Health Care Strategist

Jobs Available: Critical Access Hospital Administrator/CEO (2)

2012-01-19T18:02:00.000-05:00

Mason City-based Mercy - North Iowa is currently searching for Administrator/CEOs for two thriving critical access hospitals. Positions are located in Osage and Emmetsburg, IA.

Major challenges include furthering the strategic focus and service complement, ensuring financial stability, and developing infrastructure, goals, indicators and targets, CQI/value improvement/measures of success, and culture.

QUALIFICATIONS: Master’s degree in hospital administration or related field (MBA, MSN, MHA). Three years of hospital management experience. Strong human relations skills. Proven ability to articulate values. Demonstrate commitment to the philosophy and mission of the organization, Mercy Medical Center-North Iowa, and Mercy Health Network.

Apply online or contact Gayla Toebe at toebeg@mercyhealth.com. No recruiters please, but feel free to say you read about the position on Health Care Strategist!

The fine print: I post interesting executive-level and strategy-related job opportunities as they come to my attention. These are not my searches. I am not a recruiter and have no stake, financial or otherwise, in filling the position, just a hope that, in some small way, I can assist you, dear reader, in finding your dream opportunity. Connect with me on Linkedin, here.

Apple Destroys the Textbook. Parents Cheer!

2012-01-19T15:33:00.000-05:00

Michael Comeau: "According to Apple's press release, most titles for the iBooks 2 iPad app will be priced at $14.99 or less, cheap enough relative to standard textbooks that they''ll offset the cost of an iPad within two or three semesters.

"...at the end of the day, we should all celebrate the decimation of a very anti-consumer industry. Well done Apple, and well done publishers."

Yes, well done and we SHOULD celebrate. My only regret is that this announcement came AFTER I put four daughters through college and graduate school.

Read more here.

Ford seeks to develop "the car that cares."

2012-01-12T18:13:00.001-05:00

From PhysOrg.com: Ford, Microsoft Corp. and Healthrageous are researching how connected devices can help people monitor and maintain health and wellness.
"According to a study conducted by Pew Research:

93 percent said they seek out online health information because it's convenient - they want to get information on their own timetable, not the doctor's.
83 percent said it's because they can get more information from the Web than they can get from their own doctor.
80 percent said getting this information privately is important to them.

"As people spend more time in their cars, the ability to manage health and wellness on the go becomes more important. There are several reasons why the automobile is an ideal platform for research and development in this area:

It's convenient and private.
It facilitates personalized access to the information, products and services people need.
And it's a logical place for them to manage their health while they are more often stuck in traffic.

"The goal is to figure out how to extend health management into the personal vehicle in a nonintrusive fashion. The prototype system was designed by BlueMetal Architects."

[Read more...]

.

5 Reasons Your Healthcare Integration Strategy Is Going To Fail

2012-01-12T18:00:00.000-05:00

From Eliot Muir, iNTERFACEWARE, Special to ZDNet:

" I hate being the bearer of bad news, but I can tell you, with 100 percent certainty, that your integration strategy is going to fail. That’s the good news. The bad news is that when your strategy fails, there will be a start-up with only a handful of employees and even less money waiting in the wings to take over your market share. I am not trying to paint a gloomy picture; I am just sharing hardcore facts upfront.
...

" ...healthcare organizations looking to inoculate themselves from integration failure should follow a few common-sense, tried and true rules: develop a clear strategy up front, keep current with technology, leverage the cloud, be flexible about standards and always look at the opportunity costs inherent in custom development."
[Read more...]

Walgreens: "The pill is no longer the product."

2012-01-11T12:42:00.000-05:00

"The pill is no longer the product. Our product now is customer service and relationships with our customers that result in better health outcomes for patients and payers." - Kermit Crawford, president of Walgreen's pharmacy, health and wellness services.
Walgreen updates stores with eye on health services expansion - The Advisory Board Daily Briefing

Doctors vs. Algorithms?

2012-01-11T10:19:00.001-05:00

Do We Need Doctors or Algorithms, asks Vinod Khosla. The answer may surprise those of you spending your days worrying about an impending physician shortage.

"Eventually, we won’t need the average doctor and will have much better and cheaper care for 90-99% of our medical needs. We will still need to leverage the top 10 or 20% of doctors (at least for the next two decades) to help that bionic software get better at diagnosis. So a world mostly without doctors (at least average ones) is not only not reasonable, but also more likely than not. There will be exceptions, and plenty of stories around these exceptions, but what I am talking about will most likely be the rule and doctors may be the exception rather than the other way around.

...

"What is important to realize is how medical education and the medical profession will change toward the better as a result of these trends. The vision I am proposing here, though, is one in which those decades of learning and experience are used where they actually matter. We consider doctors some of the most learned people in our society. We should aim to use their time and knowledge in the most efficient manner possible. And everybody should have access to the skills of the very best ones instead of only having access to the average doctor. And the not so “Dr. House’ doctors will help us with better patient skills, bedside manners, empathy, advice and caring, and they will have more time for that too. If computers can drive cars and deal with all the knowledge in jeopardy, surely their next to next to next…generation can do diagnosis, treatment and teaching in these far less uncertain domains and with a lot more data. Further the equalizing impact of both electronic doctors and teaching environments has hugely positive social implications. Besides, who wants to be treated by an “average” doctor? And who does not want to be an empowered patient?"

In just a few paragraphs, Khosla defines healthcare's future. Though I happen to agree, what I find somewhat depressing is that hospitals will sit, wait and have it done TO them, missing out entirely on the future's new, exciting value streams. Missing the opportunity to participate, to benefit and to re-envision the hospital as something beyond a massive, expensive and now-empty acute care cathedral.

Because if algorithms replace doctors, will doctors (and patients) still need hospitals? Read the whole thing.

Which Patients Will Disengage From Treatment?

2012-01-07T16:48:00.002-05:00

Presented at AHRQ and termed a "stunning innovation in health care,"Mind Field Solutions' iPhone/iPad app diagnoses which patients will disengage from treatment. The new approach also provides a neuroscientific explanation of the underlying causes behind patient disengagement.

Says neuroscientist, Dr. Andrea LaFountain, CEO and Founder of Mind Field Solutions:

"We are excited about the potential that this innovation brings to healthcare delivery, outcomes and cost. Healthcare has suffered greatly due to the inability to effectively and efficiently engage patients in their self-care. This research provides a scientific framework for engagement that creates significant impact in outcomes and cost. Our data suggests a cost savings of $3billion per annum for Medicare diabetes alone,"

Read more here: http://www.sacbee.com/2012/01/06/4167823/mind-field-solutions-presents.html##storylink=cpy

Universal Agreement Is Highly Overrated As A Leadership Strategy

2012-01-07T14:28:00.001-05:00

Image From (Here) Based On Creative Commons Search

"Read, every day, something no one else is reading. Think, every day, something no one else is thinking. Do, every day, something no one else would be silly enough to do. It is bad for the mind to be always part of unanimity." - Christopher Morley (1890 - 1957)

Unanimity is bad for health care strategists too, and their organizations.

Connect with me on Linkedin.

I'm An Entrepreneur!

2012-01-07T12:08:00.000-05:00

Buy this print here.

Job: President-Center for Healthcare Innovation

2012-01-07T11:16:00.001-05:00

Responsibilities: The Allina Health System is committed to building a nationally recognized center for healthcare research and innovation positioned to advance patient care and health in our community. This position provides overall strategic and operational leadership to The Center for Healthcare Research and Innovation (The Center).

Most research conducted at Allina will be coordinated by The Center, but the emphasis will be on new research targeted at the advancement of the patient care model, epidemiology, shared decision making, the management of total cost of care, and the optimization of the health of populations. This position will ensure that The Center will serve as a catalyst for developing innovative approaches to care – within Allina, in the community, and across the industry – which deliver greater value for stakeholders.

The incumbent will lead the support of innovative projects that will:

• Advance our patient care model with emphasis on prevention, chronic disease management, end of life care and the patient care continuum.
• Improve the health of the community through collaborative approaches with other community stakeholders and with an eye towards improved health of populations.
• Support the development of innovative medical therapies and treatments.
• Pursue partnerships to provide opportunities for learning and sharing of innovations.
• Build a comprehensive and integrated approach to clinical research.
• Advance a fund development strategy to support The Center’s work.

Qualifications (Education/Experience)

• MD preferred, will consider PhD, MBA, MPH, MHA, JD, or related healthcare master’s degree.

