Jared Johnson's Health Care Perspectives

Joining the HospitalImpact Family

noreply@blogger.com (Jared Johnson) — Mon, 26 Feb 2007 15:24:00 +0000

Another example of the blogosphere opening doors that otherwise would remain closed: Tony Chen has offered for me to be a regular contributor to HospitalImpact.0rg. Hospital Impact is the most widely read hospital blog out there. It has already made for some conversations that otherwise would not have taken place.

Here is Tony's post announcing me to the HI.org family:

Jared Johnson to join Hospital Impact
note from Tony: you've recently seen the posts from Jared Johnson on The
CEO's Golden Question and color commentary on PwC 2007 healthcare trends. Today, we welcome him in as part of our blogging team - he'll bring unique perspective as a progressive, thoughtful PR professional. Please join me in welcoming him in to the Hospital Impact community!

by Jared Johnson
I count it as a great privilege to join Tony and the rest of the HospitalImpact family. I am the PR coordinator at a hospital in suburban Dallas. Ever since a Communications 101 class led me to pursue PR professionally, I have set my sights on the health care field. Something was always intriguing about all of the moving parts, plus the fact that health care affects everyone. I view health topics as a patient first and as a hospital employee second. It's one of the best ways I have learned to stay grounded and keep in mind the best interests of those we serve.
I have always been one to join in the conversation — not just to speak, but to listen. In fact, I'll admit that I usually gain more by hearing than by being heard. I am constantly in the middle of conversations — administrators speaking with clinical staff, clinicians speaking with patients, patients offering feedback to administration — it's an endless loop. I see words like "transparency" and "accountability," and I think how much more manageable these mandates could be with a more dedicated approach to communications. Fortunately, the blogosphere is a place where such communications can take place.
It may sound a little ideological, but I see an ongoing, intelligent conversation and a good dose of optimism as two necessities for making progress.

The CEO’s Golden Question

noreply@blogger.com (Jared Johnson) — Thu, 11 Jan 2007 17:03:00 +0000

[This is my second guest post on HospitalImpact.org. Thankfully, the first one only received very positive comments.]

I have been going through an unexpected process while revisiting our hospital’s online strategy. I should have seen it coming since it’s at the core of what we do in the health care practice. Still, it evaded my thoughts until our forward-thinking CEO shed some light on it.

I refer to the process of thinking about every detail of our business from the perspective that matters most: the patient’s. The context that brought about my awareness may seem trite, but it likely will stick with me for a long time. Over a three-month period, I had been working with our marketing and IS directors to lay the foundation for a Web content redesign. We started by brainstorming ways to engage users more meaningfully. We were throwing mud on the wall, and a lot of it was sticking. We had some true epiphanies in those moments, and the future for our little Web site seemed bright.

I got right to work creating a site blueprint, but soon I became bogged down in the details. Necessary details, mind you. Anyone with a drop of tech blood in their veins will tell you that you can’t go live without considering a host of things like browser compatibility, back-end functionality, security risks, validation, aesthetics, etc., etc., etc. After several weeks of project planning, our CEO requested a status update meeting in the board room. I readied the new design template, the content plan and a host of other technical data to woo and impress him.

But I was the one who was impressed. We had scarcely fired up the projector when our CEO scanned over the new design and asked,

“What would the patient want?”

The question hung in the air as he elaborated. What information and functions would the patients want that would improve their experience at the hospital? How could we possibly make their lives easier and more pleasant? Why can’t we let them start the pre-admission process early by posting the forms online? Wouldn’t that save them some time when they arrive? Why couldn’t we list our staff oncologists on the cancer care page? Wouldn’t that help them find a physician in a time of need?

In that short meeting, I understood why our CEO is who and where he is. He had been humanizing something that is not normally regarded as personable, to make it another part of the patient’s experience. That fits every definition of hospital leadership I’ve ever read.

I’m pleased to say that we incorporated more than a dozen new ideas that came out of that meeting. When our new public-facing site goes live a month from now, patients and potential patients will be able to schedule outpatient tests, download a personal medication card, fill out pre-admission forms and much more. And I made sure to add a note in my strategic planning process to ask that patient question throughout the entire process next time.
The full meaning of “What would the patient want?” is unclear to me. Maybe it means that sometimes we get buried in the processes, the scores and the data and forget to think as if we’re the ones being admitted. Or maybe it serves as a reminder that “patient-centric” is more than just a buzzword. Implementing change is no easy thing, but it can start with small instances. Things like adding the words “Your Hospital Visit” and “Patient Care” to our Web navigation. Will it translate to higher patient satisfaction scores? Will it drive volume? I’ll let you know, but I have a feeling you already know the answer.

