Notes & Links: October 14, 2013

Trust is What Makes Health Care Work – A Success Story From Belgium
Steven Shie writing at Thoughts from Broad Street captures in couple of simple clear sentences what the problem is in our healthcare system and the solution. He share with reads a lecture by Dr. Florence Hut physician in chief at Brugmann University Hospital.

If the Belgian health care system is any indication, the answer to fixing the U.S. health care system may not be tactics but a new perception of health care that is built upon mutual trust and humanity. Because when trust and humanity are gone, we see serious issues that negatively affect everyone in the system: defensive medicine, low efficiency, poor outcome, alarming safety records and most of all, the indifference for those who rely on safety net for care in a country where so many strongly believe “personal responsibility” and free market are panaceas.

Last night during the #hcsm chat one Topic 1 was –

HC needs changing, and so do HC orgs. If you could lead any HC org, which would you lead; what would you change and why?

The answers were far ranging and smart if not heart felt. 

  • would lead a private office doing DPC (direct pt care) & take care of patients the way SoMe has taught me over the last 2 yrs
  • I would lead the NCI, and start by enlisting patient panels across each aspect of the agency’s work
  • Start with the simpler stuff like making clinical trials understood by lay people…no more clinical lingo
  • If I expand to anything, I would agree either NCI, or an Insurer. To drive change today, start w reimbursement & rest will follow    

Dr. Hut is right as rain. No tactic will make a difference. It is about trust, mutual trust and respect for the humanity of healthcare. Those Belgian patients trust their HCP and they company (the goverment) with managing their healthcare. With those Americans attacking healthcar, behaving healthcare is a privilege not a right, and throwing shade at every juncture and mention it is no wonder we as a people are confused and distrustful of our system and there are no amount of chats, social media, patient engagement that can overcome the basic flaw: we don’t trust the system, our HCP, what we read, hear, see, etc. The small point of light that may help create trust are the millions of Americans who are seeking knowledge about their health and the DIYhealth movement may make a difference at the individual level. But it must be a mutilfaceted exercise of HCP, patient, provider, etc etc. 

Shie’s piece is short, smart, and full of good data we can all use. Worth the read.

Social Media in Medicine: Interview at Medicine X
Bertalan Mesko is interviewed at Stanbford Medicine X 2013. It is a short 5 minute interview but filled with understanding of what the needs of this new healthcare world we are entering. 

Mesko is so correct when he says “I believe it’s about medical communications not social media.” We can’t forget that adults learn when they seek solutions to problems and when those answers are clear, concise, and fit with the learners needs (i.e. communicates clearly).

When Talking About the Exchanges, It’s Probally a Good Idea to Look Beyond Opening Week Returns
David Dranove & Craig Garthwaite writing on The Health Care Blog gives us all some good advice, stop, take a deep breath, and step away from the Exchanges opening week returns. As we all know but just to repeat like any other web site hits must become registrations and we can’t end up having the 20% sickest Americans representing 80% of the enrollees. 




Making The Office Visit a Value Exchange

Sunday night at 9pm EDT the #HCSM chat happens. It is one of the best online healthcare chats that I’ve participated in. It is fast, smart, well facilitated, and with some of the best and the brightest minds I have the pleasure of interacting with. The topics are well considered and examined in great detail. Each discussion drives me to think more and consider the changes occurring in healthcare. If you haven’t participated or lurked and you are interested in healthcare check it out, ” …as the dormouse said, ‘Feed your head’.”

I’m sure I am the most annoying participant with my continuous hocking about SM being a tactic and we need to identify strategies/goals and then overlay a tactic. Can’t help myself Donna and Alan beat me about the head for years to learn what a strategy is and how to use it. Sunday night #hcsm takes me back to sitting in the agency and having account people talk about tactics before they identify a strategy. Backing a tactic into a strategy is putting your shoes on and then your socks. 

Sunday morning along with the NY Times I get my mailing from Digital Tonto ( One of his posts was 4 New Marketing Paradigms: here
Within that post were nuggets that clarified my thinking about those HCSM chats. 

Greg the 4 new marketing paradigms:

From Making Contacts to Building Assets

 From Campaigns to Platforms

From Awareness to Activation

From Transactions to Experiences

Yes, his post is about consumer media and marketing but let’s get real. We have to think in terms of marketing, communications, and strategies if we are going to meet the needs of patients in this evolving digital world. 

It is the patient who is driving a need to know and learn because the www is allowing them in real time to seek solutions to problems they have, classic adult learning. To assume physicians who are struggling to keep up with an ever increasing work load and diminishing returns will jump into social media as a solution without first understanding what is happening is as likely as Mitt Romney is to have a cup of coffee.So we must look at strategies that engage both physician and patients and make that amazing unit of learning (patient & physician) work harder and produce better results. In a word use a strategy to show the physician what’s in it for them. 

In the section: From Making Contacts to Building Assets Greg states ‘What’s emerging is the concept of value exchange in the form of owned media assets.’ This is not about using apps and content (tactics) to capture ‘eyeballs’ (think patient office visits). It’s about building assets and creating engagement. 

The asset is the physicians knowledge and skill at delivering care. Creating engagement is helping patients replace or complement what they’ve learned at WebMD. Physicians should become MyMD to patients seeking knowledge. Make no mistake, patients trust their physician more then WebMD or they want to. Talk about a ready made gap to close, this is one that can be done.

Take away: The office visit is greater then the sum of its parts. It is a place to begin the ‘value exchange’. 

I will examine how Greg’s other models relate to health communications and social media over the next few days. And I will show an example of how to begin that value exchange.