Health Care Strategist

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcare...

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer. In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers."  Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings. ...

From LinkedIn:

How might health care providers use technology to turn customers' mobile phones into information displays and ordering devices? A few years ago, the NY Times outlined how retailers are doing it... "(Designer Norma) Kamali is at the forefront of a technological transformation coming to many of the nation’s retailers. They are determined to strengthen the link between their physical stores and the Web, and to use technology to make shopping easier for consumers and more lucrative for themselves. ... Cisco Systems, the supplier of networking equipment and services for the Internet, is also a leader in the field. The company’s Mobile Concierge system is capable of connecting customers’ smartphones to retailers’ wireless networks — so a shopper could type “Cheez Whiz” into a cellphone, then pinpoint its location in the store." Ms. Kamali's boutique installed a technology called ScanLife , "allowing people to scan bar codes on merchandise and obtain details ...

An article at hhnmag.com offers hospitals 5 steps to becoming more consumer friendly. If you still think there's a secret sauce to your hospital becoming more "consumer friendly," these 5 steps are as good a place to start as any.  Unfortunately, it's a little like that old Steve Martin comedy bit where he says he'll teach you how to be rich. The first step is to go find a million dollars. Step 1 from the article is realizing that "...a Medicare beneficiary with chronic conditions is different from a young mom who brings her kids in for an annual check-up." This is market segmentation for beginners, and, yes, one size decidedly does not fit all. I'm sure your marketing team's been saying this for a while. Steps 2-5: have a strategy, metrics, a champion and resources. OK. Hard to argue with any of those. But those things, alone or together, won't overcome culture. They're important components to be sure, but insufficient w...

I've had this post sitting around in draft form for far too long and it's time to get it off my chest. Several years ago, MSNBC commentator Dylan Ratigan interviewed Umair Haque, author of The New Capitalist Manifesto: Building a Disruptively Better Business , founder of Bubblegeneration, Director of the Havas Media Lab and blogger at the Harvard Business Review. Though the topic wasn't healthcare, there was much for healthcare leaders to ponder. Haque draws a clear contrast between productive wealth and destructive wealth.  Both count toward Gross Domestic Product (GDP) but only the former really contributes . Says Umair, "It’s easier to make money in the short-term through exploitation and the extraction and much more labor intensive with a higher failure rate and a much greater degree of challenge to actually advance and create something that is new and different and differentiates in its creation of value. “So to me, this is a crisis that is about f...

"Your rearview mirror is so small and your windshield is so large because what lies ahead is much more important than the past." (@CHRISVOSS) What can we say about the future?  It's uncertain and the end is always near. (Jim Morrison)  The future is much like the present, only longer.  (Dan Quisenberry)  The future is here.  It's just not widely distributed yet. (William Gibson)  Uncertain. As near as tomorrow. Long duration.  Limited (and uneven) distribution. Think about how hospital strategic plans account for future competitor decisions.   If they do at all,  it's little more than simple extrapolation of past performance, a technique which, though understandable since that's where the data reside, is nothing more than crafting strategy in a vacuum. It's much easier to track competitor performance retrospectively than to forecast future decisions. Volume trends, market share, patient satisfaction, quality indicators, financia...

I recently heard from an executive colleague who, thanks to a merger, found herself looking for her next opportunity. Her story, probably depressingly familiar to many of you, was all about the big black hole of rudeness and non-responsiveness that so often sums up employers' attitudes toward candidates. This colleague, thinking she'd see the healthcare world from a new vantage point, pursued opportunities with consultants, IT vendors, architects and other suppliers who, far from appreciating her solid resume, were like the 3 Stooges of clueless. So back to a senior health system role she went, WHERE SHE NOW INITIATES AND MANAGES RFPs FOR SOME OF THE VERY SAME COMPANIES who wouldn't talk to her as a candidate, but profess their LOVE for her now that she's got money to spend on their services. Not gonna happen. Any guesses who's off the RFP list? I smiled when I heard her story, imagining the BusDev people working hard to grow the revenue pipeline, all the ...

"We decided in 2005 that no hospital executive could apply to work in this (ambulatory) company. We wanted entrepreneurs who were more open to a different way of providing healthcare services. That has been very, very successful." -- Dan Wolterman , president and CEO of Houston-based Memorial Hermann Healthcare System , Texas' largest not-for-profit health system, from an interview in Modern Healthcare .

... Customer Service. From the New York Times: Seattle's Iora Primary Care is a new model of primary care, seeking national scale and venture capital funding.  Though the ambition may be outsize, the concepts are not new. Daily team huddles. Health coaches. Taking satisfaction surveys seriously and mining results for actionable insights. Employer and payer partnerships. Pay-for-performance not volumes. Loose-tight operations (wellness options are "loose" - i.e. varying from site to site, while EHR alignment is "tight" and non-negotiable.) According to the article: "...small change(s) can make a big difference in a patient’s health — what good is the perfect drug if the patient can’t swallow it? — but the extra-mile work it took to get there can be a challenge for the typical primary care practice in the United States. Harried by busy schedules and paid on a piecework model, many doctors rush from visit to visit, avoid phone calls and em...

It's difficult to see the FCC's Net Neutrality decision as anything other than an anti-Comcast vote. Maybe I'm unique, but I side with companies making my life easier and better - Google, Amazon, NetFlix, e.g., and against companies making my life a living hell. What consumers want from Comcast, in no particular order are (1) fast connections, (2) fair prices and (3) problem-solving customer service. Welcome to hell, Comcast style. It's a good lesson for CEOs everywhere: suck badly enough and publicly enough, for long enough, and nobody will take your side when big decisions are made on the national stage. And it doesn't matter who might benefit.  What's important is revenge and YOU LOSE, Comcast. Yes, this means siding with the FCC and a gaggle of collectivist nitwits, but my distaste for them and their nitwittery pales against my utter loathing for Comcast.

