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Radiation Therapy: The Crisis Continues

More from the New York Times on radiation safety (or the lack thereof.)  This time it's Evanston (IL) Hospital and problems involving three patients during identical stereotactic radiosurgery procedures.

Investigators found problems that should have been obvious to the rankest six sigma newbie.   Poorly-designed trays and mounts that interfere with an operator's ability to verify settings.  The need to "trick" the machine into thinking it was doing one thing when it was really doing something far more dangerous.  Complex components from multiple vendors, all kludged together.  Moving data from one computer to another and then to a third, each hand-off a failure waiting to happen. 

Says the article;
"(The) system is supposed to work this way: A treatment plan is developed on one computer, then transferred into another software system that, among other things, verifies that the treatment plan matches the doctor’s prescription. The data is then sent to a third comp…

The Week In Ideas, From Knowledge @ Wharton

Feeling the need to innovate?  Spend some time brainstorming alone before you convene that team.  You'll get further before the inevitable group dynamics kick in.

The adoption of social networking makes "crowdfunding" - a style of fund raising that taps support from fans and other interested parties - feasible even for the average citizen with a dream and some creative talent.

(Thanks to Knowledge @ Wharton for the heads-up.)

LifeSpring Hospitals and Acumen Fund: Saving India's Children

As part of their year-long focus on global health called "Be the Change: Save a Life," Good Morning America features Acumen Fund's work with LifeSpring Hospitals, just one of more than 50 Acumen Fund investments that are helping to change the way the world tackles poverty.  Watch the video...





Now ask yourself why the same level of solutions-oriented design thinking couldn't be applied to YOUR community's difficult issues. You may not want to offer an entire episode of prenatal and obstetrics care for eighty dollars but I'll bet you can create a whole lot of value for a whole lot less than the status quo.

Just begin by tossing everything you think you know in the trash.  What you think you know about your customers, their needs and preferences.  About boundaries and constraints.  About where to look for innovation and ideas.  Above all, lose your edifice complex.

Focus on addressing high-priority needs in sustainable ways. And remember, a model where surviv…

Teachers: The Wellspring Of Human Capital

Is human capital important to you and your competitive strategy?  Yes?  A good but incomplete answer.

In "Attracting and retaining top talent in US teaching" McKinsey & Company's Social Sector Practice addresses the questions of who should teach and how to attract more young people from the top tier of college graduates into the teaching profession.
"McKinsey’s survey of nearly 1,500 top-third US college students and current teachers, highlighted in the report, shows that a major effort would be needed to attract and retain the best students to teaching. The stakes are high: recent McKinsey research found that a persistent achievement gap between US students and those in top-performing nations imposes the economic equivalent of a permanent national recession.""...the economic equivalent of a permanent national recession."  Think about it.

Then think for a moment about the SOURCE of human capital. Can you create - through training, hiring or steali…

Thanks For Reading!

To all my readers, Thank You, Best Wishes and Happy Holidays!

Recent visitors include the following domains:
Ketchum Communications Cedars-Sinaithe Core Foundation Drake University HCA - Hospital Corporation of AmericaAccentureUniversity of Wisconsin - Eau Claire Blue Cross Blue Shield of Oregon Adventist Healthcare the Mayo Foundation For Medical Education and ResearchSacred Heart Hospital (Eau Claire, WI) BJC Health System Advocate Health Foote, Cone & Belding Communications McCann-EricksonEast Alabama Medical Center the Izaak Walton Killam Health Centre (Halifax, Nova Scotia) Edelman PR Harvard University the Rural Wisconsin Health Cooperative Arlington Hospital (Arlington, VA) Heidrick & Struggles Intl., Inc. Ingalls Memorial Hospital (Harvey, IL) Integris HealthCome back soon.

Quote (and Question) Of the Day

"There was no telling what people might find out once they felt free to ask whatever questions they wanted to." (Joseph Heller (1923 - 1999), Catch 22)

Is your team free to ask whatever questions they want?  No?  Why not?

