What Happens When Herman’s Hermits meets Healthcare Consumerism?

Kim Jong UnThe guy with the bad haircut, the heir to the Land of Hermits—Kim Jong Un. When you type ‘Kim’ into Google’s search bar, The Great Leader is the first hit.  And he’s often wearing a Nehru jacket, as though he was the fifth member of the 60’s band, Herman’s Hermits.  How do you sing Mrs. Brown You’ve Got A Lovely Daughter in Korean?

He and his most loyal Herman’s Hermits sycophants are fun to watch on television.  They are always clapping. Maybe they’d just watched North Koreas’ version of the play, Hamilton.

Are all the clappers so enthralled with the Great Leader’s divine actions, or are they simply afraid to be the first person to stop clapping?  Whomever stops clapping first, whomever either stopped because his or her hands hurt, or because he or she was showing his or her independence to buck the norm, is in trouble.  My guess is that person is not afforded the opportunity to show his or her independence a second time.

This week, the Hermit in Chief, announced that he is going to attack Guam. I doubt he can even spell Guam.

So much for my abridged version of All The News That’s Fit To Print.

The car driving in front of me today was a Tesla.  Tesla, whether you like their cars or not, reinvented the automobile—like going from a horse and buggy to the Model-T.  Every major car company on the planet believed their company had reinvented the automobile. Their reinvention was the creation of hybrids.  Sometimes their cars ran on gas, and sometimes they ran on batteries. Those automobile manufacturers defined “innovation with a lower-case ‘i’.  They needed an engine that ran on gas, and one that ran on electricity.

Along comes Tesla.  Can you imagine how the first meeting of Tesla’s engineers went when Elon Musk told the designers to design a car without a gas tank, without carburetors, without distributors, and without mufflers?

Musk reinvented the automotive industry.  And he did so in an industry whose idea of innovation was to redesign their cars from playing music on an 8-track tape player to one capable of playing music on a cassette tape. “Innovation with a lower-case ‘i’.  Disruption with a lower-case “d”.  Tesla ignored GM, Ford, Chrysler, Toyota, Nissan, Honda, BMW, and Mercedes.

Tesla is building a Gigafactory; the largest battery manufacturing plant in the world, while Ford’s engineers are debating whether their 2018 model cars should be painted in midnight blue or beige.

There is a significant difference between ‘innovation’ and ‘Innovation’.

Healthcare is deciding between midnight blue and beige. Healthcare is deciding between relevant and irrelevant.  It is trying to decide between 8-track tapes and Pandora. Healthcare’s business model is mired in making marginal improvements on what was instead of what could be.

Healthcare cannot define what could be.

Most healthcare firms have someone in charge of ‘innovation.’  They have no one in charge of ‘Innovation’.

If you play the card game Bridge, there are over a quintillion possible different hands that can be dealt. If you play the healthcare game Consumerism, there is only one winning hand.




What Is Healthcare’s New Big Threat?

What If Healthcare Access Worked Like This?

Has the U.S. phone system finally run out of available phone numbers to assign to people and businesses?

You and I have phone numbers. Heck, we may have multiple phone numbers. Ninety-nine point nine nine nine percent of U.S. businesses have phone numbers for its customers to call.

Healthcare providers and payers have dozens, if not hundreds of phone numbers for their patients, members, and their other stakeholders to call.  They post a dozen of them on their home pages, ‘call this number to do this’, ‘call that number to do that’.  Or they post one phone number, a number that only works to complete a singular task.  If the caller needs to complete a different task, the caller is transferred to someone else, or they are given a different number to call.

It’s a telephone lottery.  Drop a quarter into the phone slot, cross your fingers, and hope the display comes up with three cherries.  If you’ve ever played the slots in Las Vegas, you know your chances of winning the phone lottery are slim and none.

Hoping you will be able to meet your patient or member experience needs by calling is fruitless. Hoping is not a viable strategy, it is a pipe dream.

Reverse segue.

Firms noted for having really bad customer service have numbers for their customers to call.  Comcast, Verizon, Sprint, Anthem, Cigna.

Evidence supports the fact that U.S. phone companies must have run out of phone numbers to assign to companies.  It appears that many of the largest Internet-based companies were not able to get phone numbers to support their customers. If you go to the websites of Amazon, eBay, Netflix, Facebook, Apple, Microsoft, or LinkedIn, their websites do not provide a customer service phone number.

