Do We Really Understand Strategic Analysis in the Digital Age?

“Most of all, strategy is becoming less about assets and capabilities and more about connections and access.  It’s not so important anymore what you have—or even what you know—but how you can forge networks of purpose which can adapt in real time.” This is from Digital Tonto’s blog post ” 5 New Principles of Strategy for the Digital Age

How many of our marketing clients and agency partners understand I mean really understand this new world? They treat it as a series of tactics without consideration for strategies. 

Notes & Links: November 13, 2013

The Complex Relationship of Realspace Events and Messages in Cyberspace: Case Study of Influenza and Pertussis Using Tweets
Nagel, Tsou, Spitzberg, et. al publishing an original paper in JMIR examine the internet and real time surveillance. The authors focused on Twitter. They wanted to explore the interaction between cyberspace message activity specific to Tweets and real world occurrence of influenza and pertussis.

In general, correlation coefficients were stronger in the flu analysis compared to the pertussis analysis. Within each analysis, flu tweets were more strongly correlated with ILI rates than influenza tweets, and whooping cough tweets correlated more strongly with pertussis incidence than pertussis tweets. Nonretweets correlated more with disease occurrence than retweets, and tweets without a URL Web address correlated better with actual incidence than those with a URL Web address primarily for the flu tweets.

The authors concluded that keyword choice is critical in how well tweets correlate with disease occurrence. Makes sense.

Dead Man Walking
NEJM has perspective from Stillman and Tailor that speaks to the real reasons we need healthcare in the country and why the screaming voices wanting to shutdown the ACA or pointing out the problems with the web sites are missing the reality, we as a nation needs to care for and serve Americans, all Americans not just the ones who are lucky enough to have health insurance.

Public Reporting, Consumerism, and Patient Empowerment
Huckman and Kelley writing in the NEJM offer insight and hope for what we are seeing in the press and online. Perhaps, just perhaps we are at a tipping point in our American healthcare mess. Patients are becoming healthcare consumers and are beaming more and more empowered based on reporting by healthcare providers.

Consider this, healthcare providers are reporting cost and quality metrics. What the authors contend may be needed is data needs to help patients determine is the treatment/procedure the option for my need, budget, and personal and family situation?

The rub here is that who is going to explain this to the patients/consumers? HCP are not getting paid for cognitive services. And there is a cost associated with developing and sharing this information. And will they hire old marketing communications pro’s like me to do this so they can deliver care?

6 Lies We Tell Ourselves
No, two of them are not those. Digital Tonto makes us stop and take a hard look at our business strategy acumen. Here are the six. Hope over to see the details.

1. I’m Rational And Make Decisions Based On Facts
In reality, we rarely have the time or inclination to think things through, so we take shortcuts called cognitive biases.

2. I’m Above Average
Research in a variety of has consistently shown that when people are asked to rate themselves on just about anything—their professional skill, driving ability, honesty— a majority believes that they are better than most.

3. My Competition Will be Static As I Transform
“The same fundamental error is also common in business life.  Strategy sessions are big on charts and graphs, but you rarely see any scenario planning.”

4. My Employees Love (And I Inspire Them)
“The truth is that power relationships are inherently mistrustful because one side can more easily opt out.  People who work for us have a strong incentive to make us believe they like us a whole lot more than they actually do, but research has shown that employees opinions are rarely aligned with their superiors.”

5. I Have The Right Information
“We’re wired to jump to conclusions if our evidence is consistent, even if is incomplete.”

6. It’s Not My Fault And I Deserve All the Credit
“When things go well we feel a justifiable sense of pride.  We worked hard, we worked smart and we prevailed.  We believe that we should be rewarded and are angry if we are not.  On the other hand, when things don’t go our way, there are always mitigating circumstances and we don’t think we should be penalized.”

Greg does his usual excellent job at making us all stop and see the reality not the unicorn rainbows.

Quote: Uwe (Need I say More?)
Austin Frakt has a quoted from Uwe Reinhardt in JAMA. I will take the liberty of copying it here since it is some important that I would hate to see you not jump to it.

