Conversations rule the day in marketing. The thinking goes that if consumers have positive experiences they will share those thoughts with their inner-circles. Word-of-mouth marketing calls them influentials.

I believe that how patients feel about your health care organization is going to make a dramatic difference in their choice to patronize you or your competitor in the very near future.

In my personal experiences with those in my circle, hospitalizations and clinic visits are often discussed. Especially if they are exceptional (good or bad, but more often bad). Those conversations are no longer limited to inner-circles, however. Which is great news for the organizations making an effort in this arena. And terrible news for those who are choosing to let it go. The web has made these conversations more sharable, more possible, more influential. It is amazing how influential a hotel review on Priceline can be from someone I have never met. But I do know that as hotel guests we share common interests. And a bad experience makes me think twice about making a reservation, a string of three+ bad reviews makes me run. Look at EBay. Are you more likely to think twice about bidding on an item from a seller who has a rating below 90%? I say yes.

Those same ideas have arrived with Health 2.0. Their impact is still limited. But now is the time to make the necessary changes so you allow and encourage patients to share their *exceptional, outstanding, WOW* experiences with the world.

And it starts with providing a (positive!) experience that is worth sharing. An experience worth starting a conversation over.

From Matter/Anti-Matter:

In an era “when all of us, journalists, business people, and designers are making the transition from being leaders of thought to curators of conversations,” as Bruce Nussbaum describes it, designers, including product designers, evolve from information architects to communication architects. Interaction designers start designing interactions between people (a.k.a conversations) and not just interaction with machines. Mark Zuckerberg of Facebook, while typically not the most eloquent CEO, nailed the mantra of the Generation C(onversation): “The other guys think the purpose of communication is to get information. We think the purpose of information is to get communication.”

…

The “aura” of the product is the people who talk about it. Products are the stories of products, and meaning is construed by memories, associations, and provocations. If product and user story match, at least partially, a narrative sandbox, a room of emotional resonance emerges that creates new, proprietary meaning: a third story, if you will. Call it “branding.”

Branding has been around for awhile. But for some reason health care (again) is late to the party. It’s not about making sure that advertisements in print, video, outdoor, online, etc. all match. It is your organization’s everything. It’s the marketing of the experience as soon as the patient is introduced to your organization. It continues with the visit. The cafeteria experience. The gift shop purchase. The bill. And every moment until…well, to be honest, I’m not sure when it ends. Think about the Mayo Clinic. You more than recognize the name. There are certain thoughts that go along with the words Mayo and Clinic. It has stories that people talk about worldwide. They are very good at what they do.

Think about your organization. Does that facility have a story worth sharing? You don’t have to be the Mayo Clinic to do this well. Do your patients enjoy interacting with your organization?  Will they share their experience with the world?

Take notice.

Why medicine delivered today is a 50/50 (split right down the middle) partnership between the physician and the patient.  And a whole bunch of other thoughts that just make sense.

Dr. Mark J. Lema guests posts at Health Commentary.  He urges the design of competent and thoughtful safety systems:

Relying on professionals to do the right thing out of a sense of duty or through fear (malpractice suits) totally ignores the fact that to err is human.  People will make serious mistakes because of misinterpretations, knowledge deficits or persistent habits of thought, even when they try to avoid them. Only systems that:

1.      Avoid Reliance on Memory

2.      Simplify Tasks

3.      Standardize Procedures and Equipment

4.      Use Constraints and Forcing Functions

5.      Use Protocols and Checklists Wisely

will move medicine out of its cottage industry practices into the modern world of systems design.

Stop. Think about how astounding this is as we enter the midpoint of the year 2008:

While the actual number of ePrescribers is something between 10% to 15% of physicians, the forces driving adoption of eRx are many and formidable.

What should be my proper response to this?  Good?  Finally?  About time?  What is taking so long?

Consider the pace of adoption: it’s truly amazing.

Anyway, news is news.  Health Populi has the details.

From Fareed Zakaria at Newsweek via Richard Florida:

“Generations from now, when historians write about these times, they might note that by the turn of the 21st century, the United States had succeeded in its great, historical mission—globalizing the world. We don’t want them to write that along the way, we forgot to globalize ourselves.”

