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Archive for January, 2009

Health Care Needs More Mavericks at Work. Here’s Why.

by Martin Trussell

The Keynote Speaker this year at the Visa Prepaid Card Forum was William Taylor, Founding Editor of Fast Company Magazine and author of the current best selling business book, Mavericks at Work; Why the Most Creative Business Minds Win, about 32 businesses that have broken the mold to find success.

“We are living in an age of disruption.” said Taylor. “Originality has become the acid test for a successful strategy.”

Taylor noted that one thing that all Mavericks have in common is a Disruptive Point of View. “Most successful companies today,” he said, “try to redefine terms of competition.”

Taylor pointed out that two-thirds of front-line employees in corporate America cannot answer the simple question, “Why should I do business with you rather than your competitor down the street?”

In today’s environment, Taylor said, there is an opportunity for businesses to introduce a new set of ideas. Each organization, he said, must be the most of something. It is no longer an option for companies to try to be good at lots of things.

“What happens when you look at an industry with fresh eyes is an ING Direct,” said Taylor. “Founded in September 2000, the originators envisioned a new way to be a bank. Now they are adding 100,000 new customers and $1 billion in new deposits every month.”

In addition to being web-based, Taylor said what really makes ING Direct a success is their unique point of view and a value system that is most important to them.

“They are on a mission to lead American’s back to saving,” said Taylor. “They want to make saving money cool again. They are to banking what iPod is to music and what Southwest is to airlines.”

The ING model, according to Taylor is easy. It is a simple product offering with no fees, no paper-based checking accounts, and no credit cards. He calls them intentionally edgy and colorful in stark contrast to traditional banks.

“They take so much pride in their way of doing business that ING Direct fires over 5,000 customers each month,” Taylor said.

How do you manage to get fired as an ING customer? Make too many calls to customer service, have too many transactions in and out of the account, demand products and services that are not part of the simple product offering.

According to Taylor, ING Direct is simply not prepared to change from their focus and the customers that their platform is built to serve.

“The only sustainable form of business leadership is thought leadership,” said Taylor.

He challenged companies to see things in their space that competitors do not see and to ask themselves the question, if I went out of business tomorrow, would anybody miss me?

So how does a company cut through the clutter? Taylor suggests the best way to stand out is to emotionally and psychologically charge whatever it is you do. ING has found a way to do this in banking, and Zappos.com has found the formula in the business of selling shoes.

Taylor said that the Henderson, Nevada, based Zappos.com is now doing $1 billion in annual shoe sales over the web. Yes, shoe sales. The one piece of clothing that you really need to try on and wear before you buy. So how are they dong it?

“It is all about customer engagement,” said Taylor. “A real person comes on the phone when you call the company, and they will spend an unlimited amount of time with you helping you go through the largest selection of shoes available anywhere.”

Additionally, the company will ship you several sizes of the shoe you want and so you can find the best fit. There is no charge for shipping the shoes to you, or for returning the ones you do not want to keep.

Taylor says that one of Zappos.com biggest worries today is making sure that they continue to staff their company with people who drink the Kool-Aid. In fact, they are so committed to weeding out those who are not destined to become superstars in their organization, that they offer new employees $2,000 in cash to leave the company after they have finished an extensive training program. Apparently, they are not getting enough takers, and that worries Zappos.com CEO, Tony Hsieh.

So, how can this learning apply to the health care industry and especially health insurance plans? Currently, it seems that most health plans are trying to be good at a lot of things: individual insurance, group insurance, ASO, consumer-directed health plans, Medicare, Medicaid… Where the disruption? Where is that company who is re-defining the competition? Who is the ING Direct of the health insurance industry? Maybe one large insurance company does come to mind. Can you quack like a duck?

Can your organization’s front line employees explain why your customers should do business with your company rather than the one down the street? How are you redefining competition? What is your company’s unique point of view, what’s your emotional and psychological passion? What is your company doing the most of? What thought leadership is your company providing to the industry?

These are all good questions to ponder at a time when the health insurance industry is under a great deal of scrutiny from several sectors. This is the time when innovators and disruptors that can emotionalize their brand will come to the forefront.

Where the Medical Markets Actually Work

by John Goodman

John Goodman is the president of the National Center for Policy Analysis

So what are you really saying, John? What are those
marvelous supply-side innovations you hint at?

