OK, so we know hospital and physician rating sites are going to be big sooner than later.  The fact that the rating information is so diffuse at this point allows us to breathe a sigh of relief.  But not for long.  This opportunity to “get the house in order” is a gift.  Act accordingly.

Dr. Michael Millenson writes in H&HN’s Most Wired Magazine on ratings.  Selected excerpts (link via THCB):

The “electronic medical grapevine,” to coin a term, is growing in importance. In 2001, the American Medical Association issued a press release suggesting that patients make a New Year’s resolution to “trust your physician, not a chat room.” As with much other New Year’s advice, this proffered piece of wisdom went unheeded. Today, online doctor ratings have become an integral part of an effort to intensify the interactivity of health care sites and thereby make them more attractive to users.

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If you think this is only the doctor’s problem, think again. Although a hospital’s reputation is woven from many threads, it all unravels without good physicians. Scattered positive or negative comments won’t have much impact, but a pattern of “best doctors” ratings or, conversely, ratings showing the “worst attitude toward patients” can be much more important in a competitive marketplace. To protect themselves, hospitals at the very least should check up on big admitters and prominent leaders of the medical staff. Like it or not, the first thing many “singles” do before a first date is search the Web for information on that potential partner. In that same spirit, keeping track of your physician partners is just common sense.

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We all know that in the real world, the importance of regulatory authorities isn’t going away. But in the virtual world, the electronic medical grapevine is growing in importance in a way that may someday rival the stamp of approval of regulators. These days, it pays to pay attention to the impact of both.

Soon market leaders will emerge in this health care rating business giving the industry needed credibility.  When that happens, it is only natural for the form of those ratings to progress.  And the natural progression will include specificity.

Take a look at SeatGuru, which gives travelers information about the best and worst seats on hundreds of airplanes around the world.  Or the newly launched TripKick which does the same for hotel rooms.  From Springwise:

While TripAdvisor (which acquired SeatGuru in 2007) gives travellers access to detailed hotel reviews by other travellers, who occasionally include info on which rooms to book, there’s definitely an opportunity in getting specific about individual rooms.

TripKick—”your hotel sidekick”—launched with about 250 hotels in 10 US cities, with more to follow. Coverage of each hotel includes detailed information on which rooms to request: which rooms are oversized (rooms ending in 03 and 04, for example), which have great bathrooms or are quieter than others. TripKick, which spent a year gathering all of this information, also points out which floors are better, and which to avoid. Guests are encouraged to add their own reviews and upload photos of rooms they’ve stayed in.

The impact of health care rating sites will be truly felt when the information gets specific.  Specific about departments, about visits, about procedures, about experiences.  Pictures included.  Are you making the necessary preparations?

The Tom Peters blog had the top ten quotes from Mr. Peters at a recent event in London. One particularly caught my attention:

Brand inside is more important than brand outside for sustained success.

What you do inside your organization when the patient is present is much more important than the advertising you use to get those patients in the door. So true.

I have been fortunate (really!) to see the inside of many hospitals. In the great ones I could feel the culture when walking through the front door. Building that culture can be complicated. Signal vs. Noise provides some simple advice:

You don’t create a culture. Culture happens. It’s the by-product of consistent behavior. If you encourage people to share, and you give them the freedom to share, then sharing will be built into your culture. If you reward trust then trust will be built into your culture.

Artificial cultures are instant. They’re big bangs made of mission statements, declarations, and rules. They are obvious, ugly, and plastic. Artificial culture is paint.

Real cultures are built over time. They’re the result of action, reaction, and truth. They are nuanced, beautiful, and authentic. Real culture is patina.

Don’t think about how to create a culture, just do the right things for you, your customers, and your team and it’ll happen.

Instead of building culture, maybe it is Happening Culture.  If you’re trying to build a great culture, you are already on the wrong path.  Let it happen by doing the right thing.  Always.  For employees and patients and providers.

Continuing the brand conversation.

Noah Brier has created a simple-looking application that is allowing users to express their feelings about particular brands.  The collected tags are then displayed allowing companies (or whoever) the opportunity to see what words users associate with a particular brand.  It’s called Brand Tags.  And it seems to be a pretty big hit.

Chances are slim that your health care organization will appear on the site.  Seth Godin provides some advice for our localized organizations: “Superbrands have a mystical connection with people. Odds are, you can’t own one, but there’s no reason you can’t build a micro one, a local one, a brand that’s magical for a smaller group of people.”

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.”

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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?

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.”

Continuing to explore new methods of care delivery. Lots of buzz on American Well a few weeks ago. Basically a patient is able to access an array of physicians instantaneously through web communication tools. Some are still quite skeptical on care provided over the internet, but this model has some legs.

Here’s a detailed explanation (insight provided) from the World Health Care Blog.

Some more on virtual visits.

Obesity rates are climbing. Its impact is worsening. The issue is quite troubling.

Americans’ eating habits have much to do with obesity. Our sedentary lifestyle (little walking, avoidance of stairs, no exercise) is also a big factor.

But there is lots to discover within these two major factors. That information will help us target preventive/health care for addressing the obesity issue.

Freakonomics reports a study which “found that neighborhoods with dramatically more fast-food restaurants and convenience stores than supermarkets also have significantly elevated rates of obesity and diabetes.”

A program in Philadelphia is targeting this problem.

We know that our environment and lifestyles have a major impact on our health, even more so than medical care.

Obesity, and its ramifications, will be the largest health issue we deal with in the very near future. The role of the health system needs to become more community collaborative as our society becomes focused on “health.” Fighting obesity is very much a public health issue—and is encouraging a move toward preventive medicine. The health system’s role could be transformed by becoming part public health agency, part individual medical care deliverer. Call it individual public health. The larger the role a health system plays in a person’s health, the more sustainable these organizations will be.

Hello Health has a very cool concept.  Read about it here.

A more conservative approach to a new (er, recycled) delivery concept (call it a hearkening to the past).

BusinessWeek has a piece on the combination of medicine and cell phones that sheds light on some possibilities—predominately in the patient empowerment arena.

A personal mobile scanner that “plugs into the phone, which beams the data to the computer, generating an image that can be transmitted to a doctor or hospital far away.”

The cell phone may also be able to act as a constant monitor of vital signs.  A patient could also use the iPhone for mobile access to health information for a yearly nominal fee.

This may be a bit audacious, but I appreciate the goal:

“The cell phone is going to solve rural health-care problems, whether it’s rural India or rural Indiana,” says Kristin Tolle, Microsoft Research’s program manager for external research in biomedical computing.