Gearing Up for 2007

noreply@blogger.com (Jared Johnson) — Thu, 11 Jan 2007 16:56:00 +0000

[This was my first guest post on HospitalImpact.org, one of the most widely-read health care blogs. If they like what I have to say, they may keep me on as a guest blogger. Wish me luck!]

2007 is shaping up to be one of those line-in-the-sand years – one that is predicted to demarcate the winners and losers of the consumer-driven health care movement more than ever before. As Exhibit A, I submit PricewaterhouseCoopers' recent report titled The Top Seven Health Industry Trends of '07. In short, PwC predicts 2007 to be a tipping point for state policymaking, pricing transparency, technology upgrades, consumer-directed health plans, drug pricing, obesity awareness and specialized healthcare facilities.

As a hospital administrator, I admit I find myself a bit anxious. I see how this whole consumer-driven health care wave could improve our patients' experiences. I see the potential for my hospital to emerge as a market leader without major strategy shifts. I also see such a drastic disconnect between the health industry and consumers that makes any hope for sustained growth short-lived, at best.

As the father of two young children, I resonate with health care from the consumer perspective as well. Because I am a user of health care first and an administrator second, I cannot ignore the nagging questions about pricing and quality of patient care. I thought I knew my own health plan until a stay in the emergency room took about twice as long and cost about twice as much as I was expecting. It's a funny feeling when you spend your days elevating grievances about your hospital and one day find yourself on the verge of filing one yourself. In times like those, it's crystal clear that calls for transparency are firmly rooted.

A couple of comments from the PwC report point to ways that hospitals can emerge as leaders and consumer advocates in this time of historic industry shifts. One of its key findings is this troubling statistic:

"Nine out of ten Americans (90 percent) believe that greed is a major reason that U.S. healthcare costs are rising, a greater number than those citing drug prices, care for the uninsured, business inefficiencies or malpractice costs."

Sandy Lutz, president of PwC's Health Research Institute, explained it this way:

"There are a myriad of issues facing health organizations and opportunities for executives to address them, but they need to also focus on closing the gap between how consumers view the industry and how the industry views itself."

If we take her recommendation as gospel, that makes every individual healthcare professional a reputation manager and PR specialist. Each of us becomes charged with answering those calls for transparency, for explaining perceived gaps in pricing and patient care. We cannot sweep under the rug an e-mail, a blog or phone call that demands recourse for an unpleasant hospital experience. We are to relinquish our role as gatekeepers and instead put more effort into explaining our business to our consumers. That is one way we can reverse public opinion about our industry, one satisfied patient at a time.

The report further suggests that government, insurers and employers ought to be the ones educating consumers on the benefits of transparency. But what if we, at the hospital level, become the first ones to do it on a national scale? What if we are the ones who drive the amount of transparency data that is made available to the public? Suppose, for instance, that consumers can locate a manageable amount of pricing and quality indicators on a hospital's own Web site rather than wading through a cumbersome third-party site that contains reams of data. Think how a patient's experience can begin days or weeks before he or she sets foot on your campus. It's the entitlement of consumers to more data about our hospitals that is changing our industry.

It appears that consumer-drive health care is here to stay. As it takes hold, transparency will continue to be an issue. We as hospital administrators can adopt the movement and find ourselves at the forefront of consumer demand, or we can fight it tooth and nail. I suspect we'll see some progress a year from now, when we're reading the 2008 industry report.

Top Seven Health Industry Trends of '07

noreply@blogger.com (Jared Johnson) — Fri, 01 Dec 2006 19:05:00 +0000

We have one of our first looks at what is bound to be a year of polarizing strategy shifts in health care. According to PricewaterhouseCoopers' survey just released yesterday, consumers will continue their charge for transparency and regulation in 2007. What is striking about the findings is something survey leader Davin Chin, MD, pointed out:

"Our survey...found a disconnect between what the American people, policy makers and industry think is wrong with our nation's health system and how to fix it. It appears that consumers may not appreciate the complexity of healthcare as a business, and therefore the industry's messages about itself and the challenges it faces are failing to resonate in the court of public opinion. This disconnect must be addressed before real progress can occur."

