Social CRM–Patients are like little thunderstorms

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 spits back links to things like military intelligence, think tank, counterinsurgency, small wars, and army major.  I think I’ve made a spelling mistake—this cannot be the same guy who jumped out of classroom window—and I add his middle initial to the search criteria. Up pops a link to CNN’s Larry King—the air date—just days after 9/11. 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 patient is capable of creating their own digital perception of your hospital. True or false, makes no difference. Patients are like little thunderstorms popping up everywhere. Healthcare providers scurry around like frightened mice passing out umbrellas and pretending it’s not raining. They’re late, their patients 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?

 

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

what’s your HIT group doing for you?

duck

I love to cook and I belong to several internet food related sites. As an aside, one of my favorites is www.chowhound.com. Maybe it’s my personality, or lack of one, but I’m not a fan of recipes, at least not the details like measuring, ingredients, cook time, and temperature. I think that this is where the fact that I function with equal vigor from both hemispheres of my brain causes conflict—probably also explains why I had such a difficult time completing my math degree. If I don’t like the details, what else is there, you may ask? It’s more than the pictures, if that was all there was I’d be satisfied just cutting pictures out of Better Homes and Gardens magazine. I like the ideas those sites generate, but I also can’t stand to be encumbered by some silly set of rules. I guess I figure that with a set of rules anyone can be successful making that particular recipe, so where’s the challenge in that.

So anyway, I decided to smoke a nice sized duck on my grill. I rinsed the bird, trussed it, pricked the skin with a fork, stuffed it with a few blood oranges, and applied my homemade rub to the skin. The apple-wood chips were smoking nicely as I placed the bird, breast-side up on the roasting rack I had placed inside the cast-iron skillet. After turning down the burners I closed the lid. The grill, I should point out, is a seven-burner, infrared, stainless steel monstrosity with which one could probably roast an entire pig or forge iron ore into ingots. Total roasting time, about two hours. I checked the thermometer on the grill’s hood; it displayed a temperature of three hundred and fifty degrees–perfect, more or less.

It turns out that it can take as long as five minutes for the grill’s thermometer to register the correct temperature. The temperature dial on this particular model redlines at seven hundred degrees, high enough to produce spontaneous combustion. After two hours at 700 degrees, interesting things begin to happen to the carcass of a duck. Upon raising the lid the entire bird looked as though it had been spray painted a matte black. The roasting rack had melted. The leg bones appeared to have been charred from the inside out—they disintegrated the moment I touched them. I felt like a helpless doctor in the ER, there was nothing I could do to save it.

Have you ever felt that way when you try to understand how any of the healthcare IT projects are progressing? How’s EHR?  What’s the impact of reform on EHR?  Why aren’t we doing more with social media?  How come we don’t have a patient relationship management (PRM) system?  According to the reports that come across your desk, everything seems to be humming along nicely. In the committee meetings, seats are filled.  The emails imply all is fine.  Looking fine and being fine are not the same.  Looks can be deceiving. Ask the duck.

By the way, the duck fat did a great job of seasoning the iron skillet, so if that ever happens to you simply explain that what you were really doing was seasoning the pan.

saint

Pay attention to patients even when they’re not at your office.

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The wheel’s still turning, but the hamster is dead. One Brady short of a bunch. I like the ocean one because it reminds me of a bit done by the comic Ron White. In the bit he talks about the time he met a woman who was wearing a bathing suit made of sea shells which he held to his ear to find out if he could hear the ocean. Maybe you had to be there.

All day I’ve been operating as though I was one Brady short of a bunch—I actually have cufflinks with Marcia Brady’s picture on them, but we’ll save that for another day. The day’s highlight revolved around my daughter’s doubleheader field hockey matches–third and fourth grade girls. Their opponents looked better, older. In fact, I thought I saw one or two of them drive themselves to the field. Forty-eight degrees, first game at 8 AM. Not enough time to grab breakfast and get to the game on time. I dropped my daughter at the field and headed to a nearby convenience store to buy her a donut. As I pulled into the parking lot I noticed that I needed gas, so I figured why not multi-task it. I inserted the nozzle in the tank, went into the store, purchased a donut, and proceeded to drive away.

