Health Care Strategist

The authors of Booz & Company's "Global Innovation 1,000 Report" offer their Top 10 things innovative companies do right (via Business Insider.com) At innovative companies, everybody is an innovator. Innovative companies measure their idea-generation success. Innovative companies change the idea a lot before it becomes a product. Innovative companies test their idea with customers. Innovative companies have an internal "idea czar." Innovative companies talk to customers and other partners. Innovative companies find ideas everywhere. Innovative companies generate ideas in three basic ways: Need seekers: what do customers want? Market readers: quickly create improvements on market trends. Technology drivers: letting their tech experts experiment. Innovative companies spend R&D money thoughtfully, not profligately. Innovative companies systematically create new ideas. Though healthcare (big pharma, mostly) is heavily represented, healthc...

 Richard S. Foster is retiring this week after 18 years as the chief actuary for the Centers for Medicare and Medicaid Services. From an interview in KaiserHealthNews.org: Q: How do we control health care costs in Medicare, Medicaid and the private sector? A: Years ago, we thought that converting from cost-based reimbursement to prospective payment systems (a set payment that covers the entire cost of the admission) was the magic answer, and it helped a lot. Then, back in the early 1990s, everybody thought managed care was the magic answer. And that helped some, too, although most of their success was in negotiating lower payment rates, which you can only take so far. We’ve had other instances -- pay-for-performance and consumer-driven health care -- that people had hoped would be the magic answer. Right now, there’s a great deal of hope that further integration of care, greater bundling of payments and other innovations like that will be the answer. I’m not optimistic that t...

Forbes :  "...it’s hard not to worry that if medicine goes in the direction of the Cheesecake Factory, where care is administered on the cheap by customer-service technologists plugging data into an algorithm, then an ancient and noble profession will face extinction because of an inability (some might say a haughty unwillingness) to adequately contemplate and communicate its essential value proposition." 

Interesting summary of the innovators and incubators reforming education in Chicago: Smart Cities: Chicago's Collaborative and Chaotic Reform Record "For over a generation, Chicago has served as the epicenter of for-profit, technology-enabled education entrepreneurship and investment." "According to Patrick Haugh, The Chicago Public Education Fund, "Chicago sports not only an impressive set of ed investors (Sterling, GSV Advisors), established industry leaders, and an emerging cohort of promising edtech startups, it also possesses a vital network of innovative ed organizations with great local leadership, and creative funders." Understatement of the waning year:  "...Chicago kids would benefit from coherent state policies aimed at equity, options, and innovation." 

From HealthLeaders:  NJ Hospital Closures May be Offset by Incentives This is what happens when hospital CEOs cling too long to, and borrow too much in support of, an outdated business model: somebody comes along, grabs a few state incentives and turns the place into a medical mall.  I'll bet the community's health improves, too.

For more details about these opportunities, contact Katie Coleman, Solutions Delivery Coordinator at Catalyst Solutions.  Candidate identification closes in a few days, so don't delay! Main: 1-800-903-9574 | Office: 303-603-3211 | Website: www.catalystsolutions.com VP of Health Care Management Services (Virginia Beach, VA) Responsible for understanding functional area of responsibility and how the functional areas interrelate, gathering requirements, performing analysis, supporting the development and testing processes, and understanding the applications, data, and associated technologies for supported areas. Support departmental methodologies and provide input for improvement to tools and processes. Provide leadership within the team, department, and organization by chairing meetings, writing and executing test plans, and coordinating with business owners. The preferred candidate will have the following experience: Perform detailed requirements gathering, analysis, and pr...

"Ads proliferate across St. Louis as hospitals push services, name-recognition" is the headline above this interesting article from the St. Louis Post-Dispatch's website.  Featuring all sides of the debate, the article includes this from Samuel Steinberg, decribed as a Florida-based hospital finance consultant who "...remains skeptical about the benefit of advertising." “It’s very difficult to be able to demonstrate that these things are worth the investment,” he said. “Hospitals and health systems that put a lot of money into advertising say it is beneficial. But when you ask them to prove it, there’s a real shortage of good research that verifies that it’s worth it.” Yes, hospital marketers are frequently remiss in not building more value-driven metrics into their work.  Too many of these marketers (those with limited job prospects) devolve from saying that measuring marketing is difficult to concluding it's a waste of time to try.  And in my ex...

