Category Archives: Featured

Featured stories

The fun of not knowing the answer

Posted on May 22, 2012 by | 2 Comments

The best part of the current startup landscape is that we have no way of knowing what will and won’t work. In fact, the situation is the same for established organizations. Between social, mobile, cloud and an Internet that now reaches billions of people, there is enormous change on the horizon.

We know from recent history that seemingly crazy ideas will break through and what seems like a safe bet will go nowhere. That’s the beauty and terror of the rapid changes we’re seeing.

Given this uncertainly, how does a small startup go from ‘nowhere’ to ‘now here’? (Love Guru reference for non-movie-buffs) How does an established company shift to meet a changing world?

Stay nimble

The first idea can often be just the precursor to the breakthrough. Look no further than Flickr, which set out to create a way to photo share as part of gaming. What they stumbled upon with photo sharing dwarfed the original plan in both creativity and financial value. What matters most about this story is that the founders were willing to see the market for their ‘accidental product’ and change gears and course.

Nimble companies change direction when the cues dictate.

Fail fast, fail cheaply

The ability to get to a great idea can require several attempts at products or services that may not work out. There are countless stories of inventors who found success on their 10,000th attempt, but that’s not the point. Get ideas out quickly and as painlessly as possible so that the good one comes to the surface sooner. The longer an idea takes to develop, the more costly and higher risk it becomes. We cherish the things that have taken our biggest investment, our ‘babies’, which can easily blind us to whether that investment was a good idea or not.

While on the topic…reward those who fail fast and don’t punish willingness to try out an idea. You’d be getting rid of your innovators.

Focus on the important things

What matters most is that the idea has market value and that you have the people to realize the vision. To that end, build a smart, creative team and avoid turnover. The longer you work to solve a problem together, the better you’ll get at it. The team will become experts at moving an idea from inception to market and will get faster and better each time.

Unless you’re one of the few who has unlimited funding (and therefore, time) and a first, perfectly conceived idea, your moves will need to follow these patterns to be successful.

Sure, there’s lots more advice about how to create or change your business. I would argue that this is the core of the problem…this is the hard stuff.

→ 2 Comments

Posted in Strategy, Featured, Disruption, Disciplines, Startups

What we all need to know about Big Data

Posted on May 12, 2012 by | 1 Comment

Watching the buzz around Big Data, it would be easy to dismiss the hype as an answer looking for a solution. After all, how many times have you read about a remarkably good business model (other than Facebook, Google or Amazon) making millions through Big Data technologies?

However, by the time you read about solutions, technology is likely already in mainstream use and past the hype, meaning: If you wait for your competitors to show results, you’re already many months behind and unlikely to catch up soon. You’re eating everyone’s dust.

Growth spurt

Big Data goes well beyond putting new labels on existing products, though there will certainly be a fair amount of that. Big Data is about a maturing set of affordable technologies that take advantage of several shifts that took place in the past couple of years. You’ve heard it before, but mobile, social, and less-known but very important machine data (logs, etc.) are increasing the data ‘haul’ at a rapid rate. Think of this, too…this is happening to organizations that haven’t maximized the data they already have.

New tech

Just in time for data’s growth spurt, we can now cheaply store lots of information through the web, or Cloud. We can keep it in-memory much more easily, too. Add to that an open source platform, Hadoop and its ecosystem, that can distribute storage and processing across many machines. Each of these is a major change in technology, but taken together, are the key ingredients for a new level of finding and understanding patterns.

Good, Bad and Ugly

Patterns give us insight into what’s happening in our marketplace and world that we never would have had through traditional means. Those patterns can be a way to sell better or to avoid disaster.

  • Good: From better consumer products to getting vaccines to critical places in the world
  • Bad: Learning why things don’t sell or where customer service is failing by ‘reading’ comments and click patterns
  • Ugly: Spotting fraud in credit card transactions, movements of money and other illegal activities

When you look at the growth of data, the advances in storage and computing, and the newly interconnected world, there is an unmistakable opportunity to be involved in game-changing ways of doing business. That isn’t hype, even though hype may blur the benefits. Big Data is our new reality.

