December 17, 2009
Have you lost the social media turf war to your patients?
Remember as kids trying to see how many bumble bees you could catch in a jar before you panicked and they all got lose? You couldn’t get the top all the way on and all of a sudden dozens of bees exited the jar as you raced across the field of clover. That’s how patients are. You try and catch as many as you can, but once they get out it’s over. So, here we go again. Social networking. We’ll get there in a moment.
For those old enough to remember the seventies, what are you able to recall about high school? If you’re like me, much of it’s selective. The web seems to be changing some of that. Classmates.com. Facebook. Ever notice how there are no rules? Anyone can get to anyone else. Unhindered. Uninvited.
There are those who never grew up, and there are those who never grew older–there’s a difference. Sometimes it’s a good thing. Like for instance trading emails with the girl in the red velvet dress, the one with whom you first slow danced in the ninth grade.
Then there’s the other side to the social networking coin. A darker side. Unless you happened to be among the minutia of students who gambolled care freely down the crowded halls during those four years believing that the school year book should only contain your picture, graduating high school gave you your out, gave you permission to euphemistically bury the bourgeoisie who needed burying. People who, when you were eighteen wouldn’t put you out if you were on fire, the very people who probably set you ablaze, now knock digitally on your facebook door asking to befriend you. Did I miss something here? The part where my fabebook-buddy-wannabe says, “Now that we’re grownup, forget I was a jerk in high school, ignore the fact that I was dumber than a bowl of mice”—sounds like I may have missed one or two of my twelve-step meetings. Recovery is progressing well—really.
Just because a hospital is paranoid doesn’t mean their customers don’t hate them. Poltergeists. The undead. The kind of customers you’d hope you’d never hear from. And yet, those are the very ones who bother to write about their experience. They Twitter, and blog, and YouTube your organization. Don’t take my word for it. Run a search and see what you find. More is being said about you than you are saying about yourself. That means you are losing the social media turf war, you don’t control the high ground or the conversation.
Patients come back and haunt deliberately. Their haunts are reflected in lower satidfaction, fewer repeat visits, and higher churn. Isn’t technology great?
December 15, 2009
The impact of Moses on EHR
Does anyone remember how many of each type of animal God told Moses to put on the ark? Are you sure? For those who missed it, Noah built the Ark, Charlton Heston built the stone tablets.
One word can make the difference between right and wrong, especially if the question is big enough. Who is asking the questions that are shaping your firm’s EHR strategy? Do you know the name of the person? What question are they asking? Is it the right one?
December 14, 2009
Why additional money may not be needed to solve your EHR problems
Have you ever done any sort of group problem solving exercise like Outward Bound to help you to think as a team? Suppose there was an exercise for healthcare and IT executives, whose goal was to get the executives to think about how to best deploy can EHR system. To do this they are given a problem and access to ‘technology.’
Here is the scenario and the rules as they are presented to the group. They are given ten dollars. The executives are presented with a bathtub filled with water, and told that the winning team will figure out the best use of money and time to empty the bathtub. Also available to them is a bucket which costs ten dollars and has a hole in it, a four-dollar cup, and a collection of wooden spoons which are free.
Any idea what the right combination is? Is there a best answer? Bucket? Cup and spoons? How would you solve the problem? Sometimes the best answer is so obvious it’s silly. Kind of like call centers? What’s the best use of the available tools? Faced with the option of buying more technology to solve the problem, when was the last time you saw someone refuse the funds?
Figured it out?
Pull the plug from the drain.
In many cases, we already have everything we need to solve the problem, we just need to know how to use it.
Just like Dorothy in the ‘Wizard of Oz.’ She had the ruby slippers the entire time, she just didn’t know how to use them. I think most EHR strategies can be improved without spending requiring millions more in technology.
That’s my story and I’m sticking to it.
December 12, 2009
can you apply social media to Patient Relationship Management (PRM)
A consultant was on one side of the river; his client was on the other side. The client hollered, “How do I get to the other side?” The consultant thought for a moment and hollered back, “You are on the other side.”—don’t try this at home kids, we’re professionals.
It goes without saying that rarely am I regarded as one with a high capacity of tolerance. When things get tough or when meetings are exceedingly dull I like to go to my happy place. Sometimes I get to go to my happy place when I least expect it. Like the time my coffee machine started leaking all over the floor.
