Patient Experience (Mis)Management (PEM)

Patient Experience (Mis)Management (PEM)–my new post for @healthststemCIOhttp://ow.ly/22uEj

EHR Czar posting

One summer in college, I worked for the state roads commission in Maryland.  If you like being outdoors, getting a lot of exercise, driving around in the back of dump trucks drinking beer it was the perfect job.

The average day went like this.  Each morning we’d report to the facility at seven, and sit around for an hour as the supervisors received their assignments for the day.  It would take another hour to gather the tools needed to complete whatever project we were given.  On the road by nine, the two full-time employees inside the truck, my friend and I laying in the back on burlap bags..

By ten, we had unloaded the tools, and scoped the work.  Most days we’d forget one or two tools needed to complete the work, radio back to the facility to have someone deliver it to us, and practice sitting on our shovels until we were fully outfitted.  It didn’t make sense to start the work knowing lunch was only thirty minutes out, so on most days we would simply wait until after lunch.  By one o’clock, our bellies full, we began our assignment—fix a guardrail, shovel some gravel, install a road sign, scoop a dead deer of the road.

The foreman, Butch, knew the location of every liquor store in the county.  Happy hour in the dump truck usually began at three—one case of beer for the two men in the front, one case of beer for my friend and me in the back.  We’d lay there with our shirts off as the supervisor chauffeured us around the county trying to kill time until we could return to the service bay.

I wonder if they need any help this summer.

One of the things I remember about that summer was a job posting in the service shed.  The posting was for a supervisor/foreman.  The single qualification was the requirement of having completed education through grade five—the “Are you smarter than a fifth grader” test.

I have no segue.  I am wondering if there is a posting in the ONC service shed for an EHR Czar.  If there were, what would be the requirements?

WANTED: EHR Czar—Fourth graders need not apply.

Count me in.

When you need something different–From thinkgeek.com

Savory Unicorn & Heirloom Tomato Bruchetta Recipe

  • 14 ounce can of Unicorn Meat
  • 6 or 7 ripe plum tomatoes (about 1 1/2 lbs)
  • 2 cloves garlic, minced
  • 1 Tbsp extra virgin olive oil
  • 1 teaspoon balsamic vinegar
  • 6-8 fresh basil leaves, chopped.
  • Salt and freshly ground black pepper to taste
  • 1 baguette French bread or similar Italian bread
  • 1/4 cup olive oilChop the tomatoes and mix with garlic, olive oil, vinegar, salt, pepper and basil leaves. Toss well. Slice baguettes on the diagonal about 1/2″ thick. Brush each slice with olive oil and add a full rounded tablespoon of Unicorn Meat, spreading over each piece. Toast in a 450 degree directly on over rock for 5-6 minutes. Do a little funky dance by yourself until it’s toasted. Serve with tomato mixture and some flaming Absinthe.

Social Media–a few thoughts on its power

The web never ceases to amaze me. I’ve gotten to the point if I can’t find something I’m looking for, no matter how obscure, I figure that I did something wrong in how I framed the search.

For example, I was trying to connect to a high school classmate, someone I hadn’t spoken with since before Al Gore invented the internet. This guy got a pair of boxing gloves for his 14th birthday. We each wore one, and jousted only long enough for us each to land a blow on the other’s nose. It hurt—a lot. We gave up boxing. In tenth grade biology, we bet him five dollars that he wouldn’t jump out of the second floor window. The teacher, who knew of the bet, turned her back to write on the blackboard. He jumped. Go straight to the office, do not pass GO, do not collect $200. We used to see how fast his red and white Mach II Mustang would go railing down Route 40. He was the guy you voted best person to keep away from bright shiny objects. The last I heard he went to a teaching college.

Anyway, I Googled him—from the imperative verb Google—I Google, you Google, he, she or it Googles. I can’t tell you his name for reasons that will soon become apparent. Google returns links to things like military intelligence, think tank, counterinsurgency, small wars, and army major. I think I’ve made a spelling mistake and add his middle initial to the search criteria. Up pops a link to CNN’s Larry King. The topic of the show, the hunt for Osama Bin Laden. To quote Lewis Carroll, “things keep getting curiouser and curiouser.”

