The previous post in this series reviewed the first year of healthcare social media and noted the correlation between engaged employees and customer service. I’ve predicted that in the coming year we’ll see progressive organizations extending the use of social tools to their employees; thereby creating a culture of information exchange and online service. Achieving a socially connected employee base at a healthcare provider is not without challenges, although it may be easier than some would suggest.

Action conquers fear

We have no reluctance about hiring someone to register a patient or letting nurses tend to patients. Healthcare providers, as Lee Aase of the Mayo Clinic has quipped, are accustomed to embracing cutting edge advances in medicine but ironically slow to adopt new business practices. And so, it should come as no surprise that many hospital systems balk at the idea of allowing a nurse or registrar represent their brand online. Many concerns can be easily relieved by exposure to social media tools and education about their use.

Compliance and regulatory issues usually top the list of concerns and rightfully so. A well-intentioned caregiver posting a patient’s picture could unwittingly generate serious legal problems for a provider. Similarly, I would not suggest completely dismissing issues relative to branding. Again, a well-intentioned employee could post offensive or misleading information.

But there are also concerns that rest on a much less solid foundation. Here, I’m referring to the red herrings of productivity, viruses (or other technological malfeasance), and inflammatory discourse. I suggest these concerns can be allayed by  what psychologists call exposure therapy.

The tools that organizations are scared to give their employees  can, in fact, be the way to overcome fears – real and imagined. It is time to begin using social media internally, within provider organizations. Doing so will help assuage naysayers and allow organizations to cultivate online ambassadors.

Connecting the dots by connecting employees

Out-of-the-gate it may not make sense to extend Twitter to 5,000 employees. However, a simple forum site, accessible only internally, may be a gentle introduction for both the organization and its employees. Consider augmenting the intranet site with a forum. Make the rules clear and accessible — no foul language, no insults, and no patient information. This is not a unique idea.

Paul Levy, the widely-read CEO blogger from Beth Israel Deaconess Medical Center in Boston set up forums when facing a difficult financial position last year. He explained that layoffs seemed inevitable, but offered an online, intranet for employees to discuss other options. It worked. Employees collaborated openly and created ways to reduce costs and save jobs. Concerns about inflammatory language proved unfounded, the conversation was civil and professional. Levy is a seasoned leader who knows criticism is often a suggestion in disguise; he’s fearless about letting employees speak freely.

If forums are the first steps, a more feature-rich social platform may follow. Multi-user content management systems like open source Word Press MU or commercial Microsoft SharePoint can be used to build powerful internal social networks. As a colleague puts it: “I can log into Facebook and see what everyone I know is up to in broad strokes, and it only takes minutes a day. Why can’t we do that across our organization?”

Imagine logging into an intranet and discovering what’s going on in finance, surgical services, registration, administration, and infection control,– all from short status updates. Wouldn’t knowing where the company as a team was headed be useful?

These kinds of controlled, internal social efforts also help employees better understand what leadership looks like. Leaders,  coached by those who understand social networks and organizational development, can model leadership by their participation in online communities. Most companies already have online training tools, so including Social Media Communications 101 is an easy drop-in that will lead to an internally connected and engaged workforce.

Next time, a deeper look at the the tools to build an internal social network…

The next level of growth In healthcare’s use of social media, must come from    the within the organization by involving all employees in the effort.

Preface

For many healthcare provider organizations, social media has become an extension of external marketing efforts.  And while  big external wins, like viral videos or news coverage of tweets can help create internal momentum, too often these actions are little more than glorified sales pitches. To truly be successful in the use of social media, providers need to begin thinking about engaging their employees in the social conversation and. creating a team of online ambassadors who serve each other and their customers more effectively. In the case of healthcare, it means engaging the  entire staff of caregivers in the conversation about bettering the patient experience.

The story so far
If seven human years equal a dog year, how would we calculate an internet year?

Only twelve to sixteen months have passed since early adopters got serious about social media in the healthcare industry. A lot has happened during that short period of time. Just recently the #HCSM twitter chat celebrated its first birthday. According to Ed Bennett’s Found in Cache, over 500 hospitals now have some kind of social web presence.  We’ve seen surgeries tweeted, the Pink Glove Dance go viral, doctors tweeting, and iPhone applications for hospitals. So what does the coming year look like for healthcare social media?

