Health Care Strategist

...in a rear-guard action?  From ClickZ : "Sure, the old guard (in advertising) may talk the talk, but the numbers seem to say that they don't know what they're talking about. A recent study by Alterian found that seven out of 10 marketing professionals admit to having little or no understanding about how their brand (or their clients' brand) is being discussed in social media. Let me say that again: 70 percent of people who do marketing for a living have no knowledge of what's going on with their brands in the social media space!" I haven't read Alterian's study in great detail, but neither do I have evidence that a 70 percent clueless estimate is too high, especially in health care. Is it that they don't know, or don't want to know?   The old guard grew up believing that they were the conversation or, at the very least, were firmly in control.  They talked.  We listened, awestruck. On some level, they probably knew that conversations...

We're coming up on an anniversary of sorts, an anniversary of the day I attended a charrette and nearly caused a riot. See, I was representing my then-employer at a two-day planning retreat (also called a charrette) on the subject of building a statewide health information network, known generically as a CHIN or a RHIO. More than 100 leaders had gathered from hospitals, physician groups, payers, the ranks of tech and IT gurus and various levels of government, all with the purpose of moving the discussions from concept to something implementable. As the festivities drew to a close, despite the group's best efforts, no compelling value proposition existed for the network. No statement of clear benefit emerged.  There was certainly no hint of how life could be improved for the end user (i.e. the patient.)  Even worse, the group's only funding plan consisted of the relatively few hospitals in the room each writing a big check. Aspirations were running high.  Specifics...

Does the notion of an Apple-like growth platform - an ecosystem, really - transfer to health care?  It's a theme I'll be developing over the next few weeks. Here's the New York Times on Apple's growth platform ; "The software and services that work on Apple’s hit products are accelerating its extraordinary expansion. Apple provides the underlying technology and marketplace: iTunes software and the iTunes Store for managing, downloading and buying music and media; iPhone and iPad software for creating applications; and the App Store for sampling and buying them. "The more people buy iPhones and iPads, the more software developers and media companies want to write applications for them, as various as games and digital magazines. And consumers are more likely to buy iPhones and iPads when more entertainment and information applications are available on them. The combination of hardware, software and services is what corporate executives, economists and anal...

Answer: "It depends on the day, and it depends on the options."    The New York Times reviews the increasing fluidity of racial and ethnic identities.  Says the article; "According to estimates from the Census Bureau, the mixed-race population has grown by roughly 35 percent since 2000. "And many researchers think the census and other surveys undercount the mixed population. "The 2010 mixed-race statistics will be released, state by state, over the first half of the year. “There could be some big surprises,” said Jeffrey S. Passel, a senior demographer at the Pew Hispanic Center, meaning that the number of mixed-race Americans could be high. “There’s not only less stigma to being in these groups, there’s even positive cachet.” Why might this matter to health care marketers?  Right off the bat, it complicates the interpretation of census data.  Demographic targeting, common in health care, relies on differences , on segments being either this or that b...

"It seems to me that people have vast potential. Most people can do extraordinary things if they have the confidence or take the risks. Yet most people don't. They sit in front of the telly and treat life as if it goes on forever." (Philip Adams)

Non-compliant. Non-adherent. Covered lives. Adverse events.  Medical loss ratios.  Show up at any discussion forum where health care's professionals gather and you'll likely hear these terms used ( and others equally jargon-heavy ) to describe the industry's customers. In this post the other day I said words matter but actions matter more.    Sometimes, frankly, words get in the way.  This is one of those times, a time for ruminations about change, cultures, linguistics and customer engagement.  Bored yet? It goes like this:  Language matters to engagement, engagement matters to customers and customers matter to us.  So language should matter to us, should it not? Health care organizations are furiously thinking through Obamacare's impact and opportunities. And in the best "Back To the Future" fashion (as if it's 1995 and called Hillarycare) many aspire to become "Accountable Care Organizations," accepting financial and clinical risk fo...