Having met such unheralded success repairing my mixer, naturally I took apart my Capresso coffee maker. Not many parts. I put it back together thinking the simple act of dismembering it might have caused it to self-heal. Fill it. Turn it on. Puddle. I called Capresso started to explain my problem. Before I had a chance to finish the rep told me what caused the problem, asked for my address, and said they would mail a new gasket overnight for free, as in F-R-E-E. No proof of purchase needed.
Talk about managing the customer experience and taking the lead on social networking. What types of things could you be doing to improve Patient Relationship Management (PRM)? How could social networking help you improve PRM?
Let’s talk.
December 11, 2009
December 7, 2009
Interoperability-this is the problem
How does one depict the complexity of the mess being presented as the national roll out plan of electronic health records (EHR) via the national health information network (N-HIN) using Health Information Exchanges (HIEs) designed by Regional Health Information Organizations (RHIOs), with the help of regional extension centers (RECs) without Standards (Standards) and with N too many vendors?
Class? Ideas? Class?
If this looks dumb, undo-able, unimplementable, uninteroperable–it’s because it is. your vision is fine.
Remember the idea behind all this is to get your health record from point A to point B, any point B. It’s that little word ‘any’ that turns the problem into a bit of a bugger.
Find yourself in the picture below, pic a dot, any dot (Point A). Now, find your doctor, any doctor (Point B). Now figure out how to get from A to B–it’s okay to use a pen on your monitor the help plot your course. That was difficult. Now do it for every patient and every doctor in the country.
Now, do you really think the DC RHIO-NHIN plan will work? If EHR were a Disney park, who’s playing the Mouse?
Should you hire a swim coach?
Swimming with guppies
Got the new bike, got the new bike shoes, got the uni (uniform-not unitard). I’ve written about my desire to compete in a triathlon. Actually, I miswrote. My desire is not to compete, it’s more accurately a desire not to make a fool of myself during the swim, more specifically not to drown.
The swimming is one of those events where having the coolest outfit doesn’t help, as there are no coolest swimming outfits (men do not let men wear Speedos). There aren’t enough North Face labels for me to wear to make me look like I know what I’m doing in a pool.
What to do? Here’s my thinking. I made a new friend, and as a bonus, she happens to be pretty sharp on the pharma side of healthcare. She swims—fast. She swims—a lot. Did I mention she swims? Longtime readers know I like to color outside the lines. Maybe I could hire her to take my place during that part of the race. Then we get back to the issue of the uni. One way or another that becomes an issue for one of us.
She offered to teach me. Lesson one was today. Lesson two will begin right after the EMTs finish their CPR on me. Rule one, no matter how cool you think you are, you can’t breathe under water. That took a few laps to master. More breathing, stroke, legs. Lots to learn.
“Let’s get a pool boy to help you not drag your legs,” she suggested.
I have difficulty passing up the opportunity to comment. She could see I had the broccoli in the headlights look in my eyes. “You hold it between your legs and it helps you float.”
I scanned the pool. There we the two of us…and the lifeguard. “It looks like he’s busy,” I offered somewhat sheepishly. “Besides, if that’s what it takes, I think we’re both better off if I drag my legs.” (A little un-PC pool humor, but why not, I was already wet and being out swum.
So, what does this have to do with why we’re here? Here’s the take away. Sometimes, no matter how smart, no matter how big your ego, you need help. Sometimes it makes a huge difference to have someone on your side who’s been there, done that, got the T-shirt.
Not with me yet? A guy (man or woman guy—send me an email and let me know when we can let go of this PC thing and just write) is walking down the road, not watching where he’s going, and he/we/she/it falls into a deep hole.
An engineer walks by. “Help me,” shouts Hole Person.
The engineer thinks for a moment, writes some ideas on a piece of paper and tosses them into the hole.
Several hours later, a finance guy walks by. “Help me out (literally)” yells Hole Person. The CFO tosses down a cheque (I use the Canadian spelling to distinguish it from someone from the Eastern Bloc as it would make no sense to toss another person into the hole.)
Days later, Hole Boy (not the same as Pool Boy in case anyone is still reading) is at the end of his rope. The work plan failed. The Check bounced.
A consultant passed, saw the man, and hopped into the hole.
“Why did you do that? Now we’re both stuck.”
