The orthopedist sanitizing my hand did not look old enough to legally use the alcohol swabs. “How long have you had this problem?” She asked me.   “About a month,” I told her. “And why did you wait a month to have someone look at it?”

“Because, I’m a guy.” That is what guys do.

“This is not uncommon for someone your age.” And exactly what age might that be? I wanted to ask her. I reinserted my hearing aid and dentures, swallowed a few Metamucil pills, grabbed my cane and waddled to the lobby.

The reason the best-laid plans of mice and men often go astray is not the plan; it’s the mice and men, and the women—see, even I can be politically correct when it suits me.

It wasn’t too long ago that the biggest healthcare consumerism issue was ensuring that your organization had a website. Next, it had to have a mobile presence, one that had some semblance of the desktop’s website’s functionality. A mobile presence qualified your system for bonus points; it merely allowed you to check the box. The website of a highly respected Pennsylvania health system has a ‘Mobile Health’ link on its homepage. When clicked, the link’s only display is a phone number—check-the-box. Thankfully for healthcare, having a mobile presence is no longer an important issue.

The reason having a mobile presence is no longer an important issue is that the issue of mobile-first has bypassed it. Mobile-first is a slick way of saying that the first place most consumers go to conduct their business with an organization is to a mobile device. It means designing an online experience for mobile before designing it for the desktop. It also means people expect to have a good user experience, and they expect to be able to complete certain tasks when they visit your mobile site

The term ‘responsive design’ comes from the strategy of design called design-thinking, also referred to as user-centered-design-—see how that word ‘design’ keeps cropping up? The opposite of employing design-thinking is designing without thinking; without thinking about what users want and the type of experience they want.

Responsive design used to mean making sure that when a user went from your website to your mobile link that the information fit well and functioned well on the smaller display screen. Now responsive design means doing just the opposite—going from a small display, the display with which users are most familiar, and making it work just as well on the desktop. (Two examples of organizations that have not done a good job of managing this consideration are FoxNews and USA Today. Everything flows nicely on a phone. It works less well on a tablet, and the desktop user experience is hideous.

So, after years and years of hard work, a very, very small handful of healthcare providers and payers have demonstrated some skill at making their Internet presence a corporate asset. All have a website—check the box. Many of those websites can be viewed on a smart device—check the box. Some smart devices actually take users to an app instead of a website—check the box.

But the number of healthcare companies whose online and mobile offerings actually lets users complete tasks would fit comfortably in a Hyundai—do not check the box.

The reason this is so important is because there are few if any reasons for people—patients, customers, and consumers—to ever visit your company via the internet more than once.

Don’t believe me? Read the stats about how many people visit you online. You will see that when compared to the number of people who call your company each day, the number of online visitors for that same day will be relatively small. More people visit you online during the weekend and after 6 P.M. on weekdays because your call centers are closed.

And half of the people who visited you online will wind up calling you because they could not accomplish anything online.

The ROI of your existing online investment is probably zero.

Ask yourself this the next time you think about why your organization has an online presence. Does the functionality of your presence answer the question, “What do we want people to know about us?” If it does, you are halfway to understanding why you have a problem.

The only reason to even have a website or an app is to be able to answer the question, “What do people want to do when they visit us online?”

And the reason your organization cannot answer that question is that the organization never asked the question.

Here is the secret sauce to being online. Nobody wants to know anything about your organization. Nobody. They want to do something, or they want your organization to do something they cannot do for themselves.

The only value most people get from visiting your healthcare organization online is when they find its telephone number. After navigating all over the site and realizing that they cannot actually schedule an appointment, or obtain a refill, or set up a payment plan, they realize they have no choice but to call. Had they wanted to call your firm they would have done so instead of going online. Or, they would have said, “Hello Google. Call Kindred,” and bypassed your firm entirely.

Is the entirety of your online functionality nothing more that a Where’s-Waldo, digital version of the Yellow Pages?

The online functionality of the best healthcare systems is probably worse than that of the mom-and-pop consignment store down the block. The consignment store’s website displays their new inventory, it lets customers buy products online, and it even sends customers alerts tailored to their stored preferences—how cool is that—2-way interaction. Cognitive 101.

Healthcare’s idea of 2-way interaction is limited to telling patients your bill is past due. Cognitive 001.

Friday I spoke with the president of a highly respected health system in Texas. We were sharing ideas about what is about to happen, about the art-of-the-possible. I said, “I ought to be able to tell a Siri-like device, ‘Schedule the next available MRI for me.’”

To which she replied, “And it should be able to reply with, ‘If you select the 6 P.M. opening Monday, we will discount the cost by ten percent. And if you pay for it now, we will discount the cost by another ten percent.” Turbo Cognitive.

If she and I had been playing poker, she had just raised my bet, and beat my three jacks with a full house. Well done.