The web. Social networking. A great tool if you’re one the outside searching, deadly in the hands of your customers. If your firm is targeted, you are pretty much defenseless. Each customer is capable of creating its own digital perception of your firm. True or false, makes no difference. They’re like little thunderstorms popping up everywhere. Companies scurry around like frightened mice passing out umbrellas and pretending it’s not raining. They’re late, their customers are wet, and they are telling everyone. Very few firms have learned that they can’t put the rain back into the clouds.

Sort of reminds me of the line in the movie Young Frankenstein, “Could be worse, could be raining.” It’s raining, and even the best firms have run out of umbrellas. What is your firm doing about it?

saintPaul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

Is the Internet good or bad for you?

I wrote this reply to Kent Bottles’ post on whether the Internet is good or bad for you.  http://icsihealthcareblog.wordpress.com/2010/06/21/kent-bottles-is-the-internet-good-or-bad-for-you/#comment-354

That’s quite a mindful—my email just beeped and my MP3 died, so I am going to put this on hold for a second.

Where were we?  A few observations if I may.  Instead of concluding we have difficulty being in the moment, since the way we’ve lived since the infusion of all digital all the time, perhaps the meaning of being in the moment has changed.  Were there similar discussions at the invention of the phone, the radio, the turntable, and the television?  Goodness knows did not we go through many of the same changes—listening to the radio while doing homework, watching TV while conversing with family?

On the issue of multi-tasking, studies suggest we are able to function less effectively while being mutli.  Does that not depend somewhat on the nature of the task?  Let us consider the question, function less at what.  If it has to do with a task of doing ones taxes while checking email and speaking on the phone; that may be true.  If the same functions are considered in light of someone who hates doing their taxes, and has no pressing deadline, no hard stop, perhaps the diversions make the onerous task seem a little less so.

Perhaps there are certain tasks we were unable to do before the internet engulfed our approach to our waking hours.  Perhaps, there are tasks made easier by multi-tasking.  I can be in a group discussion on Google Wave, giving assignments.  The group can be updating and discussing a presentation stored in a cloud—all in real-time.  While downloading a .rar file of a chapter of an audio book for a key deliverable, instead of having to rush to Borders and read it, I may have Pandora running in the background, and may get a text message from someone in the group about a comment they did not wish to share with the group.

That same group can be assigned individual tasks to be completed within the next twenty-four hours.  Members will be assigned to “post” their deliverables to the group at various times for individual comment, and a final meeting invite will be sent by the last person to finish their task.  Pretty efficient.  Certainly better than the days when we felt fortunate simply to be able to FedEx a draft of the deliverables to each of the members, some of whom are overseas, and wait 48 hours to view their feedback.

Perhaps the relevancy of good versus bad internet depends more on what you are trying to do.  Some people who have self-diagnosed ADHD—I barely have time to focus on having AD, let alone all four letters—may find this a blessing.  I have the attention span of a half-life of a fruit fly.  I bore easily, and on occasion bore others easily.  Stuck in this digital cornucopia, I am able to function at a higher level.

As I write this, I have eleven browser windows open, am synching my cell phone, downloading music on LimeWire, am working on a new blog post—not this one, and writing the first two chapters of my book on leadership.  This approach relaxes me.  If I had to do just one of those knowing I could not do something else until the first was complete, I’d be in therapy.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

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What benefit is there to meeting Meaningful Use?

Commercials bug me.  Big surprise.

You have probably seen the commercial for the Sleep Number Bed.  A bare mattress, a glass of wine on the mattress, a bowling ball is dropped on the mattress.  The glass of wine does not spill.  That makes some people rush out and buy the mattress.  Why?  For the security in knowing that just in case they leave a glass of wine on their mattress and then happen to drop a bowling ball on it, the wine will not spill.

That dog don’t hunt unless you happen to be opening a bowling alley/Motel 6.  The company is trying to entice you on the merits of doing something by asking you to make the leap of faith by equating the bowling ball falling on the bed to having your spouse get in or out of the bed without disturbing your sleep.

