What If Oysters Ran Healthcare?

New College, in Oxford, England, was founded in 1379, hundreds of years prior to the invention of the I-Beam. Enormous oak beams support the roof of the college’s main dining hall. Each beam is two feet square and forty-five feet long.

Wood has a number of characteristics.  The characteristic most relevant to this discussion is that it rots.

About 100 years ago, entomologists were studying the beams that supported the dining hall’s roof and they noted that the beams were infested with beetles. Apparently the students were not the only diners in the room. The beams could not be repaired, and the integrity of the five hundred year-old roof was in jeopardy.

Unfortunately for the college, it was widely assumed that all of the large trees from the old-growth forests had long since been felled. It appeared that the only way to preserve the dining hall was to use modern materials.

New College owned a great deal of land and actually employed its own forester—someone who could see the forest and the trees. When the college asked their forester about whether he knew of any large trees, the Forester replied, “I was wondering when you’d come asking.” The administrators discovered that when the college was built, a grove of oaks had been planted for just such an emergency.

The information about the grove of oaks was passed down from forester to forester for more than 500 years.

Long term planning: Planning that provided the perfect solution, not a series of ad-hoc fixes year-in and year-out.

When I built my home I did some long term planning as well.  I had telephone jacks and Ethernet wired to every room in the home so I could make a call from any room in the home and have an Internet connection in every room.  About a week after we moved in to the house I learned about something called a wireless router.  So much for my astute planning.

So, how does planning come in to play with healthcare providers?  Or does it?  Has anyone in your organization ever used the terms long-term planning and consumerism in the same sentence? In the U.S., and among U.S. healthcare institutions, long-term usually refers to those events that happen just beyond the threshold of the current year’s budget. Has anyone ever said, “I want to ensure that when I retire, that this is in place for the next CEO?”

When a single grain of sand enters an oyster’s home, the oyster gets irritated—if oysters had children, they would learn to get along with many grains of sand in their homes and cars—at least those oysters who drove. So, we have an irritated oyster. And when irritated, oysters get busy. And when oysters get busy, they build things. Pearls.

Let’s see if we can compare that to healthcare. When someone calls a health system, the health system gets irritated. And when irritated, health systems get busy. And when health systems get busy, they build things. Call centers.

Most health system call centers are nothing more than a big room with a lot of phones in them.  And that is exactly how they function.  There is no ability to both support care coordination and back office functions. There is no ability to support both patients and consumers. There is no first contact resolution.  There are, however plenty of opportunities to call and call and call.

And now the callers are irritated. The callers wish they new how to make pearls.

So, how would things differ if instead of the call center being just a big room with a lot of phones, someone had actually planned for and designed it to support both patients and consumers?

Your call center is probably the largest and the most complex business process in your organization. It is the only business process that will be used by everyone; patients, prospective patients, care givers, family members, and clinicians. It is the only business process whose effectiveness will sooner or later will disappoint every single user.

Yet it is never treated as a strategic asset. Here is a hint. Do not develop a plan to create the most remarkable call center in the country.

Design a plan that allows the big room with phones in it to deliver the most remarkable consumer experience in the country.

But until someone actually creates that plan and designs it to provide a remarkable experience by using the most complex business system in your organization, your call center will continue to be just a big room with a lot of phones.

Here’s one last hint. By the time you have build that call center that delivers the most remarkable customer experience in the country, you should already have started planning for a business model that does not need a call center in order to be great at consumerism.

Now, call Amazon or Netflix.

You can’t. Great consumerism; their big rooms with phones in them were turned into oyster bars. That is where you need to set your sites.


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