Healthcare’s Augmented Reality​: The Secret Of My Arrest

Perhaps I should set the stage. I went for a run this morning in a beach town on the Jersey shore. I would tell you the name of the town, except for the fact that this morning I met most of the town’s police officers, and since I still have another week at the shore, it would be silly of me to write something to make the other officers want to engage me.

I was nine miles into my run. Ahead of me was a bridge that would lead me back to the house where we were staying; three miles from here to there. There was a lot of construction on the bridge and a lot of cars. One officer may have later mentioned something about a large sign printed with the words, No Pedestrians.

I came to the apex of the bridge that crossed the bay. I was drained, and I was leaning way over the guardrail to catch my breath.

To my surprise, a state policeman, kitted out smartly in his pressed uniform, pulled alongside of me. “What are you doing on my bridge?”  He asked from the cool confinement of his air-conditioned patrol car, an undisguised tone of concern in his voice. To hear what he was saying I removed one of my ear buds.

I saw my face reflected in his Ray-Ban Aviator sunglasses. Since I was trying to cross the bridge, I thought about asking him if his question was rhetorical, like why did the chicken cross the road, but he did not look like a chicken crossing the road kind of guy.

“Are you okay?” He asked. “You don’t look okay.”

He came across as highly educated, and someone with great elocution and diction. He was impressively well mannered and well behaved. He was like the human version of a Great Dane. I thought we were getting ready to bond, but then it occurred to me that his version of deep, long-lasting friendships was probably an exchange of business cards. “I’m fine. Why did you pull over?” I asked.

“We got a few calls about a guy on the bridge who looked depressed and might be thinking about jumping.” Several other police cars arrived on the scene. The officers looked at one another, the way lions look at one another when there’s only one carcass to go around. My little section of the bridge had become standing room only. I thought they should post an officer down by the tollgate to issue tickets and bathroom passes.

Most of the officers kept their distance, I guess because they sensed there was something special about me, and they did not want any of that specialness to rub off.

“I haven’t seen anyone,” I replied. “But if I do, I will flag someone down.”

“Are you thinking of jumping?” He asked.

“Jumping what?” Only did then I realize that he thought I was his potential jumper. I may have mentioned that I have a bit of a cynical streak, and the beast was demanding to be fed.

“Jumping off the bridge. Are you sure you are okay? You look depressed.”

“I think I look like I just ran nine miles.” I placed my right leg high on the guardrail to stretch my hamstring. Below me a small armada of boats had dropped anchor and the passengers appeared to be having impromptu tailgate parties in the middle of the bay.  Everyone was looking up at me, and some appeared to be filming, so I waved. A few of the people were yelling for me to jump.

“Take your leg off my bridge,” he commanded. “I was about to call for a helicopter. Are you sure you are okay?”

To me, the entire dialog was starting to sound like a bad country and western song. If I continued across the bridge, home was only three miles away.  If he did not let me cross I had to double-back those same nine miles.

“May I continue across?” It was a stupid question, made worse by my insouciant expression. I was going to lose the battle to cross the bridge. Losing gracefully is an acquired skill. Defeats pile up on top of defeats and eventually you lose the urge to fight back. I hadn’t built up that immunity yet.

I realize it was time for plan B. Which was a bit of a problem because there wasn’t any plan B. I was going to ask him if his helicopter would give me a ride back to our house, but he didn’t look like a give me a ride back kind of guy. “May I continue across?” I asked again.

A chorus of jump, Paul, jump was rising up from the boaters. He’d had enough of me. I started to appreciate that there were so many people watching, because if there hadn’t been he may have helped me jump.

My son asked me why I ran eighteen miles. I said it was because the policemen wouldn’t let me run twelve. That was my day.

More than five hundred of you read my post on Pokémon GO. Several of you asked me to explain how that type of augmented reality could play in healthcare. Let me being by saying, augmenting reality is far better than arguing with reality.