Most, if not all,  healthcare providers  share the collective goal of improving patient experience. Sometimes, this is expressed as clinical excellence; sometimes as increased efficiency. Regardless of wording, having an entire organization discussing this type of improvement can strengthen a provider’s ability to deliver care. Just as there is a correlation between engaged employees and good service, so too is there a connection between connected employees and empowerment.

During the past two years at the hospital where I am employed, we have seen how increased employee engagement has  improved everything from patient satisfaction to clinical outcomes.

Well cared for, happy employees serve customers with an exuberance that comes from a sense of pride that cannot be induced by coaching alone. The exuberance and best in class service I have observed  across multiple service industries is a result of establishing and sustaining a company’ culture of serving customers with pride, anticipating patient needs, and caring about positive outcomes. This type of culture is rooted in engaged employees who believe in the organization’s mission. And just as service emerges from a culture of engaged employees, social media must emerge from engaged participants.

Prediction
This next year for healthcare social media will be an opportunity for progressive providers to grow in amazing ways. I say this is the year that organizations that truly embrace openness and transparency will move to the forefront. Social tools have a role inside of organizations. When they’re used to help flatten the org chart and promote discourse, the entire enterprise benefits and convey an important ethic that branding alone cannot match. The path has been paved in this last year. The very social tools that we have been using externally have an immense power when they are applied internally. More on that thought soon…

____

This post is shared with much gratitude to Meredith Gould for her editorial guidance

Of the topics discussed, one that really resonates with me are some of the complications surrounding the reimbursement challenges of our third party payor system. For those of us who work in that part of the industry it can be easy to be lulled into forgetting how complicated the system is. Ask any patient who has been denied after seeing a doctor and they can remind you about the challenges.

The Interval crew also delved into a question posted on Health Leaders Media: “If You Could Tell the CEO One Thing About Marketing, What Would it Be?” My comment on that post was, “marketing is dead”. As ambiguous and inflammatory as that comment sounds, the Interval team did a great job of interpreting my meaning. One of my favorite concepts is the idea of the “experience economy”. The term comes right from the title of a book by Pine and  Glilmore. The essence is that we live in a time when ubiquitous connectivity and real time communication (IE social media) enable consumer to discuss products and experiences in real time. To put that in context, I do not need to see a billboard about a hospital in town, I can see what people are saying about that hospital right now online. Those experiences will have a much greater impact that marketing.

Chris makes an eloquent counter point about marketing. When applied as the “art and science  of [retaining and growing a customer base]” it is not far afield from the experience economy. I would argue that under that definition the onus (and effort) moves off of traditional marketing and is placed on operations, customer service and clinical outcomes. In that sense, the need for billboards and print ads becomes superfluous – marketing, at least in that sense, is dead.

I have had the recent pleasure of some deep conversations with a friend who knows a lot more about these concepts than I do. Without a doubt those who “get it” understand that the future of healthcare marketing is not about a bigger watermelon truck. Business development has to be strategic and tied to the proverbial bottom line. When service and the patient experience are approached with the same attention, the results are surprisingly affirmative in advancing that bottom line number.

Enough of my drivel, have a listen to Chris and the Interval team here on their site, or subscribe via iTunes

This post is password protected. To view it please enter your password below:

Password:

After a twenty year stint in the U.S. Air Force as a medical records expert, Bob Ross was destined for a life in healthcare social media. Somewhere he got sidetracked.  By some accounts it was when the Air Force stationed him at Eilson and he first saw snow-capped mountains. Destiny being the fickle force that it is took Bob’s life in another direction. Today very few of us think of Ross as an Health Information Management (HIM) guru. Instead we remember him as the the afro guy who had the painting show on PBS. But, I think, were he still with us today, Bob would confirm my suspicion that he was really just preparing us for the social web.

The Bob Ross Theory of Social Content Management is simple: Let your content live where it naturally wants to live and embed it in your own happy place.

Or, as I call it at work, the argument for having our own blog site. Social networks are by definition communities; and communities are all different. It is what makes life interesting. It is also what makes the initial entree into social networking a challenge for many healthcare organizations. Is it Facebook or Twitter? What about YouTube? Should we really be giving all that traffic away (does traffic really matter anymore)? The answer is more simple that it sounds. Let the content live where it wants to live and embed it on your blog.

