Health Care Strategist

H&HN Daily:  "What Innovation Looks Like At One Community Hospital."

NY Times:  "As Scorn for Vote Grows, Protests Surge Around Globe." Political and financial institutions are seen as clueless at best, venal at worst.  A new generation vents their frustration through self-organizing, decentralized coalitions.   Many health care strategists will read this article with a sense of detachment.  That's a mistake because, above all, successful strategists are trend-aware.   So be aware of this:   A trend driven by economic frustration and doubt about the future may start in the political arena, but that's seldom where it stops. From the article: "Increasingly, citizens of all ages, but particularly the young, are rejecting conventional structures like parties and trade unions in favor of a less hierarchical, more participatory system modeled in many ways on the culture of the Web. "In that sense, the protest movements in democracies are not altogether unlike those that have rocked au...

Could you redesign a $300,000 house and build it for, say, 20 percent less?  Probably.  Easy, actually.  Just downsize some square footage, cheapen the finishes, toss overboard the granite and the tray ceilings and you're there. What if I asked you for well-designed, safe, affordable shelter for the world's poor?  Oh yeah, shelter costing $300 to build?  That's right, $300.  Not $300,000.  Not $30,000.  Not $3,000.  Three measly hundred dollars . Could you do THAT?  This team did.   And created a movement along the way, with a growing list of advisors, a website and corporate sponsors.   No incrementalism here.  No "we'll start with the status quo and make it a little better." We all know 'stuff' that's useful when the pace of change is comfortable and incremental.  Unfortunately, that 'stuff'  becomes blinders to be unlearned and forgotten when change of the $300 Hous...

Many factors drive the increasing cost of cancer care.  Sophisticated, targeted drugs are expensive to develop, test and market.  Desperate patients demand them.  Other therapies - proton beam accelerators, e.g., though engineering marvels, are capital and labor intensive.  To the mix, add a healthcare system that very rarely measures costs against benefits and says 'No. We're not doing that.' Chicago Tribune :  "Cancer cost "becoming unsustainable" in rich nations." "...a radical shift in thinking is needed to ensure fairer access to medicines and address tricky questions like balancing extra months of life for patients against costs of a new drug, technology or care plan, (oncology experts) said." "The cancer community needs to take responsibility and not accept a sub-standard evidence base and an ethos of very small benefit at whatever cost," said a report commissioned by the Lancet Oncology medical journal on the costs of can...

From Amazon.com:  If there is one strain of conventional wisdom pervading every company in every industry, it’s the absolute importance of “competing like crazy.” Youngme Moon’s message is simply “Get off this treadmill that’s taking you nowhere. Going tit for tat and adding features, augmentations, and gimmicks to beat the competition has the perverse result of making you like everyone else.” "Different" provides a highly original perspective on what it means to offer something that is meaningfully different—different in a manner that is both fundamental and comprehensive. To learn about differences, compare Yahoo! to Google.  To learn about conventional wisdom and gimmickry, compare Hospital A to Hospitals B, C and D. Looks like a good addition to my 'to read' list.  Just remember, you heard it all here first.

I thought I'd add something to the post below about ideas.  Here's one to get you started, from a student of mine in last semester's "Materialism and Idealism" class: Patients often need prodding to learn about disease and the behavioral and lifestyle changes necessary to live healthier lives.  Yet the same people often play video games willingly and exuberantly.   No prodding necessary.  What if ...you combined the two - the teaching and the game playing - into a fun, challenging yet subtly educational game? Example:    Create a video game where the combat hero's years of heavy smoking induces coughing fits that reveal his platoon's position to the enemy.    Bam!  Dead platoon.   Game over. Smoking kills.  Lesson learned. No need to carry around a jar full of diseased lungs bathed in formaldehyde.  No more 8th graders chuckling in the back row.