I think the idea is simple. Pokémon GO captures a player’s geo-location. Based on its knowledge of the player’s location, the game then spawns (places) different Pokémons

In the same general location. The player then collects the Pokémon and moves on to collect the next one.

Now, imagine a health system that new someone’s location, and knew what service the patient needed to access. Admittedly, this is a huge step for an industry that does not even provide online chat.

Suppose that you need to speak with a nurse. A virtual nurse from your system, or perhaps an independent system alerts you. You make the connection and talk with the nurse. Or suppose you are fighting depression and are having a bad day. You let your healthcare Pokémon app know that you need to speak with a behavioral health professional, and someone connects the two of you.

I think it would work like Uber Healthcare. You make a health request, and you are connected to someone without an appointment. The app will tell you the cost of the virtual meeting. It could be designed to connect you to professionals that accept your insurance. If a follow-up visit was needed, it would schedule it. If a prescription were required, it would order it.

One of the neat features of this approach is that instead of spending millions of dollars to improve outdated processes, this type of thinking would simply eliminate those processes.

What do you think?



How Did Pokémon GO Just Reinvent Healthcare Consumerism?

Innovation scares a lot of good leaders. Many are attitudinally challenged. “Into the valley of death rode the six hundred,” Alfred, Lord Tennyson wrote in Charge of the Light Brigade. The scary part is that none rode out. Staying the course tends to ensure continued employment.

Staying with the literary theme, I tend not to go gently into that good night when I talk about innovation—Dylan Thomas, not Bob Dylan. Sometimes I get this weird impulse to leap into the room and scream, “Juan, Paco, José, grab those machetes and shears . . . Viva la Revolución!” You see, I don’t mind looking like an idiot; I just like to do it on my own terms.

It is easier to spend your year counting how many paper clips it takes to run a health system. That tends to be their excuse. My dog ate my excuse. They also have a tendency to believe that curiosity is what killed the cat, curiosity about new ideas. Curiosity is why I get up each morning; besides, I am a dog person. I seek out opportunities to kick the scaffolding from under their feet.

The biggest problem leaders have when assessing innovation is that their nonnegotiability never becomes negotiable.

Have you ever sat through a strategic planning meeting? I have, and flies are dropping out of the air, dead from boredom. It is rare that I find a firm that actually has a defined strategy. What they usually have is a budget, and they leave no number unturned in their ability to explain why they cannot afford to do something that even hints of being innovative.

“So we beat on, boats against the current, borne back ceaselessly into the past.” The final line from The Great Gatsby.

Borne back to the past. Just like healthcare consumerism. The past tends to be a prologue to the future.

There are literally hundreds of health apps you can download that purport to have something to do with your health.

Most of them measure something; what you ate, what you did.

They are ineffective because if you didn’t eat right, or did not do anything, they have nothing to measure. And if you did not do anything—think exercise—you go to bed being no healthier than you were when you awoke.

You see, none of the apps can make you do anything. Samsung’s health app is called S-Health. Samsung extols S-Health as a fitness coach. It has “intuitive charts and helpful tips.” I felt healthier just reading that. It monitors things, a lot of things. Its pedometer feature tracks your steps.

For it, or any health app, to be effective, though, you have to give it something to monitor.

My children and probably many of yours live in what I call a step-free zone. A snail lapped one of them. They do not move unless food is involved. Or, at least until Monday they didn’t.

Enter Pokémon GO. One of my sons logged 9.4 miles on Monday. In a meeting yesterday, a very senior healthcare executive announced that his son walked 8.5 miles on Tuesday.

It’s not a health app. It’s not Bluetooth. What it is is something that changed behavior. The location-driven game conquered the planet in a week. Pokémon GO got more kids to exercise in twenty-four hours than Michelle Obama’s “Let’s MOve!” program did in eight years.

Fifty-three percent of smartphone users have an Android. On Monday alone, six percent of Android users opened the Pokémon GO app. It is estimated that by the third day, that there are 9.5 million daily active users.

What does all of this have to do with healthcare?