• 5-7 years experience in research arena with emphasis on public health, care model design, health services, population health, epidemiology, and progressive grant funded research (e.g. NIH, AHRQ, Robert Wood Johnson Foundation).

• 5-7 years progressively responsible experiences leading operational research.

Apply online
http://tinyurl.com/77fszfu

The fine print: I post interesting healthcare-related job opportunities as they come to my attention. These are not my searches. I am not a recruiter and have no stake, financial or otherwise, in filling the position, just a hope that, in some small way, I can assist you, dear reader, in finding your dream opportunity.

Connect with me on Linkedin, here.

Job: Cancer Center Director, Colorado

2012-01-05T00:19:00.000-05:00

Cancer Center Director, Salary Range: Based on experience/education
Bonus Eligible: Yes; Relocation Assistance: Yes
Location: Colorado

This facility has been recognized by JD Powers for excellence in patient care, as well as receiving national recognition for hospital building design. They are a mecca for skiing, snowboarding rafting, kayaking, mountain climbing, camping and just enjoying their beautiful mountain scenery. They also have the largest hot springs pool in the world. The Best Small Towns of America has named it number four in the country.

The hospital is building a new state-of-the-art Cancer Center. They currently provide chemotherapy but the radiation therapy is a necessary addition. This person will be instrumental in the development of the services provided as well as opening the new center which is designed with the look and feel of an alpine resort.

Contact Amy Engle. Clonch & Associates
ph: 813-498-1589
amy@clonchassociates.com
www.clonchassociates.com

The fine print: I post interesting healthcare-related job opportunities as they come to my attention. These are not my searches. I am not a recruiter and have no stake, financial or otherwise, in filling the position, just a hope that, in some small way, I can assist you, dear reader, in finding your dream opportunity.

Lies, Damn Lies and Statistics

2012-01-04T12:57:00.000-05:00

Except these statistics aren't lies, more of a messy, grim reality. Forbes' Dan Munro on healthcare's continuing crisis:

"These are the (statistics) that struck (Munro) as among the more compelling:

1. Medicare spends about $50B on the last 2 months of a patient’s life.

2. Medicare/Medicaid fraud is estimated at $70B per year .

3. 21% of Americans smoke – The American Cancer Society claims that “tobacco use remains the single largest preventable cause of disease and premature death (estimated at 443,000/yr) in the U.S. 45M smoke cigarettes; 13.2M smoke cigars; 2.2M smoke pipes.

4. Obesity Epidemic – in 1985 there was no state that had an obesity rate greater than 10%. By 2010 there was no state with an obesity rate lower than 20% and 36 states have an obesity rate higher than 25%. Obesity is the second leading cause of preventable death in the U.S. (estimated at 112,000/yr).

5. 23-30% of prescriptions never get picked up at the pharmacy – Surescripts study on 40M prescriptions from 2008 to 2010 .

6. There are more MRI machines in Pittsburgh than Canada.

7. 80% of healthcare bills contain errors.

8. Insurance claim errors are estimated at about $17B per year.

9. The Milliman Medical Index measures the total annual cost of healthcare for a typical family of 4 covered by a preferred provider plan (PPO). In 2002 it was $9,235. For 2011 it was $19,393.

10. By 2025 the average annual cost of family healthcare insurance will equal the average annual household income.

11. Ohio spent about $600M in 2009 on Medicaid, Foodstamps and Welfare for employees of that states 50 largest employers (including WalMart, McDonalds, Wendy’s and Krogers.)

12. The Census Bureau reported 49.9M uninsured for 2010 (roughly 16.3% of the population and statistically unchanged from 2009.)

13. The Census Bureau Report on Poverty indicates about 100M – basically 1-in-3 Americans – either in poverty or the zone just above it (annual income less that 50% above the official poverty line). This one’s not directly healthcare related – but affordable healthcare is most definitely a relative term as it applies to (or is mandated by) any healthcare system.

Safe to say it’s a mess – or as Tommy Lee Jones said in No Country For Old Men “if it ain’t … it’ll do ‘til the mess gets here.”

Let's be clear. #9 and #10 are EFFECTS, dependent variables if you will. The rest are basically CAUSES or independent variables. Address THEM and #9 and #10 begin to improve.

Focus for a moment on #10: " By 2025 the average annual cost of family healthcare insurance will equal the average annual household income." That's if current trends continue, with health care inflating at, say, 7% per year (i.e. doubling roughly every 10 years) and little-to-no household income growth. It's easy math to forecast the former overtaking the latter.

Anybody with me in saying that neither trend is sustainable? Anybody with me in saying our poets, pundits and politicians are overly optimistic in thinking about healthcare's ability to change that far, that quickly?

The mess is on our doorstep. It ain't pretty. Stay tuned.

Reinventing Rural Health Care

2012-01-04T08:55:00.000-05:00

A thoughtful article from futurist Ian Morrison on Reinventing Rural Health Care.

Among Morrison's excellent recommendations is a high-tech approach to rural health care:

"Rural communities have as much right to high-quality health care as the rest of us. But the answer can't simply be providing sufficient cost-based reimbursement to keep all systems doing what they are doing, especially if they are under scale for true quality care. In my view, the solutions will come through a reinvention of rural health care delivery, including:

imaginative use of contemporary information and communications technology;

regionalized quality improvement initiatives;

rationalized deployment of clinical technology and human resources."

I'm struck by the many innovative, simple, low-cost models and mobile technologies already at work in rural areas. The problem is they're in central Africa, not central Iowa. We're stuck with a Hill-Burton driven, cost-reimbursement-fueled edifice complex where it's easier to spend $20 million on a fancy new building than $20 thousand on mobile technology to help diabetics better manage their disease.

9 Health Care Jobs Expected to Grow by 2018

2011-12-31T15:42:00.000-05:00

9 Health Care Jobs Expected to Grow by 2018

#3: Public Relations Specialists

As the health care industry becomes more technologically savvy, smartphones and social media will become more common tools of the trade, in addition to traditional machinery. Therefore, hospital public relations will grow 52%.

#9: Customer Service Representatives
Hospitals are trending toward customer service satisfaction, conducting surveys and becoming more attentive to patients as customers. Therefore, expect to see this field in health care grow 52%.

Just me being creative!

2011-12-31T15:19:00.004-05:00

Somewhere in Texas, I think.

Creativity Is...

2011-12-31T14:41:00.000-05:00

"Creativity is allowing yourself to make mistakes. Art is knowing which ones to keep."

(Scott Adams (1957 - ), 'The Dilbert Principle')

The HBR List of Audacious Ideas

2011-12-29T18:30:00.002-05:00

I'm wasn't sure 2011's waning days needed yet another list of some kind, but Harvard Business Review's list of audacious ideas is pretty good. Why audacious ideas?

"(Because) even though (businesses are) sitting on $2 trillion in cash, they’re risk-averse, strategically incremental, and notably lacking in fresh ideas.

"We think this stinks. The world needs invention and daring now more than ever. Now is the time for audacity, not austerity. "

So here's HBR's list (the full article requires registration.)

Tackling the World Economy

Give People Shares of GDP, by Robert J. Shiller
Double Down on Start-ups, by Bruce Gibney and Ken Howery
Partner with China in Afghanistan, by Wayne Porter
Enroll the World in For-Profit Universities, by Parag Khanna and Karan Khemka

Tackling Science Challenges

Give NASA a Real Mission, by Gregg Easterbrook
Declare 20% of the Ocean Off-Limits, by Enric Sala
Electrify the Bottom of the Pyramid, by Arun Majumdar

Tackling Social Problems

Die the Way You Want To, by Ellen Goodman
Pay Businesses to Keep People Out of Prison, by Eric Schmidt
Grow More Apples and Less Corn, by Ellen Gustafson

Tackling Business Problems

Stop Tying Pay to Performance, by Bruno S. Frey and Margit Osterloh
Crowdsource Management Reviews, by Linda A. Hill and Kent Lineback
Stop Collecting Customer Data, by Doc Searls

Were it up to me, there's about 10 ideas on the list that beg for immediate implementation. Or, at a minimum, pointed questions of each Presidential candidate (including the incumbent.)

Let the arguing and ox-goring begin.

"I've Cracked It!"

2011-12-29T09:54:00.000-05:00

Reportedly Steve Jobs' final words about Apple's long-rumored venture into the thickets of TV programming. So has Apple, indeed, "cracked it?" Let's hope so.