→ 1 Comment

Posted in Data Analytics, Disciplines, Featured

Tagged

Will a system approach heal medicine?

Posted on April 30, 2012 by | 5 Comments

This is an outstanding TED talk by Dr. Atul Gawande, physician and author of The Checklist Manifesto on how to heal medicine.

“The most expensive care is not necessarily the best care, and vice versa, the best care often turns out to be the least expensive; it has fewer complications and people get more efficient at what they do. What that means is there’s hope.”

Dr. Gawande talks about how the best healthcare is a systems, not a combination of components (like drugs, technologies and specialists). A system has inputs, outputs and processes. It has a focus on standard work and checklists. The following are what define his system approach:

  • The ability to recognize success and failure. A specialist doesn’t see the end result, but a system has an end-to-end view.
  • It can devise solutions. Forget more training or technology, solutions have standard work in process/checklists that make experts even better.
  • The ability to implement ideas by getting colleagues to go along even when it involves humility, discipline and teamwork.

Please take the time to watch and comment. Thanks.

→ 5 Comments

Posted in Continuous Improvement, Disciplines, Featured, Healthcare, Markets, Process Management

Tagged , , , ,

The tragedy of free floating data

Posted on April 24, 2012 by | 9 Comments

We’re getting exceptionally good at grabbing metrics from anywhere, and in real time, too. Business intelligence tools have evolved into visualization apps and as a result, colors, shapes and lines tell us whether we should be happy or unhappy about data. We are awash in ‘cues’ from inside and outside our enterprise. But by itself, more data and better visualization aren’t the answers to better business outcomes; they are just free-floating data.

Getting to the reward

Cues are only as good as the behaviors they stimulate in response. Without paying close attention to the behaviors, which we call business processes, we end up with a ‘fog’ of activity that isn’t repeatable, isn’t accountable and is unlikely to gain the reward (which can be avoiding a disaster or increasing revenue) that the cue signaled. Worse, we can’t be sure activities that should cross functional boundaries are doing just that. This is the tragedy that befalls most organizations.

Context

Beyond a response, processes form the context for metrics. Organizations that haven’t modeled their enterprise may have the greatest dashboards but lack an ability to know how and where to make change when data shows a problem or offers an opportunity. Cues are wasted when they aren’t understood or framed properly. “That’s the way its always been done around here” is a great answer when there’s no better explanation for why and when we respond to a cue.

Best-selling author Charles Duhigg talks about the management of responses to cues in his bestseller, The Power of Habit. The cookie story is a great analogy for not understanding the context of a metric, poor organizational response and an undesired business outcome. His message is simple but powerful: Understand the cue, be deliberate in response, and gain the most favorable outcome.

Continuous improvement

Once we’ve figured out when and why we measure, we need to understand what to do when data tells us to act. We need to be constantly looking for better ways to respond and make the reward more consistent and larger. We need ways to know that each member of the organization is aligned with what cues mean, what activities cues prompt, and what outcome we’re expecting. That requires either an enormous amount of labor or automation tools that can make the effort manageable.

Going beyond data

At some point, enough cues have been analyzed, put in proper context in a business model and outcomes sufficiently optimized that the organization reaches a higher level of sophistication. Better and more meaningful cues are developed, targeting more specific opportunities, resulting in an ability to manage complex events with complex responses. The most sophisticated organizations have created a platform for a cycle of analysis, correction and organizational change. It is a virtuous cycle that only starts with data but ends with predictable reward.

What are your thoughts on the tragedy of free-floating data?

→ 9 Comments

Posted in Data Analytics, Disciplines, Featured, Future of work, Process Management

Tagged , ,

What’s the big deal with Big Data?

Posted on April 15, 2012 by | 6 Comments

Big Data is the technology focus of the year, and Hadoop is the software that is gathering all the attention of investors and startups. How much is hype and how much is ‘wave of the future’? There is always some amount of hype around new ideas, but I’ll argue Big Data has its value based in diversity.