[T]he often advanced idea that American patients should have “more skin in the game” through higher cost sharing, inducing them to shop around for cost-effective health care, so far has been about as sensible as blindfolding shoppers entering a department store in the hope that inside they can and will then shop smartly for the merchandise they seek. So far the application of this idea in practice has been as silly as it has been cruel. […]

In their almost united opposition to government, US physicians and health care organizations have always paid lip service to the virtue of market, possibly without fully understanding what market actually means outside a safe fortress that keeps prices and quality of services opaque from potential buyers. Reference pricing for health care coupled with full transparency of those prices is one manifestation of raw market forces at work.

Why Local Marketers Need to Start Thinking About Their Instagram Strategy
Okay I confess I have been a long time fun maker of Instagram calling it Twitter for people who can’t read. ( I am hearing the G and T of GTFH reminding me that good marketing and communications that captures attention uses graphics with copy). Street Fight makes a great argument on why we, no I, need to consider it.

More than anything, Instagram presents an unparalleled opportunity to build and share a brand — to show a different side by leveraging this highly visual medium. Plus, the rate of customer engagement is off the charts compared to other social channels

Great read but I would guess most of you are already heavy users of Instagram. If not see why and what a local business, healthcare provider, physician practice, etc. should consider it part of a social media strategy.

Video Break for the Day
GoPro: Combing Valparaiso’s Hills

Just watch it. Makes you want to be a 20 something again this time sans the 60s drama. 

We Got Technology but It’s Useless Without a Strategy

One of my favorite bloggers and marketing brains is Greg of Digital Tonto. He wrote a piece back in June titled ‘The Difference between Strategy and Innovation‘. Let me take a moment to present his premise, what it means to patient knowledge, and show an example. 

Strategy and innovation are different, very different. Greg states it clearly “Without strategy you have no direction, without innovation you lose relevance” We rarely speak about strategy when we discuss social media because we just accept social media is the cat’s meow. It will solve problems since all we have to do is deploy it. NOT! A clear and concise strategy needs to be part and parcel of social media in healthcare in order for it to have a maximum effect.

Greg describes a strategy as “a coherent and substantiate logic for making one set of choices rather than another”. As your mom told you “Make good choices.”  A strategy is used to leverage strength against a weakness, meet a need, or solve a problem. We speak volumes about needs and weaknesses in healthcare. We easily see the issues. But we rarely talk about a strategy and its execution when we speak about social media.

Innovation (i.e. Twitter, Facebook, G+, Instagram) is about possibilities and moving those possibilities forward by combining the old with the new. Innovation is iterative. It is an additive process improving upon existing tools/ideas to create new and better.

The single largest issue we face with the innovation of social media is that none of us are managing it, nor did we create, nor do we have the ability to change it. Social media is a tool owned by others. But it can be used to solve a myriad of problems. Social media innovation exists as a tool for any of us to use. Like most tools it can achieve specific goals, a hammer can drive a nail, a drill can make holes, drive screws, etc. Each cannot do the others job well. With a hammer or a drill we know when to use it where; in effect we are applying a strategy to achieve a goal. How can we make strategic choices using social media in healthcare?

Just to be clear social media does not solving a single problem but in point of fact it solves any number of problems. What it can do is only limited by our imagination. We have a tool that works no matter how you use it or where. It exists within the broad category of the on the world wide web. It has a life of its own. And everyone/anyone can use it. But what’s missing is the fact when social media is applied as a tool to execute a specific strategy to achieve an objective it works better. It becomes more robust. It is measurable back to the objective. Even when we have the right tool it can be disappointing. Using a hammer to drive nails randomly and not building a doghouse is rather stupid. Using a hammer to build a doghouse makes for one happy dog

A practical application would be to expand and improve patient healthcare knowledge?

Written as an objective:

  • Increase the number of new patients who are seeking to solve healthcare problems
  • Improve the quality of knowledge patients find and improve their ability to apply it to their care

The strategies would be:

  • Convince patients the importance of validated evidence based healthcare knowledge will improve their healthcare.
  • Teach patients how to find, appraise, and apply new knowledge to their own care.