Analyst Shaw Wu on why Apple should enter the TV business: “What’s missing is live broadcast television,” he wrote. “One obvious way to offer this is via the traditional way where a user subscribes to cable or satellite. But a more revolutionary, disruptive and differentiated way, is via the internet or IPTV which would be more in-line with its iTunes and iCloud model. Because of the high dependence on content providers, we believe exact timing is difficult to pinpoint.”

He added, “We continue to hear what AAPL would love to do is offer users the ability to choose their own customized programming, i.e., whichever channels/shows they want for a monthly subscription fee. This is obviously much more complicated from a licensing standpoint. And in our view, would change the game for television and give AAPL a big leg-up against the competition.” (Emphasis mine.)

Strategic separation of the magnitude Apple delivers is assembled from doing, not what others AREN'T doing, but doing what others CAN'T do. The hard stuff. The 'never been done before' risky stuff that nobody else has the fortitude or the imagination to tackle.

Like the mobility to choose my own programming. Whatever channels I want for a monthly fee. No more surfing past the twenty channels I ignore to find the three I watch. And maybe I can tell Siri "NO MATTER WHAT THE CIRCUMSTANCES, DON'T EVER SHOW ME ALEX BALDWIN OR LADY GAGA!"

Like being the easiest hospital with which to do business, the no-hassle, no-BS hospital.

Know anybody doing that? Me neither.

Is 2012 the year disaggregation and disruption (finally) come to TV? Is it the year for cable providers' stodgy attitudes and crappy service to (finally) bite 'em in the ass? Stay tuned (pun intended.)

Prayers Please

2011-12-25T00:29:00.000-05:00

Health care expert faces his wife’s cancer.

Job: Pres/CEO Rochelle (IL) Community Hospital

2011-12-22T15:24:00.000-05:00

"The ideal candidate will be a dynamic and exceptional leader with documented success in leadership, management, strategic planning, and execution of the strategic plan and vision. This candidate will have the ability to analyze problems and develop systems to accurately control the human, physical, financial, and informational resources of the organization. The CEO will have excellent communication and presentation skills at a professional level. Not only will the successful candidate serve as a highly visible role model to all, he or she must also develop positive working relationship with the RCHA board of directors, medical staff, community leaders and employees." (12/21/2011)

Contact: Stacey SibleyHuman Resources Manager
Rochelle Community Hospital
900 N 2nd Street
Rochelle, IL 61068
Fax 815-561-3125
No phone calls or recruiters please

(Disclaimer: I'm beginning to post interesting healthcare-related job opportunities as they come to my attention. These are not my searches. I am not a recruiter and have no stake, financial or otherwise, in filling the position, just a hope that, in some small way, I can assist you, dear reader, in finding your dream opportunity.

If you are a recruiter, I'm happy to post your searches here on Health Care Strategist. No charge (unless you're troubled by getting something for free. Then we should talk...)

E-mail me, Steve Davis, healthcarestrategist@gmail.com)

Surviving A Hospital Stay With Luck and Pluck

2011-12-22T14:27:00.000-05:00

A grad-school colleague once described his hobby – military history – as stories of luck and pluck stitched end-to-end. Stories replete with derring-do and narrow escapes. Suffering losses bravely while hoping for the occasional happy ending.

I feel much the same way about hospital customer service anecdotes (except there’s more unnecessary deaths and even fewer happy endings.) Still, I can’t help regaling you with another adventure through healthcare's minefields.

A friend’s father recently sought treatment for a leg infected with what appeared to be a nasty staph infection. A late-Saturday ER visit resulted in his admission and the first of what was supposed to be multiple doses of IV antibiotics.

Now this is a well-regarded hospital with a spanking new facility, a member of one of the industry’s most highly-regarded national systems. So far so good, right?

At 4:30 P.M. the next day, as the attending physician reviewed the chart, she wondered why no antibiotics had been administered after the initial dose in the ER. “No orders” she was told. So she wrote an order.

The nurse dutifully hung the IV bag yet failed to check that antibiotics were actually reaching their intended destination. They weren’t. In fact, some doohickie wasn’t connected to some other whatchamacallit, an error that wasn’t noticed until the next morning, nearly 36 hours after the ER visit.

I advised a call to the CFOs office and an utter refusal to pay for the hours wasted, antibiotics not given and another life jeopardized.

I realize that one anecdote is just that – one anecdote. I’m sure this hospital has elaborate patient safety protocols. I’m sure ‘near misses’ are rigorously investigated. I’m sure everyone talks the language of process improvement - PDCA. CPOE. EMR. Six Sigma.

And I’m sure, if Risk Management permits it, that hospital leadership would call these careless oversights wholly unrepresentative of a wonderful organization filled with wonderful people doing their wonderful best.

I’m sure. Well, pretty sure. Though if I ever find myself on the receiving end of an antibiotic IV, I'm checking the doohickies and praying for luck and pluck in equal mega-dose proportions.

Follow me (Steve Davis, Health Care Strategist) on Twitter @whatifwhynot

The Pause That Refreshes

2011-12-21T20:04:00.001-05:00

"In the name of God, stop a moment, cease your work, look around you."Leo Tolstoy (1828 - 1910)

You Need To Get Out More!

2011-12-21T19:54:00.000-05:00

"The trouble in corporate America is that too many people with too much power live in a box (their home), then travel the same road every day to another box (their office)." - Faith Popcorn, The Popcorn Report, 1991

Many pundits and more organizations are, rather suddenly, talking about innovation - what it is, how to do it, whether it offers a cure to what ails health care.

It's a long-time theme here on Health Care Strategist and if I could offer would-be innovators one bit of free advice, it would be this: get out more. You'll never get where you want to go from where you are. Boring, predictable, comfortable, sameness and routine are deadly to innovative thinking.

So see the world. Read voraciously and widely. Confront challenging ideas. Blow through your comfort zones. Chat up strangers (not counting new members at the country club.)

In fact, if you're serious about innovation and ideas, resign from the CC and hang out at a soup kitchen. The food's better and so are the people.

Your Idea Can Change the World

2011-12-20T13:34:00.001-05:00

"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"

Wal-Mart Wants To Be Your Doctor

2011-12-10T19:34:00.001-05:00

And your manager of chronic diseases. And your pharmacist. And maybe your health coach. They could even play in your ACO sandbox.

In response to the article, Wal-Mart says they’re NOT, repeat NOT “… building a national, integrated low-cost primary health care platform..." OK, got it. Not.

Unless, of course, they are.

It’s hard to deny their interest when a few scant weeks ago the retailer sent out a request for partners to help it "dramatically ... lower the cost of healthcare ... by becoming the largest provider of primary healthcare services in the nation."

It's no surprise that hospitals and physicians face stiff competition from unexpected directions. These deep-pocketed newcomers care not a fig for our outdated business models, our glacial decision-making and our ability to pervert most innovations that might disrupt the status quo.

[Read more from NPR blogs...]

My Healthcare Innovation

2011-12-10T19:30:00.001-05:00

We're shaking up healthcare with social innovation, says John Soloninka, CEO of the Health Technology Exchange:

"Health systems have been very slow to innovate and we under-realize our return from our investment in medical research and human resources. What we need is a health system that can distill and articulate its high priority problems, share them to the innovation community (internally and externally), reward innovators and facilitate rapid implementation of "disruptive" technologies. HTX is interested in My Healthcare Innovation as a way of creating and interconnecting communities of interest to share problems and best practices, while maintaining a safe and secure environment for frank discussion."

[Read more...]

I'm Sorry Mr. President

2011-12-10T13:20:00.001-05:00

I'm sorry Mr. President. I know a little something about Teddy Roosevelt and you're not him.

He fought for this country. You wrote law review articles.

He was a true outdoorsman and naturalist. You play golf, summer on Martha's Vineyard and wouldn't know a morel from a moral.

He said "Speak softly and carry a big stick." You deliver great speeches and, well, that's pretty much all.

Next time you channel someone, pick a lesser light. You won't suffer so badly by comparison.

(Image from here, based on Creative Commons search.)

The Doctor In Your Car

2011-12-09T09:24:00.000-05:00

Ford Exec To Keynote Digital Health Event At CES: Gary Strumolo, global manager of health, wellness, interiors and infotainment for Ford Research and Innovation will be the day one luncheon keynote speaker for the Digital Health Summit at the 2012 International CES.