For the metrics lovers, those who like order over chaos, those whose desk is always neat, have you discovered my Brady moment? My purpose in going to the store was to buy a donut, not gas. My mind was focused on the donut, not on the gas. Once the donut was resting safely on the passenger’s seat my mission was over, or so I thought. Something was gnawing at me as I pulled away from the pump, something that flared at me in my rearview mirror. I knew what it was a full second before my body got the message to react to it. “Hit the break,” my mind screamed. I could see what remained of the black gas pump hose as it pirouetted helplessly behind my car. I fully expected the entire gas station to be consumed by a giant fireball like the one at the conclusion of the movie Rambo. Once I was convinced that neither I nor–it turns out that neither nor does not violate the rule of using a double negative in a sentence–anyone else in the vicinity was in mortal danger, I exited my car and walked to the pump.

My first reaction, and I don’t know why, was to see if the pump was still charging my credit card. Selfish? That means that subconsciously I had already made the decision to flee, but that I didn’t want to flee if my charge card was still open. I retrieved the severed hose from the ground and inserted it in the pump, thereby closing out the sale on my credit card. I looked around. There wasn’t anyone who had witnessed my little AARP moment. Since they hadn’t, I figured why bother anyone. Kismet; my turn on the hamster wheel.

I’m convinced it’s the little things that determine whether your initiatives succeed or fail. It’s usually nothing tricky, nothing that requires two commas worth of new technology. It’s being focused and being committed to excellence in the menial tasks which comprise each patient interaction, especially those that occur outside of the office. What little things are being overlooked in your practice?  Could social media solve some of these?  In a heartbeat, and for a cost that would surprise you.

Oh, and don’t forget to hang up the hose when you’re done.

black saint 2

One component of H2.0, Social Media

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With a torn Achilles tendon and two months in a cast, my running had hit a snag. What to do when you’d rather be running? Shop, and shop with the same zest and determination that I brought to running. After all, the two sports have a lot in common. One of the things I like most about running is that it can be done almost anywhere—just like shopping. I take my running shoes with me when I travel, just like I take my favorite store; EBay.

I just lost something on EBay I’d been tracking for six days. The chinos. Granted, not something everyone would wear. But I know of at least two people, me and the person who outbid me. Outbid me with four seconds left—my strategy. Over confidence killed me. I didn’t follow my own rules. I bid high with a few hours left, and since there wasn’t any activity, outsmarted myself. I usually rush in at the last second and dash someone else’s hopes. I don’t like losing, especially when there is no chance to regroup. After I lost I Googled, ‘lime green chinos with pink flamingos’. There aren’t any.

I was an earlier adapter, made more than 500 purchases ranging in price from a penny to more than $20,000. Only had a problem with one, a two-dollar knife sharpener. You can find anything you want on EBay, except for perhaps a second pair of lime green chinos with pink flamingos. I like EBay, a lot. What’s not to like? You have an almost infinite selection, everything is on sale, you don’t have to wait while a clerk takes a call from someone who interrupted the clerk from helping you, no need to pack the kids into the car, no gas to buy. You can think about a purchase for days before committing to it, so it eliminates the impulse buy. You can comparison shop, and you can rate the sellers. You can’t rate the sellers at the mall. It’s as close to a perfect social networking experience as you can get.

If you’re Venn-diagramming as you read, there’s EBay and there’s no-EBay.  There’s no intersection of the two groups.  The no-EBayers need additional tools just to keep up with their patients.  Those tools include patient relationship management (PRM) and social networking.  Without those tools, you’re forced to have a battle of wits with your patients, and you come to the battle unarmed.  These tools are part of what’s needed to navigate the gap between H0.2 and H2.0.

EBay knows they are on top of the social media discussion. How can you tell that they know it? There is no ‘contact us’ link that is readily visible. No way to reach out and call customer care. They don’t make things, they don’t inventory it, they don’t ship it, they simply collect the money, and they bought the firm that allows them to do that. They’ve reinvented the principle of the Maytag Man. Maybe somewhere there’s a person in a small office waiting to take a complaint call. If he is, he better not be wearing my lime green chinos with pink flamingos.

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Social Media, an example

social-mediaA cold wind is blowing in from the north, blowing so hard that at times that the rain seems to be falling sideways, echoing off the windowpanes like handfuls of pea gravel. The leaves from the walnut trees, that had prematurely yellowed, dance a minuet as they slowly make their way to the ground in the woods. It feels like the first day of fall, a day for jeans, a long sleeve shirt, and a pair of long woolen socks. The temperature has nosedived. On a normal day, the first indication of sunrise would have begun to push the darkness from the sky. But today is not a normal day. The clouds are hanging low and gray against the dark sky.