And the reason they do not provide a phone number is not that there are not any available numbers, it is because those organizations designed their customer experience functions so well that their customers can meet all their customer service needs without ever having to call.

They did this not because they do not want to speak with their customers. They don’t have customer service phone numbers because they know their customers do not want to speak with them.

The best customer service companies are very complex, multi-national organizations.  They engage every one of their customers digitally, every time, at any time, and on any device.  And they capture information about every interaction they have with each customer.

And they designed their customer service functions to capture and act upon every piece of data from each interaction.  They know the history of each interaction, the good and the bad.  Using cognitive analytics, their systems use each piece of information from every interaction to anticipate the future needs of their customers.  They do this to make sure a customer’s next experience is better than their last experience.

Here are a few examples of how their cognitive platforms improve customer experience:

  • Apple and Microsoft know when a customer’s operating system is out-of-date. To upgrade one’s operating system only requires that the customer press a single icon.
  • Apple’s customer experience is identical regardless of a user’s device; phone, tablet, and notebook.
  • Facebook keeps adding new functionality and recommends new friends and almost half of the people on the planet use Facebook.
  • Facebook allows its members to create business pages.
  • Amazon knows what you’ve bought and it recommends what you should buy next. What started as s simple online book store now sells everything to anyone at any time.  They know people do not want to pay for shipping, so they eliminated shipping.  They know people like to watch movies but do not like to pay for every movie they watch, and so they created a service that allows customers to watch as many movies as they want.  Their model must be working—this week they hired 50,000 new employees.
  • Netflix seems to reinvent its entire business model once a year. They put Blockbuster out of business.  Netflix’s original model involved DVDs.  They sent you one, you watched the movie, and then you sent it back.  They recognized that was too much work for them and for their customers.  Netflix had to buy DVDs, inventory them, ship them, and restock them.  And when a movie had run its course, Netflix was stuck with thousands of copies of a DVD that nobody wanted to watch.  So, they cut their costs and at the same time improved customer experience.

Each of these firms offers a wonderful experience 24 x 7 x 365.  And they do it all without ever speaking to a single customer.

Maybe healthcare could improve its business model, cut its costs, and improve customer experience by redesigning digital and mobile engagement. If it doesn’t maybe Amazon will expand its footprint to include healthcare.  If it does, watch out.


Healthcare’s Terrible, Horrible, No Good, Very Bad Day

The east coast is the headquarters of one of my favorite companies, Wawa.  It’s a silly name for a company, especially when that company has a chain of stores whose primary competitors are older and which have a global presence.  For example, 7-Eleven—we’re open 24 hours, just not in a row.

Each Wawa store is designed to look the same.  The coffee bar, which competes effectively, at a third of the price with Starbucks, is in the same place in each store, in the far-right corner.  And customers do not have to have to speak Italian—venti—to know what size coffee to order.  Wawa’s coffee bar is barista-free.  The only downside of Wawa’s coffee bar is that people, non-Chichi white-collar MBA’s, who happen to drink coffee—99.5% of the population—cannot order a half-caf, grande, iced, sugar-free, vanilla latte, with soy milk.  But they can pour their own coffee.  One day a month, Wawa provides free coffee.

Wawa is a go-to destination. Its customers are willing to drive further simply to spend their money.  The average transaction, discounting the purchase of gasoline, is less than seven dollars.  But they do a gazillion of those less than seven-dollar transactions at each store every day.

Wawa also happens to be the largest seller, by volume, of gasoline on the east coast.  By far.  The reason Wawa sells more gasoline than companies whose sole raisons d’être is to sell gasoline are many.  Everyone needs gas.  Everyone who needs gas wants to pay as little as possible for gas.  Wawa meets that requirement.

Wawa is also offers retail banking.  Every retail company in the U.S. which has an ATM, is to get people to spend money in their stores, charges its customers a fee to withdraw their own money to spend said money in their store.

Located in the far right of every Wawa is a low-priced hoagie stand whose functionality is equal to, or better than Subway’s. In front of each hoagie stand are several electronic kiosks that allow customers to order customized hoagies.  While their hoagies are made, customers pay for their hoagie.  Also, in the summer, Wawa sells every one of their foot-long hoagies for $5.99—Hoagie-days.  Subway does not provide electronic ordering, and it does not let you pay while your sandwich is being made.