From the article:

"Just as mobile has enabled Americans to take a more active role in managing their health and well-being, automobile manufacturers like Ford are looking to develop a series of health and wellness in-car connectivity solutions designed to empower people with self-help information while they drive," said Jill Gilbert, co-producer, Digital Health Summit. "As the most progressive automobile brand in the health space, Ford has both the credibility and expertise to share insights on next generation innovations around consumer oriented health and wellness solutions on the go."

"Leveraging the Ford Sync connectivity platform and its ability to connect to mobile devices via Bluetooth, access cloud-based Internet services and control smartphone apps via voice recognition, Ford - collaborating with WellDoc, SDI Health and Medtronic - developed industry-first, voice-controlled health and wellness in-car connectivity solutions that include alerting diabetics to glucose levels through audio alerts, an allergy alert app providing location-based index levels for pollen, and health management services while on-the-go."

Interesting. Watch where this trend goes.

Winners of the Making More Health Competition Bring Fresh Innovation to Solving Problems in Health

2011-12-07T10:04:00.000-05:00

Winners of the Making More Health Competition Bring Fresh Innovation to Solving Problems in Health

Example: ColaLife - piggybacking simple medicines on soft drink supply chains, saving lives in underserved areas of rural Africa. Medicine has a hard time getting to where it's needed but cola is everywhere. Why not combine the two? Great idea!

Thomas Goetz: It's time to redesign medical data

2011-12-03T14:43:00.001-05:00

"Aggravate a traveler, then hand them a smartphone..."

2011-11-29T18:36:00.001-05:00

Especially a traveler who is also a composer and musician. From Alexandra Samuel, blogging at HBR Blog Network about Qantas Airways' misadventures through the social media minefield:

"We've been saying this for a while now but it's worth repeating: Social media turns branding into a true (if often accidental) collaboration between company and customer, in the way it enables constant and often bottom-up collaboration within organizations, and in the way it accelerates the pace of conversation and organizational change. Social media tends to flatten hierarchies, disempower gatekeepers, and give a voice to anyone who cares to speak about an issue, or a brand."

Still a doubter? Maybe you should Google "United Breaks Guitars" - another airline but still the poster child for customer revenge, and the point that started this post...

Rated Lower On Satisfaction, Hospitals Blame ‘Cranky’ New Yorkers

2011-11-25T12:14:00.001-05:00

Say the headlines. Of course the official explanation is “Well, Manhattan residents are crankier, tougher to satisfy and have higher expectations than those ‘nice’ Midwesterners.”

Really? Let’s parse cause and effect here. (Fair warning: I’m not the least bit sympathetic to the official explanation.)

The NY Times’ article offers an anecdote of a NYC patient waiting 8 hours for an imaging exam and not getting a magazine when she asked for one. And she refused to give the hospital a top score because…she’s CRANKY?

Excuse me?

And there’s this: NYU Medical Center is building new elevators to reduce waiting times, though they won’t be ready until a new building opens in 2017. How long has NYU known about their slow elevators? Decades, probably, yet we’re still 5 years and several hundred million dollars away from a solution. And we’re supposed to believe the problem is…CRANKY PATIENTS?

Excuse me?

I’ve worked in markets ranked #183 (Hinsdale, IL), #27 (Omaha, NE) and now #1 (Mason City, IA.) Admittedly 3 markets – two urban, one fairly rural - is not a huge sample size, but the difference in patient satisfaction scores between them is NOT the patients.

Leadership, culture, training, processes, strategy, focus, investments, priorities, - yes.

Patients – no.

The "our patients are crankier..." explanation is just the latest example of the "our patients are sicker..." nonsense used for 40 years by doctors and hospitals to avoid any and all quality comparisons. I don't buy the excuse-making. You, dear healthcare strategist, shouldn’t either.

The problem, IMHO: Too many leaders walking past problems - er, opportunities – without taking direct, remedial action. The symptoms:

• Talking becomes doing.
• Hiring a consultant becomes action.
• Scripting substitutes for conversation.
• “It’s on my list…” passes for progress.
• “I’ve called a meeting…” becomes accomplishment.
• Taking it to committee is a milestone achieved.
• Forming A NEW committee is considered innovation!
• Bulging PowerPoint decks become communication.
• It’s one priority among many…unless budget realities intervene, then it’s not even that.

And of course, whatever we do, we musn’t upset the docs!

Suddenly Medicare changed the grading curve. “Good enough” no longer is. And some leaders, up against the hard realities of lost revenues, must make twenty years of progress in two. Can you spot the problem here? I can and, once again, IT’S NOT THE PATIENTS!

It's time to say to the excuse-makers "Sometimes when the data say you have room to improve...YOU DO! Deal with it!"

Might New Yorkers have good reason to be cranky?

"It is so simple, just do what you love."

2011-11-20T22:08:00.001-05:00

Christina Stevens writes about senior living at her blog "Next Wave." Good stuff.

2011-11-20T15:31:00.001-05:00


http://www.amazon.com/Screw-Lets-Do-Lessons-Quick/dp/0753510995

Haven't read it yet, but love the title!

Questions For A Sunday Morning

2011-11-20T15:07:00.001-05:00

Weight loss: Commercial weight-loss schemes outperform physician recommendations. Does your heartfollow where your pocketbook leads? (Chicago Tribune)

Prostate surgery: Risks associated with prostate surgery are lower at academic medical centers. Does practice make, if not ‘perfect,’ at least ‘better?’ (Chicago Tribune)

Quality measures: Will your physician ‘fire’ you to meet standards for incentive-basedcompensation? Are you a parent whorefuses to vaccinate your kids? “You’re fired!” (Advisory Board)

Disease management: Programs for Medicare patients do not improve quality, reduce costs or decrease hospital and ED visits. It’s only one study,but disappointing nevertheless. (NEJM)

(Image from http://www.steinski.com/blog/a_question_for_you/ via a Creative Commons search)

2011-11-19T13:53:00.001-05:00

Motifake.com

"Major segments of the US economy have been lost, in some cases, forever."

2011-11-19T13:04:00.001-05:00

From Clayton Christensen being interviewed by Steve Denning for Forbes:

"Firms need to be evaluating future investments strategically in terms of how they will affect their capacity to go on delighting their customers for a sustained period in the future.

"For managers trained in traditional business school thinking, the idea that pursuit of profit is the problem, rather than the solution to the economy’s problems, may come as a shock. For business school professors who have spent their lives teaching the focus on profits and the use of IRR and RONA to measure profits, the coming change may be even more disturbing.

"Like all new ideas, in the first instance it will be rejected. Then it will be ridiculed. Finally it will be self-evident and no one will be able to remember why anyone ever thought otherwise."

What I'm Reading: "Different; Escaping the Competitive Herd"

2011-11-19T12:41:00.001-05:00

"...every year, I tell my students that marketing is the only function in the organization that is expressly designed to sit at the intersection where business meets people. Real people. And the problem with real people is that they don't see the world the same way a businessperson does. They don't speak the language of bullet points; they don't organize the world into flowcharts and frameworks. People, real people, view the world more organically. They are idiosyncratic. They are unpredictable. They are beautifully disorganized."

(From "Different; Escaping the Competitive Herd" by Youngme Moon.)

"...marketing is the only function in the organization that is expressly designed to sit at the intersection where business meets people." I like that.

(Image from http://layered.typepad.com/antidote_to_burnout/images/2007/10/06/4b14310b020017cf.gif found via a Creative Commons search)

Jawbone’s Wristband Health Monitor

2011-11-18T09:42:00.001-05:00

Bloomberg Business Week: "And now there’s UP. “The big idea here is to help make people consumers of their own health,” Rahman says. “We probably know less about our bodies than we do about our phones.” UP is supposed to change that. The pliable rubber-coated wristband is meant to be worn nonstop for 10 days at a time, even in bed and in the shower. An accelerometer inside tracks data like the number of steps a person takes in a day and the number of calories he or she has burned. The device also monitors sleep patterns and can be programmed as an alarm that wakes the wearer, within a preset time range, at the ideal moment in their sleep cycle. The accompanying iPhone application lets users share their UP data with friends, create personal challenges, and record and track each meal they eat."

On sale later this month for $100 at Best Buy, Target and Apple stores, UP may be the best $100 you've spent on your health.

[More, here.]

An Apple A Day...

2011-11-18T09:27:00.001-05:00

From From Doors Of Perception: "...between 1995 and 2010, North American taxpayers spent over $260 billion on subsidies of junk food ingredients compared to $262 million - *one thousand times less* - subsidising apples [which is pretty much the only fresh food to get a subsidy at all]."