  • Your health system probably doesn’t even have an app
  • If it has an app, what percentage of the people in your service radius are daily active users? I bet it is way, way below 1%
  • Why don’t they use it?
    • It is not fun
    • It doesn’t create a great user experience
    • There is nothing that makes it habitual
    • There are no rewards

What would happen if all of the children’s’ hospitals threw together a Pokémon GO gym for its patients? They won’t, but they should.  If you think this idea has merit, don’t call on your marketing department or IT to do it.  Call a kid.

So, this is how the world works. It is not how healthcare works.

People are getting hurt playing Pokémon GO. They have fallen off of cliffs, been hit by cars, and one was bitten by a snake. Who are these people? What do we know about them? These are the people your marketing department is trying to reach.

And what do those people do when they get hurt? Do they pull up one of your apps and schedule an appointment? Nope. Do they go to your website and schedule an appointment? Nope.

Assuming they can find the number for your health system, maybe they call your system’s call center—the very idea of that just made my head explode. It should make the heads of your executives explode.

I bet a lot of them go to the Minute Clinic. And while they are waiting to see the nurse, and ignoring their broken leg, they are probably hunting for Pokémon over by the shampoos and in the Gummy Bear aisles.

So, if your reaction to Pokémon GO is that it is just a game for kids you should think about hiring your replacement.  It is called augmented reality, and yes, it already has its own acronym, AR. patients are already lining up–virtually–for e-clinics instead of brick and mortar locations.  They will expect doctors and nurses to make virtual visits to their homes.

The firms that will fall out of favor the fastest are those with the most outdated processes–alarm bells should be going off in the heads of providers and payers, especially since many of their employees are adverse to using newer technologies in their lives.  We are not talking about upping your use of Facebook and Snapchat, or updating your blog.

I mention this because healthcare is woefully behind planning and deploying anything that even hints of its interest in innovating through consumer technologies. Heck, most providers do not even have a CRM in their call centers.

I’d be willing to bet my neighbor’s BMW that nobody in your organization has even mentioned the term augmented reality.  So, if you are so smart, you are probably thinking, what should we be doing? 

Start with these two things:

  1. Develop a strategy that allows you to close your call centers within the next 3-5 years
  2. Hire your receptionist’s sixteen-year-old nephew as your Chief Augmentation Reality Officer.

And in case the director of the FBI is trying to track down who wrote this post, he won’t be able to figure it out. (I arranged to have my email server kept in a friend’s bathroom.)


Healthcare: Is This Why Everyone Hates Consultants?

Several of you know that it is best to ignore my sarcasm; encourage me and it only gets worse. The rest of you may be waterlogged with ambivalence. There are a lot of other healthcare blogs. You should read those if you are into the opinions of people who are experts at watching water freeze, people who are pinning the tail on the wrong donkey.

If you are in habitué to learn about consumerism from an author whose ideas are presented like a sprinkling of dew on a rose petal, my blog may not be the best choice for you. I don’t sprinkle. Nor can I turn Coke into Pepsi, but I have been known to make rocks cry.

Healthcare consumerism is a walking enigma on stilts.

The fact that I’ve spent my career in consulting may have something to do with how I approach issues. Consultants, for example, are the people in the movie theaters who get dreamy-eyed when the Titanic goes down. I cried, not because I was moved, but because it was such a bad movie. When bad things happen consultants are thinking, I have a PowerPoint somewhere that told you it would sink. And we tend to make that point with all of the generosity, grace, and selflessness of Jack the Ripper.

After all, ships that aren’t likely to sink do not need consultants any more than we need another album by the Village People. Some business leaders wait to glom on to an issue until it has enough cachet. Those are the same people who will tell you that they were only responsible for sinking the lower decks of the Titanic. Getting insight from them is like reading cartoons that do not have captions. They leave the thinking to you.

Unlike HCAHPS, I am not big on nuance. I wouldn’t know a nuance if it hit me in the face. I prefer to keep equivocations about HCAHPS out of my inbox, because if you think you have a fifty-fifty chance of getting it right, there is a ninety percent chance you will get it wrong.