— Uwe Reinhardt, Commenting on “Reforms that Don’t Work

Critics of the U.S. health care system complain that price and quality data are not transparent; care often is fragmented and uncoordinated; best practices often are not followed; time and money are wasted on procedures of questionable value; preventive care and patient education are underutilized; such common communication vehicles as the telephone and e-mail are rarely used; and electronic medical records and error-reducing software are not part of normal practice.

But why are these things happening? Is it the doctors who are at fault? Or is it the third-party payer system (which, ironically, the AMA helped put in place) that is to blame? An NCPA study by Devon Herrick finds that, where patients pay directly for all or most of their care, providers almost always compete on the basis of price and quality. And because they are not trapped in a system that pays for predetermined tasks at predetermined rates, providers are free to repackage and reprice their services — just like vendors in other markets. It is primarily in these direct-pay markets that entrepreneurs are solving the very problems about which the critics complain. In fact, these solutions are usually a necessary part of the entrepreneur’s business model.

Federal Health Board versus the Federal Coordinating Council for Comparative Effectiveness

by jingemi

I have read through the Stimulus Package; I write about it alot more on my blog, www.healthitpolitics.com. One item in the Healthcare Section has me about concerned. The legislation calls for the creation of the Federal Coordinating Council for Comparative Effectiveness. Contrary to my previous thoughts, it seems that some new entities will be created.

This Council exists to compare the effectiveness of healthcare delivery and practices. It sounds alot like HHS-Secretary Daschle’s idea for a Federal Healthcare Board. Now, when Secretary Daschle presents his healthcare reform package, will he still create the Healthcare Board? Won’t this create two agencies with overlapping authority and functions? Will this create unnecessary regulation of healthcare?

I think this possibility is real. I hope that Secretary Daschle addresses this issue.

Diabetics Using Twitter to Track Sugar Levels.

by Martin Trussell

When I first conceived of writing about how health insurance plans were possibly using social media technologies like Facebook and Twitter to engage their members to seek better health, I was expecting to find more applications like the one at http://twitter.com/ss1.

Now diabetics can quickly add sugar and med entries via Twitter direct message to the ss1 Twitter account. SugarStats is a simple and easy-to-use interface to allow individual to input and access their data from home, school, work, even while on the road.

The application, which can also be accessed via a mobile device application, the web and through Endo, is operated by SugarStats LLC, a small company based out of Hawaii.

A free account can be established by going to www.surgarstats.com. Once the account has been set up, data can be entered using Twitter and a variety of other portable input devices. SugarStats will track your sugar glucose levels along with the elements that affect those levels such as medication, food intake and physical activity. Users can then easily share this information with their health care professional, family and friends to get further consultation, support and advice to lead to better health.

According to a blog established to promote the service, tracking diabetes is a simple as logging on to Twitter.com and posting a short message like this:

d ss1 bg 108 Good pre-meal BG, I’m feeling great this morning!


d ss1 med rap 6 Trying 6 units of NovoRapid to cover dinner

Then an entry of 108 goes directly into your SugarStats account at the date and time of the message.

If you want to share your sugar info with your Twitter circle you can enable the option within SugarStats to have new entries posted to your Twitter account, otherwise it is confidential and can be accessed in the form of graphs and charts by logging onto your account at http://www.sugarstats.com/.

For all the details and instructions check out http://www.sugarstats.com/

Humana Innovation Center Using Social Media to Engage Consumers and Broaden the Meaning of the Brand.

by Martin Trussell

This is the second post in my occasional series in the use of social media by health plans to engage their members to become healthier and better consumers of health care services. By social media, I am referring to activities that integrate technology, telecommunications and social interaction, and the construction of words, pictures, videos and audio.[1] In short, I am talking about blogging and the use of web sites like YouTube, MySpace, Facebook, and Twitter.

Recently, I had the chance to talk with Greg Matthews, Director of Consumer Innovations at Humana Inc. Headquartered in Louisville, Kentucky, Humana is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 11.7 million medical members. Humana offers a wide array of health and supplemental benefit plans for employer groups, government programs and individuals.

Greg said that one of Humana’s most widely-used social media programs has been the use of YouTube to host a number of videos that take a light-hearted approach to explaining complex health insurance plans and concepts. The channel called Stay Smart Stay Healthy contains links to a number of short videos with titles like Why is Health Care so Expensive? (202,000 views), and How Does Health Insurance Work? (79,000 views). So far, all the videos combined have been viewed over one million times. A similar program was launched in December to educate pre-retirees about their health care options. This retiree planning community is called REAL, and can be found at http://realforme.com/.

