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Showing posts from August, 2011

Everbody Needs A Weekly Dose...Of Ideas

Every week another batch of cool ideas lands in my inbox courtesy of the trend spotters at  Noteworthy this week:
The Kyocera-made Mi-Look is a GPS-enabled mobile device which helps ensure the safety of elders who live alone.  Think about sandwich generation applications.  How's Mom?  What's she doing?  Where is she?Curious about how your smoker's lungs look? Find out at SapientNitro. Think about other applications for so-called augmented reality - patient education, health counseling, pre-surgical  orientation.  As the website says, further possibilities abound.  The hearts of non-exercisers.  The skin of sun-worshipers.  The livers of imbibers.Groundswell Health is a San Francisco company that’s bringing the power of Groupon-style collective buying to healthcare practices and other purchasers of medical supplies and equipment.  "Now in beta, Groundswell Health aims to help the healthcare industry achieve real savings on the medical goods and services…

Can You Afford To Scrimp On Planning?

From Paul Roemer's blog Healthcare IT: How Good Is Your Strategy?:"It takes a lot of energy to dislike someone, but sometimes it is worth the effort."

"Poor planning often results in a lot of rework. There’s a saying something along the lines of it takes twice as long to do something over as it does to do it right the first time—the DIRT-FIT rule. And costs twice as much. Can you really afford either of those outcomes? Can you really afford to scrimp on the planning part of IT?"
Well, can you?

A Modest Rant

I know I've said something like this before, but it bears repeating. I use a Mac all weekend. It's my time and my money and I'll spend both however I like, thank you very much.

Returning on Monday to Windows XP feels like someone chopped open my skull and removed half my brain with a sharp stick.

Fixing An Outdated Brand: "You Have To Overwhelm Them."

Chicago Tribune: As a new Radisson Blu hotel opens in Chicago's architecturally significant Aqua building, the question is whether the lowly-regarded hotelier can go upscale.

Steven Silvers, a reputation management consultant at Denver firm GBSM, said the odds are good.
"When rebuilding a brand, you have to go all out," (Silvers) said. "If you do it incrementally, you're asking for a lot of patience. You have to overwhelm them. You have to create a level of cognitive dissonance that hits the reset button. That goes a long way toward creating a new life for an old brand."[Read more...]

Do Best Practices Suck?

They're great says Ted Coine IF your practices are sub-par and IF you assume everybody else is standing still.

"Best practices are great and all – if your current practices are sub-par. After all, you have to start somewhere. But catching up with the Joneses is a fool’s errand. The best you can ever hope for is to catch up, but that would assume that the Joneses, and all your other neighbors, don’t improve. And I think we should all be quite comfortable by now with the notion that standing still is falling behind. After all, isn’t that what the firing squad asks prisoners to do? Stand still against that wall, so they can have a clear shot?"And I love this recommendation, a little 'secret' to innovation:
"Hire people from outside the world of big business – teachers, actors, small business owners, bartenders, history majors just out of school – to work on your staff. Don’t just teach them how you do things. Much more importantly, ask them to tell you what thei…


"Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do.

"If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on."  (Steve Jobs)

Can the DMV Point the Way to Better Service?

Doug Thompson from The Advisory Board Company's IT Strategy Council used his recent adventures in disconnected healthcare to pen What could hospitals learn from (And) Why even the DMV could teach us a lesson.

The article is members-only, but I'm reproducing it here with Doug's permission.  Implementing Doug's recommendations wouldn't cost a typical hospital or clinic a lot of money, certainly nothing like that fancy new EMR where customer benefit is either assumed or incidental.  Mostly what's needed is a change in emphasis, from what benefits ME as provider to what benefits YOU as my customer.  (Note that the emphases added are mine.)

"August 19, 2011, Doug Thompson, IT Strategy Council
"Thankfully, my recent colonoscopy screening was routine, and I was back at work the next morning. Nevertheless, the process itself was uncoordinated, inefficient, and lacked a customer focus—a stark contrast to common practices in other industries. The expe…

10 Ways Your ACO can Fail

From Sara Singer and Stephen Shortell, writing in JAMA: "Implementing Accountable Care Organizations: Ten Potential Mistakes and How to Learn From Them."