From Leah Binder in Forbes: "The Best Disruptive Writings Of 2013 -- Health Care Edition" From Helen Bevan: Rocking healthcare's boat while staying in it: how to succeed as a radical in healthcare.

From Atul Gawande, writing in the New Yorker: In the era of the iPhone, Facebook, and Twitter, we’ve become enamored of ideas that spread as effortlessly as ether. We want frictionless, “turnkey” solutions to the major difficulties of the world—hunger, disease, poverty. We prefer instructional videos to teachers, drones to troops, incentives to institutions. People and institutions can feel messy and anachronistic. They introduce, as the engineers put it, uncontrolled variability. But technology and incentive programs are not enough. “Diffusion is essentially a social process through which people talking to people spread an innovation,” wrote Everett Rogers, the great scholar of how new ideas are communicated and spread. Mass media can introduce a new idea to people. But, Rogers showed, people follow the lead of other people they know and trust when they decide whether to take it up. Every change requires effort, and the decision to make that effort is a social process. (emphasis ...

From MedCityNews.com: "Mayo doc: Stop blaming patients. Healthcare industry’s take on non-compliance is all wrong." Dr. Victor Montori offers some great riffs on engagement: Non-compliance is frequently talked about as a cost and a burden put on the healthcare system by patients. But Montori’s theory is that really, it’s the healthcare system over-burdening the patient. “We have to be very careful not to blame the patients,” Montori said during his closing keynote at MedCity’s ENGAGE on Thursday. “A lot of the conversation (around patient engagement) has been, how do we get them to do stuff? To me, that’s not engagement." [...] Montori closed by asserting that the U.S. healthcare system will be the best in the world only when it begins to shrink. “Healthcare right now is all about itself. Healthcare right now is about how do we get bigger, more market share,” he said. “That means that patients have to take more medicine, have to monitor themselves more often [....

My phone rang last night, with the caller ID showing an unfamiliar number from Fremont, MI.  A quick Google search hinted that it was Honda calling, probably to determine my satisfaction with a recent oil change at one of their dealers. I'm not answering their calls.  Not now, not ever.  Why? Several months ago, after a similiar service visit led to a similar call, I told the researcher I was unhappy with the dealer for recommending what I thought were unecessary service items in an attempt to inflate my bill.  (So what else is new, right? Whodathunk?) Not twenty minutes later said dealer's service manager calls, unhappy that I'd given him and his department less than perfect marks and downright angry that I'd aired my suspicions in the survey. So I gave their customer satisfaction researchers honest feedback and they ratted me out to the locals.  Seriously? Let's make a new deal.  Mark down that I...

From CBS This Morning: University of Pittsburgh Medical Center (UPMC) "made $948 million in profits from 2011-2012."   And tax returns show UPMC spending just 2% of its annual budget on charity care.  And UPMC's CEO, Jeffrey Romoff, makes almost $6 million a year.  And Romoff also has more than a dozen administrators that take in annual salaries of over $1 million a year.  And now Pittsburgh Mayor Luke Ravenstahl is suing to revoke UPMC's nonprofit status.  Good.  I hope he wins. From the article: Professor Martin Gaynor of Carnegie Mellon has published papers on hospitals that enjoy nonprofit status but do not always function like charities. "There's a lot of concern here in the community," Gaynor told "CBS This Morning." "They've taken some actions that don't appear to be consistent with an organization whose mission is to benefit the community." Some of UPMC's funds are directed at facility improvement,...

An article in yesterday's Wall Street Journal asked "Will Health-Care Law Beget Entrepreneurs?" Will the availability of reasonably-priced insurance through public marketplaces or "exchanges" cause entrepreneurs to strike out on their own, leaving behind the comfort of big company benefits? It's a good question, albeit one with no clear-cut answer at the moment. It all depends, I guess, on one's definition of "high-functioning exchanges" and "reasonable prices." Still, it's a question to which large companies ought to be paying close attention. How many people work at jobs simply for the health insurance, jobs they'd leave in a heartbeat to follow their passion if insurance wasn't an obstacle? I don't know for sure, but I'd bet the answer is somewhere between "more than a few" and "a whole heckavu lot." And those leaving are likely to be those the company wishes would stay - the innovat...

Asks Nick Corcodilos, writing for PBS NewsHour .  It's a great question.  The answer might shape up your HR department in a hurry. From the article: A job applicant treated with disrespect can do as much -- if not more -- damage to a company's business as a dissatisfied customer. Do employers really think word doesn't get around? Maybe hiring managers assume that their HR departments handle all the necessary niceties with applicants. But just how accountable are HR departments? Does this company's public relations department realize that while it's spending millions on good press, the HR department is scuttling it? If you're a hiring manager, and you're not sure how job candidates are treated after they leave your office, please read "Respecting The Candidate." Your HR department might explain that processing applicants, job offers, hires, and rejection letters is cumbersome. Tell that to your customer who cancels the order that's a mon...

How's your patient engagement strategy working out for you?  This article might help:  Engagement is a Strategy IV: 10 Reasons Value-based Health Care Orgs Need A Social Strategy . If you want to influence behavior (which you do or will), you really can’t ignore a social strategy. We’ll need to get really good at engagement and behavior change on a massive scale. Social media strategies may be our best bet at influencing behavior on a massive scale. Not to push behavior in a direction, but to provide systems that let behavior naturally migrate toward the health people already seek."

The Entrepreneur's Guide to Hospital Partnerships by @Rock_Health from Rock Health