Or in health care, forgot to even consider the impact that globalization could have on care delivery in this country.  If the hospital across the city isn’t forcing you to be your best, the one half way around the world will.  Ask General Motors.

Here is an explanation of Second Life.

From The Guardian via PSFK:

Spanish health authorities launched a virtual portal through the Second Life website yesterday designed to help young people too embarrassed to speak to a doctor about sexually transmitted disease or a drug problem.

Real doctors will log on and offer advice to their anonymous patients. What both will see is an image of a consulting room with a doctor and a typical patient.

Dr Rosario Jimènez, of the Adolescent Attention Working Group, is one of the doctors who will spend up to four hours a week answering their virtual patients’ questions.

She said: “Teenagers do not often go to see the doctor but this is an efficient and amusing tool to reach them because we can both use the same route. Even though they do not often suffer serious illnesses, they often expose themselves to risks which can develop into problems in the future.

“This is a way to talk about their doubts about taking drugs or sexual relations which they cannot do in a traditional consultation.”

IBM released a white paper (Healthcare 2015: Win-win or lose-lose?, pdf) some time ago outlining their prescription for health care reform. As (could be) expected IBM focuses on a consumer-driven transformation. The executive summary is an interesting read—most (probably all) has been talked/written about before, but it is nice to see it outlined in one place.

A major component of the transformation will be an introduction of accountability and call for action:

Action and accountability are the basic ingredients of change. To successfully transform their healthcare systems, we believe countries will undertake the following actions:

• Focus on value – Consumers, providers, and payers will agree upon the definition and measures of healthcare value and then, direct healthcare purchasing, the delivery of healthcare services, and reimbursement accordingly.

• Develop better consumers – Consumers will make sound lifestyle choices and become astute purchasers of healthcare services.

• Create better options for promoting health and providing care – Consumers, payers, and providers will seek out more convenient, effective, and efficient means, channels, and settings for health promotion and care delivery.

Asymmetric information is a problem we often speak of during discussions of why market functions break down in health care. This next idea has been floated to combat this problem—it will be interesting to see what develops:

Health infomediaries, who will help patients identify the information required to make sound choices, interpret medical information, choose between care alternatives and channels, and interact with the providers they choose, will become fixtures in the healthcare landscape for both the well and the chronically ill, and for a much broader socioeconomic segment of the population.

The company recently launched a health care island in the virtual world SecondLife:

IBM debuted at HIMSS®08 its newest island in Second Life: IBM Virtual Healthcare Island. The island is a unique, three-dimensional representation of the challenges facing today’s healthcare industry and the role information technology will play in transforming global healthcare delivery to meet patient needs.

The island supports the strategic healthcare vision that IBM released in October 2006, entitled, Healthcare 2015: Win-Win or Lose-Lose, A Portrait and a Path to Successful Transformation. The paper paints a picture of a Healthcare Industry in crisis — of health systems in the United States and many other countries that will become unsustainable by the year 2015. To avoid “lose-lose” scenarios in which global healthcare systems “hit the wall” and require immediate and forced restructuring, IBM calls for what it defines as a “win-win” option: new levels of accountability, tough decisions, hard work and focus on the consumer.

The IBM Virtual Healthcare Island is designed with a futuristic atmosphere and provides visitors with an interactive demonstration of IBM’s open-standards-based Health Information Exchange (HIE) architecture. Working with project leads in the U.S., the island was designed and built by an all-IBM-India team.

Corporate America will have much to say about the direction of health care reform in this country (IBM’s interests are two-fold: defining that direction and then helping health care organizations and companies move in that direction).  Corporate concerns have much to say about this looming change.  It is all just so interesting.

A gathering of the web’s good health care (related) stuff…

If we could just figure out the communication thing we would solve most of our issues. Here’s the piece (via Jay Parkinson) and a snippet:

Communication in medicine grows worse by the day. What should be a pillar of quality health care is instead a resounding failure.

Patients are rushed through office visits and often leave without having their questions answered. Labyrinthine barriers have to be overcome before speaking with a physician. Reaching a medical provider via the Internet is an impossibly daunting task. Doctors rarely talk to each other to coordinate treatment plans.

