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Showing posts from March, 2009

Walgreens Offers Free Care... the unemployed and uninsured through the end of the year.
"Hal Rosenbluth, chairman of the Take Care Health Systems division, described the plan as something close to an experiment: He said Walgreens isn't sure of patient demand or how much providing the services might cost the company.

"It's likely to generate more attention for the clinics, however. Rosenbluth said a typical Take Care patient tells eight other people about his or her experience. So far, about 30 percent of Take Care patients were new customers to Walgreens."Also covered under the "free" umbrella is Quest Diagnostics, Take Care's medical lab provider.

Consumers have long memories, and tend to reward those helping out when help was desperately needed. I'll bet the experiment generates tremendous goodwill for Walgreens, goodwill that translates into loyal, PAYING customers when the economy improves.

Other providers will ask "What's so great about Walgreens? We'…

Wait! Wait! Don't Build That!

From San Francisco Business Times, health care futurist Wanda Jones advises hospitals to take a construction breather before hard-coding the past's mistakes into another generation of expensive facilities, sticking patients and taxpayers with the bills.
"Her solution: Before building giant new acute-care hospitals, invest in new multi-specialty clinical institutes that include physicians’ offices, related diagnostic and clinical services, and space to educate groups of patients with common chronic conditions. Sutter’s Palo Alto Medical Foundation is probably the closest existing entity. “Face the building with a fitness center and a health cafe,” Jones suggests. “Add a medical hotel.” Support innovations, like remote monitoring of patients with wearable vital-signs monitors. Provide case management from the outset to patients with chronic ailments. Use the Internet to communicate with them."Great ideas, but they require a risk-taking hospital board and CEO. Nobody ever …

Pure Poetry: NFPs Using Social Media

I'm No Genius But I Love A Bar

I hear health care providers talk about wanting to get better at retail. They should do themselves - and their customers - a favor and spend an hour in the nearest Apple store.

This is Oak Brook, IL, last week. The day was warm yet the heat was blasting, so the doors were open to the plaza, lending fresh air and a blast of Milanese Euro-cool to what is already a pretty cool place.

Most striking sight: a woman hurrying for her lesson at the Genius Bar, lugging her MacBrook Pro in a Tiffany jewelry bag. That's Oak Brook for you.

And the Genius Bar is itself pretty cool. What could you, dear health care leader, do with a Genius Bar in your lobby? You think health care consumers might benefit from a place where smart people solve problems, troubleshoot, offer advice? You think your "reception desk" does that? Trust me, if you do, you haven't been in an Apple store and seen the possibilities.

I purchased a $19.95 printer cable. The helpful staffer scanned both the packa…

Problem? Meet Solver!

"Instant Crowdsourcing for Companies – Cash Prizes for Idea People"

Have a problem you need solved? Are you an idea-driven problem-solver? Instant crowdsourcing awaits you at, where problems are connected with solvers and money awaits. What could be better?

Maybe they'll sell you a private-label version for your organization's internal use. Think how much more effective you'd be if you had all 5,000 employees and physicians offering ideas instead of just the few that happen to fit in the executive conference room.

Yay. Another Physician Satisfaction Survey.

Business Week magazine profiles a physician who'll leave his stethoscope at home, but regards his iPhone as mission-critical;
"Apple's (AAPL) iPhone has become a critical tool for saving time and improving the quality of the care Diamond provides, particularly when he's with patients, he says. Of 22 applications Diamond has installed on his iPhone, 10 are health related. The most important, he says, is Epocrates Essentials, which lets him quickly check for drug interactions, look up disease symptoms, and find out what lab tests he might need to order. "I don't have everything I need to know memorized," Diamond says. "This makes me look like I do."

"...Diamond's experience shows that using the iPhone in a medical setting doesn't have to be a complicated, expensive proposition. With the exception of Epocrates—which costs $149 a year, or $249 for two years—all of Diamond's medical applications were either free or cost less than $5 t…

Doubts On Digital Health Records

The EMR gold rush is on. Leading the "there's gold in them thar hills..." contingent are IT vendors sensing myriad opportunities to do what IT vendors do - build, consult, integrate, interface and implement, growing revenues at every turn. Pay me! Pay me!