However, according to Greg, most of the social media experimentation currently taking place in the Humana Innovation Center has more to learning and more broadly branding the company than it does with specifically engaging with plan members to achieve tangible results.

For example, this past summer, Humana introduced Freewheelin. Jason Falls, the director of social media at a Louisville ad agency, writes extensively about Freewheelin in a post on his blog. In his post, Social Media Case Study: Humana’s Freewheelin. Jason described Freewheelin as “…a bicycle sharing program with a community of green- and health-friendly participants at its core. It’s not just a set of stations where you can rent a bike for a few hours in big cities. It’s that, but with the fundamental higher purpose of promoting better health for humans and the earth as the fabric that ties its users together.”

The program was kicked off this summer in Louisville and also during political conventions in Denver and Minneapolis. Greg’s group used a wide variety of social media vehicles including Meetup.com, a Facebook page, its own blog and a Twitter stream to build buzz about the program. And it worked; Greg told me that over 2,200 news stories were written about the program. But, as Jason Falls noted, it was really about more than just creating hype. The efforts in the convention cities alone resulted in eight days of rides, over 7,500 total rides, 41,000 miles ridden, 1.2 million calories burned and carbon offset of 14.6 metric tons.

I’ll share more of my discussion with Greg Matthews in upcoming posts. In the meantime, Greg and his colleagues are blogging about healthcare innovation at CrumpleItUp.com.

[1] Wikipedia: http://en.wikipedia.org/wiki/Social_media

The Stimulus Proposal….

by jingemi

The stimulus package has been presented and some of my questions have been answered. Specifically, I wanted to know what programs and agencies would be distributing the money. In terms of Health IT, there will be $20 billion (and another $4 billion for examining cost-effective healthcare treatments). So how will this money be distributed?

The answer is the same way as it has been. This stimulus appears to be providing funding for programs that already exist. For example, in a non-Health IT example, the Manufacturing Extension Program will receive more funds. This program is from the Clinton-era. So for Health IT, we will probably see more funding for the Nationwide Health Information Network (NHIN), more funding for Health IT in the community centers program, more money for the states, etc.

It appears that there will be no change (pardon the pun) in how we fund Health IT. The change is in how much we fund.

Go to www.healthitpolitics.com to see my recommendations for what Health IT stakeholders can do to have a part in the stimulus package.

Social Media is Hitting the Mainstream. How are Health Plans Adapting?

by Martin Trussell

This is the first post in what I hope to make an occasional series in the use of social media by health plans to engage their members to become healthier and better consumers of health care services. By social media, I am referring to activities that integrate technology, telecommunications and social interaction, and the construction of words, pictures, videos and audio.[1] In short, I am talking about blogging and the use of web sites like YouTube, MySpace, Facebook, and Twitter.

It seems to me that 2009 promises to be, for these forms of media, what 1996 was for email. Prior to 1996, I remember being hard pressed to find anyone with an email address, and if they did have one, they rarely checked it. Likewise with cell phones, how many people could you reach on a cell phone in 1996? Not many, I’ll bet. Yet a few years later everyone was driving down the road chatting to their finds and business associates.

Similar to these other communications technologies, the so called social media channels are going mainstream and corporations and non-profit organizations alike are making an effort to understand this new media and how to use it to engage customers and clients on a level that could never occur in the one-way information flow of traditional advertising .

If you are still a social media skeptic - it’s just for kids - consider this. A recent survey by Deloitte & Touche found that 43% of Internet users over 61 spent time sharing photographs with people. 36% watched and read personal content created by others. The average blogger is a white, 37-year-old male. 38% of Facebook users are over 35. More than 67% of MySpace users are 26 or over.

This might explain while Barack Obama had over 165.000 “Followers” on Twitter when he posted his last “Tweet” the day after he was elected President of the United States. It would explain why organizations from Starbucks to the animal shelter Wayside Waifs have thousands of people following their updates on Twitter and Facebook.

Now the question becomes, if Starbucks can use Facebook to influence me to do some volunteer work in exchange for a free cup of coffee, and if Wayside Waifs can Twitter me into believing I should adopt a homeless dog, can my health plan convince me to drop a few pounds, lower the cholesterol, and check my blood pressure?

