interactive" link.)