With a flattening revenue growth trajectory, it's always tempting (and usually more fun) to blame external forces.  Fingers point 'out there.'  It's 'them!' The music industry blames piracy,   the better for minimizing their strategic mistakes while pleading that endless quests to find the next body-jiggling, platinum-selling pop diva are really "talent acquisition" and darn hard work. Now, I'm no pirate (as my monthly iTunes bill will attest.)   But somewhere there's a lesson to be learned when an industry's customers act like "free" is an appropriate price.   What is a transaction, after all?  Consideration given for value gained? A lesson to be learned.  An edifice complex to be maintained. With health care, the external forces of darkness are usually declining reimbursement. "We need managed care and Medicare to pay us more" goes the cry.  Well, sure.  Who wouldn't like their customers to fork over mo...

From Seth Godin: "It's a lot easier for an organization to adopt new words than it is to actually change anything."  Yes, words matter, but less so than actions matching the words.  Something to remember the next time your boss suggests a re-branding, a revised logo or a new tag line.  If there's an issue at all it's more likely a performance issue.  Do the hard work first and branding becomes easy.

Can innovation cure what ails us? It better. We've tried everything else. Innovation in primary care , from Hope Street Group: "Using Open Innovation to Reinvent Primary Care: White Paper."  Download the white paper here. Innovation in state-level health care , from MedCity News: "Obamacare is spurring healthcare innovation in the states."   Example:  Utah. " The House Republicans and three Democrats who voted to ’repeal and replace’ it with something that provides ’lower health care premiums through increased competition and choice’ might want to take a look at Utah. Its new internet-based insurance exchange was designed by free-market advocates." Innovation in robotics and room design , from CNET News: Medical robotics come to Kaiser Permanente's Garfield Center for Innovation.   Interesting photo gallery of the health care giant testing robotics and new, more efficient hospital room designs.

"There is always a well-known solution to every human problem--neat, plausible, and wrong." (H. L. Mencken (1880 - 1956), Prejudices: Second Series, 1920) Seems like a Mencken kind of day, doesn't it?

Time to thank a few more readers, notably, Franciscan Hospital, Cincinnati, OH Renown Health, Sparks and Reno, NV Core Foundation, Chicago, IL University of Pittsburgh, PA GE Medical / UK UBS, London, UK New York State Health Department, Albany, NY Mercy Hospital / Medical Center, Des Moines, IA Alliance Life Sciences Consulting Group, NJ Catholic Health Care West, Mission Hills, CA Global Capacity, Dallas, TX University of Minnesota, MN Citgo Petroleum Corporation, Katy, TX Bloomberg, London, UK Press Ganey Associates, South Bend, IN Candid Health Care, Houston, TX Northwest Hospital Center, MD Grady Memorial Hospital, Atlanta, GA BrainBank, Inc., Montreal Last but not least, thanks to the Guardians of Life, Liberty and the Pursuit of Happiness at Cyveillance , a Washington D.C. company billing itself as "The World Leader In Cyber Intelligence..." for visiting a recent post in which I used some unkind words - including 'fraud' - to describe the te...

WSJ Health Blog: Medical Technology Innovation Shifts To Emerging Markets . "...med tech innovators are increasingly going outside the U.S. “to seek clinical data, new-product registration and first revenue,” and that U.S. consumers “could eventually be last in line” to benefit from med tech advances. And...developing nations are becoming “the leading markets for smaller, faster, more affordable devices that enable delivery of care anywhere and help bend the healthcare cost curve downward.” "They’re able to do so because they aren’t saddled by the “entrenched health-care system infrastructure that seeks to maintain the status quo.” (emphasis mine)  Since that entrenched health-care infrastructure isn’t likely to disappear any time soon — nor do we likely want to swap our entire system for that of a developing country — one key step is to “rethink our reimbursement system..." Let's see.  On a per-episode basis, many international options cost significantly less t...

H&HN Weekly: Dan Beckham on "Defining the Brand." "If a brand stands for anything, it stands for consistency...(and) that's why most health care brands are so vulnerable. "Apply the test of consistency to everything you know about hospitals and physicians. How consistent are they from department to department, floor to floor, unit to unit, practice to practice? A long tradition of inconsistency lies at the heart of many of the quality and cost problems that bedevil health care today. (emphasis mine)  Inconsistency makes a product suspect, and no strong brand can be built on the shaky foundation of a flawed product. To build a strong brand, you first have to build a strong product. Absent strength in the product, a brand is a hollow claim, a kind of lie." A respect-worthy brand reflects that which the organization is CAPABLE of delivering and WILLING to deliver...consistently.