As a leader, are you afraid of "what people might find out," in Heller's words?  Are answers reserved for your exclusive domain?  Does not having "all the answers, all the time" challenge your self-image? Think about it.

As always, what if...?  Why not...?  Follow me on Twitter.

PHOs As Transitional Models For ACOs

Still operating that PHO - Physician-Hospital Organization?  It may be a relic of 1990's-style managed care but I'll bet you learned many hard-won lessons along the way.  Don't give up now.

Instead, use it as a stepping stone to a successful Accountable Care Organization (ACO.)  Improve your risk-sharing models, add healthy doses of transparency and physician leadership, and you just might have something there.

While I'm at it, I spent yesterday in Chicago's western suburbs with a full day of meetings and networking. On one entrepreneurial project specifically, the discussion pointed out that my thinking on possibilities and potentials was WAY too constrained, by a factor of 10. Funny. I usually have the opposite problem, but in this case I'm thrilled to think millions, not tens of thousands. Thanks to all who helped with ideas and alternatives.

And the day concluded wonderfully in a meeting with a hospital that truly understands what "competing on analyti…

Am I Leader Or Legend?

Never mind the faulty math, the Big 10 conference re-brands itself as six 'Leaders' and six 'Legends.'   Let's see.  I'm a Wisconsin alum so I should care most about...Leaders...and which teams are those again?

As an audience, physicians can be pretty tough.  But messin' with college football fans takes real courage, especially with such a questionable idea.  Somewhere a branding consultant is frantically shopping for a Kevlar athletic supporter.

Isn't it amazing how many re-branding efforts go comically awry?  I recently gave Drake University a D+ for their recent re-branding, mostly because that's the grade they gave themselves.  What grade should we assign the Big 10?  Maybe an 'F' for the math and an 'Incomplete' because I predict they'll soon ditch 'L-squared.'

What might have happened here?  Well, notice Commissioner Jim Delany's comment in the Tribune article linked above:
"I know us. I think what we did wa…

Breaking Up Is Hard To Do...

...says the song.  Brand breakups resemble the fallout from failed romantic relationships, says Time.

Brand break-ups are worst when former fans (cults, anyone?) become angry at their one-time favs for misbehaving...and with themselves for ever believing in the brand.
"The people who lashed out the most...tended to see themselves reflected in the brands they once cherished and got the most hurt when the relationships ended as a result. “Those who felt that the brands were theirs had the most to lose essentially,” says (study author Allison) Johnson, a business professor at University of Western Ontario. “They became those same brands' biggest enemies.”'In short, it's the feeling of being made the fool that motivates some brand exes to turn mean. They'll trash the offender just to provide the necessary disassociation.

So, yes, build those brand loyalists.  Just don't ever let 'em down.

Privacy And Strategy: The Logical Link

Syllogism. (n) "A form of deductive reasoning consisting of a major premise, a minor premise, and a conclusion."

From AIS's Health Business Daily, medical privacy as a strategic syllogism: Major premise: Improving patient satisfaction is a strategic imperative for hospitals.Minor premise: Increasingly, patient privacy is "a key driver" of satisfaction.Conclusion:  Therefore, patient privacy is a strategic imperative for hospitals.Get it?  A strategic imperative, not just another unfunded mandate, a compliance issue, a problem for IT or Patient Relations to solve, something on which JCAHO insists or yet another "dumb, low-priority thing the government's making us do."

Strategy.  Strategic.  Imperative.  Interesting that legislators and regulators knew it before physicians and hospitals did.

More posts on HIPAA and medical privacy:

"What Part Of 'Give Us Our Damn Data' Do You Not Understand?"

The Parable of the High-Deductible Health Plan and the Careful Shopper

I carry - and pay for - my own health insurance now that I'm self-employed and don't have some rich health system footing the bill.  Though generally healthy, I do take meds for cholesterol and seasonal allergies, wear contact lenses and faithfully keep up with the routine screenings recommended for an old fart. 

My plan is a Blue Cross high-deductible plan where I carry the first $2,500 of financial responsibility.  Man, overnight that turned me into a different kind of patient and health care shopper.