Diversity of locations

Those who argue that Big Data is just hype (and there are a few) ignore the argument that there is a new diversity of data that has never existed before. The diversity comes from the combination of internal and external (and cloud), mobile, plus the explosion of personal data from social networks. 800M people have put their preferences and relationships on Facebook, but there are many, many other places where data is now available that was never reachable before.

Diversity of users

Big Data has benefited large organizations that could afford hardware and quantitative analysts for many years, but has been out of the reach of small to medium companies. The low cost of storage and open source software has made this technology available to a broad spectrum of companies. It will only get cheaper, meaning the adoption will increase.

Diversity of data sources

The proliferation of web-enabled devices means that satellite, RFID, machine-generated and many other sources of data are in the mix along with consumer information. This data, taken at the right volume and velocity, demonstrates patterns that are useful for predicting opportunities and problems in supply chains, contagious diseases, drug therapies, and a host of other meaningful ways. It opens the door to ideas and solutions that weren’t imaginable a short time ago.

Data traction

Big Data without context or purpose isn’t all that useful, and that’s where process management comes in. In Clay Richardson’s words, Big Data needs Big Process. In his post, Big Data Ain’t Worth Diddly Without Big Process, he argues that ‘Big Process’ is a move from silo’d approaches to BPM and process improvement to more holistic approaches that have a chance to effect business transformation.

Companies have long brought together subject matter experts and mapped how things should be done, but we’ve never really been disciplined about applying the wealth of available data in a systematic way that can revolutionize business. You can’t improve what you can’t measure, and Big Data is all about having the right, timely information to measure meaningful things and affect change.

That means process becomes less about rigid flows and more about an organization being able to use data in specific ways to improve product development, strengthen marketing and sales, and create better customer service. Big Data used well drives organizational change, and that change needs to be wisely managed as an agile process infrastructure.

The companies that don’t put their ear to the tracks by managing Big Data are the ones most likely to be disrupted. And there is lots of disruption ahead.

→ 6 Comments

Posted in Data Analytics, Disciplines, Featured, IT Strategy, Strategy

Getting work done, Himalayan style

Posted on April 11, 2012 by | 2 Comments

We’re were in Kathmandu last year, trekking for our third time in the highest mountains on Earth. That’s not hyperbole…Nepal is the most vertical place you can find. It has to be seen to be appreciated. We’ve trekked through rice paddies and bananas trees as well as in deep snow and amongst Tibetan nomads…sometimes all within the span of a day. There is nowhere in the world like it.

Execution excellence

Even more remarkable is the extreme attention to business that we enjoyed over our two weeks. In a place where there aren’t really any of the conveniences (or safety nets) we take for granted, the ability to execute work is far more valued than in our Western world of constant connectivity, 24×7 shopping, and dependable basic utilities like water and electricity. They spend more time on the details and in doing the right things every time than most of us could hope for. The end result of this focus is a trekking team of four customers and twenty staff of porters, cooks, and guides that performs like clockwork.

Clockwork

We were never awakened more than two or three minutes from the appointed time. We never missed our tea and morning “washing water” even when at 4700 m (14,570 feet, the same rough altitude as Mt Whitney). Everything just worked out no matter the obstacles. It was a completely reassuring experience in a country where anything can go wrong. Where labor is so cheap ($10/day covers a porter up to 40 kilos/88 pounds), you’d think that the focus would be less on efficiency, but even low labor cost is no excuse for sloppiness. I’d even say they are far more efficient and cost-conscious than our best, most modern workplaces. Remarkable.

The reason it all worked was simple…there was a well-communicated and managed way for everything to be done. From tent setup, assignment of loads to carry to delivery of purified water, the same procedures were followed each and every time and by the same individual. This eliminated waste and confusion and made the staff easily able to focus on serving the customer. They were liberated from the everyday nonsense of confusion or frustration and available to be truly excellent at going above and beyond.

Yes, there is workplace excellence in some of the most remote places on earth. If they can have it, we certainly can, too.

