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Showing posts from February, 2009

Shorter Stays = Lower Costs...In College

Some colleges are responding to the economy by offering degrees in three years instead of the usual four.

Is that a kernel of an idea for health care providers blessed with lower-than-average lengths of stay? Consumers understand that longer lengths of stay usually mean higher charges. Will they respond to a "Go THERE and stay 5 days; come HERE, stay 3 and save some money..."message, I wonder?

I'll sit back and wait for all the "Yes, but..." e-mails to roll in.

Weak Signals Amidst The Economic Gloom?

What if...this is the beginning of the recession's end?

In the midst of dire headlines - "...a nation on edge." (Chicago Tribune), "...Fed Chief Vows To...Stem Crisis." (NY Times), "...suffering a severe contraction." (Yahoo News) there's this from MarketWatch:

"...statistical evidence is mounting to suggest that the worst of this recession may soon be past."

And the author backs up his assertion with 21 data points - good news in some cases, less bad news in others.

You can't read everything and everybody, but a strategist's job is to find weak signals in the midst of noise and blather. To see through the headlines, understanding that their purpose is not to inform, but to sell papers.

And I figured you could use some good news today, weak signal or not.

Job Available...Leader Wanted!

(Please contact Marco Nozicka directly or forward the opportunity to a colleague.)

Home health care agency going through a restructuring is looking for an experienced health care leader, BSN preferred, 4+ years home health management experience working with multiple geographic settings. Locations in Florida and Texas. Candidate must be creative, have a strong focus on building relationships and alliances, be a customer-focused, out-of-the-box thinker with strong, ethical values, a passion for results and an ability to drive cultural change. Role requires a hands-on leader, comfortable with using data and metrics to make strategic and tactical decisions. Compensation is competitive and commensurate with experience. For more information, contact Marco Nozicka. (

If You Don't Earn It, You Don't Do it

Philip Betbeze, writing for HealthLeaders Media, talks about the "Great De-leveraging" and why organic growth matters now more than ever:

"The good news may be this: You're going to be judged going forward on how well you do the blocking and tackling with operations. If you're offering poor patient care and bad customer service, for example, it's not as easy to cover that up with cheap debt, new glittering patient towers and technology purchases funded on the same, and promises that bad financial and operating performance will be fixed with the new toys. Many hospital CFOs and COOs...are focusing more effort than ever in collecting what they're owed, improving processes, bettering patient care, and other basics that should have been at the forefront of their intellectual capital demands all along—and they're only talking about expansion or acquisitions that can be accomplished organically. Much of this transformation has been forced upon us, it's …

Building & Monitoring On-line Communities

Community-building is not new to health care. There's Y-ME (now known as Network of Strength) and Us TOO, Mended Hearts and Al-Anon and 315 others listed on this web site alone.

Despite all the experience, it can be challenging to add on-line virtuality to communities accustomed to face-to-face interactions. Still, it's a great way to extend your brand and reach new populations.

Here's an excellent set of guidelines to building an active, vibrant community, from Heidi Cohen at ClickZ.

"Everything You Know Is Wrong!"

At most, I understood 20% of this article. I did understand that the very core of modern physics - Einstein's Theory of Special Relativity - is threatened by certain implications of quantum mechanics. And I grasped that a generation of physicists is confronting the possibility that much of what they believed to be true is up for grabs.

It brought to mind a story about a professor beginning the first day of class by scrawling an apocryphal warning across the chalkboard: "Everything you know is wrong." Of course if that statement's true, it's also false. Messing with freshmen is child's play.

But what if the statement reflects more of reality than we'd like to admit?

We tend to make decisions about life and organizations through a certain lens, a framework that brings stability to our world. Unfortunately, the lens can turn out to be fogged with casual ignorance and selective, self-justifying history. We may have quiet, nagging doubts along the way.…

Maintaining Customer Service During A Recession

From Business Week Magazine:

Sure, consumers are stressed, but the service expectations of those actually spending money are running higher than ever.

So treat your best customers better than ever. Preserve front-line, customer-facing jobs. Invest in inexpensive, service-improving technology...Twitter anybody? Cross-train call center reps to minimize transfers and reduce overall talk-time. Plow cost savings back into service improvements like longer hours and weekend staffing. Gain economies in ways customers won't feel - grouping supply and other purchasing decisions, for example. Get tough on suppliers that don't measure up.

Even better, you might find the ideas working both in good times and bad.

And here are Business Week's customer service champions.

"Economic Collapse As A Change Agent"

From Health Leaders Media:

"...suggesting is tearing apart our old processes and rebuilding things in a way that makes sense; in a way that eliminates duplication and waste; in a way that is meaningful to our patients and physicians. That doesn’t necessarily mean fewer people working in your organization but it certainly means those people need to be doing very different jobs."

