Health Care Strategist

From The Dallas Morning News , social media keeps athletes involved and motivated.   As a triathlete blogging at Life Is A Tri I have first-hand experience with the benefits of building a tribe to provide ongoing encouragement and the occasional ass-kicking.

"You can build a strategy around empowering employees to solve customers’ problems—but it will challenge your organization from the inside. Freeing employees to experiment with new technologies, to make high-profile decisions on the fly, to build systems that customers see, and to effectively speak for the organization in public is not something most corporations or government agencies are accustomed to doing." From the Harvard Business Review article, "Empowered" by Josh Bernoff and Ted Schadler , also authors of a forthcoming book which you can buy over there to the left.  Highly recommended.

According to Consumer Reports, the top 5 biggest annoyances are: Hidden fees. Not getting a human on the phone. Tailgating. Cell-phone use by drivers. Incomprehensible bills. Do you care? As an organization, you probably can't do much about #3 and #4 beyond a strongly-worded article in your employee newsletter. Addressing #1 is out too, unless you like trashing one of your few remaining profit centers. More's the pity. As for truth-in-billing (#5), is there any specific reason your bills are incomprehensible except everyone else's are too and you're pretty content being mediocre? That leaves #2 and, from The New York Times , LucyPhone is a company founded on the assumption that you're not likely to make much progress there either. ( LucyPhone.com ) I guess the lesson here is that if you dither long enough, some smart youngsters will solve your customers' problems for you. Of course they'll also wreck your comfortable status quo and take for ...

As hospital marketers frantically shovel content out the door, counting activity as results, are they treating social media as little more than a bigger shovel?   Several related items caught my bleary-eyed weekend reading attention... First, I completely agree with Anne Zeiger at The nextHospital Manifesto that many hospital tweets are useless and stupid.  According to Anne, "Right now, many hospital tweeters seem to think that Twitter is just another channel for publishing the same dull content they’ve always produced, and it’s killing their public image. Please believe me, because I’m dead serious about this: It’s killing your public image in Twitter-land. Many of you are coming across as slap-happy, unresponsive and, forgive me, actually rather dumb. I know you’re not, folks; I’m just telling you how it looks on our end."  What Twitterverse behaviors does Anne recommend against? Community relations messages (like "Get your mammograms right here, right now.")...

The takeaway: Beware trusting what you didn't create and can't validate. I've wondered when risk managers would speak up on the liability risks of basing treatment decisions on EHRs.  Right about now as it turns out... From Mary Vanac writing for MedCity News, "Two Case Western Reserve University professors say potential software or hardware problems, as well as user errors, could make the systems liabilities. “'Plaintiffs whose alleged injuries are associated with EHR systems could sue healthcare providers for medical malpractice,' wrote Sharona Hoffman , professor of law and bioethics, and co-director of Case Western Reserve’s Law-Medicine Center, and her husband, Andy Podgurski , professor of computer science at the university’s School of Engineering, in their article E-Health Hazards: Provider Liability and Electronic Health Record System published in the Berkeley Technology Law Journal." Let's say you're an ER physician treating a patien...

BP proves once again that coming up with ideas is NOT the hardest part of innovation.  InnoCentive, an online crowdsourcing comunity , asked its global network to submit ideas for containing and cleaning-up the Gulf oil spill.  Nearly 1,000 ideas later, BP's response? Nah.   Thanks, but no thanks.  "Too complex and burdensome to add to already stretched workdays..." How often do you look at a new idea in your own organization and say "Man, that'll take a lot of work..."? (Thanks to FastCompany magazine for the heads-up.)

Concerned about "delighting" your customers?  Stop and think for a moment says Harvard Business Review; "The idea that companies must “delight” their customers has become so entrenched that managers rarely examine it. But ask yourself this: How often does someone patronize a company specifically because of its over-the-top service? You can probably think of a few examples, such as the traveler who makes a point of returning to a hotel that has a particularly attentive staff. But you probably can’t come up with many. "Now ask yourself: How often do consumers cut companies loose because of terrible service? All the time. They exact revenge on airlines that lose their bags, cable providers whose technicians keep them waiting, cellular companies whose reps put them on permanent hold, and dry cleaners who don’t understand what “rush order” means." In short, delighting customers doesn't build loyalty; reducing their effort with consistent service and rapid p...

