Will the Truth Destroy Us?

Julian-Assange-Cuero1In the New Testament (John 8:32) it was written that, “you will know the truth, and the truth will set you free.” That certainly hasn’t been the recent experience of Julian Assange and Eric Snowden, but then discretion is not always the better part of valor where personal bravery involves risking the lives of others without their knowledge or consent.Snowden

This post is not directly about healthcare public policy, but I don’t think Pub visitors will have to search too hard to see relevant application. And if you bear with me, I try to bring it back home in the end.

In the history of our world great strategic advantages – as often manifested in terms of wealth, power and influence – have been gained through the ability to possess (and then act upon) knowledge and information that others do not. And unfortunately, a lot of public policy throughout history has been crafted and enacted for similar purposes with varying degrees of actual or perceived intent.

Now consider that historic reality in the context of what we are witnessing today with the accelerating proliferation of intentional (and unintentional) electronic content being made available to millions upon millions of individuals at the click of a mouse. Consider it too in recognition of the rogue efforts of Messrs. Assange and Snowden who have ensconced themselves in cloaks of social consciousness that to many of us look a lot more like what Andy Worhal had in mind when he coined the phrase, “in the future, everyone will be world-famous for 15 minutes.”

Whether this emerging phenomenon is couched in the recreational context of social media, the enterprise context of online marketing and promotion or the aforementioned often invoked public policy context of transparency – the resulting abject conundrum facing modern societies and public policy makers is mind boggling. Whosoever has said they would like to know the mind of God has only to reflect upon this reality a bit to know how impossible that is to even begin imagining.

As I see it, there are three aspects to assessing this phenomenon: access, discernment and reasoning. Of these, I think access is the most difficult to assess in terms of its ability to be socially impactful. On one level, it is the great equalizer – the rallying cry of anyone who believes oppression is caused by those who withhold information for the sake of power and influence. On another level, its true value is primarily dependent upon the other two aspects.

To demonstrate, think of the game of Poker. Playing a hand of five-card stud with all cards up ensures everyone has the same information at the same time – yet anyone who has ever played knows there is much more to winning than just knowing what everyone else can see. I am again reminded of that most famous quote from Sun Tzu: “All men can see these tactics whereby I conquer, but what none can see is the strategy out of which victory is evolved.” From a public policy perspective, the point is not to confuse promoting access with promoting equality: one does not infer the other without discernment and reason.

Discernment, in turn, cuts the value of access in half, or worse. It represents the ultimate double-edged sword of information management because it is just as easy to manufacture disinformation as it is to make available factual information. Actually, it is in fact easier to create disinformation because the burden of proof is relieved. Being able to discern one from the other, therefore – and to do so more quickly than the next person – will have tremendous strategic advantages in the future. And those who innovate the means to accelerate the process of reliable discernment stand to be very rich.

In what is a sad irony, a key role of government based on history should be the promulgation of public policy that helps effectuate discernment. But the relationship between information and power referenced above is a vicious and virtual simultaneous equation in this electronic age, and nowhere is that relationship more complex and threatening than where it involves elected officials. Just throw corruption into the mix and not only do you have the fox guarding the hen house but now also the lack of any accountability for who put the fox in charge.

And finally of course, although access and discernment may go a long way to at least conceptually equalize the playing field in providing the information needed to make decisions and judgments, that certainly does not ensure everyone of having the same ability to perform either. And this is where I think the unenlightened disconnect of the Gen X and Gen Y generations becomes truly evident. That is not a criticism, but rather a factual reality just as much as one day equals 24 hours while two days equals 48.

To my understanding, the human mind cannot be trained through study or discourse to accomplish the same functional abilities that can be gained through experience. For a wonderful treatise on this subject-matter I once again refer Pub visitors to Malcolm Glawell’s work, Blink. To state this point more plainly, data becomes information when it is organized; information becomes knowledge when it is analyzed; knowledge becomes wisdom when and only as it is allowed to age and gain from the benefit of life’s experiences.

Thus, having more data (i.e., Big Data) can advance the creation of more knowledge and information – but it cannot advance the creation of wisdom, at least not human wisdom (Watson and the like are another story). And this now brings us back full circle to healthcare policy. A lot of people have benefitted and been able to live healthier lives because of the wisdom of healthcare providers, and in particular nurses and physicians. If there were one guiding principal I would like to posit with respect to the development of policies that will impact the storage, dissemination and flow of electronic information in the future, it would be that such policy should not seek to promote the advancement of knowledge and information at the expense of wisdom.