People who believe consumerism is linked to HCAHPS see straws and immediately reach for them. HCAHPS are to patient experience and consumerism what Oliver Stone was to the Kennedy assassination. Only a handful of us has a license to interpret the universe.

For those who think I may be out of my depth when it comes to addressing matters of customer experience in healthcare, customer experience has no depth. At least beyond the mindset of a sixteen-year-old. And that is why I pretend to be the ringmaster when it comes to the circus of egos who are trying to tell you that you are already doing everything possible to understand what your patients expect from your organization.

Healthcare’s consumerism circus has started, and it’s going to be a three-ringer. Maybe I should be wearing a cape. But, I am a consultant; trust me. (You do not need to comment on the oxymoron.)

I find it helpful to present issues using my illusory charm and mythical footwork, and to disperse profundities to both the washed and the unwashed. Maybe that is why consultants have half-lives of fruit flies.

There are those who will tell you that when you fall off the horse, you need to get back on. I disagree. I think you need to learn to walk or to drive.

There are around a hundred and fifty million people in the U.S. who drive. They live among us. We see them driving, and we think we know how they do it. We think we know what they are doing.

I mention that because I am teaching my daughter to be one of those drivers. She has spent about twenty hours practicing, and other than backing out of the driveway, she seems to be getting the hang of it—way to go, Dad!

During yesterday’s driving lesson with her favorite dad ensconced in the passenger’s seat, she told me about a friend of hers who just passed her driving test. And she remarked, “Sally only uses one foot when she drives.” Her statement was so innocuous that I missed it.

A few miles later I asked, “What did you mean about using one foot?”

“She uses the same foot for the gas and the brake.”

By having spent years observing what is commonplace, we think we know everything about that which we observe. I watched my daughter and assumed she was using the same foot for the gas and the brake. She had spent sixteen years watching us drive her. She saw two pedals, knew she had two feet, and put two and two together and got an irrational number. We gave her the keys. It never occurred to us to tell her that even though there are two pedals that you need to use only one foot. And the reverse never occurred to her.

We learned quickly that our assumptions were wrong; mine about how she was driving, hers about how everybody else was driving.

We make the same errors every day when it comes to our knowledge of patients and customers. We assume that if someone needs an appointment, they simply call and get one. Or a refill, or an explanation about their bill, or a referral, or whatever. Only it ain’t that simple. Nothing is. Never was.

But if everyone in your system believes being a patient or a customer is simple, then why would they be concerned about fixing it? We fix things that are broken.

Instead of operating a health system based solely on assumptions, why not ask your patients and customers whether your assumptions are valid.

The real bad news is that assumptions are driven by expectations. And chances are high that nobody in your system has ever asked them about those either. As a matter of fact, health systems and payers probably have not asked their patients and members about much of anything.





How To Fix Patient Experience: Feed The Fish


If you haven’t spent much time with people of my métier—consultants, we aren’t real high on anybody’s be-sure-to-invite-to-the-party lists. Maybe it’s the shoes. My counsel has always been, we’re okay if you paper over the rough spots.

You may think consultants are business’s Robespierres. During the French Revolution, Robes—I am the yin to his yang—backed the execution of Louis the XVI. (What I love about Google is its ability to make it seem that you have a PhD. in French History even if all you know about the French is how to make a decent Béchamel sauce.) Robes, as good as his leadership was, was guillotined a year after Louis. His fate makes me glad that we do not favor the guillotine for thought crimes that may have been committed by consultants.

If you will allow me another moment of your time and allow me to pretend that I am a historian on par with Thucydides—you can also Google him; I did—you could infer that consultants are like Torquemada, the Spanish cleric who in his spare time founded the Inquisition.

I could not help myself, and I offer an apology to those of you who have made it this far without clicking over to eBay. If you have been a reader of my blog for longer than a few months, you know that I think most business problems can be illustrated best by a reference to something written by Mel Brooks. (For information on Torquemada see History of the World, Part 1—there is no part 2.)