Social media in crisis management and public health emergencies , from Lisa Gualtieri PhD, ScM and MedPageToday's KevinMD.com blog.  Tufts University and the Boston Public Health Commission used everything from Twitter to megaphones to get the word out about a major water main break affecting millions of Boston-area residents.

Wanna bet? From Hugh MacLeod at today's gapingvoid gallery: "EXCELLENCE IN EXCELLENCE "Just because you like saying the word in meetings, doesn't mean you're actually capable of reaching it yourself. In fact, the very fact that you're using it in meetings, probably means your (sic) not. "Excellence" was a big idea when Tom Peters wrote about it in the 1970s. Which is what makes the cartoon funny, thirty years later. Right now "Purpose" is the hot new marketing buzzword. In a year's time the very mention of it will make us cringe. Having been (in) the game for a while, I think all conventional marketers live by the same mantra: "No piece of language ever knowingly left uncorrupted."" Ouch. Buy a print for your board room.  It might be the best $125 you'll ever spend in there.

Robert Dudley, taking over today as BP's executive in charge of oil spill response, says this: “You learn in (a) fast-paced, unpredictable environment to stay calm, get organized quickly and make sure you can communicate across an organization so everyone knows the direction and remains committed.” Great advice for anyone caught in a crisis. (From The NY Times.)

Check out this SlideShare Presentation from Joel Selzer... Social Media's Impact on Healthcare - HCNM Keynote View more presentations from Joel Selzer .

...than to open one's mouth and remove all doubt. Grousing about those higher in the command structure is a time-honored military tradition.  But some derisive comments about civilian leadership just landed another military commander in trouble .  McChrystal's biggest mistake?  Letting Rolling Stone magazine anywhere near his team.  That's a bit like having the young gentlemen from "Animal House" plan your daughter's wedding. If "Never give interviews to journalists who aren't toilet trained." isn't Rule #1 in "Media Relations For Newbies," it should be. UPDATED: The scuttlebutt later today is that, inexplicably, McChrystal might've meant what he said and said what he meant.  If so, he should've chosen a closed-door meeting with his Commander-In-Chief to deliver the message. What's in your media playbook?  Contact me if I can help.  (healthcarestrategist@gmail.com)

From "The Bonafide Marketing Genius Strikes Again" blog , here's why Facebook matters to Ann Taylor and why it should matter to your organization: "People are talking about you (both online and off) whether you are participating in the social stream or not. Participating doesn't mean you have control over the message, but it does mean you have a voice. It also means that you have knowledge and information that you will NOT have if you continue to bury your head in the sand and complain about how stupid Twitter is or how annoying social media in general is." Get past worrying about how many 'friends' you have.   Start some conversations.  Learn something.  Build a few customer connections. 

Quote of the Day: "Accountable Care Organizations 'are a lawyer's and consultant's dream. Everyone wants to form one, and they don't know what it is, and neither do I.'" — Noah Rosenberg, a former HHS general counsel and now an attorney with Rosenberg & Kaplan, speaking at a recent ACO Summit in Washington, D.C. (Thanks to AIS's Health Business Daily for the heads-up.)

Do you remember the movie featuring a horror hotel described as easy to check into but difficult to leave...alive?  Expect a remake someday, but with a hospital setting. Improving post-discharge care and avoiding preventable readmissions is the subject of an article in  today's New York Times , finding that the process is often rushed, chaotic and uncoordinated. "Hospitals tend to focus their efforts on the admissions process, because that’s when the patient is most sick,” said Dr. Mark V. Williams, one of the authors of the (NEJM) study. “The discharge process can be just as important but rarely gets the same level of attention.” Dr. Williams is right about the focus but wrong about the reason - which has little to do with the severity of the patient's illness.  In determining why hospitals focus where they do, a good rule of thumb is always follow the money . Where does it lead?  Right to the admitting process, so critical to determining what a hospital is...

How much of your website's structure and content addresses your CUSTOMERS' needs and what THEY want to accomplish?  How much addresses YOUR needs and what YOU want to accomplish? Notice anything? Never assume that your customers' needs and your internal priorities are perfectly overlapped.  And always consider who pays your bills.