Mistake #6 is my personal favorite:
"6. Failure to Sufficiently Engage Patients in Self-care Management and Self-determination.   Patients and family members can provide considerable care particularly in managing multiple, complex chronic conditions. Patients need to be both considered a key part of the care team and educated about taking responsibility for their health and health care with support of friends and family members. Many potential ACOs have little experience with this degree of patient engagement."Really?  "Little experience?" Try none.   Try less-than none, if unlearning a raft of bad habits counts as negative experience.  I predict we'll see more than one ACO fail due to an utter inability to spell either 'customer' or 'engagement' without being spotted the first seven…
"Don't play what's there, play what's not there." (Miles Davis)

Is this "white-space strategy?" Not doing what everyone else is doing, but doing what nobody else CAN do, what nobody else has even THOUGHT of doing?

If Air Travel Worked Like Health Care

Don't you love her concluding comment? "My goal today was to provide you with outstanding service."  Umm-hmm.   How about a little less scripting and a little more design thinking?

I'm not sure if this video is depressing because it's so damn funny, or funny because it's so damn depressing.

I've seen a statistic somewhere estimating that an airline industry operating at health care's quality level (or, really, the lack thereof) would crash a passenger-laden 747 nearly every day.

Abandoning Yesterday to Seize Tomorrow

‎"Innovating organizations spend neither time nor resources on defending yesterday. Systematic abandonment of yesterday alone can free the resources, and especially the scarcest resource of them all, capable people, for work on the new." - (Peter Drucker)

So what's on your organization's "stop-doing list?"

(Thanks for the quote and a big shout-out to my friend and colleague Chris Smoot of World Vision in Nairobi, Kenya.)

"Promotoras" in Health Outreach and Education A simple idea promoting health care catches on in Philadelphia's Hispanic community.

"As the minority group least likely to have a primary-care doctor and with nearly half living beneath the poverty line, Latinos, especially recent immigrants, have challenged doctors for decades.

"But this simple idea - using people from church or the barrio to encourage preventive care - has produced success noted in medical journals over the last five years.

"The constant mention of women who visit homes and provide basic care, but were not nurses, prompted (Matthew O'Brien, then a medical resident at the University of Pennsylvania) to bury himself in the public health literature in what he calls his own "remedial M.P.H." He was surprised at how they were able to increase vaccinations and other preventive health measures in developing countries and border states."[Read more...]

A good example of design thinking, of learning from other countries'…

McKinsey: Testing Your Strategy

From McKinsey Quarterly: Ten timeless tests can help you kick the tires on your strategy, and kick up the level of strategic dialogue throughout your company.  Before you tell me you're tired of test-taking, results show that most companies' strategies pass fewer than four of the ten tests.

Test #1 is Will your strategy beat the market?
"All companies operate in markets surrounded by customers, suppliers, competitors, substitutes, and potential entrants, all seeking to advance their own positions...The best companies are emulated by those in the middle of the pack, and the worst exit or undergo significant reform. As each player responds to and learns from the actions of others, best practice becomes commonplace rather than a market-beating strategy.Good strategies emphasize difference—versus your direct competitors, versus potential substitutes, and versus potential entrants."Key to McKinsey's analysis is this: markets drive a reversion to mean performance.  So if…

Which Economies Matters More? Scale or Connection?

Dan Beckham offers his perceptive and timely insights into why "economies of connection" matter more than the CEO and investment banker-beloved "economies of scale."

"As health care leaders consider the future, they would be wise to abandon notions of "economies of scale" rooted in financial transactions and mass production. It's time to pursue those mergers and acquisitions that provide the best opportunities to consolidate caregivers in a way that facilitates "economies of connection." Whoever gets there first may be able to lock in a long-lasting advantage." (emphasis mine)[Read more...]

Decouple Primary Care From Insurance?

