“If you’re in a horror movie you make poor decisions. It’s what you do.” A group of kids is running from a murderer in the middle of the woods when they stumble upon an old cabin. “Let’s hide in the attic. No, in the basement.” One woman starts breaking down and is in tears “Why can’t we just get in the running car?!” She is dismissed as crazy “Are you crazy?! Let’s hide behind the chainsaws.” They agree “Yea, smart.” They run behind the chainsaws but don’t notice the man standing behind them. The man gives them a look as if he can’t believe how stupid these kids are. They finally notice the murderer and run off “Head for the cemetery!”

Poor decisions. Head for the cemetery. Whether you are in the provider, payer, or pharma communities, we’ve all been in one of those meetings where someone suggests why can’t we get in the running car. And we dismiss her and run towards the chain saws.

Suppose the running car suggestion is, “We need to create daily habituation with our patients and consumers.” Stated more simply, we need to get them to interact with us daily, not just once every two to three years. If a patient or consumer only contacted us once a year, creating daily habituation means getting people to increase their rate of contact by 36,500%!!!

So, how do we achieve daily habituation, and what would it look like?

There is a great deal of activity in healthcare around cloud computing. Almost every health organization is doing something with a cloud, but only with their own cloud. But few if any health systems share their cloud any more than they share their cafeteria. Not only do they not share it with other providers, they don’t share it with payers, they don’t share it with pharmacies, and they do not share it with their patients and consumers.

For example, Philadelphia has several very good health systems. Imagine looking out from the top of one of the city’s highest buildings—what would you see? You would see a cloud hovering above the Hospital of the University of Pennsylvania (HUP). Across the street another cloud would be floating above CHOP. One above Thomas Jefferson; one above Einstein, Hahnemann, Cancer Treatment Centers, and the Philadelphia VA.

A few dozen individual clouds. Partly cloudy.

You continue looking, and you see that the sun is shining on all of the people entering and leaving the various health systems. That is because the clouds only cover the health systems. The clouds do not cover the patients or the visitors or the family members, and they do not cover them once they leave the buildings.

If you are asking yourself, so what, the answer to so what is the missing link for achieving daily habituation. As a matter of fact, that answer is the missing link for achieving any kind of habituation. People, your patients and your consumers, are missing the two things they need the most to drive any kind of habituation:

• They have no easy way to communicate anything about their health with you—we both know that your call center is not a communication tool; calling your organization is the last act of a desperate person
• Your organization has not given them a compelling reason to communicate with you more than they do

What healthcare needs are Healthcare Relationship Management to interconnect:

• Patients and providers
• Consumers—prospective patients—and providers
• Consumers and payers
• Consumers and pharmacies
• Providers to payers to pharmacies to consumers

Healthcare needs a Healthcare Relationship Management Cloud, a HRMC. An interactive (think 2-way) interconnected way of communicating about whatever one party wants the other party to know.

And what do patients and consumers want you to know about them? Nobody knows. And the reason nobody knows is that nobody ever asked them. Heck, if we are being honest, most providers do not even track why people call.

Last week I met with a senior executive of a very large payer. During our meeting, I drew a large, oblong shape to represent his customers. Way over on one end if the shape I portioned off a small bit of the shape to represent the fraction of his customers that interacted with them on a regular basis. Our discussion focused not on the tiny portion of people that communicated with his firm, but rather on the much larger group of members that never communicated with them. He said they call that group of members the tail. While the term probably was not intended to reference the idea of the dog wagging the tail, it could apply.

Providers also have a portion of the population they serve that represents the tail—patients and consumers who do not interact with them. So do pharmacies. Not interacting, and not needing to interact are two different things. Not interacting is a result of:

• No compelling reason to interact
• No easy way to interact

Now suppose consumers had an easy way to interact with your organization on a regular basis. And suppose they had a compelling reason to interact with your organization on a regular basis. Why would that be a good thing for both parties? These are a few things that spring to mind:

• Healthier people
• Improved care coordination
• Reduced admissions and readmissions
• Population health management
• Patient acquisition and retention

And that is why I wrote about the HRMC. While there are benefits from everyone having their own clouds, there are many more benefits to everyone being interconnected through a single cloud. Something like the NwHIN on steroids. Of course, that is overly ambitious, but there is no reason for a provider not to build one for its patients and consumers.