Succeeding With Web 2.0

McKinsey reports on a study of 50 early Web 2.0 adopters;
"To date, as many survey respondents are dissatisfied with their use of Web 2.0 technologies as are satisfied. Many of the dissenters cite impediments such as organizational structure, the inability of managers to understand the new levers of change, and a lack of understanding about how value is created using Web 2.0 tools. We have found that, unless a number of success factors are present, Web 2.0 efforts often fail to launch or to reach expected heights of usage. Executives who are suspicious or uncomfortable with perceived changes or risks often call off these efforts. Others fail because managers simply don’t know how to encourage the type of participation that will produce meaningful results."Six factors appear to be critical:
Visible support from the top.Best uses coming from users.Incorporation into daily workflow.Appropriate rewards, including ego-gratification.Targeting technology-savvy opinion leaders.Settin…

A Branding Rant

Thoughtful brand-builders should learn a few lessons from car makerGM's struggle for survival. Lesson #1: brand proliferation, once thought a strength, can quickly become a crippling weakness as too many brands clamor for limited resources and finite consumer attention.

One author suggested that GM retreat to two, possibly three brands - volume, luxury and heavy duty - Chevy, Cadillac and, maybe, GMC. Retreat to the core, to a position you can defend and, more importantly, a position from which to grow. Great advice, for GM and perhaps for marketers in the health care provider space too.

Many health care marketers struggle with the same issue, as facilities and service-lines claim a right to their own identity. Before you know it, there's a GENERIC Cardiac Center, the LOOKATUS Oncology Institute, and a METOO Neuro Complex. Multiply that by the number of hospital campuses and major "name" donors; it doesn't take long for resources to be spread miles wide and an…

Dumb Questions Are the Best!

I asked this question a few months ago but never got an answer. That upsets me, especially considering I live but a stone's throw from appliance maker Whirlpool's headquarters. So it's either march over there and pound on their door or torture you again, dear readers, and right now it's too cold to go anywhere. Sooo...

On days like today, with wind chills firmly below zero, why can't my refrigerator's contents be cooled with outside air instead of a running a compressor to make even more cold air? Don't give me all that EnergyStar appliance crap; I could cool my milk for FREE if someone figured out how to transport a tiny bit of that already-frigid air to where it can do some good.

Moving cold air into a warm environment is something my windows seem to do rather naturally. So what's the problem with appliance engineers, anyway?

Amenities Vs. Quality...

...which is more important to consumers as they choose a hospital? Research from RAND economists says plush accommodations might just trump high clinical quality."From the patient perspective, hospital quality therefore embodies amenities as well as clinical quality. We also find that a one-standard-deviation increase in amenities raises a hospital's demand by 38.4% on average, whereas demand is substantially less responsive to clinical quality as measured by pneumonia mortality."RAND may be right, more's the pity. As if further proof was needed that 4 decades of internecine warfare over health care quality - how to define it, measure it, improve it and communicate it - has left consumers utterly baffled about how to make quality-based choices. Depressingly, many old-school obstructionists seem to prefer it that way. They're the ones reading this research and saying "Told ya so! Consumers don't understand quality and they don't buy quality!"

Here's An Idea: Wayfinding Using RFID

A few years ago, I happened on a news item about a small town (Dutch, I think) that removed from its roads nearly all traffic signs. Lo-and-behold, the town's accident rate declined markedly. Too many signs and too much information produces too much competition for a too-tiny attention span.Result: clutter, confusion and cacophony.

And, regrettably, I'm forced to admit being old enough to remember a song with lyrics something along the lines of "Signs, signs, everywhere signs. Blocking the scenery, messing my mind..." Dumb song but an under-appreciated message for complex health care campuses everywhere.

How much have you spent on your organization's internal signage? How's it working for you? Do you ever sit in your main lobby and watch people walk in? Where do their eyes go? How long do they hesitate? Do they read your signs, not find the information they're looking for and then give up and ask someone how to get to radiology even though it's r…

I Tweet, You Tweet...

...even surgeons are tweeting from the OR.
"Doing this removes a real communication barrier. It helps make something scary much more comprehendable," said Christopher Parks, co-founder of the Web site "It brings us closer together and makes us more engaged."

"As time goes by and the younger generation moves into medicine, expect even more sharing online of private medical procedures, Parks says.

"Newer and newer generations are used to putting their life online," he said. "This generation shares everything."I think the younger generation's more-relaxed attitude toward sharing life's details will be revolutionary in many ways, posing a particular challenge to the HIPAA police's storm troopers.Why worry about medical privacy when your entire life is already YouTubed, MySpaced, Twittered, Blogged and Flickred?

Interestingly, the article doesn't mention the patient...was he informed? Did he consent?

On My Reading List...

"The Blue Sweater" by Jacqueline Novogratz.