The Wall Street Journal reported a slow-down in retail clinic expansion this week. I’m not expecting that to mean the beginning of the end for retail clinics. The model is still viable and will prove valuable in helping our health care situation. From Kaiser Daily Health Policy Report:

The “boom” of walk-in health clinics at pharmacies, supermarkets and retailers “is showing signs of slowing,” the Wall Street Journal reports. As of May 1, there were 963 retail clinics in the U.S., compared with 125 three years ago. However, some retail clinic operators recently have closed 69 clinics in 15 states, and others, including CVS Caremark, have announced their intentions to scale back clinic expansion plans.

My belief of the connections between health care and education have been noted here previously. Richard Florida has provided something further to consider.  My point is that we can’t expect health care to continue to operate in the vacuum that it has (it won’t).  All possibilities (that we can think of) for the future must be considered.

I have often wondered what the efficient scale of a university is and, in particular, whether it would be better to create a second Harvard with the university’s wealth than to expand the first one. Maybe the Massachusetts state legislature will give the powers-that-be at Harvard an incentive to consider more radical expansion plans.

And if states and cities are willing to pony up billions for convention centers and stadia, and hundreds of millions in industrial incentives for factories, how much do you think they much come up with for a Harvard, or MIT, or Stanford, or Oxford relocation. Universities are already setting up foreign campuses. Trust me, it’s just a matter of time until this game gets big.

We’ve all heard of the impact the Baby Boomers will have on the future of America. To that end, it could be considered surprising that more hospitals haven’t focused on the health care needs of a to-be retiring population. Medicare won’t the highest payer. But they will provide volume. Shoot, the way things are going, health care organizations may become completely dependent upon government payers for sustainability.

As health systems become more competitive, tailoring services to the needs of specific subsets of the population is appropriate. No better population to start with than one that will push 75 million + through the system.

our own system will not open a “Center for the Aging” or classes to learn how to age gracefully or anything else remotely insulting. These years for this cohort will be the first time that an entire population has lived so long. And they aren’t just existing, they’re enjoying, experiencing, and exciting.

Tom Peters has been knocking on this door for a few years now. Here is the latest post in his 100 Ways to Succeed series (#116):

Boomers! Geezers! Now!

Before the week [day?] ends, somehow or other begin a serious conversation about your attitude toward and approach to the Boomer-Geezer market.

(Like race in the world of politics, try to examine your implicit biases—eventually with the help of an outside facilitator.)

If at all applicable, consider Very Radical Alternatives—e.g., re-aligning strategy around Boomers-Geezers.

Big idea/s:

(1) It is a big idea.
(2) Stir the pot. Now.
(3) The opportunities are enormous; the response so far is pitiful.
(4) Don’t be an idiot.

Sticking with the Tom Peters theme, the preceding blog post to that above had this quote from the head of the AARP, Bill Novelli, “People turning 50 today have more than half of their adult life ahead of them.”

Wow.  Mr. Peters continuing on Boomers:

“We are the Aussies & Kiwis & Americans & Canadians. We are the Western Europeans & Japanese. We are the fastest growing, the biggest, the wealthiest, the boldest, the most (yes) ambitious, the most experimental & exploratory, the most different, the most indulgent, the most difficult & demanding, the most service & experience obsessed, the most vigorous, (the least vigorous,) the most health conscious, the most female, the most profoundly important commercial market in the history of the world—and we will be the Center of your universe for the next twenty-five years. We have arrived!”

We.
Have.
Arrived.

(Pause: read the above paragraph, until you understand)

our own system is late.  But we’re ahead of most.  Starting now, we are tailoring services for Boomers.  Period.  How?  Not so sure.  Those decisions will be left for Boomers to make.  We obviously have some work ahead.

And the best part?  It won’t take a considerable investment to get in line.  Steady growth over the next few years will allow us to successfully add and customize services as they are needed.  From the Health Beat Blog:

“In truth, the aging of the population is not a big problem,” Uwe Reinhardt says. We really don’t have to worry about greedy geezers suddenly clamoring for more care than we can afford. For one, they won’t grow old all at once. They’ll grow old just as they were born—over a period of many years.

Principle #17:  The Boomers are coming.  The Boomers are here.  The Boomers are still coming.  Theeir impact on local health care systems will be large.  And in a competitive health care world (to be), we want them at our own system.  The customization of health care services will allow us to tailor the experiences for this huge (read: important) population.