In one store Wawa is better than your favorite three stores.  Wawa outcompetes the top firms in every industry in which it competes.  Daily, on a store-by-store basis, it sells more gas than Exxon, more subs than Subway, and more coffee than Starbucks. And it does all these things in a store with a footprint of less than 2,00 square feet.

The world went digital and so did Wawa.  Unfortunately, the designers of Wawa’s in-store customer experience were not involved in Wawa’s digital experience.

Wawa created a digital app.  The purpose of Wawa’s digital app is to let its customers use the app to order a hoagie.

I borrowed my wife’s phone. I used the Wawa app to order a hoagie-extra pickles.  The app did not allow me to prepay for my hoagie.  I drove to Wawa anticipating that Wawa’s hoagie barista would give me my hoagie.  Au contraire mon frère—I took French in high school.

I asked for my hoagie. Wawa’s hoagie barista had no record of my digital hoagie order.

I took a long time to make my point. Wawa has a digital app that allows its customers to order a hoagie.  Wawa’s customers believe the app lets them preorder a hoagie. Its customers believe their hoagie will be ready when they arrive at the store.  The app does not let them preorder the hoagie. All it does is let customers bypass the kiosk.  The value of the app is no better than bypassing the Twinkies.  Customers get to Wawa believing that their hoagie is ready.

Wawa’s customers are wrong.  Wawa’s digital engagement strategy is wrong. Not only is its strategy wrong, it’s strategy totally undercuts its customers’ expectations.  Wawa’s terrible, horrible, no good, very bad digital engagement day.

Having a digital engagement strategy that does not meet your customers’ expectations is worse than not having a strategy.

Healthcare digital engagement 101.  A website is not a digital engagement strategy.  Nor is an app.  Your patients know that.

Are You A Consumerism Consultant? No, I’m Batman

A few members of my high school graduating class were exchanging messages on Facebook about an upcoming reunion. I was making small talk with one of the women, someone of whom I did not remember from high school, and so I asked her what she did.

“I’m a psychic,” she replied, as though being in touch with those in the great beyond was the most natural thing in the world. “Are you a physic?”
Not missing a beat I replied, “No, I’m Batman. But with you being a psychic and all, you probably already knew that. Do you know the date of the reunion?” She didn’t. As best I could tell via my testing of her psychic powers, she was now zero for two. I decided not to ask her if she knew whether I was going to attend the reunion.

Customer experience is never as difficult as those in charge of managing it make it out to be. One does not have to be a psychic to understand what customers want. All they have to do is ask. But they don’t do that, do they?

Healthcare’s number one customer experience tool are its call centers. And why not? People call. Lot’s of them. And so, it would be helpful to build a big room, buy a bunch of phones, and hire a bunch of people to answer those calls. Check the box, mark it complete.

After all, the statistics support the fact that with that many people calling, that must be their preferred method of access. And if it is their preferred method of access, it must also be their preferred method of engagement. Otherwise they would not be calling.

It is difficult to convince a health system executive whose system receives 200,000 calls a month that the high use of the call center does not mean that his or her health system is meeting its patients and customers where they want to be met. Perhaps 200,000 people are calling because they have no other option.

Digital consumerism is the other option. It is the option that can reduce the number of calls per month to 100,000. It is the option that will acquire patients, retain patients, and manage their health.

There is something called the Sharpshooter’s Fallacy. If a person with no shooting experience fires 100 shots at the side of the barn, chances are that those shots are fairly widespread. The only information that can be gleaned from the shots is that the shooter had no skills. However, once the shooting has finished, if someone were to paint a large target around the largest cluster of those 100 shots it would be possible to infer, incorrectly, that the shooter was not a novice. That is the fallacy one can create by looking at data the wrong way.

Healthcare’s customer experience fallacy is that a call center is a critical component of their success. 200,000 people call, ergo, they must want to call.


Half of the people who call call for one simple reason. Those 100,000 people have already tried to have their needs met online. The only reason they are calling is because the health system was too quick to paint a target around all of those calls and erroneously concluded that they were solving the problem.