No more Zocor for $90 a month.  Now it's WalMart's generic statin for $5.  (I've always hated WalMart and don't know which is worse; the price of setting aside that hate or the fact that the price is so low.)

No more going where my doctor tells me for lab tests and EKGs.  His in-house phlebotomist is convenient but pricey.  The hospital up the street is service-constipated, their billing is aggressive and nasty and their prices are worse - when they know what t…

World Class Oncology Programs

From the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins (via Becker's Hospital Review) here are seven keys to developing a world class oncology program.

How will you know when you've arrived?  Wondering what a world class oncology program looks like?  Here's Becker's list of 30 Hospitals With Great Oncology Programs. 

You're probably not on that list, but it doesn't mean you can't be.   What's holding you back? 

Top 10 Health Technology Hazards

From ECRI (via the Wall Street Journal's Health Blog) a list of the top ten health technology hazards around which health care facilities should focus their efforts.

In descending order of importance, the list reflects the volume of reported errors, their likely severity, the possibility of mitigation and the "high-profile" nature of the problem.

Interestingly, the report ranks surgical fires #9 on the list and says they're as common as wrong-site surgeries.

Other readings on risks in health technology, specifically radiation therapy:

Radiation Safety and Trust As A Business Strategy.

One In 20 Radiation Therapy Patients Will Suffer Injuries.


"...everybody has a plan until they get punched in the mouth."

(GE's CEO Jeffrey Immelt quoting that immortal philosopher Mike Tyson in an article about GE's recovery and new "making stuff" strategy,  in today's NY Times.)

Wikileaks - implications for EMRs? Definitely, says Dr. Westby G. Fisher.

Wikileaks' - implications for corporate data security?  Absolutely.  More, here, from Knowledge @ Wharton about what's called "...the first really sustained confrontation between the established order and the culture of the internet." 
"For companies, the WikiLeaks case may ultimately serve as a parable on guarding sensitive information. Joseph Turow, professor of communication at the University of Pennsylvania's Annenberg School for Communication, says the State Department cables released by WikiLeaks, while controversial, are perhaps more well-thought-out than most internal corporate communications. "If I were a CEO, this would not make me feel comfortable. I would be very concerned that this would happen in my company," he says. "The cables that have been released look incredibly tame compared to the e-mail that people send around corporations."'Though HIPAA …

Trendwatching.com's 11 Crucial Consumer Trends For 2011

Trendwatching.com's latest Trend Briefing outlines "11 Crucial Trends for 2011."  Health care trendwatchers might want to pay attention to Trend #6 - "Wellthy."

What or who are the Wellthy?  They're the growing numbers of consumers who are...
Expecting health products and services in 2011 to prevent misery if not improve their quality of life, rather than merely treating illnesses and ailments.Among the 73% of U.S. consumers who consider being physically fit important to being "well."One of the 500 million people worldwide expected to be using mobile health applications by 2015.The young people currently using the nearly 17,000 available health apps (almost none of which, incidentally, are provider-developed.  Whoops.  Another opportunity missed.) What can you do with this trend knowledge?   Apply it, of course, says the report.
Influence or shape your company's vision.Develop a new business concept, a new venture, a new brand.Add a new service…

Change The Way The World Tackles Poverty: Acumen Fund's Example

Acumen Fund is where problems meet dreams, ideas, entrepreneurs, innovation and "patient capital."

Investments, not grants. Sustainable solutions, not crisis du jour headlines.



Would this approach work in your community? On your big "impossible" problems? Why not?

Are there really any "impossible" problems?  Or just too-timid solutions?

What if...?  Why not...?  Oh yeah, that's me on Twitter. (@whatifwhynot)  Follow me and I'll follow you back.

We don't need a new hospital.  Wait.  What?
"I guess we can all figure out why UH and CCF are trying to out-duel each other, building expensive, redundant facilities that will be an enormous financial burden to our economy and population, both of which are shrinking and in distress."Uh-oh Smedley, I think they're on to us!