Having a blog-type site is more than just having a place for long from posts. They are the blank canvas for our own social media oil painting. One of the biggest advantages of a content management system like Wordpress is the ability to aggregate all of your social web efforts. With a blog site, or “social hub” as we have started calling our site, content like videos can live on sites like YouTube. The advantage is that you can present them on a site you own and control. It also lets you showcase them alongside your other social content like photos from Flickr, audio from AudioBoo, presentations from SlideShare, etc.

There is another distinct advantage to The Bob Ross Theory. As hospital web content expert Ed Bennett often points out, YouTube is the third most visited site online, making it the second biggest search engine (after its parent, Google). Ed is also quick to share the tip that the more information you populate about your video, the more likely it is to come back as a search result. Where else would a happy little video want to live? Once uploaded, you embed that video on your blog site and share your own link via twitter or facebook, but the video still lives on YouTube. It is the best of both worlds.

The Bob Ross Theory is not limited to videos. Flickr is the 34th most visited site and second largest photo site after Facebook. Lets put a happy little photo right there. Now add some tags, a description and presto, it becomes a search result on Yahoo!. When you want to share that photo or slide show, you embed it as a blog post and share that link.

Pretty soon your blog site is not such a blank canvas, it is full of happy content. When prompted with: ‘Bob, everything in your world seems to be happy.’ Ross replied: “That’s for sure. That’s why I paint. It’s because I can create the kind of world that I want, and I can make this world as happy as I want it.” 1

For more information on getting started with a blog site, take a look at Lee Aase’s SMUG site.

1 Wikipedia http://en.wikipedia.org/wiki/Bob_Ross

Thanks to all those who participated:

• Dr. Jeff Livingston aka @macobgyn
• Christine Kraft  aka @christinekraft
• Dr. Val Jones aka @drval
  
• Jon Richman  aka @jonmrich
• Nick Dawson  aka @nickdawson
• Liza Sisler  aka @lizasisler
• Greg Matthews aka @chimoose

And a special thanks to the producers of the event:

• Meredith Gould aka @meredithgould
• Tom Stitt aka @tstitt

Finally, and to reiterate what I said at the top of my segment in the audio cast, thank you to the #HCSM community. In the last year we have laid the ground work that is changing the face of healthcare. Every day this group comes up with new ways to improve the patient experience. After all, we are all patients.

2009 Food Trends

The end of the last decade had a clear trend, it was when we took food back. Over the last few years us foodies have been kicking to the curb the ideas of factory made, mass produced food. Reaching a crescendo in ear of the factory food manufactures in 2009, the “local movement” has taken hold. There is still a long way to go before the movement is even mainstream, but it is clearly making headway. Want to know more? Have a listen to this episode of the Splendid Table. In addition to eating locally, we are continuing to pay more attention to the quality of our food. Books like Pollan’s Omnivores Delemma (though published in 2006) helped draw our attention to what we are eating and where it comes from. As home cook and diners we are celebrating by returning to slow cooking, artisanally made foods.

• Bacon – this is probably not news to anyone who has eaten in the last year. Bacon has transcended mere breakfast food to ubiquitous ingredient.  Perhaps a symbol of our rebellion against low fat, low carb tasteless diet food, last year we embraced cured smoked pork belly with vigor.
• Slow food – We came back to crock pots, braising, and the family meal in 2009. In addition to things that cook slowly, we also returned to things that that time to prepare and eat; quite literally the antithesis of fast food. The wonderful result of slow food is often slow eating; spending more time around the table with the people we really enjoy breaking bread with.
• Traditional food merchants – Though still not widespread, many medium and smaller sized cities are seeing the return of butchers, fish mongers, bakeries and traditional purveyors. In recent years we have begun rewarding the entrepreneurial foodies who setup specialty shops in our towns. Think about this, would you take your car to a place that claimed expertise in all manor of transportation from skateboards to horses? No, we take our cars to mechanics who work on four wheeled passenger vehicles. Why are we buying our food in a place that sells everything from trash bags to meat in plastic sitting on a diaper?

My top meals of 2009

This portion of the review is regrettably challenging for me. Our travel was sparse, our time to eat out limited and our energy to sleuth out foodie finds minimal. Although a year that included sushi, Vail cannot be considered unfortunate by any means.