Next in line are health care providers, suspecting (rightfully, alas) that they'll be bribed to do what they should have done on their own 10 years ago. Pay me too! Pay me too!

Here, from the NY Times is a refreshing perspective:
In the (New England Journal of Medicine) article, identified as a “perspective,” Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane portray the current health record suppliers as offering pre-Internet era software — costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements.

Instead of stimulating use of such software, they say, the government should be a rule-setting referee to enc…

Metra Gets Twittered

Are you a Chicago-area commuter wondering if your train is on time? Now your cellphone and Twitter work together to tell you, thanks to Tony Zale, an enterprising programmer working a few evenings and weekends.
"Metra was surprised to learn someone had figured out how to provide the service on Twitter for free, Zale said.

"Metra also was surprised Zale did it by working a few hours at night and on weekends, spokeswoman Judy Pardonnet said. Metra plans to award a contract for a train tracker service this year, she said."Notice that last sentence? Metra planned to PAY someone to develop the service. Instead, a customer working for free did it for them, using free tools. I wonder how many other customers are interested in solving shared problems at little or no cost to the organization? I smell an emerging trend and intriguing possibilities for leaders everywhere, regardless of industry.

How about an application to let you know if your physician is running on time for yo…

Build Me Something...

"Design an outpatient pavilion along with the necessary work-flows and processes that'll reduce costs per episode of care by 30%..."

Information across my desk today hints that this economic downturn is affecting health care construction spending to a greater-than-expected degree based on historical precedent. If you are a vendor to the health care industry (architect, facilities planner, contractor, equipment vendor, etc.) watching your project backlog evaporate, maybe it's time to change the rules of the game.

The game goes like this. Think about a major Fortune 500 company, say, Intel, spending millions of dollars on a new chip manufacturing plant. Can you imagine them doing so without knowing - to the penny - the new plant's impact on manufacturing costs? No, you can't.

So why is the game so different in health care? Have you, dear vendor, EVER had a health care client say to you "Design an outpatient pavilion along with the necessary work-flows a…

What's Over the Horizon?

Help your over-the-horizon foresight by paying attention to trends in the venture capital and start-up communities. To get you thinking, check out the links down a ways in the right sidebar, under the "Emerging Companies" header.

Here for example, from OneMedPlace's Med Tech Sentinel blog, you can read about developments in treating drug-resistant TB, a huge benefit for the estimated one-third of the world's population already infected, and innovations in mitral valve repair, offering less-invasive treatment options for thousands.

Nascent ideas, both, but two more "what if's...?" for health care strategists to plug into their models and begin asking the right questions, like...
How can we monitor these ideas and others like them?When could the idea reach maximum impact?What does the idea replace or substitute for?Are there partnership opportunities for early adopters?
What might this mean for our brand, our physicians and our patients?Are there other ways …

What Consumers Keep During A Recession

In "What Consumers Cling To In Lean Times," the current Business Week suggests why health care hasn't shown its usual level of immunity to economic downturns.

What are consumers clinging to? Hint: cellphones - yes. Cable TV - no.
"People have a fairly consistent game plan for dealing with a recession," says John Berry, a vice-president at GfK Roper Consulting. "The list of things they cut back on is very consistent, and that points to opportunities for grabbing people through those shifts in their behavior."

"People tend to eschew products deemed frivolous or overpriced. But that doesn't keep them from embracing new technologies—even items that carry high price tags. The condition, of course, is that the products are seen to deliver good value for the cost."It may be that health care's prices have finally gotten so decoupled from reality that consumers no longer see good value being delivered for the cost.

Saving The Planet, One House At A Time!

I'm starting a new business development project: assisting a friend with growing his company offering an innovative line of pre-fabricated green housing.

Several trends are coming together to make this the right idea in the right place at the right time: the Federal stimulus package and tax incentives for alternative energy, Mayor Daley's vow to make Chicago the greenest city on the planet, the need for affordable, environmentally-conscious housing and (not a moment too soon!) a cultural revolt against building ever-more bloated, exurban McMansions.

Very cool stuff. I'd like to live in one myself.