From MedCity News:  "One of the biggest issues today in medical technology is not regulatory, or reimbursement, or the burden of clinical evidence; it is the lack of a sufficiently clear understanding of the market and market dynamics."

Advertising: The Best (Or Worst) Of Times

Does advertising have a future?

Mad Men or just mad?  From Bloomberg Business Week: "We're not dead yet!" say the "lumbering advertising behemoths."

Boot Camp for digital immigrants.  From Fast Company: A moment of unsettling disruption filled with possibilities.  "There's never been a better time to be in advertising...or a worse time."

The Week In Ideas

First: the new age of nanomedicine.  "This type of imaging verges on Star Trek territory." (Medical News Today)
Why not...   Embrace the emerging opportunities provided by molecular imaging and photoacoustic tomography to improve the management of high-risk patients with life-threatening disease?  And ask whether this technology would be additive to your roster or what it might replace.

Next: artists and musicians will work for health care, exchanging their art for treatment.  An intriguing idea, though difficult to scale and not a long-term substitute for insurance. (Business Week)
You could try...   Replicating the O+ Festival in your community.  Or building an on-line exchange to connect artists with willing caregivers.
Finally, overhauling the states' long-term care delivery systems using innovation roadmaps from the Center for Health Care Strategies. (Medical News Today)

What if...   Care was transformed by learning from the examples of a few pioneering, boundary-pushin…

What would happen if employers walked away from health coverage?

Kaiser Health News reviews the scenarios and they aren't pretty; 
"The question, then, is how the reduction in business' health coverage subsidy -- $400 billion a year in the example here -- would be replaced, and what might happen if it isn't.

"...consider that a new dedicated tax of $400 billion per year would be an astounding five times the bailout and economic stimulus that, earlier this year, rightly or wrongly, raised the fury of the American people. Will we also be willing to bail out the health care industry, because it is "too big to fail?" (emphasis mine.) Finding the dollars to keep the current health system and the industry afloat would require a new national commitment of historic proportion, far greater than the recent Wall Street bailout.

"Either of these scenarios could result in massive public conflict and, equally importantly, significantly diminished resources for the health care sector. An inability to continue funding the indus…

Defusing Health Care's Ratings Bomb?

Back in September I posted an item, linking to a question from consultant Dan Beckham, about whether health care is the next big "ratings bomb."

The November 20-21 Wall Street Journal announced that Meredith Whitney, a prominent banking analyst, plans to set up her own credit-rating firm and is in the process of applying for a license to be a "nationally recognized statistical rating organization," or NSRO.

The article doesn't say whether Whitney's new firm will rate tax-exempt health care debt, though it'd be nice to see the Big 3 credit raters (Moody's, S&P, Fitch) facing some independent, intelligent  competition.

I think Beckham is right - there is a timer ticking in the health care debt market.  Too many hospitals adding too much debt chasing demand that even the dumbest politician now recognizes as unaffordable and unsustainable.  Anybody else worried? 

If history is any guide, the usual suspects will announce a crisis nine months after th…

Competition For Thee But Not For Me!

Venture Capital Returns To Health IT

From AIS's Health Business Daily:  Health care's venture capital chill may be thawing.

Lisa Suennen, a cofounder and managing member of Psilos Group says there's "tremendous interest" in the IT sector, though uncertainty about health reform and pending reimbursement cuts makes it "nearly impossible to determine which types of companies will thrive."

Investment sweet spots include:
Automating sales and support processes to reduce insurers' overhead and administrative costs.Patient safety applications, particularly those with potential to reduce medical errors.Assisting the newly insured with access to care issues, possibly in an OpenTable model .Helping employers transfer retirees from group coverage to private Medicare plans.Improving member health in the Medicaid population, estimated to increase by as much as 20 million beginning in 2014.Supporting Accountable Care Organizations (ACOs) once the funding model becomes clearer.(Please be aware that, t…

Creativity Under Siege

From Harvard Business Review, via Business Week magazine, blogger Teresa Amabile outlines the factors that keep creativity and innovation flowing.  Not surprisingly, her formula turns out to be pretty simple: the right people working in the right environment.