I try to bring a certain bon homie to your day. In the world of consulting, some would say I have what is called the Pope’s Gift. What that means is that if the Pope walked outside on a perfectly cloudless day an opened his—I’m not being sexist with my pronoun—umbrella, that every Catholic for miles around would open theirs, too. Some believe that if I opine that you have a problem, chances are pretty good that you have that problem.

I tend to raise the issues by screaming epithets—wrong word, but I like it—because I believe there are many organizations delivering lip-service about how important their customers are. The catch is that there are executives in those organizations with their hand in the cookie jar, and their first inclination is to point at the refrigerator—doesn’t it seem like the word refrigerator ought to have a ‘d’ in it somewhere?

Fixing consumerism has a lot of low-hanging fruit. The problem is that many of the people in charge of fixing consumerism and access and engagement cannot tell the difference between fruit and cannolis.

As I wrote previously, an executive vice president of a huge health system moved to a certain city to start his new job. The city is irrelevant. It could easily be your city. He—without throwing aspersions to the politically correct crowd, because he was and is a he—called his employer, to get an appointment with a PCP—primary care physician—to those of you who are still playing. And he was unsuccessful in his effort to get an appointment.

This happens hundreds of times every day. It happens at your health system.

But it happens ‘in camera.’ In camera is a legal term. The term refers to a discussion that happens in the absence of others—the people at your health system who should know that these attempts to access you health system are happening—but who do not have a clue.

Imagine you are that executive and you are sitting in your office. I am going to employ a little literary license to set the stage.

Your two hundred gallon salt-water aquarium is bubbling away on the far wall. Your desk is uncluttered. You Mont Blanc pen and pencil set sits front and center on your leather desk pad, poised to sign whatever strategic document appears on your blotter.

Three hundred square feet of polished glass walls afford you a view of whatever river happens to flow beyond your parking garage—you can pick the city and river of your choice without affecting the outcome. A nifty Degas print, uplit by an LED lamp embedded in the hand-stitched Oriental tapestry, whose colors that happen to match your socks, colors that were hand ground by lama-farming urchins in Nepal, hangs on the far wall.

Your kingdom awaits your leadership. So what do you do? Feed the fish? Adjust the Degas print?

Try this? Take off your jacket and tie—the fish won’t mind. Take the elevator to the third floor, and sit in the surgical waiting room. Talk to the person sitting under the television who happens to be reading a dated copy of the Latin American Economist magazine. Just talk and listen.

And then go to the first floor. Keep talking and keep listening. Spend the next hour in admissions. Spend another hour in the ED waiting room. And another where you do the lab tests—and bring your magazine to keep yourself from going nuts. Then go back to admissions. A lot of the people you saw earlier are still there. And leave the magazine because you don’t understand economics and you don’t speak Latin American.

Then go back to your office. Put on your tie and your jacket. Have your admin get you a cappuccino. And create a new to-do list of all of the things you learned about what you need to do to improve patient access, experience, and engagement.

And if after twenty minutes of thinking about what you need to do, and you look down at your list and realize that you have not written anything, write this:

“Feed the fish.”

That way, you will leave the office knowing that the day was not a total waste of your time.



Digital Customer Experience: I Stole The Strawberries

This weekend I watched the movie, Eye In The Sky, a modern wartime political thriller. The movie deals with the ethical and moral implications of eliminating terrorists through the use of drones, while minimizing collateral damage—their phrase not mine.

Most of the film involved what might best be described as a game of hot potato, as each of the people responsible for approving the strike order passed the buck to someone else in their chain of command. The drama centered on whether the bad guys would get away before the decision was made. The holdup in the decision process was because the drone’s camera showed that a young girl might be killed if the drone’s missile was fired.

I turned to my wife and remarked, “How cool would it be if Donald Trump walked into the mission planning room and taught everyone how to make a decision?”