Wonder why you haven't gotten a raise recently?  Does it seem your income goes less far than in years past?  Blame healthcare inflation.  Or, as one economist said recently, "...healthcare stole your raise."   Brian Klepper, PhD , blogging at KevinMD.com predicts that healthcare is in for a new organizational structure. At our first meeting years ago, Tom Emerick, Walmart’s then VP of Global Benefits, told me, “No industry can grow continuously at a multiple of general inflation. It will eventually become so expensive that purchasers will simply abandon it.” He said it casually, as though it was obvious and indisputable. Health care is playing out this way. From 1999 to 2011, health care premium inflation grew steadily at 4 times the general inflation rate. During that same period, the percentage of non-elderly Americans with employer-sponsored health coverage fell from 69.2 to 58.6 percent, a 15.3 percent erosion rate. Health care’s boosters lik...

Says Bryan Vartabedian, MD in this Healthleadersmedia.com article : Speaking to the great responsibility point, Vartabedian contends physicians are complicit in the controversy surrounding the unproven, but social media-fueled association between the MMR vaccine and autism. "There are 65,000 pediatricians in the American Academy of Pediatrics," he says. " If all of us just once a year had created a small piece of content, be it a blog post, even a comment, we would have ruled the search engines, and none of this really ever would have happened ." "When we think about social media, and when your institution talks to you about social media, almost invariably it will be viewed from the perspective of risk. All we see is the risk associated with it, and all your orientation and your programs, everything will center on risk and nothing will center on opportunity."

An interesting question posed at HealthLeadersMedia.com . 4 health leaders offer wide-ranging suggestions, including building trust and collaboration, reducing the number of stakeholders yet finding ways to work together, and reforming the tort liability system. Hard to argue against 'more trust' isn't it? Yet it's axiomatic in healthcare that one person's 'waste' is another person's 'income stream.' You mess with my income stream and I may have a problem trusting you. "Go get some trust..." sounds a little like comedian Steve Martin's promise to teach us how to be rich. Says Martin, "First, go find $1 million dollars!" Umm, OK. I'll go find some trust while I'm at it and fix healthcare's problems too. Maybe it's fair to consider the requirements for more trust. What preceeds trust? What creates the right conditions for trust to occur? There's no tried-and-true formula, no "add two parts wate...

From TheAtlanticCities   "The Harvard Graduate School of Design released the new Ecological Urbanism app last month. The interactive app, available at the iTunes store, adapts content from the GSD book of the same name, which explores how designers can unite urbanism with environmentalism. Combining data from around the world, the app "reveals and locates current practices, emerging trends, and opportunities for new initiatives" in regard to the future of cities." Imagine something like this for predicting the future of health systems and hospitals, combining measures of community health, strategic trends, financial viability, with experts from around the world adding data and context. Hmmm.

From Healthcarefinancenews.com:  "Most hospital M&A transactions are financially unsuccessful, study says." "According to a recent study, a majority of hospital and health system merger and acquisition transactions have not been financially successful. "Booz & Company, a global management consulting firm, analyzed a sample of 220 hospitals with pre- and post-transaction performance data over a 10-year period (between 1998 and 2008) and found that less than half (41 percent) of all acquired hospitals outperformed their market. [...] "Sanjay suggested that it’s important for hospitals to merge with other hospitals that have like-minded views about the future and culture, as well as shared views around their positioning in the market. "So, for example, a merger between an academic medical center and a small, community hospital in an underserved area may not be ideal."

“The system is that there is no system. That doesn’t mean we don’t have process. Apple is a very disciplined company, and we have great processes. But that’s not what it’s about. Process makes you more efficient. “But innovation comes from people meeting up in the hallways or calling each other at 10:30 at night with a new idea, or because they realized something that shoots holes in how we’ve been thinking about a problem. It’s ad hoc meetings of six people called by someone who thinks he has figured out the coolest new thing ever and who wants to know what other people think of his idea. “And it comes from saying no to 1,000 things to make sure we don’t get on the wrong track or try to do too much. We’re always thinking about new markets we could enter, but it’s only by saying no that you can concentrate on the things that are really important." [BusinessWeek, Oct. 12, 2004]

No, says Steve Wilkins, MPH, writing at KevinMD.com.   Physicians, hospitals and other providers are being misled by  industry pundits claiming that more health information technology (as in EMRs, PHRs, smartphone apps, and web portals) is the key to greater patient engagement.   It’s not. Part of the misunderstanding concerning the role of HIT comes from how the discussion about patient engagement is being framed.  According to the pundits, patient engagement is the physician or hospital’s responsibility.  And like everything else these days, we can fix it if we just throw more technology at the problem. Can anyone say Stage 2 Meaningful Use requirements? [...]  The role of physicians, hospitals and other providers is not so much one of needing to engage patients in their care.  Rather, providers need to “be more engaging” to patients who are already actively engaged in their health. Take the simple act of a trip to the doctor’s office...