Says the article:
"We all wince at the thought of how Xerox utterly failed to innovate on PARC's inventions, allowing Apple and Microsoft to run away with most of them. But there's no denying how world-changing those inventions were. The organization that gave birth to them illustrates—by way of contrast—why so many of today's organizations are creatively sterile.

What made PARC so different from organizations where creativity falters? An abundance of all three key ingredients: Smart people who think diferently.Passionate engagement.A creative atmosphere."Amabile concludes by asking whether, 40 years after the birth of PARC, workplaces have gotten better at fostering that sort of brilliance?  For all the tal…

Medicare Cuts Pose Credit Risks For Some Health Care Companies

From the WSJ Health Blog: "Certain industries stand to face the sharpest cuts in government money, Moody’s says, namely home health, as well as oxygen and durable equipment companies. Hospice care, nursing homes and specialty hospitals are also expected to lose millions off what they receive now." 

A risk of building business models around chasing Medicare largesse is that this year's generosity has a habit of becoming next year's cost-cutting priority.  Better to focus on adding long-term customer value, assuming that what Medicare gives with one hand is soon taken back with the other. 

Now might be a good time for a cash-rich hospital or health system to round out their service portfolio with a couple of newly-inexpensive acquisitions.

Question Of the Day

Who gets recognized and promoted in your organization?  Those flogging the current business model to yield up its last farthing of value?

Or those pointing the way to the future's new businesses and value streams?

From Crisis...Opportunity

From MobiHealth News: AT&T offers WellDoc's DiabetesManager, a mobile phone-based diabetes management solution, to AT&T employees as part of a strategic alliance to jointly market DiabetesManager to the "entire health care system" including self-insured employers, payers and disease management organizations.

From Clickz: "Great companies embrace social media because they have nothing to hide and welcome everyone to discuss their products, services...social media requires more of a cultural change in companies than a strategic change."

From HealthLeaders Media: Consolidations involving for-profit hospital companies acquiring struggling not-for-profits are a growing and 'favorable trend, says Moody's.  

Seeking grant funding?  Prepare to be accountable for results, says Hospital and Health Networks."Increasingly, foundations are requiring objective evidence of specific changes in health status, behaviors and/or knowledge resulting from prog…

Nice Try! Now Knock It Off.

One of blogging's occupational hazards is comment spam.  In the guise of complimenting the author on his occasional perspicacity, spam comments redirect the unwary to offers for discounted medications and other useless drivel.

My tracking stats tell me that nearly all the spam comes from India, as highlighted by the above image outing a spammer from Tirupati, Andhra Pradesh, India...wherever that is (click on the image for a closer look.)   Bangalore, Hyderabad and Ahmadabad, Madras too, all have spammed their share.  So great to see an economic renaissance being put to such good use!

Thanks to Blogger's comment moderation feature, it's easy and quick to wax 'em into the ether where they belong.  They keep trying, I keep deleting.  Still, it's 30 seconds I'd rather spend dreaming up fresh things to say.  30 seconds a day...part of the price we pay for indulging the world's dipwads, apparently.

Change the World!

Starting with your neighborhood!

Architect Jeff Sommers will be a guest speaker for my "Materialism and Idealism" class on November 22, discussing his dream for a reformation in urban residential design. 

Here is a link to an article in Green Bean Chicago about Jeff's current project: a prefabricated, urban home meeting the criteria for LEED Platinum certification.  Meaning: really green and quite cool.  The Urban-C3 is built under climate and quality-controlled conditions in a factory near South Bend, IN, then trucked to the site and assembled in a day.

Forget everything you think you know about prefabricated construction.  It ain't just for double-wides any more!

Other links:
Square Root Architecture + Design on Facebook, including videos of the modules being built in  the factory.Square Root Architecture's blog.Project photos from Curbed Chicago.A Chicago Tribune article describing the project's long journey.A link to the Urban-C3 micro-site.As I've n…

Hospitals Using Social Media To Bolster Customer Service?

Inquiring minds (well, mine at least) want to know how your hospital is using social media as an integral part of a customer service strategy.