Hats off to Buddiraj Rai for his excellent leadership of a great trek. If you have interest in taking a trek, let us know and we’d be happy to introduce you to the best trekking company in Nepal, Adventure Geo Treks.

→ 2 Comments

Posted in Featured, Process Management, Workplace reality

The End of Football as We Know It

Posted on April 3, 2012 by | Leave a comment

First published in the Harvard Business Review.

As much as companies like to tell you the customer is king, that’s hardly true in most industries. Instead, major players put enormous effort into narrowing our choices — selling us on what they have to offer.

These efforts are obvious in the bricks and mortar world, where retailers control what goes on the shelves, but it’s not all that different for e-commerce. Although etail increases consumers’ access to more and more products, the focus remains on getting people to want what companies choose to provide.

Right now, this power of incumbency is enormous and very undemocratic. And, one might argue, heading toward consolidation, as Apple has consolidated the music distribution business and Google, Amazon, and various other platform providers vie to dominate electronic publishing.

Parallel trend

But a parallel trend is building toward giving customers far more opportunity to express their views. And those who move to harness that collective voice have an opportunity to storm many traditional vertical markets.

It’s already happening at scale in one of the most centralized industries in the world — sports broadcasting.

During the Super Bowl more analysis was delivered with more passion on Twitter (10,000 tweets per second near end) than any network announcer could hope to muster. Participation in the commentary was wide (many people posting) and deep (people posting many times), and continued well after the game. And the best analysis of the commercials was found on Twitter and Facebook, not necessarily the USA Today Ad Meter.

Advertisers were ready to cash in on these spontaneous conversations with prebuilt Twitter and Facebook campaigns set to launch at just the right moments in the game. And, not surprisingly, start-ups all over Silicon Valley are developing new ways to harness these conversations through technologies that enable sports consumers to express and share their own views independently of traditional network broadcasts. These start-ups are aiming to thrive by giving fans more control over how they watch sports, when they watch sports, and what sports they can see.

Take Greg Carlson, who (perhaps as a result of being an avid San Francisco Giants fan growing up in a Brooklyn Dodgers household) joined with CEO Aaron Krane to become a founding member of OnSports, a site for crowd-sourcing sports commentary. Regardless of what’s on the family TV, sports fans can follow and contribute commentary before, during, and after their favorite teams’ events, whatever they are. OnSports doesn’t have to guess what its customers want, and Carlson has sometimes been surprised by what bubbles up — like the high number of boxing conversations his site attracts. OnSports didn’t seek boxing fans, but it was found and embraced by them nonetheless.

Similarly focused on letting fans decide what they want are statistics sites: like StatSheet , which automatically transforms sports data into compelling stories, complete with charts, tables, and graphs, giving fans knowledge and insight normally reserved for the pros; and numberFire, which performs sports analytics for fantasy league participants.

Going direct

Even as Google and Apple reportedly flirt with the idea of distributing European Premier League soccer content independently of broadcast TV, online distributors with direct access to sports content can already apply technologies like OnSports, StatSheet, and numberFire to broadcast niche sports in the United States. New entrants need only register a URL, attract an audience, and serve just the most profitable segments of the market. Without barriers like FCC licensing, studios, and broadcast towers, any sport (curling? squash? women’s boxing?) can find an audience.

If those new entrants prove profitable enough, incumbents like the NFL, MLB, NHL, and NBA could be induced to look to the web audience for profits. Rather than continue to tango with the cable companies or the networks, they could conceivably go direct to the fan base by crowdsourcing the commentary, using IP/billing codes to localize it (say, Boston locals talking about the Red Sox during the game), and inserting local commercials. When that happens, traditional content distribution models could well become obsolete.

As could the televisions, too, as more and more fans get used to streaming to larger, thinner, higher resolution monitors. That’s in fact what we do in our house, where we don’t own a television, aren’t connected to satellite, and have no phone lines or cable TV. We use cell phones, a couple of iMacs, and have two large screens connected to Apple TV units that stream from our computers. We only watch commercials during the Super Bowl.