AIS's Health Business Daily: "US Oncology May Go National With Private-Sector Accountable Care Organization." "Leonard Kalman, M.D., who is one of several medical directors for the huge for-profit oncology practice-management firm and chairman of the board of managers of Miami-based Advanced Medical Specialties, says that he thinks US Oncology-affiliated practices as a whole, including his, are interested in exploring such commercial ACO-like ventures. In fact, he says, a major hospital in Miami has approached his 40-physician practice about handling cancer care in such a way. “Our ACO partner is a dominant hospital system where we put basically all of our patients,” he says, declining to name it. "When cancer becomes the primary diagnosis, the oncologist basically handles the patient’s primary care, Kalman explains. “Remember, the majority of an oncology patient’s care is cancer care,” he says. So while ACO patients may require occasional care from other so...

New York Times :  Johnson & Johnson "...looks like a plane spinning out of control." An ongoing case study in how to damage a trusted brand. Also from the NYT : Warby Parker defies conventional wisdom to sell prescription eyeglasses online.   You shouldn't sell eyeglasses online.  Consumers won't buy.  Wait.  You are?  They are?  Whodathunk?! Chicago Business: More hospitals posting ER wait times online.    I recommended this to my then-employer a decade ago.  The ER docs are probably still twitching.  Can somebody explain to me why it's horribly risky for a hospital to be years early, but OK to be years late? CNN: WikiLeaks now promising to reveal Swiss banking secrets , including those of 40 politicians and "pillars of society."   Think everybody loves you?  Think again.  What secrets are at risk in your organization?  Is your approach based on locking-down information?  Or, at all times, ...

WaPo: Are "robocalls" part of your customer contact strategy? Get ready for robo-revenge .

Seth Godin: "...how much extra would you pay for a plane that was guaranteed to be always on time, or a surgery that was always guaranteed to work?"

Another fat, bloated, arrogant, close-minded, over-priced, value-deficient industry sees its revenue model whacked by web-enabled kids. Music distribution?  Health care? No, textbook publishing . And as an adjunct professor myself, let me say that assigning or selling a $200 textbook is committing academic fraud.

Business Week: "(Health care investors) want to own companies that...will help bend the cost curve by not just slowing the rate of health-care costs but helping them decline."  

Paul Roemer: "Dinner Is Warm.  It's In the Dog! " Jeff Goldsmith: "5 Reasons Why ACOs Could Fail."

FuturePundit: Medicine 2.0: Ordering Your Own Medical Tests .  How does your strategy change when consumers order their own tests?  Does it change the basis of competition?  Does it change your customer definition?  Will your customers need more coaching and information? MedCity News: Ohio's Rocket Ventures investing $8 million in bio-science and alternative energy startups this year. Curious about health care's future? Watch today's venture capital allocations.

Some thought-provoking questions (at least I think they are...) Are you more interested in what EVERYBODY is doing (i.e. best practices and benchmarking) or in what NOBODY is doing (i.e. innovation?) Do you prefer to be the BEST among many or the FIRST among few? Are you content being 'least-sucky' when the bar is set at full-on 'suckitude?'   What if those around you are mediocre?  (Think customer satisfaction in airlines or hospitals.  Nobody, not even top performers, score very well compared to other industries' top performers.  Your hospital may be Press Ganey's shining star, but maybe your benchmark should be Ritz-Carlton, not some like-sized hospital cohort.)   And if you respond with something like "We're not a hotel and health care is difficult and complicated..." I guess we know how you'd answer the first two questions, don't we?

From Yahoo! Sports; "All of a sudden, Elway popped up on Twitter, announcing everything from the names of new potential head coach candidates to his thoughts on the future of quarterback Tim Tebow. It's been refreshing for fans, and a look in the eye to those NFL organizations who believe that CIA-level confidentiality must accompany every single move they make -- down to a change in the brand of bathroom tissue in the coach's office lavatory. "Now, Elway and his team have upped the ante when it comes to giving the fans an inside view. They've posted snippets of the pre-interviews with current interim coach Eric Studesville and New York Giants defensive coordinator Perry Fewell. The linked videos give unique insight into the thought processes of the men interviewing to become Denver's newest head coach. One has to wonder if Rick Dennison and John Fox, who are expected to interview by Wednesday, will do their own videos, but the signs are good -- Elway told...