Acumen Fund's Jacqueline Novogratz is truly one of the world's most innovative and dynamic thinkers. Her idea of "patient capital" - a melange of philanthropy and venture capital, is hard at work around the world, offering new opportunities to the world's poor and disadvantaged.

Now you know why Acumen Fund is listed over there in the sidebar under "Where I Find Ideas." You may find some there, too.

More On Mobile Health, From

Mobile health is starting to take root in developing countries.Initiatives underway include;
Collecting population-based medical information.Giving diagnostic and analytic tools to health workers.Delivering educational programs with airtime as an incentive.Improving medication compliance with SMS text alerts.Creating the "mHealth for Development" programme, co-sponsored by the UN Foundation, Rockefeller Foundation and Vodafone.Curbing the spread of epidemics.Gathering vital statistics in rural areas of Columbia.Embedding mobile phone chips in prescription bottles.Maybe I've missed something, but I don't hear much about these ideas where I live - in the so-called "developed" world. Perhaps it's easier to get things done when you're only fighting poverty and disease, not entrenched corporate interests who dog your every step.

Zagat Comes To Health Care...

...and, predictably, physicians hate the idea of being rated like, well, restaurants and hotels. Eeek!
"Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said he was skeptical about open forums evaluating doctors.

“There is no correlation between a doctor being an inept danger to the patient and his popularity,” Professor Caplan said. Reviewing doctors is “a recipe for disaster,” he said."I'm not sure consumers are all that good at evaluating bacteria counts in restaurant kitchens or fire-safety systems in hotels either, and yet somehow life goes will this debate.

Meanwhile, web entrepreneur James Currier is developing Medpedia, a free, online medical encyclopedia. Contributors will be limited to trained medical professionals, probably one reason this effort is garnering significant support from the medical community.
"(Currier...) has high hopes for the potential of the service to revitalize attitudes toward health care.…

Winning By Not Following The Herd

Michael Lewis's "Moneyball: The Art of Winning An Unfair Game" is one of the best books ever written about thinking differently in the pursuit of competitive advantage. Focusing on one baseball team - the Oakland A's - and their attempt to replace brute-force spending with cheaper, creative insights, the book offers the open-minded baseball fan an entirely new lens through which to see America's pastime.

Yesterday, Lewis turned his data-driven eye on the NBA, with an article in the New York Times Magazine about the Houston Rockets' Shane Battier, a forward who doesn't do most of the typical box-score things - score, rebound or dish out assists. Yet Battier's teams win abnormally often, much more often in fact than Battier's contributions seem to warrant.

In a stats-driven league, Rockets' General Manager Daryl Morey has come " think of (Battier) as an exception: the most abnormally unselfish basketball player he has ever seen. Or ra…

Open Source Funding, From Mark Cuban

Mark Cuban, occasional loudmouth, frequent blogger and full-time owner of the NBA's Dallas Mavericks, offers a unique opportunity to all those out there with a business idea seeking funding:
"...looking for an idea that hopefully could inspire people to create businesses that could quickly become self funding. Businesses that just needed a jump start to get the ball rolling and create jobs. Im a big believer that entrepreneurs will lead us out of this mess. I just needed a way to help.

"So here it is. Some people will love it, some will hate it. It is what it is.

"You must post your business plan here on my blog where I expect other people can and will comment on it. I also expect that other people will steal the idea and use it elsewhere. That is the idea. Call this an open source funding environment.

"If its a good idea and worth funding, we want it replicated elsewhere. The idea is not just to help you, but to figure out how to help the economy through hard work…

"What We Buy Is Garbage."

It's been said you can learn a tremendous amount from your most unhappy customers. If so, health care needs to pay attention to Dr. Paul Grundy, I.B.M.'s director of health care transformation.

"What we buy is garbage" says Dr. Grundy, expressing his vocal dissatisfaction with a system where costs and quality are totally decoupled - the former rising rapidly, the latter indeterminate.

Now, I.B.M. and UnitedHealth Group have formed a partnership in Arizona to give patients a "medical home" where care can be better coordinated. quality improved and costs reduced.

Eight ways to use video to support your marketing efforts. Educate. Inform. Capture knowledge. Transfer knowledge. Repeat.

Connect with remote sites or customers. Recruit new employees. Capture customer feedback. Orient new employees. Deliver wellness information. Summarize pre-admission instructions and post-discharge information. Extend your PR reach and news coverage.

Let your physicians introduce themselves and their practice styles to visitors on your web site. Teach basic health-enhancing skills like handwashing. Offer video tours of your fancy new LDRPs.