“The Doctor Will Skype You Now . . .”

healthcare-marketing2-300x199In this month’s edition of the McKinsey Quarterly is an insightful article: Six social-media skills every leader needs.  If you are either currently – or aspiring to be – in a position of managerial leadership at any level of your organization and plan to work for more than a few more years, this is an article you need to read.

And if you are working in healthcare, I think you will find the personal and organizational ramifications of the Six Dimensions of Social-Media-Literate Leadership model presented in the article to be particularly exciting – and troubling.  Because of the inherent nature of the industry’s product (i.e., human health), the potential benefits and threats presented by social media are accordingly heightened.  When messaging distribution spins out of control and goes viral at a manufacturing concern someone could lose face.  When messaging gets convoluted in a hospital someone could lose their life.

The opportunities for creating organizational value through social media are vast and still largely untapped.  For example, the ability to engage and capture a broad spectrum of individual thinking; the ability to facilitate collaboration and engagement across social and cultural barriers; the ability to build brand loyalty through direct communication; the ability to accelerate innovation.

The other side of the social media sword is just a sharp – and even more so in healthcare.  Risks of individual privacy are at the forefront.  But there are also tremendous risks associated with distribution of disinformation, as well as the misuse and/or misunderstanding of credible information.

As the article points out, “the leader’s task is to marry vertical accountability with networked horizontal collaboration in a way that is not mutually destructive.”  How is this done? I have highlighted below the key points I took out of the article.

Accept Reality
Whether appreciated or not, social-media is a transformative disruption that is changing the way organizations operate (their structure, their strategic positioning, their business models).  The article describes McKinsey’s work with General Electric’s leadership in their social-media-transformation.  It is not a fad of the entertainment-minded pre-Baby Boomer generations.  Ignore its implications on the future at your own peril.

Learn to Let Go
The days of being able to carefully plan, construct and deliver your message via traditional forms of media (i.e., whether through print, e-mail or video) are quickly waning.  Today’s distribution network has been turned upside down: the message often starts with social communication and then gets crafted, molded and morphed into new meaning as it cascades upward through organizational hierarchies.  Recognize sooner rather than later what this means for your ability to control messaging.

Embrace – and Learn – Media Technology
In social-media risk mitigation, the best offense is a good defense.  The sheer volume of information bits from e-mail distribution, networking and news aggregation is overwhelming for most of us.  Being able to use tools that help navigate and focus your attention on highest priorities is essential.  Also being able to understand when, how and in what context your messaging will be received should help guide your communication style.  There are some wonderful software applications to increase your abilities in this area.

Stay Tuned In
Part of GE’s Leadership Explorations program includes reverse mentoring, where senior leadership is able to engage with media-savvy millennials to accelerate their knowledge and understanding of emerging social-media technology and applications.  Staying on top of the social-media evolution takes precious time that has to be diverted from more meaningful endeavors.  In other words, time has to be made to stay on top of it.

Be Cognizant and Be Careful
If you are familiar with the old adage, Some things are better left unsaid, then internalize that phrase and broaden its application to any potential means of sharing a thought via social media.  I have been personally mindful of the line from Kipling’s poem, If: “If you can bear to hear the truth you’ve spoken twisted by knaves to make a trap for fools . . .”  Unfortunately, that
is an inherent risk that comes with raw and transparent communication. 

Healthcare organizations – and their leadership teams – that “get” the socially and culturally transformative implications of social-media will note in the model presented by McKinsey aspects that reflect their own evolution.  They will be able to recognize and identify with the opportunities and challenges presented because they have already begun to experience both firsthand.

For those who don’t get social-media, well as was written in a Western Union internal memo in 1876, “this ‘telephone’ has too many shortcomings to be seriously considered as a means of communication.  The device is inherently of no value to us.”


Consumer-Driven Senior Care

In a recent article published in Beckers Hospital Review:   6 Trends in an Era of Consumer-Driven Healthcare, hospital executives were provided with the strategic implications of current and emerging trends in consumerism.  These same trends will undoubtedly impact organizations that provide senior housing, aging services and post-acute/long-term care.  Understanding, analyzing and developing strategies to address the challenges and benefits from opportunities presented by/offered as the Baby Boomer generation begins to hold sway over the healthcare delivery system will be important for both providers, as well as policymakers.  So I thought it might be useful to try and interpret the key themes presented in that article from the perspective of senior housing and care (SHC) organizations.