A few days ago we learned that, as a group, hospital employees are pretty unhappy. Well, their customers are no happier. Key Findings from Deloitte LLP's 2010 U.S. Survey of Health Care Consumers : 76 percent of consumers grade the system as “C” or below.  48 percent believe that more than half of health care money is wasted.   Less than a quarter (23 percent) of consumers believes they understand how the health care system works.  42 percent of consumers surveyed support government-required health insurance compared with 38 percent who say they are against it.  However, 42 percent say they would choose an employer-sponsored plan over the government’s (25 percent), all other factors being equal. Among the uninsured, a government-sponsored plan is favored (38 percent vs. 28 percent).  One in three consumers believes that the market needs 10 or more insurance companies competing to ensure consumer choice.  7 out of 8 consumers believe themselves to ...

An interesting way to visualize hospital quality performance , using an infographic produced by GE and Lisa Strausfeld at Pentagram .  Look up your favorite hospital...or the one for which you work. (Thanks to Fast Company magazine for the heads-up.) By the way, if you're interested in Strausfeld's work in "information-focused design" (and you should be if you're not) you may want to try that book over there to the left - "Envisioning Information" by Edward R. Tufte. From an Amazon.com review:  "This book will be really helpful to any web page designer, UI designers, statisticians, cartographers, scientists, or anyone concerned with presenting dense information in a clear way."   Don't waste time or money on "PowerPoint For Morons."  Most PowerPoint presentations are already sufficiently moronic, don't you think? Instead, spend an evening with Tufte's classic.  You'll think differently about turning informatio...

"...smart marketers will recognize (Twitter) as a stream of free consumer data to be mined in near-real time." says the article in Harvard Business Review . Authors Scott Berinato and Jeff Clark analyzed and graphed more than a half-million tweets relating to Apple's recent iPad launch and offer these recommendations: Learn about the competitive landscape.   Look for your brand and rivals, together and apart. Look for unexpected themes.   "Persistent words point to persistent ideas." Dig deeper into the stream.   Look for common words and word combinations. Look for user experiences.   An excellent place to prioritize product development ideas. Learn why negative words are coming up.   They may represent consumer "pain points" and the way to customer service improvements. Learn about conversation dominators.   They usually mean something important has happened. See Berinato's and Clark's analysis here.   Interesting stuff.

Look out your window.  WAY out your window, at emerging markets - Mexico, India, Rwanda. Does your hospital have an indigent care "problem?"  Might it really be an opportunity in disguise, an opportunity to develop more creative ways of delivering health care to populations unable to afford your "edifice complex?" Surely those models don't exist, do they?  Read on... Consultants from McKinsey conducted research in partnership with the World Economic Forum to study the most promising novel forms of health care delivery and, in particular, to understand how these innovations changed health care's economics. The takeaway: innovators—some from developing nations—have found ways to deliver care effectively at significantly lower costs while increasing access and quality.   Examples: "A Mexican telephone-based health advice and triage service available to more than one million subscribers for $5 per month, paid through phone bills. "In India, ...

"The Dartmouth Center studies repeatedly show that efficiency and effectiveness go together in health care. There is no clinical advantage to making the process more clunky, difficult and expensive. And more is not better in health care—doing more tests and more procedures actually correlates not just with added cost, but with worse outcomes. Efficiency, convenience and low cost are therapeutically effective. "This is the giant prize at the center of the labyrinth of changing health care: We could do it better for less. Much better, for much less. And more and more companies are heading straight for that prize." (From Joe Flower writing in H&HN Magazine) I was nearly evicted from a hospital COO's office last week for suggesting that what he counts as "success" - more filled beds, more procedures, higher intensity - should be seen as process defects elsewhere in the health care system.  A new generation of entrepreneurs (along with their venture c...

"...without engagement, there's no reason to be doing anything in social media." (Via Liana Evans and ClickZ.)

"$112 billion...in lost sales (a 4.3% decline) are projected for pharma manufacturers over the next nine years as the provisions of health reform begin to take effect, according to a new report from PricewaterhouseCoopers." ( Via AIS's Health Business Daily )

A friend sent me this video after reading the post below.  Dan Pink makes the case much better than I do and certainly more artistically!   Money is a motivator at work, but only to a point.  You need to pay people enough to take money off the table.  Once that's accomplished, autonomy, mastery and purpose take center stage.