A feint.  A maneuver designed to distract or mislead you from the real purpose.  Meaningful Use.  Certification.  A feint.  Designed to distract or mislead you from the reason you need an EHR.  The terms of Meaningful Use, that is, what is meaningful to your organization should be set by your organization, not some national standard applicable to every hospital in the country.  Hospitals are not ubiquitous—the Meaningful Use standards are.  How can a single set of standards be in line with what you require?

What’s the feint?  Certification, cash incentives, Regional Extension Centers.  A full court press trying to get hospitals to do what the feds want it to do in order to meet their goal of a nationwide interconnected healthcare system.

What proof, other than a check, has anyone offered that you benefit from meeting Meaningful Use?

Should you try to meet Meaningful Use?  I think not.  There is no ROI, and the full set of standards have yet to be published.  What should you do?  Have a glass of wine, or better yet—go bowling.  Don’t forget to buy one of those snazzy bowling shirts.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

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Stuck in a Hole? Stop Digging.

When you find yourself in a hole, stop digging.  Einstein said it differently—doing the same thing over and expecting different results is the definition of insanity.

I spent fifteen years consulting in what used to be the Big 8 accounting firms.  I spent the last fourteen years going through a self-contrived twelve-step program to cleanse myself from the prior fifteen.  I left during the period I was told I was up for partner—be careful what you strive for as you may attain it.

That brings us to last week.  I was invited to meet with one of “those” firms.  For what purpose?  To discuss leading their Healthcare IT consulting practice.  And, met with them I did.  The gentleman walked into the room and extended his hand toward me.  One his ring finger was a large gold nugget ring—I kid you not—the kind worn by Texas oil men and Philly gangsters.  His pompadourish hair was over-gelled, and his pocket handkerchief was flamboyant enough to have come from a belly-dancer’s chiffonier.

I started getting the willies two minutes into the conversation as he was explaining how the much the industry had changed, how much more genial it had become.  Indeed.  Sort of like saying Satan had mellowed.

I was getting angrier by the minute.  Not at him, but at me for having ignored my hard-earned good wisdom and thinking maybe things would be different this time.

There’s the expression saying if you don’t study history you are destined to repeat it.  I’ve decided to get a better grasp of history.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

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Contact me: Google Talk/paulroemer Skype/paulroemer Google Wave/paulroemer

EHR Groundswell

EHR, there’s a new groundswell against meaningful use. How do I know? I’m starting it now.

After lunch, if I’m in the right mood, I may start one against certification.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

My profiles: LinkedInWordPressTwitterMeetupBlog RSS
Contact me: Google Talk/paulroemer Skype/paulroemer Google Wave/paulroemer

Bumble Bess & Red Velvet

Remember as kids trying to see how many bumble bees you could catch in a jar before you panicked and they all got lose? You couldn’t get the top all the way on and all of a sudden dozens of bees exited the jar as you raced across the field of clover. That’s how customers are. You try and catch as many as you can, but once they get out it’s over. So, here we go again. Social networking. We’ll get there in a moment.

For those old enough to remember Ronald Regan, what are you able to recall about high school? If you’re like me, much of it is selective. The web seems to be changing some of that. Classmates.com. Facebook. Ever notice how there are no rules? Anyone can get to anyone else. Unhindered. Uninvited.

There are those who never grew up, and there are those who never grew older-there’s a difference. Sometimes it’s a good thing. Like for instance trading emails with the girl in the red velvet dress, the one with whom you first slow danced in the ninth grade. The Internet, pretty neat little thing.

Then there’s the other side to the social networking coin. A darker side. Unless you happened to be among the minutia of students who gamboled care freely down the crowded halls during those four years believing that the school year book should contain only your picture, graduating high school gave you your out, gave you permission to euphemistically bury the bourgeoisie characters who needed burying. People who, when you were eighteen wouldn’t put you out if you were on fire, the very people who probably set you ablaze, now knock digitally on your Facebook door asking to befriend you. Did I miss something here? The part where my Facebook-buddy-wannabe says, “Now that we’re grownup, forget I was a jerk in high school, ignore the fact that I was dumber than a bowl of mice”—sounds like I may have missed one or two of my twelve-step meetings. Recovery is progressing well—really.