Humor In Medicine: “What Are You Doing On My Bridge”

bridgeThe temperature was in the mid-nineties and the humidity was not far behind.  Nine miles into my run I was approaching the crest of the two-mile long bridge that crossed the bay that separated the mainland from the island, and I was leaning over the guardrail to catch my breath. I was dog-tired, dehydrated, and my feet felt like they had swollen to twice their normal size.  (Getting older sucks, but it’s better than the alternative.)

To my surprise, a New Jersey state policeman, kitted out smartly in his pressed uniform and wide-brimmed hat, pulled alongside me. “What are you doing on my bridge?”  He asked from the cool confinement of his air-conditioned patrol car.  There was an undisguised tone of concern in his voice. To hear what he was saying I removed one of my earbuds.

I saw my face reflected in his Ray Ban Aviator sunglasses.  Since I was trying to cross the bridge, I thought about asking him if his question was like why did the chicken cross the road, but he did not look like a why did chicken try to cross the road kind of guy.


“Are you okay?” He asked.  “You don’t look okay.”

“I’m fine. Why did you pull me over?” I asked. “Was I running too fast?” He did not look like a was I running too fast kind of guy.  I just heard on the radio a news report saying a guy looks like he may be ready to jump off a bridge.

“I got several calls about a guy on the bridge who looked depressed. Are you thinking of jumping?”

“Am I thinking of jumping what?”

“Jumping off the bridge. Are you sure you are okay? You look depressed.”

“I think I look like I just ran nine miles.” I placed my right leg on the top of the guardrail to stretch my hamstring.

Eighty feet below me a small armada of boats had dropped anchor and the boaters appeared to be having impromptu tailgate parties in the middle of the bay.  Everyone was looking up at me, and some appeared to be filming, so I waved. I could hear a few of the boaters yelling for me to jump.

I could hear the thwump-thwump of a television news helicopter as is hovered overhead, its parabolic microphone pointed in my direction. (I embellished my story a little to make for a better blog, but it’s my blog.)

“Take your leg off the bridge, and back up slowly,” the officer commanded as he slowly approached me. “I was about to call for a police helicopter and rescue divers. Are you sure you are okay?”

To me, the entire dialog was starting to sound like the Bridge of Death scene from ‘Monty Python and the Holy Grail’.

Bridgekeeper: Hee hee heh. Stop. What… is your name?

King Arthur: It is ‘Arthur’, King of the Britons.

Bridgekeeper: What… is your quest?

King Arthur: To seek the Holy Grail.

Bridgekeeper: What… is the air-speed velocity of an unladen swallow?

King Arthur: What do you mean? An African or European swallow?

Bridgekeeper: Huh? I… I don’t know that.

[he is thrown over]

Bridgekeeper: Auuuuuuuugh.

Sir Bedevere: How do know so much about swallows?

King Arthur: Well, you have to know these things when you’re a king, you know.

I was going to ask him if his helicopter would give me a ride back to our house in Ocean City, but he didn’t look like a give me a ride back kind of guy. If I continued across the bridge, the home was only two miles away.  If he did not let me cross the bridge I had to double-back those same nine miles. “May I continue across?”

“No, you can’t do that from here.”

An interesting statement, You can’t do that from here.

I was analyzing a hospital’s website. There was a link on the homepage stating that if I clicked it I would be able to schedule an appointment. (It was right next to the link telling me that if I clicked it three times I could continue across the bridge and go home.)

I clicked the scheduling link. The next webpage told me how much they wanted to help me schedule an appointment and how important my health was to them. The following webpage told me about all the services I could schedule. The final webpage told me that if I wanted to schedule an appointment I should call the hospital Monday through Friday between eight A.M. and five P.M.

The website’s scheduling web page should have included a 24-point, bold disclaimer stating, You can’t do that from here.

Like trying to cross the bridge.

Healthcare’s ‘Honey Do List’

There are a variety of ways for guys to prevent your spouse from adding things to the ‘Honey Do List.” I may have just created a new one.

We have several large, black exterior lights whose color has faded because of their exposure to the sun. Those faded black lights are attached to white boards, which are, in turn, attached to the home’s white stucco exterior.

I should have known better. I was trying to be helpful. Trying to do something without being asked. And so I went to the hardware store and purchased a few cans of black spray paint. Did I mention that the color of the paint is black?