The Rise Of the "Spa-Spital"

From Springwise, here's an interesting start-up idea: in-hospital spa services for new moms, from Go Home Gorgeous:
"Minneapolis/St. Paul-based Go Home Gorgeous offers a variety of in-room spa services for new mothers designed to help them go home from the hospital feeling better than they did when they arrived. Available services include a "foot thanking" treatment...scalp, neck and shoulder massage...traditional body massage...and a postnatal body therapy package. Gentle massage, aromatherapy and soothing music are used to transform the hospital room into what the company calls a "Spa-Spital" room, where eucalyptus-infused steam towels, for example, decrease water retention, deepen breathing and increase circulation. After mom and baby are home, meanwhile, the company's in-home "Sleep Relief " offerings include night nanny, baby nurse and postpartum doula services—night nannies even arrive fully self-sufficient with their own cot, pillow, bl…

Free Speech For Me But Not For Thee

(Thanks to Nat Hentoff for the title, by the way.)

Blogger and BIDMC CEO Paul Levy spent a few moments this morning here on Health Care Strategist, leaving a comment taking me to task for accepting advertising from the SEIU. If you've read Paul's blog, Running A Hospital, you know there's a long-running, very public disagreement between BIDMC and the SEIU over a number of issues.

The ad in question is one of Google AdSense's context-sensitive ads, appearing when you click on one of several posts specifically mentioning BIDMC. To my knowledge, it's never shown up on the main page - at least I've never noticed it before.

The SEIU is obviously running a keyword-driven, anti-BIDMC web campaign. Purchasing BIDMC-related keywords is their right and, from their perspective, a smart, easy, low-cost thing to do. Were I Paul, I'd get my web team to do the same thing, only more so - more ads, bigger ads, better ads, more keywords, better response tracking, more pre…

The Last Dance

Wall Street and Washington both suffer from the illusion that what they do is life and death, all the time.

On that score at least, those of us in health care are mostly illusion-free, though, with so much focus on the business of health care, it's easy to forget that behind every strategy, every spreadsheet and PowerPoint presentation, there's a real person with fears and dreams, hopes and memories, and a last wish to dance one more time.

Don't forget it.

The Will To Power...In Marketing

Great article from strategy+business:"Measuring Your Way To Market Insight."

Authors Leslie H. Moeller and Edward C. Landry show you the path to analytical prowess - about your customers, your marketing and your ROI...
"As marketers move to a more varied, shifting mix of advertising and promotion, they are coming face to face with the lack of insight they have historically had about which media choices work well, why customers buy, and what returns will be generated by their spending. This lack of insight did not matter very much when marketers had no choice but to depend on television, radio, and print — the traditional mass-market media. Television’s gross ratings points (GRPs), which measure the percentage of a target audience reached by a particular advertisement, didn’t explain why particular ads or placements led to increased sales and others didn’t, but that combination of mass media and metrics was the only game in town. Now, however, there has been an explosion …

Marketing: The Disciplined, Organized Pursuit Of Revenues

ATTN: Health care marketers! It's never too early to plan for the day when your CEO demands more ROI accountability from you and your team. Customer Relationship Management (CRM) can make you a better, faster, smarter, more accountable marketing professional.

Learn more from Deloitte Consulting and Paquin Healthcare; they're inviting you to attend a free webinar on CRM for hospitals scheduled for April 1, 3:30 pm EDT.

Study Doubts Value Of Screening For Prostate Cancer

Studies reported in this week's New England Journal of Medicine question the value of routine screening tests for prostate cancer. Today's New York Times puts the data in perspective:
"Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose (a patient) has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life."Conclusion: for the occasional life saved by a PSA test, there is a substantial risk of over-diagnosis and over-treatment.

So much for adding "free PSA tests" to your list of "community benefits." And maybe health care planners should re-examine those rosy scen…

Every Business Is A Growth Business!

Blogger and CEO Paul Levy continues to updates us on BIDMC's progress toward resolving a budgetary shortfall with as few layoffs as possible. I'm sure his many constituencies appreciate his candor and transparency about the process and the difficult decisions ahead.

I hope that revenue growth is included somewhere in his deliberations. Addressing the expense side of the ledger, the BIDMC team's attitude so far is refreshingly "one for all and all for one." Still, add another admission or two each day and the picture gets a lot brighter.