Then it points out this boggling statistic:

"Nine out of ten Americans (90 percent) believe that greed is a major reason that U.S. healthcare costs are rising, a greater number than those citing drug prices, care for the uninsured, business inefficiencies or malpractice costs."

As a public relations professional, that number astounds me. It signifies a chasm that at this point seems unbridgeable. It makes me question what messages are being communicated, how well they are being received and who is receiving them. That's Communications Theory 101, and apparently it's where we must return to re-connect the health care industry with our consumers.

The article summary is intriguing; the full report is available in PDF:
http://sev.prnewswire.com/health-care-hospitals/20061130/NYTH02830112006-1.html

PricewaterhouseCoopers Identifies Top Seven Health Industry Trends of '07
Predicts Tipping Point for HSAs, Pressure on Pharmaceutical Pricing and More State Action

PricewaterhouseCoopers has identified the following as the top seven trends in the health industries for 2007, based on its work with leading employers, policymakers, associations, advocacy groups and organizations across the health industries, including hospitals, health systems, physician groups, government and commercial health insurers, pharmaceutical companies and life sciences firms:

1. States Take the Initiative: In the presence of federal gridlock, states are taking the lead on divisive issues such as stem cell research, health insurance coverage for the uninsured and oversight of advertising and promotion by pharmaceutical companies. Responding to local social and fiscal concerns, states are developing innovative insurance programs, forming public-private partnerships to spur innovation and passing legislation to drive greater accountability and transparency from hospitals, physicians and pharmaceutical manufacturers. According to PwC, such state-led initiatives will likely expand in 2007, but the risk is a patchwork quilt of local programs and regulations.
2. Transparency Could be Revealing: The demand for transparency around pricing, quality measures, safety standards and community benefit is being driven by and is supportive of consumer-directed healthcare and pay-for-performance. In 2007, the health industries will focus on becoming more transparent, but government, insurers and employers need to educate consumers about the availability and use of such information. Providers will need to dedicate more resources to reporting, a strategic issue that can no longer be delegated down in the organization.
3. Time to Walk the Talk on Technology: Developing a digital backbone to support electronic health records, interoperability and transparency is a national priority, but the public mandate is unclear and the industry is struggling with the cost and return on the investment. According to PwC's research, nearly one-quarter (24 percent) of Americans don't yet believe that having an electronic health record will improve the quality of healthcare, and four in ten consumers (42 percent) are unsure. Progress will take an investment of resources from the government and/or the private sector.
4. Consumers Take the Wheel: The shift toward consumer-driven healthcare as a way to control costs will continue, but the year ahead will be the tipping point for HDHPs and HSAs. Insurers, employers, and to some extent the government have been proceeding in favor of consumer-directed health plans in the absence of strong support from the consumers themselves and from strong data on the results of such changes in benefits. PwC's consumer research found that only one in seven Americans (17 percent) surveyed by PwC thinks that increased cost-sharing is a "very important" way to reduce healthcare costs. With a critical mass of people now enrolled in these plans, 2007 will be the year to see whether they really have results to offer, and for consumers to weigh in on what they think of them.
5. Price Check for Pharmaceuticals: Forty-two blockbuster drugs will lose their patents in 2007, opening the door to generic equivalents and potentially creating an enormous loss of revenue for brand name pharmaceutical manufacturers. PwC's consumer survey indicates that the public is quite aware of and sensitive to drug prices, perhaps due to relatively high cost sharing and price transparency of pharmaceuticals, relative to other health services. Nearly three quarters (72 percent) of consumers surveyed said they would be willing to take a generic versus brand--name prescription drug. According to PwC, drug pricing will come under continued pressure from generics, and pharmaceutical companies will have to develop innovative pricing strategies to compete.
6. Obesity is the New Smoking: First smoking, now weight. There is a culture shift around healthy eating sweeping the United States, as evidenced by the number of fast food chains cutting out transfats and U.S. companies introducing health and wellness programs. Two-thirds of U.S. adults are overweight, and obesity's impact on chronic health problems is stirring healthcare organizations and employers to aggressively promote weight loss. Public attitudes have yet to catch up: While three in five Americans (61 percent) believe health insurance should cost more for smokers, only 40 percent believe it should cost more for those who are overweight because of poor lifestyle habits. In 2007, expect public health campaigns to push the envelope on obesity through wellness programs and financial incentives to lead healthier lifestyles.
7. Small is Big: The competitive landscape will change as healthcare gets smaller, more focused and patient friendly under consumer-directed healthcare. Physicians and hospitals are now competing with retailers, several of whom have announced plans to open mini-health clinics within their walls. Consumers like the idea: Four in ten people surveyed by PwC (42 percent) said they would seek non-emergency care from a retail health clinic. In addition, large general hospitals are seeing competition from increasing numbers of smaller, specialty hospitals, surgery centers and outpatient clinics, the result of regulatory action overturning the specialty hospital ban. There already are 130 specialty hospitals in operation and more under construction, predominantly in the South and West.