The Challenges Facing Low-Quality Universities

2011-11-17T09:43:00.001-05:00

From The New Republic: "A Much Needed Challenge To Low-Quality Universities." Higher education is in crisis. Out of touch thinkers and policymakers. Skyrocketing costs (even faster than healthcare.) Mounting student loan debts. De-emphasized teaching and research while administrative layers grow without limit.

Despite the serenity of most college campuses,

"...the reality of higher education is that most students today don’t have access to..an idyllic (and expensive) college experience, never have, and never will. Instead, many get stuck in big, low-cost lecture courses of indifferent quality provided by institutions that treat students like anonymous tenants. Those are the places that are going to be transformed by technology.

"These disruptions will take many forms. While it’s impossible to predict exactly what the typical college student’s educational experience of the future will look like, the changes will almost definitely include a decline in the number of students living in or commuting to physical locations to attend classes. Instead, students will accumulate credits from a range of different online providers, each specializing in different subjects and programs. Some firms will focus on tutoring, some on career counseling, some in assessing knowledge and skills. Students will increasingly use the fast-growing library of free content being generated by the Open Educational Resources movement. The component parts of the traditional conglomerate university will be picked off by specialty providers, just as newspapers have seen different pieces of their business model attacked by Craigslist (classifieds), blogs (op-eds), Groupon (local advertising), and more.

"The institutions likely to get hit earliest and hardest include a lot of relatively non-selective regional four-year universities, many of which are continuing to raise prices in vain attempts to climb the U.S. News & World Report status ladder. They also include many high-flying for-profit institutions. The brave new world of online higher education isn’t necessarily one where everyone goes to the University of Phoenix. Publicly-traded for-profits like Phoenix, Kaplan University, Corinthian, and others have been successful primarily through innovations in marketing, business processes, harvesting federal financial aid dollars, and scale. Their actual educational programs, even those conducted online, are often quite traditional—and expensive. When technology does to higher education what it has done to scores of other industries—empower consumers, create new markets, and rip huge amounts of cost out of the system—the least innovative for-profits could be the first to fall."

Empower consumers. Create new markets. Rip huge amounts of cost out of the system. Of course it happens AFTER my daughters have graduated.

If Disney Took Out Your Trash

2011-11-07T18:42:00.001-05:00

If you’re a reasonably long-time reader of Health Care Strategist, you’ve heard me criticize health care's apparent incuriosity about the innovative world beyond some walnut-paneled boardroom.

“Not invented here. Can’t work. Let’s take it to committee. Better yet, let's form a NEW committee! It’s too risky. Health care is different. You don’t understand - we’re a hospital, not Google! Nobody else is doing it. Why should we?”

Some of you think I’m being too hard on an industry that’s paid my bills for 25+ years. Really? Then tell me why this story is headline-worthy:

"Community Hospital Borrows Show Biz Staging."

Visit any Disney property and what you WON’T see are maintenance carts, food deliveries, trash removals or employees rushing to their job station. All that operational stuff happens behind the scenes, away from the paying public’s eyes.

Lessons from Disney

Disney pioneered this separation of public and private spaces in the early 1960s at Anaheim’s Disneyland and a decade later on a bigger and better scale at Orlando’s Disney World. By my count that’s 50 years of very public, consumer-focused design. 50 years of lessons to be learned by anybody willing to stop, think, and ask “What if..? Why not..?”

Disney’s thinking has, quite belatedly, diffused throughout health care’s design community. Yet even today it’s sufficiently rare that projects based on this philosophy make headlines.

Ask yourself something: in 50 years, how many times have YOU vacationed in the Magic Kingdom? How many times have your colleagues, your planners and architects visited? Thousands?

And still decades passed before someone in healthcare went “Hey! Wow! What great ideas! Maybe our customers don’t want to see us moving red-bagged trash down a public corridor. And maybe patients on gurneys would rather not be gawked-at on those long elevator rides from 5-East to Radiology and back again.”

Yes, they are great ideas. Ideas that sat there in public view for decades while generations of healthcare execs went merrily along their way. What are we walking past right now, day after day, without seeing the problem and the opportunity? And don't answer 'nothing.'

I think of myself as a hospital leader AND a consumer. I seldom go anywhere without observing what works (and what doesn't.) What I love (and what I loathe.) The details of service and process excellence. Sometimes that's all innovation requires - those everyday consumer experience, a little reflection, some exploration and lots of empathy.

"I went to Disney World and loved it...but why?"
"I shopped at an Apple store and loved it...but why?"
"I stayed at a Ritz-Carlton and was amazed...but why?"

(The 'why's' are the most important, by the way.)

Of course now you can read books about Disney and Steve Jobs and RItz-Carlton, no travel required. But so can your competitors and wouldn't you rather get there first?

I suppose I should recognize progress instead of criticizing delays. After all, it’s been months since I heard a hospital bragging about the cool flat-screen TVs in their new bed tower. (As if you could buy anything else…)

Your Next Health Coach May Be...

2011-11-03T10:32:00.002-04:00

...your car. From Edmunds Inside Line:

"Ford cars and trucks may soon be able to tell you when to take a puff on your asthma inhaler or test your blood glucose level, as the Dearborn automaker is poised to take its Sync communications system far beyond infotainment.

"The Dearborn automaker offered a tantalizing — if somewhat disconcerting — look on Wednesday at the potential for a vehicle to be your partner and coach when it comes to health and wellness.

"Ford said it was intent on demonstrating a paradigm shift in the way its Sync communications system is used. In the not-too-distant future, a car could let you know the UV index so you could apply the proper amount of sunscreen, monitor your food choices at McDonald's, or check your calendar to see whether you'll be playing sports that day and may need an extra puff or two on your asthma inhaler.

'"We're not trying to turn the car into a medical device," said Alan Hall, a Ford spokesman in a phone conversation with Inside Line. "We're a conduit for healthcare to become mobile."'

As they roll out their own health coaching strategies, do physicians and hospitals see Ford as competition? Maybe they should. And I'll bet Ford gets there first.

Actually, turning the car into a medical device is fine with me. I'd much rather deal with my mechanic than my HMO or some clinic's wretched appointment scheduling system. My mechanic only charges an arm and ONE leg.

Hospital Marketers: TIme To Own the Growth Agenda

2011-10-30T13:52:00.001-04:00

Hospitals' salad days are over, at least if you believe the breathless headlines. Gone are the days when business models could be built simply by chasing Medicare's hot reimbursement du jour.

Unfortunately, more than business models were built on such crabbed thinking. Where Medicare led, capital structures, facilities, strategic thinking, indeed the very definition of 'success' were sure to follow.

And follow they did. Massive was the party. Crushing are the debt loads and mediocre the results. Naturally a pounding hangover ensues, though the remedy - perhaps a 'rescuing' full-asset merger - is neither quick nor painless.

(Example: Elmhurst Memorial Healthcare's dalliance with Northwestern Memorial HealthCare. “I think having that new facility is going to be a real challenge for (Elmhurst) financially,” says my friend Brian Sanderson, a partner at Oak Brook-based accounting firm Crowe Horwath LLP)

"We've nothing left to cut!" is the common refrain - common, predictable and mostly untrue. Still, organizations make their own reality and, if you believe you're out of ideas, you are.

So might I suggest it's time to GROW? And by growth, I don't mean (say it quickly so it blurs together) "Let's grow Orth-onc-diac!" Like every other hospital on the planet. No, that party's long over. Incremental value lies in completely new directions.

New directions begging for someone to reframe, to call 'time-out' on the B.S. of "I don't have to outrun the bear, I just have to outrun you!" Someone to innovate and incubate new generations of business models. Someone to OWN THE GROWTH AGENDA. Why not you?

Time for idea-driven marketers to leave the past behind and take a big step forward.

(Connect with me on Linkedin.)

Marketing LEADS

2011-10-29T15:23:00.000-04:00

Some hospital marketers are obsessed with control. You probably know one or two like that, more's the pity.

"Stop interrupting!" they tell their organizations. "We're working our plan and we know what's best for you!"

Anything outside that neatly packaged world view becomes an imposition, a ripple on the quiet millpond of reality. "He LEADS" is never said about marketing control freaks because they're never Listening, never Engaging or Adapting, rarely Delivering Strategic Separation (I know that's 2 'S's.' Humor me.)

Having a plan is fine. Having an opinion is expected. An emphasis on control benefits neither.