That’s what I hope to find out. I have scheduled a series of interviews with people at the county’s largest health plans to learn what, if anything, they are doing to use social media to engage their members. It should be interesting, so check back soon for the next installation.

Up next: Innovation at Humana.

[1] Wikipedia: http://en.wikipedia.org/wiki/Social_media

World Health Care Blog welcomes Jeff Gruen, MD

by World Health Care Blog

The World Health Care Blog is pleased to welcome Jeff Gruen, MD as a new contributor. Dr. Gruen leads the healthcare services practice at PRTM. He brings 25 years of experience as an executive and consultant and is a recognized expert in healthcare services strategy, consumerism, information technology, and innovation. Jeff will serve as chairman of the Military Health Summit at the 6th Annual World Health Care Congress, April 14-16, 2009.

Prior to joining PRTM, Jeff was president of the care division, chief medical officer, and later senior advisor to the CEO at Revolution Health Group. He was previously the national medical executive for UnitedHealth Group’s Optum program. Prior to United, Jeff was chief medical officer and led business development for an innovative disease management/healthcare web-portal company that raised $50 million in private equity and was responsible for doubling revenues in less than two years.

Jeff serves on the board for the Disease Management Association of America, the eHealth Initiative, and the American Academy of Family Physicians’ TransforMED Innovation Division. He holds a Master of Business Administration from Harvard Business School and a Doctor of Medicine from Northwestern University’s Honors Program in Medical Education, and he graduated from a pediatric residency at Yale New Haven Hospital. He is a former clinical professor at Harvard Medical School and a board-certified pediatrician, as well as an experienced emergency room physician.

Who am I and what’s Congress up to?

by jingemi

First off, my name is Joe Ingemi and I am new blogger for the World Healthcare Congress. My area of expertise (and I use that term loosely) is political and governmental initiatives in the Health IT sector. I like to see what the federal, state and local governments are doing (or not doing) to facilitate the adoption of Health IT. I write a blog about this area called Health IT Politics (www.healthitpolitics.com). Since there is usually alot to cover on this topic, I will utilize both this blog and my own to discuss what is happening.

Well, the 111th Congress promised to be fertile ground for Health IT. In addition to President-elect Obama and Sen. McCain supporting Health IT, there were many bills introduced last year to promote Health IT. Congress passed the E-Prescibing Act to incentivize E-Prescribing among Medicare providers. Congress also increased funding for Community Health Clinics; some of the funding went to the adoption of Health It by those clinics. Also, introduced were the Pro(Tech)T Act and the Stark Bill. Both codified the Office of the National Coordinater and the NHIN and provided funding. The Stark Bill also provided for ONC regulating Health IT. Sen. Baucus also discussed Health IT in his reform proposals.

However, as the new Congress convened, there was not much action in terms of Health IT. President-elect Obama’s stimulus plan includes Health IT funding so perhaps Congress is simply relying on this bill. At www.healthitpolitics.com, I discuss the perils of this strategy. I also discuss how the Health IT community should react to the possibility of Health IT being stalled.

While we are in this strategic pause of Health IT legislation, I think it is worth thinking about workforce requirements to sustain Health IT adoption. Congressman David Woo has addressed this issue during his career. I definitely think that funding of any kind should include resources to train practitioners and patients in the use of Health IT. Community colleges, universities, and techinical schools should expand their curriculum to include Health IT. Private companies may also consider expanding their training options.

Such a initiative would be beneficial no matter what happens to the stimulus. Should the stimulus pass with resources for Health IT, we would have the workforce in place to make the spending a true investment. Should the stimulus fail to pass, a workforce trained in the use of Health IT might generate demand to bring Health IT adoption from the grassroots.

Health IT training might be the factor that makes Health IT adoption become permanent! I look forward to continuing the conversation with you.

Just how well do EMRs Work?

by John Goodman

John Goodman is the president of the National Center for Policy Analysis.

To visit the Marshfield Clinic, a longtime innovator in health information technology, is to glimpse medicine’s digital future.

A computerized patient record is a continuously updated document that includes the patient’s health history, medications, lab tests, treatment guidelines and doctors’ and nurses’ notes. However, there is no crisp, conclusive cost-benefit arithmetic. Marshfield can point to various measurable savings, but has scant proof they outweigh the millions spent in the past and the $50 million-a-year technology budget. Link

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