The exterior lights protrude from the side of the house by about a foot. Someone smarter than me might have approached spray-painting the lights with a little more preparation. They may have approached the problem with a roll of duct tape and sheets of plastic to cover the white boards and the white stucco. Did I mention that the color of the boards and the stucco is white?

It would be easy for me to tell you that a sudden gust of gale force wind was responsible for changing the intended path of the spray paint as it left the can. But, there was no wind. The lights are once again black, but

The lights are once again black, but so are the boards and the surrounding stucco.  The refurbished lights look very good. High gloss black accentuated against a white background. Or, as it turned out, a background that is now white-ish.

Trip number two to the hardware store to buy two cans of white spray paint. White boards and white stucco, as I learned after I tried to touch up my overspray of the black paint, becomes a tad less white after ten years. So, try to picture my current dilemma. Black lights. Off-white boards and stucco. And a bright white repair job wedged between two of my new favorite colors; black and off-white. As I look at the results of my work, I am reminded of the Doctor Seuss book, The Cat In The Hat Comes Back, when the pink stain that spreads across everything confronts them.

Enough about cats.

Would you think less of me if I tell you about the voices? I was having trouble sleeping. The sheep-counting thing wasn’t working for me, so I decided to listen to the voices in my head. They gave me a choice between two tasks before they would allow me to sleep; listen to an entire Celine Dion CD, or tie together four disparate facts in a way that made sense. I opted for the facts.

Fact One: Marie Osmond’s never-ending commercial for weight loss. “I’m Marie, and I lost 50 pounds on Nutri-System.” Marie must have been really big.

Fact Two: The never-ending commercial about Mario Perillo advertising trips to Italy. “You may remember my father.”

Fact Three: The spam emails I get from someone named Olga who wants to meet me.

Fact Four: The spam emails I get from Mr. Mumbagi telling me that my uncle left me a large inheritance

And this is what I came up with.

“Can’t wait to meet you, Olga,” I replied. But I wanted to lose weight before I met Olga, so I called Marie, and asked her to tell me about her weight loss secret. Then I emailed Olga, and I suggested that she meet me in Italy. But I didn’t know anything about getting to Italy, so I called Mario Perillo’s son to find out what it cost to go to Italy—it isn’t cheap, even if you bring your own Chianti.   And that left me with no other choice than to reply to Mr. Mumbagi’s email to ask him to expedite the payment of my uncle’s inheritance.

Sooner or later, all the facts make sense. The circle of life.

The circle of life plays out pretty much the same way in healthcare. Examine these four facts—they happened to the same person who was spray-painting his exterior lights.

Fact One: A patient goes online to try to find the date and time of his appointment

Fact Two: A patient calls his health system to find out what day his appointment is. However, he does not remember the name of his doctor at the specialty practice.

Fact Three: A patient arrives for his hand surgery only to discover that the surgery does not take place at the doctor’s office.

Fact Four: A patient calls the health system to ask where he is supposed to be for surgery.

But what if our friend, the spray-painter with the bad hand, had an interactive solution from the health system that would have made facts 1-4 irrelevant? What would have happened if the interactive solution had sent him, or me, a reminder of his appointment that included the date and time and location and a map?

What would have happened is that the surgeon, after asking why my hand was covered with patches of black and white spray paint, would have performed the surgery. And the poor patient would have returned home with his hand wrapped in bandages. And the patient’s wife, who wanted to chastise him for having spray-painted the white boards and stucco black, would have seen the bandages, and she would have been sympathetic to the patient instead of asking why the stucco was black. She would have directed him to his favorite chair, put his feet up on the ottoman, turned on Fox News, and brought him a glass of kale juice.

But there was no interactive app. There was no way for the patient to learn the location of his surgery. And so, the patient returned home only to discover that a team of contractors had constructed scaffolding around his entire house, and had removed all the stucco.

Healthcare’s circle of life.

Design an interactive solution.

Save a husband.


The 5 Pages That Define DIgital Patient Access & Engagement

This is how patients and consumers want to access and engage with their healthcare. You’ll notice, it does not involve a call center.

The EMR does not pass the test of being both necessary and sufficient as it is not accessible to new patients, family members, or caregivers.