LEADS means empowerment, not control. The best ideas, not MY ideas. Teaching, not telling. Learning, not arguing. Listening, not talking. 'We,' not 'I.' All of us are smarter than one of us.

Try to be the marketer about whom it is always said "She LEADS." Everything else is just commentary.

Seth Godin: "If Committees Told the Truth."

2011-10-29T13:57:00.000-04:00

That truth would be:

"Hi, we're here to take your project to places you didn't imagine.

With us on board, your project will now take three times as long.

It will cost five times as much.

And we will compromise the art and the vision out of it, we will make it reasonable and safe and boring."

Or as I always say, committees are where ideas go to die.

An eBay For Purchasers and Providers

2011-10-25T22:20:00.002-04:00

BIlling itself as a "health services exchange," Open Health Market offers discounted, fixed, packaged pricing for an episode of health care.

Discounts. Fixed pricing. Packaged services. Easy access. Transparent quality data.

From the article: "...this concept goes flying over the head of four out of five" U.S. hospital executives. "I'm stunned at how difficult it is for most of them to get their minds around it."

Stunned? Really?

More here at Open Health Market's website.

“He told them it was ugly and too complex..."

2011-10-25T18:39:00.002-04:00

From The Daily News Blog: "Bio: Steve Jobs was a details man, even in his Memphis hospital bed."

"In Walter Isaacson’s biography of Apple CEO Steve Jobs that went on sale Monday, there’s some fascinating detail about Jobs’ stay in Memphis during 2009, when he got a liver transplant at Methodist University Hospital’s transplant institute.

"Jobs, who died earlier this month at age 56, was ever the details man, even in his hospital bed.

"There’s a moment in the book’s recounting of Jobs’ transplant when Jobs pulled off an oxygen mask, grumbled about the design and ordered someone to bring him five different choices of masks. He said he’d pick the one he liked.

"Same for the oxygen monitor on his finger.

“He told them it was ugly and too complex,” Isaacson writes of the monitor. “He suggested ways it could be designed more simply.”

So here's a question for you: before, during and maybe even after Jobs' hospital stay, how many hospital staffers saw those same devices - O2 masks, oxygen monitors, etc. - without spotting the obvious? How many learned nothing, noticed nothing, simplified nothing?

Here's another question: how many other opportunities like that are lying fallow in YOUR organization?

Wanna bet the answer is an integer significantly above zero? Dinner? You're on!

(Connect with me on Twitter @whatifwhynot )

Great PowerPoint Presentations: Oxymoronic?

2011-10-24T09:19:00.001-04:00

No, but sometimes they can be rocket science as Edward Tufte shows in "PowerPoint Does Rocket Science--and Better Techniques for Technical Reports."

Tufte studied NASA's PowerPoint-fueled discussions as engineers struggled to assess the damage, if any, space shuttle Columbia sustained during a 2003 liftoff when a small piece of foam insulation broke off, striking the orbiter's left wing. We all know how that story turned out.

Thankfully I'm called to deliver presentations with ideas, not lives, hanging in the balance. Still, telling a story clearly, concisely and powerfully never hurts.

Sun Comes Up, It's Tuesday Morning

2011-10-18T09:21:00.000-04:00

Not very organized today, so you'll have to put up with a few random things catching my eye...

1. Distrusting their government's message on nuclear safety, Tokyo residents self-organize and go looking for radioactive hot spots. Guess what they find?

Watch this "self-organization" trend. It's coming to a health care neighborhood near you. Maybe they'll self-organize into a booster club for your current business model...though I wouldn't bet on it.

2. The Regenstrief Institute (IN) launches an initiative to encourage innovation, naming John Duke, M.D., the Institute's first Innovation Officer.

"We are encouraging everyone associated with the Institute to come forth with ideas. Traditionally researchers develop ideas and then pursue funding. Learning from successful organizations such as Google, Facebook and Netflix, we are both accelerating and democratizing the idea process. We are encouraging everyone, from established researchers to fellows-in-training to software developers to research assistants to affiliated clinicians to let us know what they think has potential," said Dr. Duke, an internist and informatics specialist.

Democratizing the idea process. I like that, having once worked with a hospital CEO whose idea of innovation was "I think big thoughts. You do what I tell you."

3. And Dr. Westby Fisher asks what would a doctor's version of Occupy Wall Street look like?

"Must doctors accept the pervasiveness and intrusiveness of the inside game in health care? If they didn’t, I wonder what doctors’ placards might say?"

Whatever they say, I'll bet the spelling improves (though not the handwriting.)

4. Mother Jones' Kevin Drum says the future is brighter than you think. (Thanks for the heads-up to LongForm.org's "weekend reads for wonks.")

Social Media In the C-Suite

2011-10-13T13:23:00.000-04:00

C-Suite denizens have had difficulties warming up to social media. Most are used to being, if not the entire conversation, at least in charge of what's said, when and to whom. Social media's democratizing effect threatens that neatly-ordered world.

And it's humbling to learn that your thoughts and opinions aren't crystalline, brilliant or even very persuasive. Readers talk back, using adjectives like idiotic and clueless, sometimes alone or in very creative combinations. (Happens to me all the time, in case you're wondering.)

A critical (though common) misperception is that social media is about "Me talk. You listen. Me talk more. You do what I say!" That never worked with my daughters and I doubt it'll work for many hospital CEOs.

In "Social Media in the C-Suite: Listening, Learning and Creating a Strategy from the Top Down" Knowledge @ Wharton interviews author Michael Lewis about the opportunities and pitfalls in implementing a social media strategy in the C-suite.

Says Lewis:

"...most people misinterpret what social media's about. They use it as a talking vehicle. Social media is a listening vehicle. It's both. But most people don't understand that the real power is to be able to listen to the customer in a real time and effective way."

[...]

"It (starts) with listening and evangelizing throughout the organization. And enabling (active participation) in social media. And gearing up for the fact that the world is changing at a rapid rate right now. And it affects every business, as Eric said, every aspect of the business. That's not easy, to re-imagine your entire organization in the time frames that social media will affect it. But look, social media can topple governments. It's going to affect your business."

There it is: "Social media can topple governments. It's going to affect your business."

I'd change that last sentence to read "It's affecting your business, right now, today." Your job, dear C-suiter, is to screw up your courage, don some adult underwear, join the conversation and turn it to your competitive advantage.

2011-10-09T12:36:00.000-04:00

Randy Lewis writing in the LA Times, discusses a little-known aspect of Steve Jobs' legacy:

"Stevie Wonder said Thursday that he sought Jobs out late in his life to express his gratitude for matters that went well beyond what he and his company did for music.

"The one thing people aren't talking about is how he has made his technology accessible to the blind and the deaf and people who are quadriplegics and paraplegics," Wonder, 61, said. "He has affected not just my world, but the world of millions of people who without that technology would not be able to discover the world.

"His company was the first to come up with technology that made it accessible without screaming out loud 'This is for the blind; This is for the deaf.' He made it part of the actual unit itself. There was application inside the technology that allowed you to use it or not use it.

"The iPhone, iPad touch, iPod touch, all these things, even now the computer, are accessible to those who are with a physical disability," the 25-time Grammy Award winning singer, songwriter and instrumentalist said."

2011-10-09T11:21:00.000-04:00

David Leonhardt writing in the NY Times: "Health care is far larger, with the United States spending at least 50 percent more per person on medical care than any other country, without getting vastly better results. (Some aspects of our care, like certain cancer treatments, are better, while others, like medical error rates, are worse.) The contrast suggests that a significant portion of medical spending is wasted, be it on approaches that do not make people healthier or on insurance-company bureaucracy."

This May Hurt A Little Bit: Entrepreneurs Can Fix Health Care

2011-10-07T15:33:00.001-04:00

Washington Business Journal WBJ BizBeat: "Former Kaiser CEO: Entrepreneurs can fix health care."

"Entrepreneurs — not the government and surely not established industry players — will be the ones who ultimately fix the deeply flawed American health care system, said Dr. David Lawrence, the retired CEO of Kaiser Permanente."

“The problem with incumbent medical care systems is, they don’t change,” Lawrence said. “What they tend to do is capture the innovation, the entrepreneurial activity, and either slow it or they transform it to what their needs will be, and they often bastardize what are very, very important innovations.”

Lawrence predicted pain as the system evolves.

“To do these well is going to require disrupting traditional medical relationships with patients, it’s going to require disrupting sources of income for the traditional medical care system, and it’s going to require disrupting the relationship of the consumer to the medical care system," he said.

