Why Is Healthcare’s Unknown Variable–meCare?

As a married man, and the father of a daughter, I find myself wondering, if I speak my mind when I am alone in a forest and neither of them hears me, am I still wrong? The vote was 2-0, and it did not encourage me to continue to speak my mind. Which is why I write my blog.

Have you ever wondered about whether Shakespeare had an English teacher? And if so, what that experience must have been like for the teacher? These are the types of questions that keep me up at night. “William, put down your pencil and pay attention. And quit making up so many nonsense words.”

Creativity is easily killed by those who are afraid to make mistakes or to be seen as foolish.

This weekend my son and I attended the Rochester Institute of Technology’s student orientation day. The dean showed a series of cartoons related to designing a perpetual motion machine. Slide 1: A falling cat always lands on its feet. Slide 2: A piece of bread covered in jelly will always fall jelly-side-down when dropped on a white rug. Slide three: Tape the jellied bread to the back of the cat. Slide 4: Hold the breaded cat over a white rug and drop the cat. The cat is designed to always land on its feet. The jelly bread will always land on the white rug. If the cat is about to land on its feet, the jelly bread will cause the cat to spin so that the jelly will hit the rug. If the jelly is about to hit the rug—meaning the cat will land on its back—the cat will spin around so that it will land on its feet. So the cat and the bread spin in perpetuity, never hitting the ground.

To the one percent of you who are thinking, “That makes sense,” kudos to you. To those who are inclined to argue that the jelly bread could not possibly make the cat turn over, perhaps that reflects a need to spend more time coloring outside of the lines. In order to do anything creative, you have to be prepared to be wrong. And that is important because we have all witnessed the results of not being creative, of being afraid to be wrong. The fear of being wrong more often than not delivers results that are lukewarm.

Then there is the story of the young girl who never paid attention in school except in art class. As she was drawing the teacher asked her what she was drawing. “I’m drawing God,” she replied. “But nobody knows what God looks like,” the teacher told her. (To give credit where credit is due, I borrowed the Shakespeare and art class illustrations from Sir Ken Robinson’s TED talk.)

“They will in a minute.” Now there is an example of someone whose imagination wasn’t controlled by what someone may have thought.

If you want to see an example of a group of someones whose imaginations were controlled by the thought police you need look no further than your firm’s website—the place where imagination went to die. Your website is your organization’s digital representation of your brick and mortar facilities. The big difference between the two is that when someone enters your building you meet their needs, and you do that close to one hundred percent of the time. Chances are, however, that when someone goes to your website you meet their needs less than ten percent of the time.

A key measure of the effectiveness of your website is called Conversion Rate Optimization (CRO). CRO includes figuring out what the person’s needs are and meeting them. If you cannot do that there is no business reason to have a website. And to meet a person’s needs you have to know what those needs are. And to know what those needs are you have to ask. Chances are high that nobody in your organization ever asked a visitor why they went to your website. Chances are also high that visitors will not visit your site more than once.

Half of the people who call your organization have been to your website and could not complete whatever transaction they needed to complete. That is why they are waiting on hold to talk to someone who does not even have the tools to recognize that the person calling is a patient undergoing chemotherapy.

So, let’s drift back to the idea of design, imagination, and creativity. And let’s see if we can tie that into the black holes that exist in healthcare and customer experience. Think back to some of the most recent meetings you attended. I’ve been in many of those meetings. After a few hundred of those meetings, I began to notice a pattern; a pattern of what is unspoken, and yielding to my self-appointed title of ‘Chief Imaginist,’

I yield the floor to whoever the person was in the meeting at CVS who raised his or her hand and proposed, “What if we quit selling cigarettes.” A pin-drop question. An ‘Imagine a World,’ moment.

I have never witnessed a pin-drop question in a meeting, and I’d wager that neither have you. There are no ‘Imagine a World moments.” That is because there are no imaginists. There are no dreamers—at least in the area dealing with how do we make it easier to do business with us; how do we improve wellness.

We need meetings where someone says, ‘Great idea. Run with it.’ Where someone asks, ‘If you could change anything, what would you do?’ Where nobody says, ‘That would never work here.’

The reason those things would never work here is that they do not fit the corporate rubric. The people who raise those ideas are culled from the herd—sausage. The ideas wind up as the discarded detritus of your organization’s business strategy. When imagination and creativity are pushed aside, so is the organization’s ability to compete.

What would your system have to do to attract everyone who was not aligned to a health system, everyone who was not currently under treatment, to make your system his or her provider of choice?

In the recesses of my mind, the answer lies with your consumers; more specifically with each consumer. Consumers can’t be grouped into neat little piles like republicans and democrats. Viewing consumers, as a ubiquitous whole does not solve the problem, it worsens it.

People, your customers, and patients are not interested in eCare. They are not interested in population health, or value-based purchasing, or your ACO. Their only interest is in me-care. My health. And it appears that they are alone in that pursuit. After all, can you name a single provider, or payer, or retail pharmacy, or life sciences firm that can demonstrate their interest in how you are right now?

People will pay for me-Care. They will queue up around the block. None of them finds solace in the fact that your EMR recorded the removal of their gall bladder three years ago. None of those people finds solace in the fact that you prescribed them amoxicillin last year for their ear infection, or that you paid their claim for that prescription.

What the me-care patients want to know is whether you can tell them how they are today; right now.

And you can’t. And the reason you can’t is that you haven’t invested a dime in trying to ascertain that.

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