The speed of information, or lack thereof


Michael Stillwell pulled an interesting chart out of a book called A Farewell to Alms. It’s a table of the speed of important news reaching London. For instance, in 1805 the news of the Battle of Trafalgar took 17 days to travel the 1100 miles to London; that’s a speed of 2.7 mph. By 1891 when the Nobi earthquake occurred in Japan, it only took the news one day to travel 5916 miles, a speed of 246 mph.

Nowadays an email or a Twitter update can travel halfway around the world nearly instantaneously. The 2008 Sichaun earthquake occurred 5100 miles from London with the first Twitter update in English occurring about 7 minutes after the quake started. Assuming the message was read a minute later by someone in London, that’s 38,250 mph. Had the Twitter updater been right at the epicenter and able to send a Twitter message 30 seconds after the quake started and was read a minute later in London, that’s 204,000 mph. Five orders of magnitude improvement in 200 years…not too shabby.

And health care still can’t get hospitals across town from one another to transmit important medical information.

Transparency is so hard.


I look at the transparency issue not as a moral right, but as a business tactic, tool and threat.

1. If you run around acting like the things you do will never be seen in public, you’re going to get busted. Sooner or later, the marketplace is going to see the effects of your actions, and living as if this is certain makes it far more likely that you’ll find a happy ending.

2. Your job as a marketer is to tell a story, which is a lot like putting on a show. If you can use the tools of transparency to tell that story better, do it! But if your audience will enjoy the story more (and your business will be more likely to succeed) if you apply some misdirection and magic, then why not?

1. Why hospitals (+ health care, etc.) (are starting to) make an attempt at transparency.

2. For the time being, transparency at most hospitals does not make the story more compelling, at least not in the “let’s attract more patients” sense.  Also why hospitals (+ health care, etc.) are not more prudently pursuing Number 1.

Communication matters, a lot

It is a striking realization the number of health care’s problems related to communication, or the blatant lack there of.  Most recent example from Press Ganey (pdf) (oft-inflated, high 5s!, another argument for another day) patient satisfaction data:

…patients’ top priorities are how well they were kept informed about delays, how well the staff cared about them as people and how well their pain was controlled. It also mattered if the waiting room was comfortable.

Patient experience matters more every day.

Hey, at least we’re (mostly) happy. (Some of us, anyway.)

Time reports on Americans’ happiness with their jobs.

Aside from members of the clergy, the scale tops out at 57.7, that’s the percentage of workers who say they’re ‘very happy’ in the happiest category.  For health care, those who say they are ‘very happy:’

Physicians = 43.89%

Managers (health and medicine) = 42.5%

Registered Nurses = 36.29%

Radiology Techs = 34.6%

Lab Techs =33.2%

Licensed Practical Nurses = 30.6%

Physical Therapists = 30.3%

Nursing Aids and Orderlies = 28.3%

Pharmacists = 24.7%

Okay, so there is some room for improvement.

Wrong-incentive health care

Health care pontificators like to talk about incentives.  Who can blame them/us?  Health care pays its players (or, all too often, doesn’t pay them) to do some funny things.

Today’s example is from The New York Times.  Background info, “One in five Medicare patients, for example, returns to the hospital within 30 days. Over all, readmissions cost the federal government an estimated $17 billion a year.”  Wrong-incentive health care:

Medical providers all too familiar with the financial double bind include Park Nicollet Health Services, a hospital and clinic system based in St. Louis Park, Minn. Park Nicollet started tackling the readmission problem four years ago, spending as much as $750,000 annually on more nurses and on sophisticated software to track heart failure patients after they left the hospital. It reduced readmissions for such patients to only 1 in 25, down from nearly 1 in 6.

But the reduction has been a losing proposition. Although the effort saved Medicare roughly $5 million a year, Park Nicollet is not paid to provide the follow-up care. Meanwhile, fewer returning hospital patients mean lower revenue for Park Nicollet.

Part Deux: Marketing is everything, especially the “process” stuff

Eric Karjaluoto tells a story about why you should consider forgetting social media.  Agree or disagree; there’s a larger marketing lesson in his story.  It’s a tale of finding a dentist in Vancouver and the importance of s-e-r-v-i-c-e.