The program: 

Develop a curriculum working with a team of social media healthcare activists that would cover the following learning points. 

  •      Identify the healthcare issue needing a solution
  •      How to search the internet: Process, tips, and tricks
  •      What are some trusted sites, what aren’t?
  •      How appraise if a site should be trusted
  •      Social media: Rules of the road, how to make it work, being a good citizen, and security
  •      What is evidence based medicine
  •      What to do with your new knowledge

Identify local libraries and ask them to use the curriculum to teach members or whoever. Offer members of various social media groups to go into the library to teach. 

Once the course is completed those attending opt in to participate in the following

  •      Twitter hash tag specific to that library 
  •      FB page
  •      G+ page

The social media tools are used here are part of the strategy. They work to reinforce learning that has taken place in the live library event. Learners uptake knowledge and information at one time but to truly integrate that knowledge into actions they need to reflect and consider how what they learned can be used within their own healthcare framework and experiences. That is done through questions, recommendations from other participants, new information, how others are using new knowledge, etc. What is occurring is that the one time learning activity is not becoming and ongoing learning/participation/social moment.

Bottom line social media is not a strategy and a tactic. It is not a floor wax and desert topping. It is a tactic that requires a strategy to make it work.

Drilling Down with a Digital Strategy

Last week Digital Tonto has a very timely post ‘4 Essential Question to Ask About Your Digital Strategy’ since the #hcsm chat on Sunday’s generally addresses digital issues within social media without speaking directly to strategy issues I thought I would briefly review Greg’s post and bridge to healthcare SM. You can read it here

 The first question Greg presents is ‘What is my Business Problem?’ The question here is how can the needs of consumers be done ‘better, cheaper or made more accessible or more enjoyable.’ Those who know me know that my primary tenant regarding marketing and communications is applying the principles of adult learning to the consumer and understanding what problems they want to solve. If we know the problems the consumer (patient) wants to solve we can better speak to them directly at a higher order of interest. ‘You talking to me?’ Greg also makes a point that I have been hocking; any digital solution needs to work with other factors as in value, convenience, culture, and market constraints. In short the strategy.   

The second question Greg asks is: ‘How Can Digital Technology Help Me Solve That Problem?’  Key to the answer is to look at banking in person as in depositing checks; it’s a pain in the ass. Chase solves that by allowing customers to deposit via Mobile Phone picture. But as Greg rightly states it is not stand alone, it involves the entire organization. I agree SM (digital technology) is not stand-alone it must function within the organization and within an identified strategy.

The third questions asked is: ‘How Can Digital Technology Open Up A New Opportunity?’ Digital technologies are not just used to create efficiencies they need to create value and transform how business is done. Or how health is delivered.

Greg’s final question: ‘Has Your Business Gone Digital Without You?’ Leave us not forget that we are finding it harder and harder ‘to see where analog begins and digital ends’. And all of this is moving from the keyboard and mouse to the phone. Bottom line your business strategy needs a digital strategy and for me the key word here is strategy and I would add that that digital strategy should work with analog, face to face interaction, etc.

What I believe we are seeing is a split screen in healthcare and social media. On one side are SM strategies that are integrated and working with clearly identified strategies as with Mayo Clinic and other large institutions. These institutions are working daily to make SM solve HC problems patients and institutions are having. On the other screen there are individuals and institutions just throwing SM on the wall to see what sticks without a strategy or clearly defined set of goals. In either case there is a growing and deliberate movement toward integrating HC, SM, with marketing strategies that grow the business. And to be clear when I say grow the business I am not only referring to size and revenue but to outcomes and changes in behavior for both patients and HCP.

It is my opinion that larger organizations are integrating SM well with their marketing strategies. What I would add is that we need to move SM from the institutional level to the physician, patient, office, and home level. But each needs to identify a set of goals and simple strategy that can be executed and measured. Plan, execute, and measure.