The "Layoff As Failure" Mantra

Do me a favor, will you? If you, as a health care leader, feel compelled by dire circumstances to lay people off, stand in front of your mirror before you do the deed and repeat the following mantra 100 times:
"I have failed. My business is performing just as badly as those around me because...I am unable to look for opportunities in a sea of difficulties...I don't understand how to execute a growth strategy....I failed to engage my employees' creative energies in helping us grow...and I failed to hardwire customer loyalty in distinctive ways. And now it's too late. I have failed. And so others must pay the price."Say it loud, say it proud.100 times. And then go re-write your vision statement to something closer to the truth, something along the lines of "We're no worse than anybody else."

So You Think Layoffs Are A Necessary Evil?

Here are 9 companies who disagree. Through January, all 9 had maintained a perfect track record of no layoffs, ever. They're in diverse industries, some you'd never think of as necessarily resistant to recessions or layoffs: retail grocery - a notoriously low-margin business, the boom-and-bust energy sector, and insurance.

It's nice to hear an organization say its employees are valuable. It's even better to find a few who, apparently, mean it.

RCA Works In Marketing Too.

(RCA: Root Cause Analysis.)

I blogged here about Hyundai offering nervous consumers a "no harm, no foul" right to return a new car within 12 months of purchase if the buyer loses a job and is unable to make payments.

Today, the news reports are full of carmakers' plunging sales except for Subaru (sales up 8%) and, you guessed it, Hyundai (sales up 14%).

Domestic and several foreign manufacturers - even Honda and Toyota - talk as if a turnaround is mostly out of their hands. They're in the "wishing and hoping" category - wishing and hoping for sales to stabilize or at least fall more slowly, for a bailout to arrive, for a few more months breathing room, anything. Sales, meanwhile, are in the tank.

Hyundai, on the other hand, stayed home from Washington and got after it, responding directly to the ROOT CAUSE of customers' concerns: fear of job loss.Lo and behold, sales are up 14%.

Go figure. Maybe this stuff works after all.

Did I mention Hyundai's sales…

Self-Adjusting Glasses

According to today's Chicago Tribune, an atomic physicist, playing around one day with a water-filled lens, may have discovered an inexpensive way to correct vision. Product: self-adjusting eyeglasses. Market: "...close to 3 billion people."
"Eyeglasses using Silver's simple, self-adjusting technology are now poised to revolutionize the way the world's poor—and quite possibly the rest of us—see, potentially coming to the aid of billions who struggle to squint enough to farm, study, drive or hold down any job."Cost? Maybe as low as $2 a pair once manufacturing volume picks up. And thus is another sector of a bloated, complacent industry threatened by someone thinking a bit differently, ignoring the old guard's objections and challenging the status quo.

How many more of these "holy cow" moments will it take for the health care industry to wake up and acknowledge a fundamentally changed world? The dinosaurs must've acted similarly on …

Cloud Computing

Once upon a time, when someone told you your head was in the clouds, it wasn't meant as a compliment. But now it may mean you're aware of an emerging business tool - cloud computing."...some companies are getting ready to dive in. Some form of cloud storage is likely to be a part of the data management plan now taking shape at Adventist Health in Roseville, California. It could be something as simple as hosting videos by hospital chaplains on YouTube, says Adventist CTO Greg McGovern. It makes no sense for a health care company to develop its own video player and hosting platform when it can take advantage of the most popular one on the market, he adds."

Patient Scheduling = Executive Learning

At a PPE (Prior Place of Employment) of mine, we offered the usual gamut of outpatient diagnostic imaging services - on-campus, off-campus, physician office-based, whatever. And, somewhat unique among providers at that time, we also offered a 24/7 centralized call center where patients (or their physicians) could schedule procedures based on their own criteria - perhaps a specific date or time, or the first available appointment at a specific location, even first available anywhere in the network.

I knew the system intimately; I was the executive responsible for its creation.The software worked as advertised - which is to say most of the time and pretty well. The call center staff was as dedicated and diligent as you could ever wish for. The problem? Well, much of the organization hated the concept and the flaws it exposed.

An under-appreciated benefit of scheduling centrally is learning which leaders and locations are out there hustling for business. You might think that'd be…

Google-izing Health Care

According to McKinsey estimates, the United States spends "about $650 billion more than might be expected given its level of wealth and the experience of similar countries." Spending on outpatient care accounts for two-thirds of that excess. Simply, Americans spend too much and receive far too little value in return.

Time for disruptive innovation in health care? In a word, yes!
"Using innovation management models previously applied to other industries, Clayton M. Christensen, a Harvard Business School professor, argues in “The Innovator’s Prescription” that the concepts behind “disruptive innovation” can reinvent health care. The term “disruptive innovation,” which he introduced in 2003, refers to an unexpected new offering that through price or quality improvements turns a market on its head.

"Disruptive innovators in health care aim to shape a new system that provides a continuum of care focused on each individual patient’s needs, instead of focusing on crises. …