An admission a day? I'll bet the 6,000 BIDMC team members could do that standing on their heads. Ask em.

Trends In Retail Medicine

Sg2's Bill Woodson on trends in retail medicine: (free registration required)
"The very crowded and diverse market that is Chicagoseems likely to embrace many models of primary care including retail clinics, urgent care centers, home monitoring programs, e-visits, the "medical home," concierge practices, federally qualified health centers (FQHCs), and the corporate clinic.

"Indeed, 5 years from now we will look back and note that this moment in health care was marked not by the "retail clinic" but by the aggregation and disaggregation of different value streams. In short, we are starting to adopt different models of channel management that have marked the evolution of every other part of our economy. What in the world does that mean? It means that we are finding opportunities to stick things together and pull things apart in ways that add value for different types of customers. The retail clinic, the e-consult, the cancer nurse navigator—and bundled pay…

Can You Pass A CEO Test?

From New York Times columnist Adam Bryant, interviewing Greg Brenneman, chairman of CCMP Capital:
Q. What do you consider the keys to effective leadership?

A. The most important thing is that you treat everybody incredibly well and lead with a bit of humility. I’ve found that when I go into a company to lead it’s important to have a plan and to make that plan a simple one that everybody can understand. So even before I go into a company, or even if we’re looking at a business here at CCMP, I’m constantly asking the question, “What are the two or three levers that, if done right, if pulled correctly, will really turn this business?” Then what I do is take that and put it into a one-page plan.A one-page plan forces you to separate the "vital few" from the trivial many." A very under-appreciated skill for a CEO...or anybody else for that matter.

What? You Think You're On The Board For Your Looks?

After being bailed out three times (and counting) and reporting the largest quarterly loss in history, AIG now says certain senior executives are legally entitled to $165 million in incentive compensation.

I doubt they're right though, in any case, I'd make 'em sue me to get the money. ( I hear Barney Frank is now on the case; maybe that makes you feel better than it does me.) Regardless, it's time to re-focus away from the actual bonuses, and ask who structured and approved such breathtakingly flawed compensation contracts?

Who legally obligated AIG to pay bonuses EVEN WHILE the company is crashing and burning?

Who memorialized the idea that executives deserve more, more and more, EVEN AS AIG's very existence hinges on continued taxpayer largesse?

Who signed those contracts saying "Yeah, we'll pay bonuses for a range of scenarios UP TO AND INCLUDING AIG reporting the largest quarterly loss in American corporate history?"

Someone on the AIG Board's …

How About A Discount? I'm Glad You Asked!

Interesting article in the New York Times about negotiating prices with health care providers. The Times is right: whether insured or not, consumers can and should negotiate prices.
"And keep in mind that doctors, hospitals and medical labs are accustomed to negotiating. After all, they do it all the time with insurers. A hospital may have a dozen or more rates for one procedure, depending on whether Medicare, Medicaid or a private insurer is paying the bill, said Ruth Levin, corporate senior vice president for managed care of Continuum Health Partners, a nonprofit hospital system in New York. Your request for a special arrangement will hardly confound their accounting department."Perhaps. I've seen accountants confounded by matters far less complicated, but let's not get sidetracked here.

Right now, dear marketer, there's more fiction in your hospital's charge master than on, more 'wishing and hoping' than at Victoria's Secret. But a…

No Layoffs!

Here's the best way to handle layoffs: avoid 'em in the first place. Paul Levy from Running A Hospital shows you how to address a $20 million budgetary shortfall, with town meetings to build employee engagement (read the comments Paul appended to the post) and a chat room (which he refuses to take down despite some snarky comments, apparently.)

Good for Paul and the BIDMC team.

More here, from The Boston Globe.

Go To Walmart For Milk, Leave With An EMR

From the New York Times: "Walmart Plans to Market Digital Health Records System."
"The company plans to team its Sam’s Club division with Dell for computers and eClinicalWorks, a fast-growing private company, for software. Wal-Mart says its package deal of hardware, software, installation, maintenance and training will make the technology more accessible and affordable, undercutting rival health information technology suppliers by as much as half.