The story goes that, upon hearing of Richard Nixon's election triumph, a resident of New York's tony Upper East Side exclaimed "But how could that happen?  Everybody I know voted for McGovern!" Usually attributed to film critic Pauline Kael, it's an example of the logical fallacy known as hasty generalization : drawing an overbroad conclusion based on a statistically insufficient sample.  From the Wall Street Journal : "In reality, Kael was more self-aware than that. What she actually said, as reported by the Times in December 1972, was: "I live in a rather special world. I only know one person who voted for Nixon." But you see how the fallacy works: By her own account, Kael led a parochial life, seldom venturing outside her "special world." If she had mistaken her circle of acquaintances for a representative sample of Americans, she would have been mystified by the election outcome." To a certain extent, we all live "pa...

Have nonprofit healthcare providers' improvement efforts hit a wall?  Standard & Poor's Rating Services seems to think so, in this story (via Reuters.)   From the story: "Adding to pressures, inpatient volumes are dropping. "With pending budget sequestration at the federal level, health reform implementation, and continuing pressure on state budgets, we believe the next several years will be difficult for most providers," said S&P. "Furthermore, we believe that the improvements of the past several years may be reaching their limit and thus will not be able to keep pace with longer-term revenue pressures, especially in light of weaker volumes." "S&P says more rating downgrades are possible for not-for-profit healthcare systems over the next two years. It noted that the proportion of systems with positive or stable outlooks is shrinking, which "supports our opinion the multiyear trend of improved financial ratios is unlikely to...

Photo by: Cillian Storm Creative Commons Not strategy.  Leaders, more likely, at least those managing by catchphrase, as Dan Beckham suggests . From the article: "The Problem of Buying into the Catchphrase "One proponent of the "culture eats strategy" catchphrase, Shawn Parr, an innovation and design consultancy CEO, made his case in a Jan. 24, 2012, Fast Company article holding out shoe company Zappos as an example. In response, Bob Frisch, a strategy expert with experience at the Boston Consulting Group, had this to say in the same publication a month later: "Parr attributes the success of Zappos to a culture that is inclusionary, encouraging, and empowering.' Customer service representatives write zany emails and company leaders have often affirmed their belief that if you get culture right, success follows. But Zappos also has fast delivery, deep inventory, a 365-day return policy and free shipping both ways. That's a strategy — not a...

Photo credit: philosophyblog.com.au (Creative Commons) Though you'll never hear them say so publicly, many health care organizations view privacy as just another costly bureaucratic mandate, not a strategic differentiator.  Have you ever seen a hospital or medical practice compete as "the organization best equipped to protect your privacy?"  I thought not. And I can't explain why this is so.  Certainly the "protect my privacy" segment is, numerically, substantial enough to gain an astute marketer's attention. Perhaps some marketers underestimate their customers' privacy concerns.  Or it could be that, when push comes to shove, health care consumers value other things in their health care experience more than they value privacy, in which case those marketers are making a smart decision about priorities. It could be that health care organizations are (rightly) terrified of making a brand promise they can't keep.  Perhaps 'privacy...

From Seattlepi.com : "These aren't your typical loos. One uses microwave energy to transform human waste into electricity. Another captures urine and uses it for flushing. And still another turns excrement into charcoal." Read more, here .

Lest you think my last post overstated the case FOR "rogue" employees and AGAINST all you IT traditionalists, let me tell you a story. Recently, my team and I searched for a way to connect ourselves and a dozen or so vendors - designers, agencies, printers and consultants.  Something like Dropbox or Google Drive .  "No go" said IT.  Not secure enough. What alternative(s) were we offered?   SharePoint of course, assuming that my modest little corner of the empire would fund the expense (ranging anywhere from a few tens of thousands to the low six figures.)  I countered with a fast "No thanks.  At that price point, I'd have to sell a kidney or something." But without knowing it at the time, IT's response was a blessing in disguise. Now I'm (quietly) using iDoneThis (free) to track projects and team and vendor accomplishments,  IdeaScale (free) to generate engagement around innovative ideas and strategies,  Evernote (free) to o...