I was standing at a busy intersection clicking my heels and repeating the phrase “there’s no place like home.”

A young woman approached me and tapped me on my shoulder.  She had a Kim Jong Un wannabe haircut.  Her heavily tattooed legs were wrapped from her thighs to her ankles in cellophane, and she had more metal in and on her body than the Tin Man.  The cellophane confused me.  I thought she might be using it as a degaussing cloak to ward off alien magnetic rays.  She asked me if I was okay. I should have asked the same question of her. I learned later that cellophane is applied to people with new tattoos to prevent the tattoos from bleeding.)

“Are we in Oz?” I asked.

“No, we are in Los Angeles.” “Is there a difference?” I asked—I can be quick when I need to be.

Most of the major streets in L.A. have what appear to be three-foot natural grass putting greens embedded in the sidewalks.  But I never saw anyone practicing their putting.  I did, however, see several dogs use the greens.  I wondered how city dogs—dogs who have never seen real grass—knew that the putting greens were for them.

“I’m sensing you’re a man of few words,” she said.  “I only use the ones that are needed,” I told her.

“So, what do you do?” she enquired.  Thinking this conversation could take more time than I had, I replied “whatever it takes” and I left the scene.

Rule number 1: If you Google something and get no hits, whatever you Googled does not exist. I Googled “Healthcare Consumerism Score.”  Zero hits.

Rule number 2: Just because you get a hit when you Google something does not mean that what your search yielded has any value. I Googled “Healthcare Consumerism Index.” 1,030 hits.  950 of them from a single firm.  And those 950 hits offer 950 uninteresting ways of trying to make their survey data sound interesting. If you are interested in reading about cost and value spending—how they define consumerism—you should get a copy of their report.  Me? I’m waiting until they make it into a movie and stream it on Netflix.

And here is my issue.  Who is interested in cost and value spending?  Health systems and the feds; not consumers.  Consumerism without consumers is no better than a tuna sandwich without the tuna.

I’ve asked dozens of healthcare executives how they define consumerism.  They don’t.  I’ve asked those same executives how they measure the consumerism capabilities of their systems.  They can’t.

And so, I’ve created the Digital Healthcare Consumerism Index—DHCI.  The index measures one attribute.  What are the digital consumer capabilities of your health system, and if they exist, how good is the user-experience?

The DHCI measures eight specific digital consumer functions, plus a mobile-first rating and rating for user experience.  Your health system either provides the function, or it doesn’t—that keeps the math pretty simple.  In theory, the scores will range from zero t0 ten.  (But who am I kidding?  I have only come across one health system that scores above a five.)

In the artifice of healthcare consumerism, a fifty percent score puts you on the top of the food chain looking down on every other health system.  “We’re better than everyone else.”  Maybe it’s good enough to be the best of the worst.

In real world consumerism, the world in which your consumers and patients live, a fifty percent consumerism score has your health system looking up at such notable consumerism failures as RadioShack, Borders, and Sears.  Healthcare consumerism needs to improve significantly just to be good enough to meet the failure threshold achieved by Fortune 500 firms.

The digital consumerism mantra—bricks to clicks—is simple, but it is simple for a reason. It works.  The consulting firm McKinsey concluded that the greatest healthcare myth is that customers do not bring the same expectations about customer experience to healthcare that they do to other industries.

The phrase “I’ll know it when I see it” was used in 1964 by United States Supreme Court Justice Harold Potter in describing his threshold test for obscenity in Jacobellis v. Ohio.

Patients and consumers use the same metric when it comes to healthcare consumerism.  They’ll know it when they see it.  So far they haven’t seen it.