Hospital comparison Web sites aren't helping; how do we help ourselves?

noreply@blogger.com (Jared Johnson) — Wed, 29 Nov 2006 18:42:00 +0000

Miami Herald health care writer John Dorschner's October 29, 2006 column described the difficulties consumers are having when trying to decipher hospital quality measures from comparison Web sites. It indirectly helps make the case for why hospitals ought to be the ones posting this data, not just third parties.

FROM THE ARTICLE >>

"...The hope is that bringing market transparency to healthcare will drive business to the providers that deliver the best care at the lowest price, reducing costs and improving outcomes.

The reality, at least for the moment, is murkier.

Hospital executives dispute the accuracy and meaning of the data, and few consumers are using the information. Even boosters of the transparency movement -- who include government officials, insurance companies and business owners fighting spiraling healthcare costs -- say that what's now available is often confusing and perhaps useless."

(FULL TEXT >> http://www.miami.com/mld/miamiherald/business/15873434.htm)

From this statement, it is logical to conclude that posting the data is meaningless without wrapping it in consumer-friendly packaging. Just because we're dealing with tons of raw data doesn't mean we can ignore the basic tenets of Web design that make the user experience successful -- intuitive navigation, graphic appeal, logical content groupings, et al.

MORE >>

"Much healthcare information remains hidden, particularly about problem doctors, mistakes in hospitals and the industry's bizarre pricing system. Still, a stunning array of information on hospitals is now available."

So we are making progress in the quantity of data that is posted, but we still have major issues with how to present it.

FINALLY >>

"The hospitals involved say these numbers are misleading. But for many business and political leaders -- from Republican Newt Gingrich to Democrat Hillary Rodham Clinton -- this information is key to changing America's healthcare system and reducing soaring costs by allowing consumers to shop for healthcare the way they shop for other goods and services."

Even more of a reason for hospitals to take charge and post the data ourselves! Let's use the data within our own contexts to tell consumers why we are delivering the best care. Don't let consumers rely solely on click-intensive third-party comparison sites. Let's extend marketing strategy to the Web, and tell our own stories in our own words!

In this way, health care organizations can learn from the example of school districts. In Texas, for example, an interested patron can log on to a third-party site like the Texas Education Agency (http://www.tea.state.tx.us/perfreport/aeis/2006/index.html) and view a comprehensive data set regarding any of the state's 1,300 school districts — helpful, but an incomplete picture of a district's performance. Instead of relying on that, many districts take the time to post test scores and other performance data on their own sites. They complement the data with explanations of meaning.

The Convergence of Transparency and Health Care Web Sites

noreply@blogger.com (Jared Johnson) — Tue, 28 Nov 2006 16:07:00 +0000

Health Care Transparency
Pricing Information
Quality Measures
The Web

Q: What do these things have in common?
A: They are finally converging as a result of the new consumer-driven health care wave. It is a trend that is gaining momentum, and one that cannot be ignored. When the masses have ultimately spoken, legislators may be the ones who mandate what and how much to post online regarding pricing information and quality measures. At that point, some organizations will emerge as leaders and patient advocates, while others will resist with all their power, destroying every last ounce of their goodwill.

This blog is devoted entirely to discussing best practices and principles that are driving health care organizations' Web strategies — specifically, issues relating to transparency and the posting of quality measures/pricing information.

At this point, there remain more questions than answers:

What can hospitals hope to gain by adopting Web transparency policies early?
How many hospitals are posting this information already?
Who ultimately benefits from making this information available?
Why are hospitals traditionally resistant to transparency?
Who will be the real winners and losers once consumer-driven health care takes hold?
Are there any resources for hospitals that are starting from square one?