Specifically, how are you engaging on-line communities in proactive, problem-solving ways? What are you doing to solve problems before they become full-blown PR nightmares?  And how does your social media strategy support your efforts?

Are you doing it?  Trying it?  Planning it? Thinking about it?  Avoiding it? 

Let me know. Leave a comment or e-mail steve@t1resources.com.

ACOs Put Slow-Moving Hospitals At Risk...

From ACO Business News:

"The shift accountable care organizations will bring from pay-for-volume to pay-for-value — and their focus on total population management, closely aligned incentives and a degree of coordination among providers not typically seen in most markets — cuts to the heart of a hospital’s traditional business lines and operating margins. In the cards: Fewer admissions, shorter lengths of stay, fewer emergency department visits, and fewer procedures and tests. And experts warn that if hospitals don’t take a seat at the table, they could be at risk of losing one of their most valuable assets — their physician referral base...."


Are the Bugs Winning?

As bacteria get craftier and deadlier, the Obama administration considers incentives - tax breaks, patent extensions, etc. - to coax Big Pharma back into the antibiotic development business.

Serious stuff.  And next time you're at your doctor's office with what's probably a virus, refrain from asking for a Cipro prescription.  You're just contributing to the problem.  Keep it up and someday it won't work at all, maybe when you really need it.

Certifying Businessess As "Elder-Friendly"

Elders In Action certifies Oregon businesses as "elder-friendly."   Mystery shoppers assess factors like signage and menus that are easy to read, websites designed to be easy to navigate, seating that's convenient and at the right height, customer service able to handle questions like "I don't drive.  How can I get there by bus?"

How many hospitals would qualify, I wonder?

I'm Your Mystery Shopper.

Yesterday I happened to call a hospital where I toiled for 20+ years. You know the one.   It used to be the finest hospital in its area by a wide margin and still thinks of itself that way,  though the state's new quality database says otherwise.  It's doing the usual things passing as hospital strategy - shiny new buildings, highly-paid consultants, scripted customer service programs.  Acquiring hospital practices from any willing seller.  Tweeting and Facebooking.  Branding, logos, taglines.  Heck, they even hosted the Stanley Cup for a day.

Good for them.  Until it's time to execute against that pesky brand promise.

See, the stunningly misnamed "Information" Desk answered and promptly transferred me...to the wrong department. Several transfers later and with each getting further removed from my desired telephonic destination, I spoke with a woman who assured me she didn't know the number I needed, had no directory in which to look it up and, in fact, ha…
"Your idea doesn't have to be big. It just has to be yours alone. The more the idea is yours alone, the more freedom you have to do something really amazing. The more amazing, the more people will click with your idea. The more people click with your idea, the more it will change the world." (Hugh Macleod, How To Be Creative: 2, 08-22-04)
This quote recently took its rightful place at the top of my "all-time great quotes" list:

"A committee is a cul-de-sac down which ideas are lured and then quietly strangled." Sir Barnett Cocks (1907 - 1989)



We all need a map - a personal GPS - for avoiding that dark street.  Maybe this book can help.

Avoid Compliance Risks When Deciding How To Pay Employed Physicians

Wondering how to pay all those newly-employed physicians?  Stay away from methodologies based on charges or collections, says South Bend, IN attorney Bob Wade.

According to Wade, a much better and safer approach is a mixture of base salary - derived from major national surveys - and an at-risk component based on RVUs.

(Thanks to AIS's Health Business Daily for the heads-up.)

Because Life's Too Short To Live In Boring Houses!

From Jetson Green blog: construction of the first C3 Modular Home is underway in Chicago.  The brainchild of my friend Jeff Sommers and his firm Square Root Architecture + Design, the home offers numerous green elements such as Energy Star appliances, WaterSense fixtures, a mini-split HVAC system, multiple layers of insulation, high performance windows, and a solar thermal system.

Other features include;
"(An) exterior (featuring) a rainscreen application covered in reclaimed barn wood, fiber cement board, and painted metal siding.