How many great ideas started with "I have an idea..."?  (4 words.)  Or "What if..?"  (Two words.) Or "Why not..?"  (Two more.) If you are an average-sized hospital, you have, maybe, 2,000 people working in your organization? Think there might be, say, 10 great ideas in there somewhere?  10 new, paradigm-busting, customer-delighting game changers? 2,000 people, ten great ideas, two words.  2,000/10+2 It's not exactly Pythagoras as math formulas go.  But before you question the power of new ideas, here's a headline for you: "Online gamers (i.e. scientific novices) crack AIDS enzyme puzzle." "Online gamers have achieved a feat beyond the realm of Second Life or Dungeons and Dragons: they have deciphered the structure of an enzyme of an AIDS-like virus that had thwarted scientists for a decade ." Kids, thinking differently, solving problems.  It's not that the ideas aren't out there, waiting.  They are. "W...

Words you don’t often see juxtaposed – ‘poor’ and ‘Warren Buffet.’ But perhaps some sympathy is in order. Omaha’s Oracle has had a few misfires recently, first offering some patently stupid tax  advice to the White House’s current occupant. You know of whom I speak - the leader of a clique believing any tax rates short of 100% are an opportunity-in-waiting. Next he invests $5 billion in Bank of America. With the check’s ink barely dry, BofA says ‘See ya!’ to 30,000 jobs. Isn’t it swell being an Oracle? He should’ve allocated that $5 billion among several dozen innovative startups, staying far away from the old-money banking triumvirate of fat, dumb and clueless. Some startups would have crapped out (just ask the White House…cough…Solyndra…cough.) but there’s no way the ensuing wreckage would’ve cost 30,000 jobs. Now THAT’S change we can ALL believe in.

" Again and again, Steve Jobs would step up to entrenched players in media and explain their business to them in ways they didn’t recognize from the inside."

...improve customer service.  Attending a town hall forum in leafy Downers Grove, IL , Commonwealth Edison officials heard “You’re treating us like Cubs fans!” That’s a pretty good insult, intuitively understood by even the most diehard Cubs fans. In reality though, NOBODY, not even electricity-starved suburbanites, are treated as shabbily as Cubs fans. But I digress. Interesting, isn’t it, to think what your customers, organized into a public mob, er, audience, would say about your hospital? You: “Yes sir, you over there standing at the microphone. Do you have a comment?” Audience member: “Yes I do, thanks for asking. I’m feeling pretty (blank.) You treat us like (blank.)” What’s in the blanks? “I’m feeling pretty good . You treat us like royalty !” Maybe.  Maybe not.  Of course all of YOUR customers LOVE you. Your golfing buddies tell you so, and when have THEY ever been wrong?  (Maybe they’re White Sox fans.) I wouldn't blame you if you avoided o...

Chicago News Cooperative:  "State Challenges Hospitals' Tax Breaks." “Hospitals think they should get tax exemptions for merely what they do in the community,” said John Colombo, a professor of law at the University of Illinois at Urbana-Champaign who has followed the issue of nonprofit hospital tax exemptions nationally. “It’s problematic: The overall number that each of these hospitals is reporting is abysmally low. Given the state of the economy, one would expect the charity services going up.” Bloomberg Business Week:  "Illinois Says Hospitals No Longer 'Poorhouses' Shielded From Taxes." “Hospitals aren’t poorhouses anymore,” (says Colombo.)  “Just because they were exempt in 1900 doesn’t mean they should be exempt in 2011. The world is different.” Yes, the world is different in 2011, especially when for-profit Vanguard Health Systems can buy 4 hospitals in the Chicago area, pay taxes AND deliver charity care in amounts "not materially different...

Aren't they the same thing?  No, says Paul Roemer, alerting us to this fun fact: "EHR certification inspectors will be dropping in on hospitals like UN inspectors looking for WMDs, only they’ll be slightly less congenial."

"A modicum of doubt about one's abilities tends to ensure better quality control."     Indeed.

GeekPress: "I am a physician, so I had already been using my iPad for my work, reading PDFs of medical articles, communicating with my colleagues via e-mail, etc. But when I broke my hip in an accident a few days ago, the iPad became my lifeline to the outside world..." [Read more...]