“We’re a high-volume, low-cost company,” said Marcus Osborne, senior director for health care business development at Wal-Mart. “And I would argue that mentality is sorely lacking in the health care industry.”One observer calls Walmart's strategy "...a game changer." I'd call it the latest sign that health care's decades-long dithering about efficiency, quality, systems and processes is drawing to a merciful, customer-led close.

Can You See "Normal" From Here?

McKinsey defines the "new normal," post-recession: less leverage, more government, falling consumption levels, centers of economic gravity shifting toward Asia. And an opportunity-rich environment, favoring those with the foresight to see what has changed and what remains the same for markets, consumers and industries.

For health care leaders used to leveraging-up, the days of easy access to debt markets are probably over. Operating margins and retained equity will become the primary drivers of capital spending. Only those with the strongest balance sheets will find welcoming lenders.

And though the Obama administration appears firmly committed to re-making health care, improved access will come at a price: more scrutiny of methods and decisions and, overall, declining reimbursement to pay for the grand plans.

Baby Boomers, too, may slam wallets shut for some types of discretionary spending, but I'm betting their willingness to invest in maintaining and improving thei…

Close The Deal! It's NOT That Hard!

What do you say to a business, trying to gain new customers in a struggling part of the economy, that shoots off its own foot? I generally like The Wall Street Journal. Like it enough, in fact, that I thought I'd subscribe for a year. I'm not thinking that any more.

I receive The Journal's regular direct mail solicitations offering a year's subscription for about $100. Their web site offers a slightly higher rate, though still heavily discounted from normal. But since I live in what can be charitably called "The Boonies" I called their toll-free number to make sure daily home delivery is available. It is.

"What's your best rate for a one-year subscription?" I asked? I was quoted a rate nearer to $400 than $100. Apparently the lower rates are available ONLY to those signing up on-line.

Hmmm. So The Journal's direct mail teamspent all that effort convincing me to subscribe - wasted effort, as it turned out, when the call center team di…

"Investing In Health Care: Opportunities & Challenges"

"I'm of a view that great companies are founded in times like these."says Harry Rein, general partner of Foundation Medical Partners, speaking to a conference sponsored by the Connecticut Venture Group and the Connecticut chapter of the Association for Corporate Growth.

"The consolidation of practices and the disruption it causes will create opportunities for entrepreneurs," said Rein, whose company is a national health care venture capital investment firm specializing in early stage investments in the medical device, biopharmaceutical and predictive medicine technology sectors.

Speaker Michael Neuscheler, founder and chief executive officer of Ivyrehab, a chain of physical therapy facilities, said back-office support technology will be crucial to a health practitioner's ability to continue to provide services as workloads increase. "Billing and collection software will advance. I see that as an emerging field," he said, adding that physician manag…

"...Major League Middle Class Anxiety."

Knowledge@Wharton reports on a panel discussion about the prospects for health care reform.
"...a statistical backdrop for the panel's discussion: 42 million Americans uninsured, another 40 million under-insured, about 16% of the nation's GDP spent on health care. "Health insurance now costs 17% of family income," ... up from about 7% in the early 1990s... Despite all those dollars, though, "a third of what we spend on health care right now adds no value."It's that last statement that gets me. Though I agree the system contains huge amounts of slop, I'm also acutely aware that one person's "non-value-added spending" is the next person's - or lobbyist's - income. No medical pun intended, but the the streets'll be slick with blood before that debate is finished.

And here, futurist Joe Flowers echoes my " crisis comes opportunity.." mantra, advising that "The path out of crisis is the path to the futu…

Physician Ratings Meet the First Amendment

This is almost too hysterically funny to be believed. But apparently Dr. Jeffrey Segal, a North Carolina neurosurgeon, is totally serious. More's the pity.

Physicians are asking patients to sign what amounts to a gag order, giving up their rights to post comments on-line about the physician, "...his expertise and/or treatment."

I agree that the web sites in question are probably not the best information source for someone seeking a physician, though it's debatable whether they're better or worse than conversations over the back fence or after PTA meetings.

Do misinformed patients occasionally post an unfairly negative comment? Sure. Has an undeserving physician ever been praised? Without question. But whether falsely negative or falsely positive, anecdotes about errors are not evidence for much of anything, let alone insisting on a gag order before starting treatment.

Smart consumers (and that's many more of us than certain physicians think, apparently) …