The 2,000 square-foot home (has) four bedrooms and a private interior courtyard, which (draws) natural light into the interior.

Otherwise, C3 Modular will be built with FSC-certified wood framing, low-VOC finishes, paints, and sealants, and natural hickory and cork flooring. Also, six 50-gallon rain barrels will accumulate water for landscaping and garden use."Check out the photos.  Full disclosure: I've served as an informal strategic and f…

"We Can Be Heroes (Just For One Day)"

Does your organization have heroes? Who are they?

Those who hit their expense budgets or those who delight customers and grow revenues?

Those with zero customer complaints or those who realize that a complaint is a 'gift' - a chance to improve?

Those finding fault in every difficulty or those uncovering opportunity in every difficulty?

Those for whom "It's new, untried and innovative" is an idea-killer or those for whom it's a discussion-starter?

Those grumping 'why?' or those cheering 'why not?'

The 'plodding risk-avoiders' or the prudent risk-takers?

Who did YOU recognize at your last leadership meeting?  And what signals did it send?

Follow me on Twitter at @whatifwhynot.


What A Team!

Spent part of the day with a colleague in Chicago's western 'burbs discussing consulting opportunities. Great ideas shared. Thanks George!

And with a tri-training coach discussing my business plan and assumptions for a triathlon-related e-commerce venture. Great ideas shared. Thanks Joe!

And with another consultant brainstorming about creating an innovative business incubator for a large health system. Great ideas shared. Thanks David!

And a long conference call with a managed care thought leader and consultant as we pondered the pros and cons of responding to an RFP to help one of America's largest states confront health reform's implementation challenges. Great ideas shared. Thanks Bill!

Notice a theme here?

Where Is "Business Growth" On Health Care's Agenda?

Former "car czar" Steven Rattner, writing in yesterday's Wall Street Journal, says this about the auto industry:
"For any company with a competitive line of products in a business where fixed costs are high and market share tends to shift only gradually, total volume is the most important determinant of profitability."High fixed costs.  Gradual shifts in market share.  Might that also describe health care?  I think so.

Sure, be seamless, safe, cost-conscious, accountable, value-driven and integrated.  Just make sure your priority list includes business growth.

And remember that the basis for competition in health care is changing, and growth may require pulling different and unfamiliar levers.  Acquiring new skills.  Creating insightful metrics and customer feedback loops.  Identifying emerging value streams and risk assessment methodologies.

Rest assured that when health care has finished yet another round of cathedral-building, generations of leaders will surv…

Crowd Accelerated Innovation

When hospital CEOs wonder why nobody cares about their fancy new strategic plan, I answer that they likely have an engagement problem, NOT a communications problem. Simply, people are more engaged in what they helped create.

So is "crowdsourced innovation" a worthwhile addition to the health care strategist's toolkit? What if you tried this during your next planning cycle? Might you move the "engagement and buy-in needle" to something on the high side of "modest?"

TED's Chris Anderson says 'yes.' The rise of web video is driving a worldwide phenomenon he calls Crowd Accelerated Innovation -- a self-fueling cycle of learning that could be as significant as the invention of print. But to tap into its power, organizations will need to embrace radical openness.

Does A CEO Walking Through A Forest Make A Sound?

Also from Business Week: If a CEO yells "innovation" in a forest while everybody else covers their ears, did s/he really yell anything at all?

Turns out you also need believers, leaders (probably from outside your industry), a tolerance for failure, lots of experimentation and learning, your own "innovation language" and an acute awareness of when to give up and move on.

ExpertConsensus: Second Opinions For $20,000

A few days ago I wrote about the second opinion program offered through Partners HealthCare System, Inc's Center for Connected Health.