Yes, says Kay Plantes, writing on business model innovation in WTN News:
"Within (the healthcare) muddle rests the opportunity for huge innovation by...providers, payers and their suppliers. And the most important place for that innovation is better primary care. Two examples of big pay-offs from primary care innovation are Denmark closing half its hospitals and Ohio saving half a billion dollars on caring for diabetic patients in its Medicaid system.

"A very fruitful area for (health care) innovation is stripping primary care from insurance payments, thereby eliminating the high (as high as 40%) tax insurance administrative processes pose on primary care services while giving individuals a medical home to improve their primary care outcomes."[Read more...]

That aside about Denmark closing half its hospitals is intriguing, don't you think?

gapingvoid cartoon #378

What The World Needs, From Jacqueline Novogratz

From Acumen Fund's Jacqueline Novogratz's new letter:

"As a world, we have to do a better job creating the conditions that enable human beings to thrive in every country. Too often governments and aid agencies have focused on large-scale infrastructure projects that rarely reach the poor. Instead, we need more patient capital investing in entrepreneurial solutions that ultimately enable low-income individuals to help themselves." (Emphasis mine.)

[Read more...]

Why Is Healthcare So Slow To Automate Processes?

Dr. John D. Halamka has some reasons, including this:

"...hospitals and professionals are seldom paid by their customer. Payment usually comes from an intermediary such as the government or insurance payer. Thus, healthcare IT resources are focused on back office systems that facilitate communications between providers and payers rather than innovative retail workflows such as those found at the Apple Store."

I agree there are many 'reasons.'  I also know that the line between 'reasons' and 'excuses' gets finer by the day.

[Read more...]

Is There A 'Hidden' Health Care Market?

From Booz&Co's Strategy+Business: "There is a hidden financial services market in the U.S., estimated at 9 million "unbanked" households. On average, these households have annual earnings of US$18,600, resulting in an estimated $169 billion in income that never flows through a bank or credit union."

Tapping those billions is really not that difficult.  For starters, hire more employees who speak Spanish, educate staff members on cultural issues, and help customers with paperwork.

I'm waiting for health care providers to wake up to the whole "Bottom Of the Pyramid as opportunity" idea.  For starters, they're not "medically indigent," they're "customers."

Transparency: Good For Thee But Not For Me!

Columbia Journalism Review: "My...colleague Charlie Ornstein likes to say that stories about hospital ribbon-cuttings, wings named for wealthy benefactors, and expensive new technology are what hospitals want journalists to report on. They are less eager to have us write about quality of care, or malpractice suits, or anything that disturbs the pretty pictures they want to paint. So when a press release for a Boston hospital’s new operating rooms and post-anesthesia care unit showed up, I took a second look."

Attention: Entrepreneurs!

Working on an innovative startup?  Register it at Startup Open for a chance to be recognized as one of 2011's Top 50 startups.

Win prizes like a full year in Entrepreneurs' Open’s Mentoring Program with Michael DeLazzer, founding partner and creative mind behind Redbox, the world’s 2nd largest video rental company with revenue exceeding $1 billion, or an all expenses paid trip to Liverpool and VIP delegate credentials to the Global Entrepreneurship Congress in March 2012.

MN Hospital System Partners With Chicago Incubator

From MedCity News:  Ridgeview Medical Center, a health network comprising an acute care hospital and seven clinics in the far western suburbs of Minneapolis, announced that it is partnering with Healthbox, which will launch a three-month acceleration program for healthcare tech entrepreneurs in January.
“Our philosophy has changed over the past couple of years in that we want to be involved in healthcare innovation and in the development of disruptive technologies,” said Robert Stevens, president and CEO of Ridgeview Medical Center. “We want to create change within the industry as opposed to complain about what’s happening to healthcare by changes coming from the outside.”[Read more...]