Lawrence's six areas of entrepreneurial opportunity: triage, navigation, chronic illness, preventative health care, wellness management and end-of-life care.

The re-making of health care has already begun. Hospital executives, at least those with the slightest curiosity, should be terrified by the energetic entrepreneurs focused on the idea that many (most?) hospital admissions are properly viewed as defects somewhere else in the system.

Fix the defects...cut off admissions...add value...save costs...keep the value. Repay VC funders. Repeat.

Many successful business plans have been built on less.

Why The Next Steve Jobs Will Never Work For Your Hospital

2011-10-06T16:25:00.004-04:00

Your hospital has thousands of employees, but could you use your very own version of Steve Jobs? Probably, but don't kid yourself. He'd never get past your H-R department's first line of defense, with his attitude and his iconoclastic views and his wardrobe. Someone would scrawl "Weird and Possibly Dangerous" across his resume and that'd be that.

But don't fret. I'm pretty sure the feeling would be mutual. And that's why your hospital's branding tagline really ought to read "We're no worse than anybody else."

The NY Times' David Pogue on Steve Jobs: "Imitated, Never Duplicated:"

"Here’s a guy who never finished college, never went to business school, never worked for anyone else a day in his adult life. So how did he become the visionary who changed every business he touched? Actually, he’s given us clues all along. Remember the “Think Different” ad campaign he introduced upon his return to Apple in 1997?

“Here’s to the crazy ones. The rebels. The troublemakers. The ones who see things differently. While some may see them as the crazy ones, we see genius.”

"In other words, the story of Steve Jobs boils down to this: Don’t go with the flow.

"Steve Jobs refused to go with the flow. If he saw something that could be made better, smarter or more beautiful, nothing else mattered. Not internal politics, not economic convention, not social graces.

[...]

"Suppose, by some miracle, that some kid in a garage somewhere at this moment possesses the marketing, invention, business and design skills of a Steve Jobs. What are the odds that that same person will be comfortable enough — or maybe uncomfortable enough — to swim upstream, against the currents of social, economic and technological norms, all in pursuit of an unshakable vision?

"Zero. The odds are zero."

Hospitals are dangerous places. Lives hang in the balance and there's no place for freelancing. But couldn't you use just ONE cranky visionary, just ONE person reminding everybody that going with the flow sometimes means you're in the sewer? One lone voice holding mediocrity hostage, screaming "Dammit! Life is too precious! We can be BETTER! Lead, follow or leave!"

"Zero. The odds are zero."

Depressing.

And lest you think that Jobs' legacy offers no lessons for hospital leaders, consider this: for all his innovative vision and creativity, his ability to distort reality in "insanely great" ways, Apple remains one of the planet's most disciplined and focused organizations. Disciplined around process and philosophy. Focused around doing a few things exceptionally well and NOT doing whatever detracts from those few things.

Those are lessons worthy of ANY organization.

Doctors Learning to Speak "Iowan"

2011-10-05T13:22:00.001-04:00

From Iowa Public Radio: Doctors Learning to Speak Iowan at Mercy Medical Center in Mason City, IA.

"Learning to speak English is one thing, learning to speak Iowan may be something else entirely. Iowa, especially in its more rural areas, has many foreign-born physicians practicing in clinics and hospitals. On today's program, we’ll find out about an innovative program in Mason City that helps doctors understand our state with courses like "Topics for Small Talk with Iowans." We'll talk to the teachers in the program at Mercy Medical Center North Iowa, Univ. of Northern Iowa professors Mark Grey and Michele Devlin. We'll also hear from the man who devised the program, Dr. David Little, and Family Medicine Residents Dr. Sreevalli Dega and Dr. Anileen Prabhakaran."

2011-09-28T11:42:00.000-04:00

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

“You’re looking at a generation of 20- and 30-year-olds who are used to self-organizing,”

2011-09-28T11:29:00.007-04:00

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 authoritarian governments this year, toppling longtime leaders in Tunisia, Egypt and Libya. Protesters have created their own political space online that is chilly, sometimes openly hostile, toward traditional institutions of the elite.

"The critical mass of wiki and mapping tools, video and social networking sites, the communal news wire of Twitter and the ease of donations afforded by sites like PayPal makes coalitions of like-minded individuals instantly viable.

“You’re looking at a generation of 20- and 30-year-olds who are used to self-organizing,” said Yochai Benkler, a director of the Berkman Center for Internet and Society at Harvard University. “They believe life can be more participatory, more decentralized, less dependent on the traditional models of organization, either in the state or the big company. Those were the dominant ways of doing things in the industrial economy, and they aren’t anymore.”

What are health care's "dominant ways of doing things" and what happens when they aren't any more? Do we adjust only when the bonds of trust are irrevocably gone and our customers are fed up with our crap? For now, we in healthcare are seen as the good guys - expensive, but good. For now...

UPDATE: In all the media coverage of Steve Jobs' passing, there's this from the NY Times: "What Steve Jobs Understood That Our Politicians Don't."

"After all, if you wanted to really get a picture of how the national culture has evolved in the last few decades, particularly in the urban areas that drive economic growth, you could do a lot worse than to study Apple’s string of innovations. (Steve) Jobs understood, intuitively, that Americans were breaking away from the last era’s large institutions and centralized decision-making, that technology would free them from traditional workplaces and the limits of a physical marketplace."

[...]

"And no politician wants to really innovate without focus groups, to make a sustained argument for any solution that might entail risk or imagination. Our parties are less like Apple and more like General Motors, churning out this year’s streamlined model of the same cars it was asking you to buy 20 years ago. Even the circuitry of the democracy remains essentially unchanged; a nation of voters who can find their cars and pay their mortgages online still can’t envision the day when they can cast their votes from an iPad."

Politicians aren't the only ones "not gettin' it."

What's On Your 'Unlearn' List?

2011-09-27T18:55:00.004-04:00

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 House magnitude is necessary. Unlearning and a willingness to stand apart from the comfortable herd spouting 'We're no worse than anybody else.'

What would you have to unlearn to deliver an episode of care for, say, fifty percent less than today? You better figure it out before the marketplace does, or you'll be living in one of those $300 houses. Actually, it may not be that bad.

[Read the Harvard Business Review article...]

Have Cancer Treatment Costs Grown Beyond 'Sustainability?'

2011-09-27T13:30:00.004-04:00

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 cancer care."

"Different" by Youngme Moon

2011-09-25T12:54:00.000-04:00

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.

Smoking Kills and I've the Game To Prove It!

2011-09-24T14:17:00.006-04:00

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.

"I Have An Idea..."

2011-09-19T20:31:00.006-04:00

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.

"What if..?"

Leave a comment about how your organization is cultivating the next generation of game-changing ideas. Where do you find them? Nurture them? Reward them? Thanks!

Poor Warren Buffet

2011-09-16T18:03:00.002-04:00

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.

Hospitals Need A Steve Jobs.

2011-09-16T18:00:00.001-04:00

"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."

I'm From the Mob and I'm Here To Help You...

2011-09-16T17:53:00.005-04:00

...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 organized mobs, oxymoronic as they are. Still, you could do what these leading Michigan hospitals are doing:

Ask patients one at a time, like Dr. John Popovich Jr., president and CEO of Henry Ford Hospital.
Ask patients to keep tabs on their experience with a real-time journal, like St. John Providence Health System.
Eat in the cafeteria once in a while, like Gene Michalski, CEO of Beaumont Health System in Royal Oak. Not a bad idea and I’ll bet the food improves.

The Battle Over Hospitals' Tax-Exempt Status Heats Up In Illinois

2011-09-14T18:32:00.006-04:00

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" from their tax-exempt, not-for-profit competitors.

I don't think anybody (even Illinois' tax authorities) begrudges a "no margin, no mission" mindset. But to my NFP brethren in Illinois, I'll simply say this: if you wish to be thought of as a charity, then act charitably.

In case you're unclear on the concept, let's return to the source - Merriam-Webster:

Char-i-ty. A noun, meaning (1) benevolent goodwill toward or love of humanity, or (2) generosity and helpfulness, especially toward the needy or suffering.

The more you act like any other business (even one that just happens to deliver a social good like health care) the more you'll be treated like any other business. That is to say rudely, at arms' length and 'just show me the money.' But fair's fair since that's pretty much how indigent patients feel leaving your ER.

One percent of revenues devoted to charity care? I'm not sure where lies the tipping point between business and charity, but c'mon. That falls on the side of 'caught red-handed.'