The consultant smiled in a Grinch-like fashion—please see prior blog for the segue. “I’ve been down here before, and I know the way out.”
Kind’ a like a swim coach.
EHR projects have more zeros than you can count. What if you could hire someone who knew the way out?
I may know someone who can help.
December 6, 2009
Dear Sir Richard Branson:
For those who care about how your patients view you.
REF: Mumbai to Heathrow 7th December 2008
I love the Virgin brand, I really do which is why I continue to use it despite a series of unfortunate incidents over the last few years. This latest incident takes the biscuit.
Ironically, by the end of the flight I would have gladly paid over a thousand rupees for a single biscuit following the culinary journey of hell I was subjected to at thehands of your corporation.
Look at this Richard. Just look at it: [see image 1,].
I imagine the same questions are racing through your brilliant mind as were racing through mine on that fateful day. What is this? Why have I been given it? What have I done to deserve this? And, which one is the starter, which one is the desert?
You don’t get to a position like yours Richard with anything less than a generous sprinkling of observational power so I KNOW you will have spotted the tomato next to the two yellow shafts of sponge on the left. Yes, it’s next to the sponge shaft without the green paste. That’s got to be the clue hasn’t it. No sane person would serve a desert with a tomato would they. Well answer me this Richard, what sort of animal would serve a desert with peas in: [see image 2,].
I know it looks like a baaji but it’s in custard Richard, custard. It must be the pudding. Well you’ll be fascinated to hear that it wasn’t custard. It was a sour gel with a clear oil on top. It’s only redeeming feature was that it managed to be so alien to my palette that it took away the taste of the curry emanating from our miscellaneous central cuboid of beige matter. Perhaps the meal on the left might be the desert after all.
Anyway, this is all irrelevant at the moment. I was raised strictly but neatly by my parents and if they knew I had started desert before the main course, a sponge shaft would be the least of my worries. So lets peel back the tin-foil on the main dish and see what’s on offer.
I’ll try and explain how this felt. Imagine being a twelve year old boy Richard. Now imagine it’s Christmas morning and you’re sat their with your final present to open. It’s a big one, and you know what it is. It’s that Goodmans stereo you picked out the catalogue and wrote to Santa about.
Only you open the present and it’s not in there. It’s your hamster Richard. It’s your hamster in the box and it’s not breathing. That’s how I felt when I peeled back the foil and saw this: [see image 3,].
Now I know what you’re thinking. You’re thinking it’s more of that Baaji custard. I admit I thought the same too, but no. It’s mustard Richard. MUSTARD. More mustard than any man could consume in a month. On the left we have a piece of broccoli and some peppers in a brown glue-like oil and on the right the chef had prepared some mashed potato. The potato masher had obviously broken and so it was decided the next best thing would be to pass the potatoes through the digestive tract of a bird.
Once it was regurgitated it was clearly then blended and mixed with a bit of mustard. Everybody likes a bit of mustard Richard.
By now I was actually starting to feel a little hypoglycaemic. I needed a sugar hit. Luckily there was a small cookie provided. It had caught my eye earlier due to it’s baffling presentation: [see image 4,].
It appears to be in an evidence bag from the scene of a crime. A CRIME AGAINST BLOODY COOKING. Either that or some sort of back-street underground cookie, purchased off a gun-toting maniac high on his own supply of yeast. You certainly wouldn’t want to be caught carrying one of these through customs. Imagine biting into a piece of brass Richard. That would be softer on the teeth than the specimen above.
I was exhausted. All I wanted to do was relax but obviously I had to sit with that mess in front of me for half an hour. I swear the sponge shafts moved at one point.
Once cleared, I decided to relax with a bit of your world-famous onboard entertainment. I switched it on: [see image 5,].
I apologise for the quality of the photo, it’s just it was incredibly hard to capture Boris Johnson’s face through the flickering white lines running up and down the screen. Perhaps it would be better on another channel: [see image 6,].
Is that Ray Liotta? A question I found myself asking over and over again throughout the gruelling half-hour I attempted to watch the film like this. After that I switched off. I’d had enough. I was the hungriest I’d been in my adult life and I had a splitting headache from squinting at a crackling screen.
My only option was to simply stare at the seat in front and wait for either food, or sleep. Neither came for an incredibly long time. But when it did it surpassed my wildest expectations: [see image 7,].