When it comes to business, very few executives like to shake the trees. That is because gorillas are often found in trees. I tweeted last week that a woman had asked me to explain what I do. My reply was, “I am the guy who drags the elephant into the room.” Your room. And I like it. Gorillas and elephants.

One of the first things you learn in business school is to trust facts and only facts. Do your best to avoid deductions, and run away every time a hunch comes within ten feet of you. I tend to do the opposite. I rather enjoy doing a swan dive off a deductive highboard even if there is not a single drop of factual information in the pool. (I try to make the most out of being underestimated.)

In business, when a senior executive comes up with an insipid suggestion, the rules of decorum dictate that it be treated like Einstein’s theory of relativity. Sometimes there is no suggestion, there is only silence. People came knocking at the idea door only to find that there was nobody home. No ideas can be as detrimental as bad ideas.

When someone tells you, “We’ve got our arms around consumerism,” don’t believe half of it. Believe the other half.

Think back to the last important business meeting you attended. Sooner or later you realize that nothing that is being said is making sense.

“The time has come,” the Walrus said,
“To talk of many things:
Of shoes–and ships–and sealing-wax–
Of cabbages–and kings–
And why the sea is boiling hot–
And whether pigs have wings.”

Sound familiar? When someone doesn’t know what to say almost anything will do.

I’ve been in many meetings on consumerism, access, experience and engagement. And when the most senior person in the room discovers that his or her organization as been missing in action on those issues, everyone knows it. That individual stands there like Captain Queeg, rolling ball bearings around in their palm and ranting about who stole the strawberries.

Today I spoke with a very knowledgeable, senior clinical executive at a very large and respected health system. I learned that the health system we were discussing had spent months researching and updating its website to reflect what people want from their healthcare provider.

After my call, I went to the website to see what their research told them people wanted from their healthcare provider. They must have concluded from their research that people really, really like the color blue. The aesthetics are nice. Aesthetics are usually the final task in design thinking—make sure it looks nice.

However, all of the tasks that take place prior to aesthetics involve making sure that people can actually do something on the website—your digital representation of your brick and mortar facility.

Since I was already at the site, and since I like blue, I decided to stick around for a while and give the website a test drive. I began with the Contact-us box. I wrote a very nice note. I received an immediate response; 500 Error. Check back with us later. I may not need a doctor later. There is a link for Donations and Pay Your Bill. Both of those links seemed to be working very well.

I clicked on Locations. They have a lot of locations. I tried Patients and Visitors. More blue. Lots of words. Nothing actionable if I were a first-time patient other than a link to share the page with a friend who also likes blue. I registered as a new user. A nice touch. But I did not receive a confirmation, nor did it come back with Hi Paul, what would you like to do next?. In fact, it did not come back with anything.

Consumerism 101: Patient Acquisition. Registering online does not have equal value to having someone do something; set up a profile. Do you want to add family members? Do you want to schedule an appointment? Do you need to speak with a clinician? Add your pharmacy information? List your doctors? Complete a health history?

This system is also in the process of centralizing its call centers. Since offering a seamless omnichannel experience is so important, the best advice I can offer them is to make sure that the carpeting in the new call center is blue.

BTW: I took the strawberries.




Your Patient Access Strategy: Shift Happens

The New York Times is written using language that can be understood by an eighth grade student. I have an eighth grade student. He refuses to read my blog even though our collective tax dollars suggest he should understand it.

It is one thing to write at a level that an eighth grader can read. It is another matter entirely to try to understand what an eighth grader can comprehend. Never the two shall meet.

A few years ago when I began my blog, I had to figure out who my audience would be, and at what reading level I should I address my remarks. Most healthcare blogs are written at a level that supersedes my ability to decipher the message, and so I wondered, is it possible to take a complex issue and relate it in terms that would resonate with those of you who are kind enough to spend a few minutes with me each week?

A friend suggested that I write in crayon and she encouraged me to use a lot of pictures. Maybe I could write a pop up book that could also serve as a conversation starter. A coffee table book.