Just because a hospital is paranoid doesn’t mean their patients don’t hate them. Poltergeists. The undead. The kind of like patients you’d hope you’d never hear from. And yet, those are the very ones who bother to write. They write, and blog, and YouTube your hospital. They deliberately come back and haunt. Their haunts are reflected in higher costs, fewer patients, and higher churn. Isn’t technology great?

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

My profiles: LinkedInWordPressTwitterMeetupBlog RSS
Contact me: Google Talk/paulroemer Skype/paulroemer Google Wave/paulroemer

Are hospitals making the the same mistake as BP?

“The time has come,” the Walrus said, “To talk of many things: Of shoes and ships and sealing-wax, of cabbages and kings—…

A lot of the strategic issues in healthcare are not easily explained.  One issue can be explained to a fifth-grader.  So, get your crayons out and follow along.

Fifty-some days and counting.  Say it with me—BP.  In many respects healthcare’s approach to social media is analogous to BP’s—the major difference is that neither the payors, pharma, nor the providers has yet to wipe out an entire geography—but the week is not over yet.

BP is offering an MBA in how not to use social media.  Nobody is queuing up on Amazon to buy the book, “BP’s ten pointers on crisis management.”

The funny thing about disasters is being able to schedule them in Outlook.  There are no pop-ups fifteen minutes before the big bang reminding you to get ready—“pipeline blows up in 15 minutes.”

We both know, sooner or later you will have one.  While yours may not crater the shrimping industry, it may be enough to do some serious damage to your business.  Most hospitals have a risk management group.  BP has one.  The mission statement of risk management is to assess and mitigate risks.

BP’s group probably had a plan in place to address a number of risks—risks like OPEC, an expansive war in the middle east, a tanker collision.  Apparently, they overlooked the risk of having a blowout a mile under the ocean.  Who’da thunk it?

If you Google “oil spill” there are fifty million hits.  Add “BP” to the search and the results narrow to a mere forty million.  That toothpaste is never going back in the tube.  People who can’t find the Gulf of Mexico on a map know that BP ruined it.  Thirty years from now people will still know the name of the firm that poisoned the Gulf, destroyed businesses, ruined vacations, made people sick, and cratered home sales along hundreds of miles of shoreline.

No matter what type of disaster BP could have faced, they demonstrated they were not prepared.  Even if it is proven that the disaster was not BP’s fault, it is too late to change their ownership of it.  Nobody is ever going to delete those forty million Google pieces linking BP to failure.  If BP hired a thousand workers whose only job was to try to counter each piece of negative media it would take them decades.

What is the one word to describe BP’s social media strategy?  LATE.

There is no useful social media strategy worth anything that begins after a disaster, none worth anything that begins after a misstep, after a faux pas.  Dictionary.com defines a faux pas as a social error—a boo-boo.

Unlike Meaningful Use, a good social media strategy can have an almost infinite ROI.  A good social media strategy, in addition to adding revenues and capturing patients, can help assuage the bleeding.  A good social media strategy played out in advance creates allies.

Let us look at this from the perspective of large healthcare providers.  What types of unfavorable events could negatively affect a hospital?

  • A medical disaster
  • Fraud
  • Medical errors
  • Reform
  • Scandal
  • Medical malpractice
  • Natural disasters
  • A data breech

While all negative events are not the same, many aspects of a good social media strategy apply regardless of the type of problem.

There are two major components of a good healthcare social media strategy:

  1. It should be pro-active.  Your social media strategy should be building goodwill each day.  Google the name of your hospital and see how many hits you get.  Next, see how many thousands of those hits are attributable to people outside your organization—too many to count.  You are already late.  People are already posting videos and writing about you.
  2. It should be reactive.  Make sure your “What are we going to do now?” account has a positive balance.  At the very least make sure you can push a button and unleash a plague of social media “I feel your pain” initiatives.

I’d wager a hospital could develop an outstanding social media strategy for less than one-tenth of what it pays in legal fees.

saint Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy

1475 Luna Drive, Downingtown, PA 19335
+1 (484) 885-6942
paulroemer@healthcareitstrategy.com

My profiles: LinkedInWordPressTwitterMeetupBlog RSS
Contact me: Google Talk/paulroemer Skype/paulroemer Google Wave/paulroemer