• 18 week aged New York strip steak at the Wildflower in Vail Co – This was one of the best steaks that I never ordered. It was my father who called for the rarely cooked (and rarely well aged) cut. To add to the improbability, those who know my cynicism for hoity-toity, resort style restaurants are undoubtedly surprised by the inclusion of the Wildflower on this list. The steak was the standout dish of the meal, but it was the service that made the experience remarkable. If the economic situation (remember, we are not supposed to say depression) of 2009 has taught us anything it is that we do live in a service economy. The businesses who are going to make it are those that understand exceptional service. The Wildflower, and our fortunately named server Nicolas (he was French, thus no ‘asssh‘ – or h) were the quintessential definition preemptive service; understanding the customer’s unexpressed wishes and seeing to them. Have I discussed my passion obsession for service before?
• Sushi at Hatsuhana - I’ve said it many times (including in 2008), Hatsuhana in New York is the best sushi that I know of. Hatsuhana is not avant garde sushi, unlike the fusion and insanely creative creations of my friend Osada (formally of Takah Sushi in Aspen which has gone donwnhill since his departure). Hatsuhana is traditional in the best sense. When I first mentioned it to Osada his comment in whimsically broken English was “[Americans] dont eat there, only Japanese”. And although not entirely true, the place is frequented by Westerners and Asians alike, it is rooted in real sushi culture. In the spring of 2009 I found myself in New York for a speaking engagement; due to schedule, I was in and out in less than 24 hours. One thing I made sure of was a meal at Hatsuhana. I walked in straight from the airport to a nearly empty sushi bar, owed entirely to my late arrival. I started with one of my guilty pleasures, ankimo – cured and steamed monkfish liver served with ponzu and chives. I’ve long held the belief that you have to gain the trust of a sushi chef and there is no better way to their heart than to request a childhood favorite. I asked for sawagani which are unctuous and umami laden fried tiny fresh water crabs. Sadly I learned they are illegal in the US thanks to a frivolous law suit. Never the less, the gauntlet was thrown and when I asked the chef to chose for me the reward was spectacular. There is benefit of arriving very late at a place that prides it self on new fish daily. In an effort to make use of the ingredients that he was most proud of, I was literally spoiled for choice. What followed was a virtually private meal of non-stop piscine creativity. For once, it paid to be late.

My Top Kitchen Endeavors of 2009

As alluded to above, 2009 did not see a lot of kitchen time from me. I would like to think it was because I was too busy, which is in part true. Also the case, some of the passion was gone. Perhaps the former led to the later, or maybe it was experiencing so few inspiring meals (only 2 on this years list above, compared to 5-1o in years past). Regardless, I just did not feel as innovative or inspired as I have in years past. Two meals in particular proved the exception.

• The New Visits charity dinner in Lynchburg – Can you say ‘over the top’? We started by mailing a very simple “comfort food” menu to guests with items like ‘tomato soup with grilled cheese’ and ’southern barbaque’. The reality, at least my hope in how it was perceived, was very different. The tomato soup, pictured above to the left, was a gazpacho aspic with jalapeno and cucumber caviar. The bbq was all day braised pork belly served under a glass filled with apple wood smoke. It did not stop there – the salad nicoise was deconstructed and the olives had a surprising twist, they were liquid inside… the bisque was an sea urchin foam…liver and onions? foie gras torchon served with apple butter on a southern biscuit and shallot salt. It was a great night, well executed with expert help (hi family!).
• New Years Eve, aka the Sous Vide Experiment -  Of all of the things I have played with recently, sous vide has to be the technique that has me the most excited about cooking again. Sous Vide, or under vacuum, involves cooking foods sealed in vacuum bags submerged in a precisely controlled water bath. Put practically, if you want a piece of beef to be perfectly medium, say 134F, then why not cook it at that temperature? When you think about it that way, it makes perfect sense. The added benefit of the vacuum bag is there is no loss of moisture of flavor from the meat. In fact, you can infuse just about any flavor you want. It does not have to be meat either. Veggies can be perfectly cooked as well. For New Years Eve we started with a take on the croque madame – fine dice of home cured bacon lardons and brioche, a scant bit of aioli with some water cress for color all topped with a butter fried quail egg. It was a perfect one bite dish! We moved on to veal cheeks which had been cooked en sous vide for 8 hours in butter and a braising liquor of squab stock and aromatics. We capped off the meal with buffalo tenderloin that was also cooked en sous vide, enveloped in duck fat with just a hint of sage. Check out the menu here for the complete details.

The end of the decade was still a resplendent one in terms of dining in the Dawson world. I would be remiss to call myself anything but lucky. The thing that I am perhaps the most excited about is becoming invigorated again about spending time in the kitchen. Here is to eating in 2010!