I demurred. And from my friend’s counsel I’ve learned that the most beneficial writing style is to offer something that combines the best of Mel Brooks with the best of whomever may be your favorite cynic du-jour. And that the most important takeaway is to make one point, a point so simple that even an eighth grader would understand. Not to infer that that is all you can understand, but I write at a level that even I can understand that about which I wrote.

And so my effort to explain the machinations of healthcare to myself, because that is the reason I write, continues. To quote the eloquent Mr. Brooks, “Mongo is just a pawn in the game of life.”

I think of myself as healthcare’s Mongo. I am also thought of as the guy who likes to drag the elephant into the room.  Mrs. Roemer tends to think that my mother, the original Mrs. Roemer, raised a particularly hardy breed of idiot.

Now, on to the reason we each arrived at this spot. Healthcare and its strategy. I refer to this type of strategy as a post-factual strategy, one where myths and irrationality hold sway over what is really going on.

The great thing about tying your business strategy to luck, is that luck is free. At least at the thirty-thousand foot level. You don’t even need to allocate the cost of a planning meeting. You simply send an email that reads something like this; “this whole consumerism thing may or may not work. Let’s see what happens.” If it works you are golden, and it did not cost you a cent.

If it doesn’t work, your a priori, preprogrammed response is to blame IT.

Luck’s bill becomes due and payable when it doesn’t pan out the way you hoped it would. When it comes to the business of healthcare—how healthcare is run—basing your firm’s survival on a monkey-see-monkey-do approach could work most of the time. Everyone is focused on HCAHPS; we should focus on HCAHPS. The hospital down the road has three MRIs, we should have three MRIs. Worry about big data even though we have little data.

As long as your competitors are in lock-step with your approach, your results are no better, or no worse (plus or minus) than the firms doing exactly what your’s is doing.

Unless–in case you have not been paying close attention, this is where I start to tug on the elephant.

And therein lies the rub. Each time someone enters a room he or she has a choice, “Do I turn the lights on, or do I leave them off?” When it comes to planning patient access, evidence suggests most firms choose not to turn on the lights.

The problem comes when someone in a competitor’s IT or marketing or innovation group asks a question. Asks this Question.

“What would happen if people could do what they want when they want using any device they want? His or her colleagues begin to sweat profusely. They get the same uneasy feeling that the CVS executives must have gotten when someone asked, “What if we stop selling cigarettes?”

That question, if acted upon, throws luck under the bus. The que sera sera business strategy is now in a world of hurt.

I studied math in college—well, I sort of studied it. Statistics, probabilities, possibilities, permutations. Linear algebra—it wasn’t all that linear.

A flip of a coin. A turn of an angry card. Luck is a game of chance.

Your firm’s business strategy does not have to be.

You may have attended a few of the meetings where these toss-of-a-coin, future of your firm issues are decided. Freshly minted MBAs with Pepsident smiles, a full head of hair and wearing skinny jeans. Visio presentations—PowerPoint is too 80’s for them. Zoom in. Zoom out.

“We’ve analyzed the big-data, and it tells us that our best strategy is to stay the course.” Those same MBAs are still wondering how an ice cube sunk the Titanic. The thing overlooked by the skinny-jeans crowd is that one cannot base an argument on big-data when one has no data.

If one were to survey patients and prospective patients about what access issues bother them they would have heard two replies; we want someone to know who we are, and we want someone to know how we are.

How and who—or is it whom?

But your system cannot deal with that. If you think of your hospital as a castle, your call center serves as the castle’s moat. It instills confidence and nullifies wariness. Your electronic moat is doing exactly what is was designed to do, protecting your firm from people from getting to you.

Your call center cannot answer ‘how’ or ‘who.’ And neither can your website. “Find a doctor?” No thank you. I want to schedule an appointment with that doctor. And that is when your Cisco servers start to gurgle. It is what happens when the temperature of the core of a nuclear reactor exceeds the reactor’s ability to cool the core.

Shift Happens.

