Dodge client Tim Kelly from Dialog Medical attended the Institute for Healthcare Improvement’s National Forum this week and came away impressed with outgoing CMS Administrator Dr. Donald Berwick’s presentation on the six major causes of healthcare waste in the US. He provides additional insights in this post.

Donald Berwick, MD, former CMS Administrator, spoke at the Institute for Healthcare Improvement’s National Forum on Wednesday. Dr. Berwick helped found the IHI and served as its President until he was chosen to head the Centers for Medicare & Medicaid Services 16 months ago. Berwick resigned from CMS last Friday as it became clear that his appointment would not be confirmed by the Senate. Dr. Berwick is a charismatic leader and is universally respected in the medical community, particularly for his initiatives to improve patient safety. The IHI attendees heard a thoughtful discussion of the six major causes of healthcare waste in the US. These included:  overtreatment, failures of care coordination, failures of reliability-poor execution, administrative complexity, pricing failures, and fraud and abuse.  Dr. Berwick also shared his recommendations on five principles to guide our efforts to reduce that expense – costs that exceed $1 trillion each year.

Two of Dr. Berwick’s comments, in particular, resonate strongly with the efforts of those of us in the healthcare IT community to improve the delivery of care. First, Berwick encouraged the audience to, “do everything.” No single or small collection of initiatives will solve the challenges that face us.  The corollary to that comment is to “start at scale…pilots will not suffice.” The clients we support would prefer to do projects sequentially and slowly. We serve Dr. Berwick’s vision if we take the steps and shoulder the tasks that, in turn, allow our customers to be ambitious and sweeping in their undertakings.

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“e-Patient Dave” deBronkart was diagnosed in January 2007 with Stage IV, Grade 4 renal cell carcinoma (kidney cancer) at a very late stage. His median survival time at diagnosis was just 24 weeks; with tumors in both lungs, several bones, and muscle tissue. He received treatment at Boston’s Beth Israel Deaconess Medical Center: his surgeon removed the extensive mess and the Biologic Therapy program helped him participate in a clinical trial for the powerful but severe High Dosage Interleukin-2 (HDIL-2). His last treatment was July 23, 2007, and by September it was clear he’d beaten the disease.

An accomplished speaker and writer in his professional life before his illness, today Dave is actively engaged in opening health care information directly to patients on an unprecedented level, thus creating a new dynamic in how information is delivered, accessed and used by the patient. He is the recent author of Laugh, Sing and Eat Like a Pig. In this Q&A post, he explores the intersection of his marketing background with current patient empowerment efforts.

1. Tell me a little about your marketing career prior to embarking on your ePatient Dave “calling,” as you’ve described it.

I’ve been in high tech all my life, though not always in what we’d think of as high tech today. For instance, typesetting machines – I worked on some of the earliest computerized typesetters (modified IBM Selectric typewriters). I was a product manager for a typesetting manufacturer, and I wrote product information (making complex subjects accessible to lay readers). I helped move high-end technology downstream, giving speeches at sales meetings and conferences to evangelize new things. When I was 28, I gave a product demo speech at a newspaper convention and had people lining up for 45 minutes to get in. That was fun.

I’ve long been a fan of automation and data-driven workflows. Twenty years ago I helped create a highly automated typesetting system for Business Card Service, the world’s most automated stationery printer.

Ten years ago I presented a paper in Paris (http://www.gca.org/papers/xmleurope2000/author/s23-01auth1.html) on how to use XML for data-driven digital printing, which at the time was a brand new technology. Keep in mind that one key to value in that industry was relevance: properly used, personalized print delivers more relevant content to each recipient, which earns more “dwell time” in the mind, which converts directly into more conversions and more sales.

That became relevant to me a few years ago when I became my employer’s webmaster and got into PPC (pay-per-click) advertising, which is all about understanding what’s in the mind of the person you’re trying to reach, and presenting them with quick hits that are authentically relevant.

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Rob Culbert is the president of Culbert Healthcare Solutions, a professional services firm serving healthcare organizations in the areas of operations management, revenue cycle, clinical transformation and information technology. In this blog post, he stresses the need for successful alignment strategies.

The healthcare industry is buzzing right now about accountable care organizations (ACOs) and other models of community physician/hospital alignment. In a “back to the future” movement faintly reminiscent of the 1990s, hospitals, health systems, and community physicians are once again considering the advantages and disadvantages of various alliance strategies. A big difference this time around, however, is technology.

The ACO concept is an attempt to improve patient care and lower its cost through shared responsibility and reimbursement across the continuum of care. It’s one of many burgeoning initiatives designed to promote less-expensive, better-quality preventive measures rather than more costly acute care. While still in its infancy, it nevertheless is rapidly pushing hospitals and physicians toward more collaborative, coordinated operations.

What’s important to understand about ACOs—and other physician/hospital alignment strategies—is why they are taking off now. I believe the answer involves both the complexities and the opportunities offered by electronic health record (EHR) technology. (more…)

Dr. Neil Baum is a nationally recognized urologist, speaker and author. His most recent book, Marketing Your Clinical Practices: Ethically, Effectively, Economically, Fourth Edition, is an updated and revised edition of the best selling guide to medical practice marketing, including new topics and advanced techniques. Dr. Baum also provides thoughts on various topics through his blog.

Times are tough for doctors. Reimbursements are decreasing and overhead costs are escalating. As a result, doctors’ incomes are declining. There are no signs that the current administration is going to resolve this situation to the benefit of physicians and their practices. So what are doctors to do? I suggest implementing a marketing strategy during these difficult times.