From researchers at Press Ganey ( via Anne Zieger at The nextHospital Manifesto ,) hospital employees hate their jobs. And the usual responses - rejiggering pay, benefits and job content - have reached the point of diminishing returns. When confronted with Press Ganey's results, more than a few executive teams will survey their own employees and conclude "We're the outlier.  OUR employees LOVE their jobs."  A few of those teams will be correct.  Many more will be wrong, courtesy of the mathematics of "averageness."  In a normally-distributed world, not everybody can be above average. What to do? Maybe start with a simple goal: make work more compelling than bowling . (One of my all-time favorite blog post titles.  But you'll have to click on the link to see what I mean.) It's said that, as voters and citizens, we Americans will nearly always do the right thing...but only after exhausting all other options .  Now replace "Americans" ...

From The New York Times:  A new ad agency got involved and now memos are flying asking that employees call it 'Chevrolet' not 'Chevy.'  "...though the (latter) is one of the world’s best-known, longest-lived product nicknames." “We’d ask that whether you’re talking to a dealer, reviewing dealer advertising, or speaking with friends and family, that you communicate our brand as Chevrolet moving forward,” said the memo, which was signed by Alan Batey, vice president for Chevrolet sales and service, and Jim Campbell, the G.M. division’s vice president for marketing. “When you look at the most recognized brands throughout the world, such as Coke (sic) or Apple for instance, one of the things they all focus on is the consistency of their branding,” the memo said. “Why is this consistency so important? The more consistent a brand becomes, the more prominent and recognizable it is with the consumer.” Batey and Campbell are right about employees acting as brand am...

In a funny and thoughtful TED video, ad man Rory Sutherland says many flashy, expensive fixes are just obscuring better, simpler answers. To illustrate, he uses behavioral economics and hilarious examples. Sutherland's premise:  "...large organizations have actually become completely disconnected with what actually matters to people."  And "...our sense of self-aggrandizement (demands) that big important problems need to have big, important and expensive solutions attached to them." Sound familiar?  A hospital spends $100 million on a new bed tower because "patients demand private rooms."  Well, of course they do.  What other options did you give them? It's axiomatic that someone given $100 million to solve a problem will solve it quite differently from someone given only $1 million.  And, depressingly, there's absolutely no guarantee that the expensive fix will be the most effective. If you want to know how to better serve Medicaid pat...

It might be the moon's phase or maybe the Gulf oil spill has everyone in a screaming blue funk (I know it does me) but the week past's theme is best described as "We've no time for new ideas.  We're not thriving, in fact we're in total survival mode." To which, thankfully, I was tactful enough not to ask "Who the hell's fault is that?"  Because I knew what I'd hear:  "We tanked along with the economy.  We're getting killed by managed care.  The capital markets have slammed shut while our capital needs escalate.  Patients are putting off the health care they can't pay for.  Our volumes slowed while bad debt zoomed.  Medicare cuts are coming.  Medicaid's not paying its bills. We're coping as best we can."  Such a familiar litany, I've started calling it the Big Blah-Blah , the hospital CEO chant.  But do you notice anything? The excuses, er, reasons are focused externally, on the "out there."   ...

Says the Chicago Tribune in this article about an emerging trend in urban living . Full disclosure: I've served as a strategic advisor to Jeff Sommers and his firm Square Root Architecture .  The idea is well-positioned along a number of fronts: reducing construction and energy costs, improving affordability, in a gorgeous, urban-chic envelope, and all with the potential for creating dozens of new jobs as the factory (a former modular home and RV facility) gears up for volume production. For now Jeff is my client; someday I'd like to be his and build my own Urban-C3.  Now to locate an urban environment with a beachfront view...

Domino's tosses barbs at itself, and it is paying off - chicagotribune.com "You can't do candor all the time, but once or twice, it works." states Mac Brand, a consultant in Chicago for Bellwether Food Group Inc. My question: why can't you do candor all the time? And why shouldn't you?  Concluding otherwise implies a level of confidence in fooling a great many of your customers at least some of the time. How many leading brands are built and sustained on THAT foundation? Your customers are usually the first to find out about your lousy quality, not the last. So just whom are you kidding by not "doing candor all the time?"