The garage door creaked and moaned as it rose along the aluminum track. Halogen headlights pierced the darkness. Its driver, an unkempt and rather rotund woman in her 40s eased the car down her driveway and proceeded through the still slumbering neighborhood. She was a friendless woman, who along with her husband and daughter kept to herself. The neighborhood children were afraid of her, too frightened to retrieve a ball if it fell into her yard.

“Were those your dogs barking? I was asleep,” she screeched as she hurriedly exited the car wearing her oversized pajamas. The site alone was enough to frighten children and a few grown men. “I’m going to find out whose dogs were barking,” she chided. “And when I do, someone will be hearing from me. I took my last neighbors o court because their dog barked. I don’t like children. I don’t like dogs. I don’t like yard work, and I don’t want to be invited to any community activities.” I feel pretty confident she won’t have to worry about being swamped by invitations.

It was actually almost ten in the morning the day she registered her complaint—dawn to some people I guess. Three days later, the letter arrived in the mail. The return address indicated it was from a homeowners association. The letter stated that if we couldn’t control the barking of our dogs that we would be reported to the community board of directors. For second, we didn’t know how to react—then we started to laugh. The reason for the laughter was simple; my wife is on the Board of Directors. It’s like the East German Stasi is alive and well and living in Pennsylvania. I can picture this woman hiding behind her drapes, her little steno pad in hand, recording each and every bark that disrupts her bliss.

She’s a tattletale, a 40-something whose problem solving skills never grew beyond that of a third grader. She lives right next door, 100 feet away. We’ve only seen her three times in the 28 months we’ve lived here. Six months ago she sent us a fax, complaining about something or other. A fax, mind you. To her next door neighbor. This is too easy. It’s social networking run amok. She has become my poster child for bad manners, a benchmark against which all subsequent social networking commentaries will be measured.

There are also good social networking opportunities, especially for large healthcare providers.  Such as?  Do you record the number of patient calls you get each year by call type?  The fully loaded cost of each call is probably somewhere around twenty dollars.  What percentage of those calls are resolved the first time?  What percentage of those calls could be answered  more effectively without the phone? How do you answer a call without a phone?  By having the caller get what they need from some form of social media site.  In less than a few months you could design a web site and YouTube presentation to explain your bills better than any single person could explain it on the phone.  You could provide a similar service for patients who need help contacting their insurance company, and need help dealing with that firm.  The ROI on social media is significant, and it’s nicer than sending a fax.

Well, that’s it for the moment. I’m off to the store. I think I’m going to buy a third dog.

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What does it take to be the best hospital?

Below is a reply I wrote to a question raised on Hospital Impact, “What does it take to be the best hospital on the planet?”

http://bit.ly/v4pr6

I’d like to hear what you think it would take.

Great question and one that needs to be asked with much regularity.  I target my comments at the healthcare business as opposed to the business of healthcare—the clinical part.

May I begin with a statement that may have many readers reaching for their delete keys?  As one who has consulted to many industries, to me the healthcare business appears to be stuck in a 0.2 business model and is being forced to rapidly reinvent itself in a 2.0 model—my use of the term 2.0 does not imply the Internet.

My comments are based on observations, conversation, and inference.  My executives have told me privately that world-class physicians do not necessarily become world-class business executives.  Many lack the depth of experience that is needed to know what aspects of the healthcare business is broken, duplicative, wasteful, or in need of repair.  While discussing EHR, I was told recently by a former CEO of a large hospital that his peers were making multi-multi-million dollar decisions without any sense of the data needed to support those decisions, basing them on what a friend had decided, what they read in an in-flight magazine, or a conversation they had at a convention.

There seems to be significant faith placed in the notion of, “That’s the way we’ve always done it.”  That expression surfaces often when one raises the issue of why a hospital has multiple IT departments, multiple HR groups, payroll, registration, and so forth.  Why do something once if you can do it less well five times.

There seems to be enough waste that for some hospitals looking at moving forward with EHR, my first piece of advice is instead of aiming for best practices, let’s aim for a single practice.  Evaluate how to implement a shared service or managed services approach to business functions that are not part of your core business model.

I close with the notion of what other businesses call customer relationship management (CRM).  For a hospital, patient relationship management (PRM) is one of the unspoken wins waiting for someone to lead the charge.  Add a social media effort to it, and all of a sudden it’s like the hospital gave itself a facelift, at least from the perspective of the patients.

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