Here’s a little historical perspective:

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In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

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In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

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In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

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In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

Jack Beaudoin, Vice President, Content & COO, MedTech Publishing Company (publisher of Healthcare IT News and Healthcare Finance News):  In the late 1990s I was hired away from my first daily paper by its larger and more metropolitan competitor. When I arrived, I was told I was part of a plan to put my previous employer out of business. That was silly, I replied. Just wait five years — all my readers were over 70 and the newspaper would go out of business on its own accord. In fact, that little daily is still publishing today and it’s the big metro paper that was on the brink of extinction this past winter.

News of the death of print – and of print readers – has been greatly exaggerated, to borrow from Mark Twain. We’ve been eulogizing it for 20 years and the damn thing won’t die. Fact is, some print publications will turn out the lights, and others will continue to press on, and a few will even thrive.  I happen to think that in some use cases, newspapers and magazine remain superior media to their electronic cousins.

Certainly, the Web, email, social networks, smart phones, e-readers and other devices show that print isn’t ideal for all use cases. What I think is generally true, however, is that no single medium is ideal for all use cases. For example, Healthcare IT News and Healthcare Finance News readers repeatedly demonstrate an appetite for trustworthy, source-supported news across multiple media. Information is consumed at different times, by different people, for different reasons. The role of publishers is to provide content that readers value when they want it, using the medium of their choosing.

(Incidentally, this is a lesson clinicians are teaching: they may have a preferred way of adding data to a health record, but they likely don’t have one way. Relevant data ought to be populated by voice, by writing, by scanning and by keying — all depending on the immediate context and circumstances.)

I don’t believe the closing of a single print publication portends the death of print anymore than the closure or acquisition of a single healthcare IT vendor suggests that the industry itself is in danger. Publishing is emerging from what some are calling the worst 18 months in a generation and, sadly, there was bound to be a shakeout. As for the future, the unique role that print once played has already been diminished, but print will still have a role to play.

In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

 Anthony Guerra, Founder/Editor, HealthSystemCIO.com: Print media is dying, but it’s got little to do with the traditional reasons cited for why an online vehicle is so much more powerful. Most editors and analysts note that information can be brought to the reader faster online, and therefore by comparison print — with its two-month lag times between story assignment and publication — just cannot offer the same compelling content it once did. Of course, Web sites also count audio and video among their advantages over print, as well as the ability to bring readers into the content creation process through commenting and blogging. While all these reasons help explain why online is defeating print from the readers’ point of view, that’s not what’s putting magazines out of business.

Print magazines are going out of business for two reasons:

1 — Online is simply a better buy — Media buyers must explain to their managers exactly what benefits have been gained from their spending. To be clear, there must be a direct connection between marketing dollars spent and SALES — the greater the evidence that can be provided to a media buyer about the results of their spending, the better they can determine the value of that spending, and decide whether to continue it. Vehicles which afford more precise feedback about their effectiveness are FUNDAMENTALLY more attractive to buyers than those which cannot be measured.

For example, everyone in the print business knows about the BPA and their circulation statements. The most these statements do for a buyer is give some indication of the “list” — though enough telemarketing dollars can generally get any publication the list it wants. But the list number is largely irrelevant. When I’m talking to potential buyers about my stats, I don’t even mention the list. I could have a list of 100,000 – what’s the point to a buyer if no one is opening the enewsletter? List and open rate are both silly numbers to convey when trying to attract a buyer because they give little information about those who will actually see the buyer’s advertisement. The only numbers that I want to convey are impressions, opens and clickthroughs. Those numbers are real, can’t be faked and, depending on your content, can tell buyers a heck of a lot about your readers.

In the print world, BPA just tells the list number. There is no way to gage either opens or impressions, so fundamentally it is a “faith” buy. As a buyer, it’s much easier to prove you’ve spent the company’s money well by requesting tamper-proof Google Analytics reports from your media partner. To the media buyer, online is simply a better mousetrap because they can determine know how many mice have bitten the cheese. They no longer have to take the mousetrap peddlers word for it.  

Since it’s clear online is the better media buy, dollars will continue to flow in that direction. Now, we come to the part of the story where the buyer must decide WHICH online venue to use for its outreach. Fundamentally, online-only outlets will outperform print/online outfits because they can focus all their attention on that one medium. Greater focus will always yield higher quality.

2 — Print magazines have bloated infrastructures that cannot support their declining revenues. The success of a business is not measured by revenues. Those revenues only have meaning when compared to expenses – this is the margin or profit. Print publications may have revenues 10 times greater than their online competitors, but their expenses are tremendous. Obviously the publication that just went out of business found itself in a position where the gap between top line revenues and expenses ceased to exist.

With better, fresher content for readers, more concrete feedback about results for media buyers and a compelling business model, online will continue to attract more and more marketing dollars. Print magazines will either quickly move their resources online and develop a plan to phase out paper-based production or cease to exist. The future is online. The only question is who’s coming along for the ride?   

In the latest installment in a series, a healthcare editor responds to the question – is print media dying? To view earlier installments please click here.

Mark Hagland, Editor-in-Chief, Healthcare Informatics: I don’t believe that “print is dying” in the healthcare IT space at all. What I do believe is that our space has been, and will remain, a competitive one, with very demanding editorial and presentation requirements for all entrants. Specifically in the healthcare IT trade media arena, everyone recognizes that this is a crowded space, which adds to the challenges. What I believe is that success will necessarily involve a combination of a very strong online presence and a very strong core print foundation, with synergy between the two spheres. Outside the healthcare IT trade space, the picture is more complicated, obviously, so I’ll restrict my comments to our area.