Think of this as P&G would. P&G has a national and in some cases a regional strategy. That strategy differentiates the brand, establishes a position, and communicates a message. But when you go into the store, shelf facings, packaging, pricing, etc. are all local pointed to tactics within the larger strategy. They promote, expand, extend, execute, and bring brand to life at point of sale with the consumer in a personal way. Healthcare and digital should work toward that face to face personal integration.

In healthcare the need is there to create a value connection between the parties involved and to leverage that value over the entire life of all parties. It should be done at both the macro level and the micro level. One patient one HCP www.MyMD. The strongest long-term value relationship is the patient and the HCP

Are We Not Men? We Are Devo! Or Customer Driven Healthcare not Product Driven

NEJM August 29, 2012 published a perspective by Asch and Voipp titled: What Business Are we In? The Emergence of Health as the Business of Health. They present a cogent argument that healthcare today is similar to Eastman Kodak who after 131 years in business filed for Chapter 11 protection in the US. Kodak had an opportunity to create digital images and meet what customers wanted. Well they didn’t. Our healthcare system is in the similar throws of failing to read the handwriting on the wall. Are elements of our healthcare system behaving similar to Kodak, ignoring consumer wants and needs?

Our healthcare system largely focuses on producing healthcare, not health. Consumers want health and healthcare is a means to that end. It is the system we have in place, it is the fact of life and death in the US. Our system is designed around writing prescriptions, performing surgeries, and imaging. The authors rightly state this is how we get the health we want, through this system. They also go on to present the fact that our current system looks at health and disease as if it were entirely biologic and not in reality driven by social determinants, economics, personal behavior, social disparities, environmental influences, geography, etc.

Add to that the simple fact we are now in an age of outcomes. Never before have we had the ability to identify, measure, and report outcomes from entire systems and populations down to a single physician. We know what is working for whom and are making healthcare decisions based on that knowledge.

Finally the authors point to the fact our healthcare system is now testing costs and non-payment for preventable readmission or payment for bundled care. Outcomes and payments will be linked going forward.

In summary the authors state that unlike Kodak who were clueless about what their customer wanted successful physicians, hospitals, and provider systems will ‘shift their activities from delivering health services within their walls toward a broader range of approaches that deliver health’ They will in effect answer this question, ‘What do we need to do to move from a product-oriented industry to a customer-oriented one?’

Currently healthcare is about selling a product based on a response to a need, an illness an accident. It is a reactive model built less on customer’s needs and more on a situation. The system orders more tests, lowers costs, and drives utilization. It is like a broker churning your account. This strategy is inherently going to fail because of the changes listed above. The system is not looking at what customers want and where the puck is going to be but what is an immediate point of purchase behavior. The system is built on more use greater the revenue and ultimately profit.

The authors speak to the need for organizations and providers to look at wellness programs and other offerings that move the hospital away from being a provider of products to meeting customer needs.

In my opinion there are two additional factors that point to a direction that becomes a solution to the need to become customer oriented. We know the numbers. A larger portion of the adult population uses the Internet to search for health topics. To solve a health problem a greater number of patients and people are searching, chatting, joining, sharing, etc. online health questions, knowledge, information, etc. They are integrating this new knowledge into their healthcare corpus compendium. Some may be using it with their HCP but it is more likely their efforts are thwarted or fall on deaf ear. But they remain steadfast in their access of healthcare knowledge, data, and information.

Healthcare can get into a simple customer oriented business: information and knowledge transfer. Each hospital, each physicians office, each clinical department, etc. can become resources for knowledge, information, and data. Each and every one of these parts within healthcare can become a resource that customers (aka patients) can turn to, rely on, and trust.

Knowledge is power and that is not limited to who has the knowledge but, where that knowledge resides, how it is transferred, what its context, and how the receiver of that knowledge uses it and where. This model becomes the single most important connection driving exchange of knowledge and changing the dynamic from providing a product to providing a service based not on need but a relationship.

PS: A great analysis of content and publishing to support this idea from Digital Tonto.