News From the ACO Frontier

Tennesee's Saint Thomas Health is projecting a January launch for MissionPoint Health Partners, an ACO-qualified organization but one with bigger aspirations and a smart partnering strategy. From The Tennessean:

"The partners include Saint Thomas Health’s five hospitals and 200 affiliated physicians, Cisco Systems, The Advisory Board Co.’s Crimson Services initiative, Applied Health Analytics and the YMCA of Middle Tennessee."MissonPoint is using a telemedicine platform from computer networking giant Cisco to improve access to medical specialists for rural, underserved communities. It plans to expand use of the high-definition video system to two other Middle Tennessee communities and add new specialties such as dermatology and psychiatry.

"Nashville-based Applied Health Analytics’ part of the mission is to help pinpoint health risks within populations of employees and recommend ways to address those problems, which could include a high rate of obesity, for example.


Jeremy Grantham Takes The Long View

And this money manager puts his money where his mouth is.  From the New York Times:

"Energy “will give us serious and sustained problems” over the next 50 years as we make the transition from hydrocarbons — oil, coal, gas — to solar, wind, nuclear and other sources, but we’ll muddle through to a solution to Peak Oil and related challenges. Peak Everything Else will prove more intractable for humanity. Metals, for instance, “are entropy at work . . . from wonderful metal ores to scattered waste,” and scarcity and higher prices “will slowly increase forever,” but if we scrimp and recycle, we can make do for another century before tight constraint kicks in.

"Grantham believes that the best approach may be to recast global warming, which depresses crop yields and worsens soil erosion, as a factor contributing to resource depletion. “People are naturally much more responsive to finite resources than they are to climate change,” he said. “Global warming is bad news. Finite reso…
Can you guess the innovation having the biggest impact on health care in the last 35 years?  It's Hospiceaccording to a Modern Healthcare Magazine contest. (via The Richmond Register.)

Says Brenda Wallhausser, community outreach coordinator for Hospice Care Plus in Berea,
"Hospice care’s focus on the patient’s wishes and priorities and its inclusion of caregivers in the care process make it stand out, as do the fact that care is provided in the home and that hospice care is inter-disciplinary, tending to not only pain management, but also symptom control, and psycho-social and spiritual health,"Not a bad formula, but what does it say about health care overall when things like focusing on the patient's wishes and interdisciplinary care win awards for innovation?

The Blade Runner Strategy

Though I consider myself a planner and a strategist, I only reluctantly admit to engaging in debates about terms like "mission" and "vision." What are they? How are they defined? Which is which? Honestly, I long ago stopped caring.

Instead, I prefer the term "legacy" - i.e. a gift, a bequest, something handed down to future generations.Think about it this way: imagine someone - an historian - sitting down in 50 years to write YOUR history and your organization's. What are you creating TODAY that's worth memorializing? What are you doing TODAY that might, possibly, endure for longer than a strategic planning cycle or two? What's your gift?More about that in a moment...

Last night I watched a 3 hour-long meta-movie - a movie about a movie - about the making of the movie Blade Runner, Ridley Scott's dystopic, claustrophobic vision of the not-so-distant future.Blade Runner was released in 1982, the same summer as E.T., early in the decade Ronal…
From Esther Dyson on healthcare: "Don't Fight the System, Erode It!"
"Dyson thinks of healthcare in much broader terms than many people do. There is the current healthcare system with hospitals, doctors, and insurance—that is the intractable part that is hard to change. But then there are all sorts of activities around the periphery that are more in our control, what she calls user-generated healthcare.” Increasingly, technology is making it easier for us to collect personal health and fitness data to help us combat our own vices such as drugs, alcohol, bad food and sitting around. It is user-generated because we create and collect our own health data through personal fitness devices like Fitbit or aself-measurement services like GreenGoose, and can view our personal health dashboards online."

From Booz&Co's strategy+businessGlobal Lessons for Controlling Healthcare Costs.
"A flurry of activity is evident as more and more payors in both developed and developing nations reach beyond their borders. They are seeking proven treatment guidelines and attempting to utilize reference standards created in other healthcare systems. They are also investing internationally to enhance their revenue streams and gain access to broader practices and knowledge."