Business Week spotlights another second opinion program with a decidedly different business model.  For a fee of $20,000, ExpertConsensus convenes panels of top specialists in a teleconference format to "generate treatment plans for people with confounding illnesses."
"ExpertConsensus Chief Executive Officer Richard D. Forman maintains that his nine-month-old company has "no direct competitors" because it performs the dirty work of gathering documents, recruits top doctors, and minimizes institutional bias through its panel approach."Since January, ExpertConsensus has "seen" 12 clients.  Though Forman maintains his company has no real competitors, prospects may not see it that way.  A second opinion from Cleveland Clinic's MyConsult Online Medical Second Opinion service is $565.  And it's free if your e…

Report: Technologies To Improve Transitions From Hospital To Home

Health care faces many difficult decisions and transitions to improve care quality, maximize efficiency, and enhance patient experience.  And it's where one process or level of care connects to another, the so-called 'handoffs' that represent fertile ground for improvement opportunities.

The Center for Technology and Aging has released an interesting report examining technologies that help improve transitions from hospital to home and reduce readmissions;
"Several technologies are widely available and have potential to support post-acute care transitions, but they are underutilized," said David Lindeman, Ph.D., Director of the Center for Technology and Aging. "Home-use technologies help decrease readmissions in a variety of ways, including engaging patients and caregivers in ways that promote better communication, medication adherence, and monitoring of chronic conditions."Download the complete report at http://www.techandaging.org

The report covers four…

The Predictive Value Of Social Networks

After mapping humans' intricate social networks, Nicholas Christakis and colleague James Fowler began investigating how this information could better our lives. Now, he reveals his hot-off-the-press findings: These networks can be used to detect epidemics earlier than ever, from the spread of innovative ideas to risky behaviors to viruses (like H1N1).

Rare Disease Community On MEDPEDIA Platform

A recent Mayo Clinic-hosted forum on innovation produced the recommendation to apply the "free" or open concept to health care, in forums called "collaborative care networks."  These networks - large databases, really - offer doctors, patients and researchers ways to enter, search and access a vast pool of clinical and anecdotal data unavailable to any one person or institution.

I don't usually reproduce press releases wholesale, but this RareSpace announcement from Medpedia seems to fit this innovative concept;

MEDPEDIA PLATFORM EXPANDS WITH ADDITION OF RARE DISEASE COMMUNITY RareSpace Leverages Medpedia’s Technology Platform SAN FRANCISCO, CA (June 29, 2010) –Medpedia today announces RareSpace, an online knowledge sharing platform designed in partnership with the R.A.R.E. Project and the Children’s Rare Disease Network to advance research and share information about the rare childhood diseases that affect 22.5 million American families. This resource is availabl…

Is Health Care the Next Ratings "Bomb?"

Sure, the rating agencies missed the meltdown of real estate and financial services.  But hospital and health system ratings are solid, right?

Maybe not, says Dan Beckham, writing in H&HN Magazine.  Beckham's "Bond Rating Delusion" should give you some pause, whether you're issuing or investing.

I've been through several so-called "due diligence" processes for ratings reviews and mergers (the latter twice as the acquirer, once as the acquired.)   In that admittedly limited experience, I've found the process stunningly haphazard and superficial.

I remember our acquirer demanding a full audit of our managed care contracts, an activity I took seriously since, at the time, I was the system's executive in charge of managed care contracting.  We spent days preparing, gathering information on contract terms and performance, making sure it was all organized just so.

The appointed hour came.  A junior attorney showed up in my office, paged desultorily…

Second Opinion Program Aims to Improve Cancer Care

From Angela Mass, writing for AIS's Health Business Daily:
"Recognizing the importance of getting an accurate cancer diagnosis from the beginning, a handful of companies are taking advantage of a program that gives a second opinion to people who have a cancer diagnosis. Offered through Partners HealthCare System, Inc.’s Center for Connected Health, Partners Online Specialty Consultations is a website that offers second opinions from specialists at a Harvard Medical School-affiliated hospital."Supermarket chain Hannaford Bros. Co is an early client, motivated, in part, by discovering thatlocal physicians were following National Comprehensive Cancer Network (NCCN) guidelines only 30% of the time.

According to Bill Sullivan, principal consultant for Specialty Pharmacy Solutions LLC,
“...There is a direct corollary with cost containment (e.g., not wasting dollars on an ineffective protocol). Patients would be better served by being prescribed the presumed most efficacious prot…