Futurist Ian Morrison nicely sums up the future of ACOs and offers Ten Laws of Accountable Care.  Many hospital strategists act as if ACO-related decisions get easier once all the cardiologists, say, are employed. They're wrong. And by the way, the headline speaks to the difficulty of improving health care by identifying and rooting-out "waste."

There may be an app for that , assuming you're willing to look at city government for inspiration.  San Francisco uses mobile phones and "co-creates" with the community to "...(take) things that are annoying to people and (make) them less irritating." Why couldn't hospitals adopt the same approach - writing apps and co-creating with customers?  Oh right, there's nothing annoying about hospitals.

From Mashable : Maybe you missed these: 40 New Social Media Tools and Resources . And a great HOW TO:  Use Social Media to Create Better Customer Experiences . From McKinsey Quarterly, one of 2010's best articles: Measuring Word Of Mouth Marketing . "In the mobile-phone market, for example, we have observed that the pass-on rates for key positive and negative messages can increase a company’s market share by as much as 10 percent or reduce it by 20 percent over a two-year period , all other things being equal. This effect alone makes a case for more systematically investigating and managing word of mouth." Word of mouth remains an important part of the health care marketing mix. Now there may be a way to measure those conversations.

How do you grow?  A critical question for health systems, communities, policy makers and incubators alike.   Writing in Bloomberg Business Week, Vivek Wadhwa argues that nurturing a few tiny companies is a better bet than what he calls misguided "behemoth-centric policies." "Established companies are job destroyers..." says Wadhwa, citing research from the Kauffman Foundation finding big companies erasing 1 million jobs per year from 1977 to 2005.  Maybe there's a better way... "...the Kauffman Foundation's Robert Litan just published Inventive Billion Dollar Firms: A Faster Way to Grow. It's a succinct argument that suggests helping a few really innovative startups become big businesses. How many? Maybe less than 60 ." Read the article, review the fairly compelling math.  And notice that Kauffman puts its money where its mouth is, with an initiative called Kauffman Labs For Enterprise Creation targeting promising industry sectors and en...

Measured over a sentient, professional lifetime,  knowing the HOW of thinking is more critical than knowing the WHAT.  I tell my students that all the time.  And me being me, I plunge even further into the deep end of educational counseling, suggesting that an aspiring leader's electives are better spent learning the HOW - in classes on philosophy, logic and literary criticism, than in slogging through more of the WHAT in accounting theory (an oxymoron...), business law or econometrics. Why memorize what you can hire? It's not an opinion likely to endear me to business school faculty, but they're frequently part of the problem, not the solution.  The learning and thinking stopped the moment 'Ph.D.' became their last name. No, successful strategists think like insurgents, NOT like incumbents (see the post below riffing on Seth Godin.)   For that you must learn HOW to think.   For Lesson #1, turn to "Why Criticism Matters," a fascinating New York T...

Today, several related themes point the way to R&R - Resolutions and Revitalization - in 2011.  First, Seth Godin contrasts status quo-destroying insurgents and committee-pleasing incumbents .  Says Godin, "It takes guts to be an insurgent, and even though the asymmetrical nature of challenging the status quo is in their favor, often we find we're short on guts. ... and then the incumbents prevail." So, resolution #1: More insurgents! Second, Anthony Cirillo muses about hospitals staying relevant , given that many are ceding first mover status on key industry opportunities; "Frankly I see little...progressive behavior from hospitals. It is easy to hide behind the "complexity" of hospitals and the "it's hard to turn a battleship on a dime" mentality. So we have business as 'fee for service' usual while others are progressively plowing ahead. ... "There is no lack of gumption from those outside of the hospital arena. If...

I just realized that I've passed 500 posts here on Health Care Strategist (this is #503) without anybody telling me to shut up.  Amazing.