And the thing is, the thing that is overlooked each time the healthcare savants and wellness Mensas gather in the board room with their Ouija boards, they discover that patients rarely use Ouija boards when selecting their healthcare provider.

Those people are trying to answer the question for themselves, “Will I buy healthcare from you?”

That is a two-hundred thousand dollar question—the lifetime value of a new patient. This is the same individual that your marketing department spent tens of thousands of dollars trying to entice that person to call your health system.

And that is precisely where your luck ran out. Your flip of a coin just came up tails 173 times in a row, it beat down probability and it beat down possibility. And the reason that happened is that patients and prospective patients and caregivers and family members have the ability to take common sense and turn it into string theory when it comes to understanding what your organization should do to meet their needs.

Everything your health system does needs one thing; patients. A young CEO asked his mother, “Where do patients come from?”

“They come from the phones,” answered his mother. “We call that access. And access begets engagement, and engagement begets satisfaction, and satisfaction begets patients.”

And so the CEO smiled, and he pictured flying phones bringing swaddled patients to his hospital.

Would Hiring A Sommelier Improve Healthcare?

The tag line on my bottle of Coke is, #ShareaCoke. I read it as Sharia-Coke. Perhaps nobody else read it the same way. But if you are Coke’s Marketing Officer, did you really want to take that chance?

Most days I feel like I am Alan Turing’s ghost. The reason I do what I do is to entice companies to do what they cannot imagine, and most times I do not have to apologize for that because they have not taken the time to imagine it.

There are a lot of idioms about horses. I may not know what an idiom is, but I went to Google, and I was good to go. You can lead a horse to water; hold your horses, don’t look a gift horse in the mouth. If you are a hippophile—one who loves horses, I shall leave it to you to find others. There is an idiom that states, “You can’t beat a dead horse.”

My rapprochement is, of course, you can, if it is the only horse available. And sometimes you should; my apologies to the horses who may have been following along up to this point.

I look at healthcare through puce-colored glasses. The healthcare business, on the provider side, is a world-class, 2.0 industry. No other nation can provide the services we provide. However, the business of healthcare, how we run it, is a 0.2 industry. Providing world-class services without being able to make it easy for people to acquire those services is ridiculous. Isn’t it?

There may be some of you who continue to wonder why you are reading a blog written by someone you believe to be a healthcare heretic; a witch. One way to help you cast aside such dispersions would be to drop a house on me—like in the Wizard of Oz. If it turns out that I am wearing striped socks and ruby slippers, and my legs curl up, you were right, and you may get on with your real work. Otherwise, may I entice you to humor me for another minute?

Running your business well comes down to doing a few basic tasks extremely well every time. Being successful requires that you execute those tasks at a level above and beyond how others execute those same tasks, and it requires that your customers believe that you are capable of doing that again and again.

Once you miss that opportunity nobody is going to award you a do-over. Several formerly grand firms missed their opportunity; Blockbuster, Radio Shack, and Sears provide grim reminders. Barnes and Noble seemed to have just realized that their boat sailed and left them tied to the dock. NPR announced that the former bookstore behemoth is considering turning their stores into wine bars. Maybe their business strategy is that after millions of their former customers buy books on Amazon that they will come to Barnes and Noble to read their books and enjoy a nice pinot noir with fava beans.

I cannot think of a single entity that has managed to put the toothpaste back into the tube after having missed their industry’s defining moment.

Healthcare’s defining moment is now. Or, never.

The 0.2 business model, the one reliant on call centers open only half as many hours as Comcast’s call centers is in for a rude awakening. The business model needs to leapfrog itself. Executives can try to multiply the model by 10 to get it to 2.0, or they can develop a strategy.

Healthcare 0.2 is:

  • Stationary
  • One-way
  • Unintelligent
  • Monday through Friday from 8 AM to 6 PM

Healthcare 2.0 is:

  • Mobile
  • Interactive
  • Cognitive (Understand, Reason, Learn…URL)
  • Cloud-based
  • 24 X 7

if executives choose to forego the move to 2.0, perhaps they should consider hiring a sommelier.