Gatekeepers

These developments should serve as a wake-up call for any broadcasters still thinking of their role in terms of gatekeeping — that is, of presenting sports to fans and interpreting what they’re seeing through expert commentary. As Carlson suggested, when asked what led to the idea of OnSports, “We looked at the existing sports environment, powered by ESPN, CBS, Fox, and Yahoo, and there wasn’t a way for fans to be part of the one-way relationship. Our vision is a crowd-powered, 24/7 highlight reel, where fans are editors and content creators. OnSports brings an inherently social experience catered specifically to the sports community.”

What’s true for American sports is true for any market that engages people’s passions and where consumer opinion hasn’t been adequately addressed. These markets will certainly change when the choices aren’t pushed out by retailers but are instead decided by the collective conversation joined by those who are most passionate about the topic.

The facilitators of those conversations stand to become very powerful. Whether they will be the ESPNs and Yahoos of the world — or new companies we haven’t heard of yet — may depend how much traditional gatekeepers seek to enable, rather than control, those conversations.

→ Leave a comment

Posted in Disruption, Featured, Markets, Social, Sports

Facebook, MySpace and reinventing the wheel

Posted on March 26, 2012 by | 7 Comments

Social without structure is chaos. The most popular social tool in history, Facebook, appealed to a large audience and decisively crushed MySpace by giving people what they wanted: A familiar framework for expressing who they are, what they like, and viral games and apps that involved their friends, all without paralyzing them with choices. The structure made for a level playing field that allowed the most creative and the least to both participate together.

MySpace, on the other hand, by allowing nearly unlimited creativity, became a mishmash of often colorful and too-often annoying personal expression. It became chaotic because it was lacked any cohesion or familiarity. Eyes and brain become tired when half the work is just to get to the information, let alone assimilate it. Creativity, taken to the extreme, begins to feel like chaos.

Apply intelligent structure

It needs to be good out of the gate. As each customer of social technology rolls out, they invariably create a hierarchy to express their business. Independently, each creates their unique form of structure that suits their model and culture. While this isn’t a bad thing in itself, it can also be a painful process that leads to false starts, restructuring, and worst of all, user fatigue and cynicism. Look no further than the uproar each time Facebook makes an interface change. Getting social patterns right at an early point has a positive impact on adoption, and adoption is critical to making a social platform effective.

Searching for information can be frustrating. A ‘starter structure’ can mitigate that by organizing information in a way that is intuitive, creating easy navigation and faster discovery. The benefits accelerate when capabilities are added like auto-suggest which leads to faster and more appropriate classification, a better user experience, and more adoption…a virtuous cycle.

It has to be better than each workplace reinventing the wheel. Sure, you can argue that social platforms need to advance corporate uniqueness, but that same argument could be made for IT standards, HR practices, and many things that that clearly benefit from some level of standardization. Standards also reflect the bringing together of experience and the advice of many diverse voices.  To be fair, it could also be argued that this is group think that runs counter to the benefits of being out-of-the-box and innovative, but starting somewhere is better than rolling the dice on getting it started well. Besides, a structure as a starting point is just that…a place to begin.

Allow a folksonomy

A great start carries the organization to the point where culture and innovation take over. Rather than a burdensome taxonomy that restricts conversation and ideas, a social structure needs to morph over time to bring in the best that the whole organization has to offer. Rigid structures won’t work any better than a lack of structure. A great social technology implementation has to allow people to creatively change the structure in a way that makes sense. Owners of a line of business, for example, would be able to add to or change the framework for their line of business.

In keeping with the democratic nature of the social revolution, everyone should be able to create new business topics a level below what exists and alongside what is missing. They should also be able to create personal topics, even at work, rather than having them leave the social platform as they seek alternative ways to communicate their passions.

Adapt a framework

If you agree that giving social structure is a good thing, the only remaining question is where to find such a thing. A great social framework would need to be as inclusive as possible and have mutually exclusive categories. It would need to be an enterprise model at the highest level and would need to cover all of the functional areas that make up the modern corporation’s value chain.