Which Is More Important: A Certified EMR or a Productivity-Improving EMR?

2011-09-14T17:22:00.000-04:00

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."

2011-09-13T10:40:00.000-04:00

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

2011-09-04T12:25:00.000-04:00

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...]

Everbody Needs A Weekly Dose...Of Ideas

2011-08-31T23:32:00.000-04:00

Every week another batch of cool ideas lands in my inbox courtesy of the trend spotters at Springwise.com. 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 that are bought and sold every day."

And that's just a week's worth. If you can't find an idea worth implementing, you're NOT trying very hard.

Can You Afford To Scrimp On Planning?

2011-08-31T22:22:00.001-04:00

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

2011-08-29T19:13:00.000-04:00

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."

2011-08-28T21:05:00.000-04:00

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...]

Knock Knock! Anybody Home In Strategic Planning?

2011-08-26T13:58:00.002-04:00

From Georgia Everse at HBR Blog Network: "Eight Ways to Communicate Your Strategy More Effectively."

Great ideas for those of you wondering why your strategy, lovingly crafted and lavishly announced, with great effort and more than a little expense, landed in your organization with a hollow thud...followed by deafening silence.

[Read more...]

2011-08-26T12:57:00.000-04:00

JAMA: How to improve patient safety with your EHR? Add natural-language and free-text processing algorithms. In short, think Google, not billing codes.

[Read more...]

Do Best Practices Suck?

2011-08-25T18:14:00.000-04:00

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 their fresh eyes think of your systems. Every time they ask Why (as in “Why do we do it like this?”), give them a sign of your thanks – a crisp $100 bill, an afternoon off, a long lunch with you someplace special."

[Read more...]

Work...Love

2011-08-25T09:15:00.001-04:00

"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?

2011-08-23T10:04:00.002-04:00

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 Amazon.com? (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 experience left me thinking: What could hospitals and their CIOs learn from Amazon, American Express, and others?

"The initial office visit: I like to stay on top of things: pay my bills before they are due, keep up with the lawn, meet deadlines at work. But it was still surprising that I had to remind my physician that I was overdue for a colonoscopy—in fact, I was two years late.

"How could this happen in a world where Amazon.com sends me tailored reminders about things they think I might buy? Were my expectations unreasonable? Or is our health care system out of touch with modern life? My screening would give me plenty of other reasons to consider these questions…

"The referral: My physician referred me to a gastroenterologist who didn’t use an EMR system in his office, so I filled out all the same paperwork and repeated the physical exam. While waiting, I booked a flight through one airline on a “code share” with another airline. The details were seamlessly and automatically transferred to the second airline’s system–-no duplicate data entry required.

"The gastroenterologist’s office later called to move up the time of my procedure due to a cancellation, but I never received an electronic confirmation of the original appointment or the time change. My airline schedule, on the other hand, is archived in my inbox. If my flight is canceled or delayed, I will automatically be updated via email and text.

"The check-in: When I checked into the hospital for my procedure, I wrote my name on a slip of paper, which was several minutes later carried by a volunteer into a nearby room for processing, for greater privacy. I realize that health care providers are feeling nervous about security, but there are more efficient and effective solutions. When I book a hotel, I pre-enter my personal information online, and it’s instantly confirmed at the check-in desk without any forms.

"During registration the financial counselor asked for $800, although screening colonoscopies are 100% covered by my insurance. After half an hour of confusion, we learned the gastroenterologist had submitted a more costly billing code in case he had to remove polyps during the procedure. His office said they’d refund our money if he didn’t find anything, but I wondered whether he would look really hard for something to take out to justify the code. Imagine prepaying the hotel mini-bar in full—just in case you need those seven sodas and five snack packs!

"In yet another contrast, American Express earns my loyalty with billing and dispute resolution systems that put my interests first and ensure satisfaction with card purchases.

"Waiting for the procedure: After I searched in vain for the status of my procedure, waiting room volunteers explained that colonoscopies like mine were not included on the outpatient surgery center tracking board. However, even the Department of Motor Vehicles gives me a number that I can track on screens throughout their waiting room--no matter what sort of vehicle I am registering.

"Later, I undressed and waited for my colonoscopy in an empty room full of stored mobile devices. As I was being wheeled into the actual procedure room, it dawned on me that even my health club doesn’t have me change clothes in the equipment room.

"Post-procedure: I did not see the doctor after the procedure and a month later I still have not heard anything from the gastroenterologist or my primary care physician about my results. I did, however, just receive a personal note from the owner of a furniture store where I once bought a chair.

"I wanted to share this story because health care organizations must improve the customer service they provide. As patients exercise more discretion about their providers and providers are rewarded for patient loyalty under accountable care, now more than ever, it is imperative that we evaluate ambulatory surgery processes from a patient’s perspective.

"Listed below are four items many patients do not consider a luxury:

•Connected EMRs for employed and affiliated physicians;
•An integrated patient portal including scheduling, PHR link, reference information, and two-way communication capabilities;
•Electronic pre-registration and check-in capabilities linked to clinical and business systems; and
•Physician e-mail communications with patients."

10 Ways Your ACO can Fail

2011-08-21T18:13:00.001-04:00

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 letters.

Those ACOs will do everything technically and legally correct - hire the docs, buy the EMRs, redesign the organizations - only to realize too late that their long-term success hinges on convincing people to eat fewer hamburgers and more vegetables. Good luck with that.

[Read more...]

2011-08-21T15:33:00.000-04:00

MedCity News: What happens to healthcare reform if the individual mandate is overturned?

Try this: things continue spiraling downward until 2020, when a Republican President signs national health insurance into law.

2011-08-20T16:38:00.000-04:00

"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

2011-08-20T15:48:00.002-04:00

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

2011-08-20T15:07:00.000-04:00

‎"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

2011-08-19T13:07:00.002-04:00

Philly.com: 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' models and thinking differently about health improvement. And the sceptics? Mostly academics, for whom it's always about titles and credentials.

Me? I'm sufficiently pragmatic to care more about results

McKinsey: Testing Your Strategy

2011-08-17T13:40:00.003-04:00

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 you're LIKE everybody else, benchmarking against everybody else, copying everybody else, why should you expect to peform BETTER than everybody else?

Strategy is about winning through differences, not enjoying the warmth of some cliff-jumping herd.

[Read more...]

Which Economies Matters More? Scale or Connection?

2011-08-16T17:10:00.001-04:00

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...]

"The iPad is a healthcare marketing workhorse."

2011-08-16T09:33:00.002-04:00

The Healthcare Marketing Exchange: 12 ways to use an iPad for hospital marketing and public relations.

Decouple Primary Care From Insurance?

2011-08-15T14:44:00.002-04:00

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?

How Much To Surgically Remove Foot From Mouth?

2011-08-14T16:44:00.000-04:00

You do a decent thing for people who don't have or can't afford health insurance, then turn around and call them "...repeat offenders in the emergency room?" Really?

I know what she meant, but c'mon.

gapingvoid cartoon #378

2011-08-14T14:20:00.001-04:00

Buy your own, here.

What The World Needs, From Jacqueline Novogratz

2011-08-13T16:12:00.000-04:00

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...]

QR Codes To Drive Mammography Volumes

2011-08-13T16:01:00.000-04:00

From Athens (GA) Banner-Herald: "Athens Regional Health Services' leaders decided to use (QR codes) to launch women to a special hospital website and, hopefully, get them to sign up for a mammogram."

Why Is Healthcare So Slow To Automate Processes?

2011-08-13T15:55:00.003-04:00

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...]

"Colleges Are Overrun By Administrators"

2011-08-13T15:44:00.000-04:00

Reader's Digest Magazine: Price competition may be coming to academia. Can health care be far behind? Read the article, substituting 'hospital' for 'university' and 'physician' for 'professor.' No need to substitute anything for 'administrator' as they seem fairly ubiquitous.

The analogy isn't perfect, just close enough to be intriguing.

Is There A 'Hidden' Health Care Market?

2011-08-13T15:34:00.001-04:00

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!

2011-08-13T15:20:00.001-04:00

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."

2011-08-13T15:13:00.000-04:00

"Innovation centers may be manna from heaven for healthcare entrepreneurs looking for a quick infusion of cash."

2011-08-13T15:05:00.000-04:00

Business Week: How Irvine and San Jose, CA lure startups. Hint: it's not about poaching companies from other places. Another hint: sometimes it does take a village.

Attention: Entrepreneurs!

2011-08-13T14:56:00.001-04:00

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.