Texting health

The Consumerist:

American researchers conducting a study overseas teamed up with banks to send text messages to consumers to remind them to save. There was a 16% increase in savings account balances by the cohort that got messages pointing out how the bank offered specific incentives for consistent deposits.

However, the messages that pointed out the bad things that could happen if you don’t save money did not affect the amount of money saved.

Could the same concept be transferred to wellness text message reminders?

The number of text messages in the U.S. grew from 75 million to 135.2 million from June 08 to June 09, The New York Times:

No single factor perfectly explains the steep growth in texting. It has little to do with technology, since the number of phones capable of texting grew only 7.3 percent from June to June. But “bucket plans,” whose users buy a deep, cheap “bucket” of text messages rather than paying a per-message fee, have certainly encouraged texting.

What’s the competition doing?

This is, to a very large extent, the healthcare business model:

Why do so many websites have the same shiny thing that users don’t want?

Company D saw something shiny on Company C’s website, so they launched the same thing.

Company C had the shiny thing because they had seen it on Company B’s website, and so they copied it.

Company B had the shiny thing because they had seen it on Company A’s site.

Company A did it because someone thought the shiny thing sounded cool.

From Good Experience.

Many chairmen unaware of hospital quality

This is inexcusable:

The journal Health Affairs will soon publish a survey of the chairmen of more than 700 hospitals. Its main message is that many hospitals are not even aware of what they do well and what they don’t. The physicians who conducted the survey, Ashish Jha and Arnold Epstein, gave the chairmen a list of issues — including financial performance, organizational strategy and the quality of health care — and asked them to name their board’s two top priorities. Roughly half did not name the quality of care. Yet the chairmen said they believed that the care at their hospitals was above average. Even at those hospitals that Medicare data suggest are among the worst in the country, 58 percent of the chairmen said they thought their hospital was above average. Not a single one said the hospital was below average. – David Leonhardt’s “Making Health Care Better” in The New York Times Magazine.

It’s hard to believe not one thought of their care as being below average.  It’s an illustration of the Goliath the quality healthcare movement is up against.  Or they don’t want to publicly admit problems–which is a likely scenario.  Or the hospital is good at some stuff and not so good at others–which, too, is a realistic situation.

Crowdsourced healthcare?

Tim Leberecht writes about the experiment that is the world’s first crowdsourced advertising agency:

It’s always good to be the first, and while crowdsourcing, the trend, may have jumped the shark, a fully crowdsourced creative agency is a bold creative experiment and still news. Two Crispin Porter + Bogusky alums, John Winsor and Evan Fry, together with Claudia Batten, the founder of Microsoft-acquired video game advertising shop Massive, have launched Victors & Spoils (V&S), “the world’s first creative agency built on crowdsourcing principle.”

The creation of Twitter’s logo, analyzed here by Ed Cotton, illustrates the beast that has been unleashed:

The story of Twitter’s logo appeared in Wired a few days back, the basics of the story suggesting that Twitter paid no more than $6 for its identity. In a world where product performance trumps image, this is going to be par for the course for many a new brand starting out.

The reality that logos can be purchased for $5 and ads can be sourced from the crowd, should be sending a giant reality check through the halls of branding and communication agencies worldwide.

What implications could this have on the delivery of healthcare (beyond logos…)? It’s not the care that needs crowdsourcing.  It could be argued that the majority of routine healthcare services can be delivered by relatively low-skilled practitioners.  The consultation where physicians figure out what’s wrong, while also becoming more prescribed each day through technology and decision support tools, is a valuable component of the healthcare delivery process.

A new service from Change:Healthcare provides an example of what’s possible, though the service is not explicitly crowdsourcing.  From Springwise:

ASKch is a new service from Nashville-based healthcare information provider Change:Healthcare that allows users to send quick healthcare questions via Twitter and have them answered within 60 seconds. Consumers can simply tweet a question such as, “what is diabetes” to @askch, which is now in beta; in return, they get a short description of the disease and a link to more information.

The request, in this case, is posed directly to an individual.  But extend the thought: what if medical questions were posed to a crowd of qualified medical practitioners?  The question wouldn’t be so much as “what is [insert condition]” but rather a list of symptoms with the results being potential conditions.  Another threat to the current model of primary care?

Do you fear when you fly? There’s an app to help that.

Safety numbers need to increase in order to enable healthcare to do the same.  But a neat concept to address fear from Virgin.

jayparkinsonmd:

Virgin rocks.

Virgin Atlantic has had an amazing 98% success rate in curing fear of flying though its Flying Without Fear classes. These are seminars held throughout the UK that provide flight knowledge through a Q&A session with Virgin Atlantic flight crews, followed by a psychology session to make attendees aware of what makes them afraid and provide techniques to combat the fear. At the end of the day, attendees are taken on a short flight to try out their new knowledge and prove to themselves that they can fly without becoming paralyzed with panic. To reach a much larger audience, Virgin Atlantic has just released the Flying Without Fear app [US$4.99, iTunes Link]. While the app doesn’t include a visit from a flight crew or a psychologist, it’s designed to make the techniques that have been so successful in Virgin Atlantic’s in-person classes available to owners of the iPhone and iPod touch.

Do you fear when you fly? There’s an app to help that.

I likewise recall, and without nostalgic glow, the less technologically sophisticated but generally more humane doctors of my childhood and youth–doctors with the legendary “bedside manner.” Those nonstop doctors were man and women who, in their willingness to visit patients’ homes, had agreed to expose themselves to the context of patients’ lives–the rooms they lived their precious lives in, the beds in which they’d expressed their love and bred their children. In my experience, those doctors never indulged in false consolation (they had after all few effective drugs); but the depth of understanding that they gained by submitting themselves to the lives of their patients–as opposed to demanding that their patients come to them, however painfully–gave them a far better chance of meeting the sick as their equals, their human kinsmen, not as victim-supplicants broiled in institutional light of the dehumanizing air of all hospitals known to me.

Reynolds Price in “A Whole New Life

Don’t do that…

Bruce Buschel published the first half of his 100 Things Restaurant Staffers Should Never Do.  It’s great reading (and insightful learning…).  And while not universally applicable to our healthcare service world, there are some beauts with transferable resonance:

1. Do not let anyone enter the restaurant without a warm greeting.

9. Do not recite the specials too fast or robotically or dramatically. It is not a soliloquy. This is not an audition.

15. Never say “I don’t know” to any question without following with, “I’ll find out.”

27. For red wine, ask if the guests want to pour their own or prefer the waiter to pour.

41. Saying, “No problem” is a problem. It has a tone of insincerity or sarcasm. “My pleasure” or “You’re welcome” will do.

46. Never acknowledge any one guest over and above any other. All guests are equal.

My view is that we should arm healthcare workers with organizational values, their application as a guide to communicating and serving our patients.  Step-by-step behavior doctrine is too controlling in a wildly varied world.  That written, there’s something about a “things you shouldn’t do list” that bites a bit harder in our disciplinary-focused work ecosystem.

Lucky for us he publishes the second fifty this week (using predictive URL technology: here’s a guess at what the link may be, will update with exact when it is published).

Update: Here’s the link to part deux.