Key Trend 1: Transparency
The Affordable Care Act specifically focuses on two areas of transparency: the gathering, assembly, analysis and reporting of clinical and operational data by healthcare providers (e.g., provisions found in the Elder Justice Act ~ Sec. 6703 of the Affordable Care Act); and the assimilation of comparative cost/benefit – i.e., value – information and analysis, particularly relating to provider charges and third-party reimbursement of same (e.g., Health Insurance Exchanges).

With or without the constitutionality of the Affordable Care Act, the message here for SHC providers is quite simple: get used to it.  Nay, if you want to be around in another decade, embrace it.  We are accelerating toward a period of time during which provider culture will be predominantly impacted by data-driven marketing, clinical performance, operational efficiency and financial reality.  And the watchdog enforcing voluntary compliance will not be CMS, state governments or private accreditation: it will be your own stakeholders and constituents.

Key Trend 2: Social Media
People talk – and, of course, people with more time on their hands talk more.  Evidenced by the well-documented social mobilization of the 1960s and 1970s – Boomers know how to communicate.  The intriguing, albeit sometimes almost depressing, realities of electronic social networking offer a challenging conundrum to SHC organizations.  Many, if not most, healthcare providers have embraced that reality in one form or another – whether that’s physicians communicating with patients via e-mail, hospitals using online YouTube videos to promote post-discharge wellness education or organizations like MorseLife in Florida developing an iPhone app (the MorseLife All) that connects seniors in its market to their campus.

Connecting in real time, however, carries with it a variety of challenges and opportunities.  The clinical side of healthcare (the side that can save your life) requires a keen sense of discipline and objectivity – two elements largely vacant in much of social media.  But there seems to be very little standing in the way of information – and misinformation – being haphazardly propagated as proxy for clinical expertise via such media.  Consumers recognize this risk, and that will offer an opportunity for SHC providers to be positioned within social media based upon their credibility, expertise and authority.  Recognizing this has important implications for brand management.

Key Trend 3: Consumer Empowerment
The underlying objective of increased transparency, access to comparative outcome analytics and evidence-based healthcare/medicine is, of course, to help position the healthcare consumer to be in a position to better advocate for their own healthcare. The benefits of such empowerment, however, will necessarily be tempered to the extent the targeted audience is unable to take full advantage. As we know, this is often true of a senior population that may face a variety of obstacles (e.g., mobility outside the home, effects of medication, propensity toward dementia). For good or ill, it will likely fall upon SHC organizations to play a proactive advocacy role for many disenfranchised seniors.

And this will put those providers in a potentially perilous position. Being an advocate usually necessitates having a healthy dose of skepticism. It is difficult, at best, to challenge and defend at the same time. It is sort of like playing a game against yourself: you will always win – and lose. But that is what innovation is all about – finding value-added solutions where none were thought to exist. Those organizations that develop innovative approaches to consumer advocacy for the senior population in ways that add value to all stakeholders will find huge competitive advantages in the future.

Key Trend 4: Consumer Expectations
Much has been written regarding the comparative demands of the Boomer Generation relative to previous generations, but demographically we have really only begun to see this manifested where product and service offerings target the 55 – 65 age cohort (e.g., Active Adult communities, age-defying miracle cures and, of course, Harleys).  But where those Boomer consumers have begun to make their mark the evidence of their purchasing sophistication and discernment is compelling.

Boomers demand value.  And as written in this space before, value in healthcare must be understood as providing better patient experiences and outcomes at an overall lower aggregate cost.  So while value is emerging as the driving force of third-party payer expectations (whether that is from employers, private insurers or Medicare/Medicaid), it will also be the driving force of the empowered consumer.  The message for SHC providers is clear: think value first, often and always.

Key Trend 5: Consumer Outreach
The proliferation of electronic communication media offers some very compelling opportunities for SHC providers to “connect” with their targeted markets.  In doing so, however, it is important to recognize how many other sources are competing for the attention of individuals in those markets.  While I recognized that at a theoretical level, this blog has been a firsthand experience of having to reconcile your individual perceptions on the value of content produced with the actual level of interest generated.

As I have been making the point in presentations on Healthcare Reform, if we get everything else right – increasing access, improving affordability, bending the cost curve, expanding the caregiving labor force – but fail to improve upon the overall health and wellness of our society, we will have failed miserably in creating a healthcare delivery system that is sustainable.  SHC providers are very uniquely positioned to leverage the benefits and advantages that electronic media can offer to help improve the overall health and wellness of the senior population in their communities.  And such efforts will find great synergy with other strategic efforts to develop integrated care and home and community-based delivery models.

I think SHC providers have more to gain than lose by being proactive in embracing Consumer-Driven Healthcare.  What do you think?

  ~ Sparky