There are many models out there that fit these descriptions, but there are extra benefits to using a framework that is widely known and well vetted. The wider the better, as the future will likely bring ‘social benchmarking’ as organizations look outside to compare what is happening in a broader market, geography, other industries, etc. Just as classic benchmarking today looks at the effectiveness and cost of process, social benchmarking provides the opportunity to accelerate through the comparison of ideas, thought patterns, arguments and external collaboration. Choose once and choose wisely.

The APQC Process Classification Framework (PCF) is a great example of a structure that can be easily used as a social classification framework, tailored as a practical matter and to accommodate the proliferation of mobile devices as a way to get work done:

In this example the conversation around Managing Reporting Procedures would be expressed as either <6.6.1ManageReportProc> or as <DevelopManageHumanCap.ManageEmpInfo.ManageReportProc>. Level 1 category <SocialConversation> would be an example of an adaptation for this new paradigm.

The point of structure is to determine the best place for the conversation so that the intellectual capital of conversations and collaboration can be preserved. Without thoughtful organization, you’re just as likely to see <NHLPlayoffs> at the same level as <ManageSalesForecast> and <PartyShoppingList>. Don’t laugh…it is already out there in spades.

Keep it flexible

While advocating for a social framework, there’s no reason to limit the conversation to what can be defined through a hierarchy. Just as in Twitter, tagging is an excellent way to mark content that has a useful theme or cuts across functional boundaries (and thus isn’t well-suited to a hierarchical model).

But it goes beyond the end user’s ease of use…every organization should be using hashtagging to mine important information and answer questions like, “Which organizations are talking about a particular topic?” and,  “Who’s talking about a topic within a given organization?”

Make it inclusive

There’s no reason for a social network to be bound by the firewall or physical building. Our suppliers and customers are equally valuable as a source of collaboration and communication. Make sure that you’ve chosen a structure that works with your broader community and isn’t acronym heavy and only sensible to an ‘insider’. This point makes another argument for the use of a widely accepted social framework to aid understanding and adoption.

For a similar take, see Chris Lynch’s website and the article Rethinking Social Architecture in the Enterprise.

→ 7 Comments

Posted in Featured, Frameworks, Social

You had me at, “Would you like a grande latte?”

Posted on February 22, 2012 by | 17 Comments

My local Safeway isn’t what I would call a very modern store. And the employees are either high school kids bagging groceries and collecting carts or middle-aged cashiers, bakers and butchers. It was a big step forward a few years ago when I could sign for my credit card purchase on an electronic device.  I had just finished my transaction today when the store manager stepped up and said, “Mr. Taylor?”. I nodded my head slowly as I didn’t think he knew my name. I was even more surprised when he said, “My system tells me you’re one of our best customers. Would you like a grande latte? I’d like to offer you a grande sized drink of your choice at our Starbucks.”

I asked him how he knew.  He pointed to his smartphone and said, “It’s a new thing we are doing to show our appreciation.” Huh…my low-tech local grocery store has taken a big step up in having the right data, in the right hands, at the right moment, and with the right context. I wasted no time getting my latte and left the store with a big smile on my face.

Personalization

But I have a secret…we really like shopping at Trader Joe’s. We go to Safeway because it is closer to my house and carries some things TJ’s doesn’t. Recently, we’ve begun gradually spending less at Safeway and more at the other store, probably something he didn’t know. The ‘personal’ touch he showed, however, is more than we get elsewhere and provides something to think about before we take our business a few miles away.

Now, I don’t think he really knows me personally, but his systems were smart enough to capture that a good customer just punched in their discount code at register 3 and provided him with the name. The elapsed time between identification of the client and the offer of a token of appreciation was probably less than ten seconds. To redeem my drink, I simply used my code again at the Starbucks register and watched the sale ring up as $0.00. Having that data just a minute later would have been too late as I would have left the store and the opportunity would have been lost.