The first dentist’s office is ultra-sleek and equipped with all the modern amenities (e.g., flat screen TVs):

My young, impeccably well-groomed dentist (who I have since nicknamed “Mr. Shiny”) finally made his appearance. He greeted me warmly and asked, “What would you like to change about your smile?” By the end of my appointment, I had a work-order in hand for approximately $1,000 in services. They seemed to believe that these were quite pressing matters that should be addressed quickly.

Feeling uncomfortable with the experience, he decided to look for another dentist.  Found was a dentist’s office with imperfect decor and lacking (the admittedly unnecessary) modern amenities:

My new dentist spoke with me for a few moments, and then proceeded to clean my teeth. I’ve never had this happen before; in my experience dentists dart-in and do the “big stuff” leaving the cleaning to an army of bubbly twenty-year-old hygienists. I was rather dumbfounded.

She explained that although this may be a less profitable approach, it helped her better “know” her patients’ teeth. She told me a little about her kids and how proud of them she was; no big sale–just a friendly chat. Along the way she mentioned that although her practice is small, at the end of the day she always feels good about the work she does.

I noted that I likely had work that needed to be done, given the results of my check-up and the procedures that were suggested two years ago. She looked closely at the x-rays and explained that although she’d love to sell me something, I really didn’t need any of it.

This goes back to the marketing is everything, “process” stuff conversation.  Provide excellent service and the “marketing” budget could be slashed; pay attention:

The dentist I finally ended-up with simply concentrated on doing her job well. While so many of us are overwhelmed by the many things we could do to market our companies, I believe hers is in fact a much better way to do so.

Within five-minutes of leaving my new dentist’s office I called my parents to talk about how great the experience was. Since then I have told no fewer than ten people the same story. I’ve even started conversations with friends noting, “Do you have a good dentist? If not, I just found an amazing one!”

Everything is marketing, especially the “process” stuff

Yesterday, the groundwork was laid on the importance of the process elements of a hospital visit.  Patients, when evaluating their satisfaction with a hospital visit, evaluate the service (interactions with providers and staff, satisfaction with hospital food, etc.).  They don’t judge the health outcome of their stay.  It makes a whole lot of sense because patients know good service; they’re less likely to know the right way to feel at discharge, unless the outcome is awful.  They evaluate within a familiar frame.

That creates opportunity for health care.  Here it is, From the Head of Zeus Jones:

we like to think that the best marketing ideas are actually company operations that happen to be really appealing or compelling to customers too. One of the many advantages of this line of thought is that marketing is completely integrated into the business and you don’t have to spend money to build marketing programs that then build your business, you simply spend money on building your business.

Integrated marketing allows proper focus on the “process” stuff.  Spend “marketing” money on improving those elements instead of television commercials pushing the brand.  The process is where the (good) (and bad) stories happen and the stories are where the brand is genuinely pushed. Given the power, story works.

Traditional health care marketing is not marketing.  Integrating “marketing” into every operational activity is.

Need ideas?  There are several here.

(link via influx insights)

Maybe this will help…

Dr. Jay pointed to this truth from Dana Blankenhorn at ZDNet Healthcare:

Newcomers to the health IT business, whether individual reporters or giant companies like Microsoft, often find themselves in a time warp. It’s always 1986 in the health IT business. By that I mean there is an enormous and growing ecosystem of consultants, suppliers, software, service and peripherals outfits the likes of which has not existed in the mainstream PC business for over 20 years.

Obvious opportunity.  So, maybe that’s why Marketplace reports that health care venture capital is shifting from drugs and devices to information technology.  A quote from Kryptiq CEO Luis Machuka, a medical software company:

Health care IT is a good place to be right now from a fundraising point of view.

Of course the Hello Health folks are doing good work.  It’s going to take more great ideas/companies to get us to 1996 (2010 would be great, too!) in the health information world.

Finding the opportunity.

I reckon the crux of our problem is that our thinking was/is too short-term:

Thinking about the future is fundamentally important to dealing with the challenges of today. In order to confront these problems successfully, we have to think carefully about the implications and results of the steps we might take, not just in the immediate moment, but as conditions continue to evolve. As we’ve seen time and again, it’s all too easy for actions that seem reflexively correct to lead to far greater crises down the road. (Fast Company)