Yes! It’s another crime-scene cookie. Only this time you dunk it in the white stuff.
Richard…. What is that white stuff? It looked like it was going to be yoghurt. It finally dawned on me what it was after staring at it. It was a mixture between the Baaji custard and the Mustard sauce. It reminded me of my first week at university. I had overheard that you could make a drink by mixing vodka and refreshers. I lied to my new friends and told them I’d done it loads of times. When I attempted to make the drink in a big bowl it formed a cheese Richard, a cheese. That cheese looked a lot like your baaji-mustard.
So that was that Richard. I didn’t eat a bloody thing. My only question is: How can you live like this? I can’t imagine what dinner round your house is like, it must be like something out of a nature documentary.
As I said at the start I love your brand, I really do. It’s just a shame such a simple thing could bring it crashing to it’s knees and begging for sustenance.
Yours Sincererly
XXXX
- Paul Charles, Virgin’s Director of Corporate Communications, confirmed that Sir Richard Branson had telephoned the author of the letter and had thanked him for his “constructive if tongue-in-cheek” email. Mr Charles said that Virgin was sorry the passenger had not liked the in-flight meals which he said was “award-winning food which is very popular on our Indian routes.”
My submission to an NPR writing contest
Cleaning my desktop, I found this. They provided the first line and set a 600 word limit.
The nurse left work at five o’clock. A twelve-hour shift—only lost one, better than some nights, worse than others. Two hours before sunup, the icy wind gnawed at her ankles. With her caffeine gauge on empty, she ducked into Starbucks, glancing waywardly at the plethora of coffees posted overhead on the menu board. “Do you guys actually pay someone to think up all this stuff?” She asked rhetorically.
The still groggy looking twenty-something guy behind the counter ignored her, not a bright move on his part. His hair looked like it was cut with an ax; an errant flap of it fell over his right eye with each movement of his head. His right ear lobe was pierced in three places, although he only wore one earring. The nurse noticed a barbed-wire tattoo around his left bicep.
Intent on continuing the conversation, even if it was to remain one-sided, the nurse inquired, “I suppose you guys have marketing gurus who make these monumental product decisions.” However, nobody who knew the nurse would ever accuse her of being chatty, she never wasted words.
“That word “venti,” that’s Italian, right?” Twenty-Something occupied himself by steaming a pot of skim milk. “So, help me think this through,” she implored. “Since venti is the one in the middle, it must be Italian for medium. And, “Grande,” that must mean large. Right? So, here’s where I’m confused. The one labeled, “Tall.” Something tells me that doesn’t translate to small in any language. If you take a small cup of coffee, and make people order it as a tall cup of coffee, maybe they will actually think it’s larger than it really is. QED. Quod erat demonstrandum. That’s Italian for cut the crap.” The nurse felt she was jousting with an idiot. Nonplussed, Twenty-Something merely rolled his eyes and asked her what she wanted.
The nurse was usually not a half-caff, double mocha, skimmed latte kind of person. In fact, it troubled her that some people were, troubled her a lot. The person she tied up and left in the trunk of her car was one of them; he hadn’t known when to shut up, so she had done it for him. By the time she had checked on him during her break, he’d frozen solid.
“Any ideas?” The Twenty-Something foolishly pressed the nurse.
“What do you recommend for somebody who just wants a cup of coffee?”
“Do you want regular or decaf?”
“What’s the strongest you have?”
“Ethiopian.”
“Give me your largest.”
“Shall I leave room for cream?” asked Twenty-Something.
She looked at the prices. Two dollars for a cup of coffee. Why would anyone pay that much and then hide the taste of the coffee with cream, she wondered. “No cream. Instead, give me a latte grande with skim milk.”
“One grande latte,” Twenty-Something replied, correcting her syntax. “Is that all?”
“Better give me a large orange juice. That’s what’s it’s called, isn’t it, or is that also a grande?”
Her wit was lost on Twenty-Something. “Large,” she murmured through her teeth.
“And a bagel, plain.”
“Toasted? Cream cheese?” She knew he was toying with her.
She’s had enough, grabbed the coffee, and headed for the door.
He hollered for her to pay, but the look she gave him to him to let it go.
Too bad the trunk couldn’t hold two. She’d come back tomorrow to visit the boy.