But wait, there’s more

If that was where it ended, it would have been a nice story. The manager also offered a big discount on roses from the flower shop. I replied that I buy my flowers from somewhere else, and he said, “Yes, that’s why I’d like you to get them here.” He knew what I didn’t buy at his store. He was making an attempt to capture my business without selling against himself. I said that I couldn’t today but asked if it was good for next time, and he replied, “I’ll put the offer on your account through the 31st of December.” I loved it.

I probably will buy the flowers another time.

This story is likely to become something we all see happening at an increasing pace as more enterprises move toward better tracking of customer trends, improved availability of key data, and strategic use of mobile devices. It isn’t just about loyalty, either, as the rose offer showed…it is about expanding revenue by having the tools to increase revenue in creative new ways. When the ’2 Second Advantage’ can happen at Safeway, it can happen anywhere we find ourselves.

→ 17 Comments

Posted in Data Analytics, Event Enabled, Featured, Future of work, IT Strategy, Markets, Retail

Tagged , , , ,

The coming storm in healthcare #healthcare #BPM #EMR

Posted on February 4, 2012 by | 14 Comments

Regardless of the Supreme Court decision on Healthcare Reform at the end of March, many elements of healthcare reform are here to stay. At issue in the Supreme Court decision is the ability for the Federal Government to mandate that every citizen have healthcare or face tax penalties. But there is much more to a broader agenda of healthcare reform that will drive new business activities and technology.

These will be on of the biggest process and technology transformations in our history. If we’re smart, we’ll involve events, rules, social, mobile, continuous improvement, supply chain and every other ‘new’ way of doing business. You’ll find the details in the following three articles, but before you fall asleep reading the titles, read below:

Each one of these ideas is a critical part of where healthcare is going in the future and will very much affect everyone’s treatment and its price. All of this change will be an enormous undertaking for the healthcare industry (Insurers AKA ‘Payers’ and Providers). Nothing this big happens easily.

Outcome vs. fee-for-service

The greatest transition is the move from health care providers as stand-alone silos of increasingly costly service to a cohesive network of organizations measured by patient health outcomes. You can’t dispute that this is a necessary thing, but why is it so difficult?

For starters, medical professionals have been compensated for discreet services that have an associated fee. This was the reason for the creation of the ICD-9 codes that are now obsolete (more on that in Part 2). Measuring outcomes is an attempt to end ‘coin-operated’, silo’d healthcare. Restructuring this model from a payment and technology angle is an enormous challenge.

Healthcare collaboration

Breaking down treatment silos also means being able to move data in a privacy-protected way (those privacy protections are known as HIPAA regulations). Electronic Medical Records are the first step and will be covered in Part 1. This is much more than reducing the stacks of paper in storage. When doctors notes, treatment plans and prescriptions are on paper, there’s no way for that information to be used by the physiologist, the radiologist or the outpatient facility. It is very difficult to expect a collaborative outcome if there isn’t a modern, protected way for everyone involved to share information. The outcomes are also much more difficult to compare and analyze. Keep in mind collaboration doesn’t have to be through traditional means (nor should it be).

Secure, enterprise-level social media is powerful form of EMR and a brilliant collaboration platform that can bring together the patient, the medical professionals and the patient’s support community (i.e. non-medical).  This is game-changing and needs to be thought through.

Information transparency

Once everything becomes electronic, it can be moved between applications in a standard way. This won’t happen if traditional healthcare technology vendors continue to build applications and systems that won’t expose data easily so that it can be shared.

At some point, avoiding this becomes a critical part of the healthcare reform plan (more on that in Part 3). Many systems have been built on keeping data ‘inside the walls’, which coincidentally ensures that healthcare IT customers are forever stuck with software. This practice is known as vendor lock-in. The traditional ‘vaults’ of information need to be opened or replaced, and that won’t happen without a fight.

A recent TechCrunch article compared the state of healthcare IT to where Newspapers were a few years back…acquiring, taking on debt, and not modernizing.

OK, now you’ve gotten the overview of the storm that’s coming. When the dust settles, we should have something better than today, regardless of political issues.

Next up, Part 1 – EMR Shortfalls

→ 14 Comments

Posted in Featured, Healthcare

Tagged , ,