Happiness as Competitive Advantage? A Challenge for Health Companies

company_happinessYou may be familiar with the Kingdom of Bhutan’s Gross National Happiness (GNH) index. This small Himalayan nation is the only country in the world that measures and aims for national happiness as its most important objective. The intent is to build an economy and culture based on spiritual values more than on material wealth. It prioritizes GNH over GDP. Bhutan’s commitment inspired the United Nations to pass a resolution that placed “happiness” on the global development agenda.

What does this have to do with you and the success of your company that’s in the business of health?? Potentially, a lot. As you read what follows, consider the notion of balancing both profitability and happiness as guiding values and major indicators of success.

Bhutan’s young King Khesar put it this way in his coronation address: Yet we must always remember that as our country, in these changing times finds immense new challenges and opportunities, whatever work we do, whatever goals we have – and no matter how these may change in this changing world – ultimately without peace, security and happiness we have nothing. That is the essence of the philosophy of Gross National Happiness. Our most important goal is the peace and happiness of our people and the security and sovereignty of the nation.

Most companies in the health industry base major business decisions on financial metrics like ROI to shareholders, quarterly numbers, and EBIDTA. Which makes sense. You need to be successfully financially and deliver a return to investors to be a going concern.

Money matters, no matter how dedicated your company is to improving health and saving lives. “No margin, no mission,” as the late Sister Irene Kraus, former CEO of the $3 billion Daughters of Charity National Health System, is credited as saying.

And, and… maybe happiness can matter just as much as money, and measurably contribute to your company’s financial success.  Especially since you’re in the business of health. Many start with employee happiness and well-being. Kaiser, Genentech, Mayo Clinic are a few of the health companies that have a reputation for really investing in the well-being –  and thereby the happiness – of their employees.  And there’s much further to go.

Let’s do a thought experiment: What would if happiness of your employees was a measure of your organization’s well-being? What about delivering  happiness to your customers?  Can you imagine happiness as part of your brand promise? Part of your unchanging core values? A key differentiator in highly competitive market? A metric you proudly talk about to shareholders and investors?

Be happy??

Companies in Healthcare: What Could Make You Disappear??

The healthcare industry is changing at an incredible pace. That means winners and losers. New companies emerging and existing companies going away. What could make your company disappear?

To be clear, by “make your company disappear” I don’t mean some super-powered ray gun or a natural disaster that would ‘poof!’ make your company suddenly vanish, dissolve, or fade away.  I’m asking seriously what could make your products, services, or company irrelevant, obsolete, or undesirable?

And I apologize. I know disappearing can be an unpleasant thing to think about. But it’s really important to think about, especially when you’re doing well. As you know, there is a plethora of products, services, and companies that were once great, and then succumbed to forces that made them disappear.

In today’s healthcare environment, just consider the impact of Meaningful Use or the MEDTECH Act; the shift toward value-based reimbursement or growing influence of GPOs; the proliferation of wearables and monitoring devices; and the health plays of leading tech companies like Apple and Google.

Any of these forces can position a few as market leaders, necessitate radical restructuring for many, make other companies disappear, and launch countless new startups to replace them. You want to stay strong. Be proactive. Don’t be one of the disappearing companies or a victim of circumstances.

First consider your company’s relationship with the market and healthcare business environment. Start with these five questions:

  1. What change in the market can make my products or services irrelevant, obsolete, or undesirable?
  2. What technological innovation can make my products or services irrelevant, obsolete, or undesirable?
  3. What shift in consumer behavior can make my products or services irrelevant, obsolete, or undesirable?
  4. What policy or regulation can make my products or services irrelevant, obsolete, or undesirable?
  5. What competitor can make my products or services irrelevant, obsolete, or undesirable?

Your answers should help you look beyond the present, see threats to your long-term viability, and proactively make plans to preserve your company’s existence and well-being. Think big picture, not just about what might replace your offerings, but what might integrate your technology into something bigger, like smartphones have integrated the functions of MP3 players. Consider too getting input from KOLs and customers to give you a more well-rounded perspective and greater certainty in your conclusions.

Now take a look at your own internal practices and beliefs, that if unchecked, can prevent you from being agile and responsive, and ultimately make you disappear. But don’t do this assessment unilaterally, get feedback from your team. Drawing on the innovation work of Dartmouth professor Vijay Govindarajan, think about these three traps that can make even highly successful companies flop. Do any apply to you?

  1. Major investments in systems or technologies can make it prohibitively expensive for you to move to newer and better tools. But the longer you stay with what you have, the harder it is to switch. Some call this the “sunk costs” fallacy.
  2. Fixation on what brought you success blinds you to new things that can threaten or displace you. You don’t see it until it’s too late. Then you respond with desperation. Sometimes “if it ain’t broken, don’t fix it” just does not apply.
  3. Hyperfocus on today’s marketplace can lead you to ignore new trends and market forces, and future opportunities and threats. You may be too wrapped up in the business to focus on the business. You’re all about today, and lose out on forward thinking.

Combine your answers to the first set of questions about your company’s relationship with the market and external environment, with your assessment of traps based on internal practices and beliefs. Be honest.

Stay strong. Don’t disappear!

Med Tech Product Managers: Persuading Your Management To Support Your Innovation

innovationJames is an experienced product manager at a large device company. He has a winning new population health idea supported by a strong business case.

James knows his new initiative will pivot the company well for the future of value-based reimbursement. He also knows that maintaining the status quo will be a death knell as the fee-for-service paradigm gradually disappears.

James has solid ROI projections and trend analytics to back it all up. He also knows his idea fits and delivers on the CEO’s stated vision for the company’s future.  He has pitched the idea up the management chain internally on several occasions.

The problem is James is not getting the support he needs from upper management. He gets heads nodding but no action. No commitment. Overall lukewarm reception.

Why? Because even though what James is proposing is sensible, timely, backed by facts, and aligned with the corporate vision,  it requires going in a direction that is unfamiliar to the company. It is perceived as an unknown. It is therefore seen as risky business.

What should James do? It doesn’t make sense to simply repeat the same arguments and expect a different result. He already made the best case he could. But he knows the window for competitive advantage is slipping away.

James needs other voices to give his bosses enough confidence to say yes and invest in what they know is a good idea and necessary for the company’s long-term viability, despite their concerns. These other voices need to be strong enough to overcome fear of change, fear of moving into an unfamiliar space.

James doesn’t need a large quantity of voices. Survey numbers won’t make his case more persuasive. The status quo thinking he needs to overcome is not rational. He needs to strategically manage relationships with his internal customers. Persuasion at an emotional level if required.

Specifically, James needs smart, influential people that genuinely share his thinking and who his bosses will listen to with open minds. That means select key opinion leaders and perhaps several important customers who will voice their agreement with three things: 1) The underlying premise about healthcare’s inevitable shift toward population health management and value-based reimbursement. 2) The recommendation to take proactive action now in order to be positioned to serve healthcare customers in the impending new business reality without losing viability in the current fee-for-service environment. 3) The reality that not taking action is the riskier choice.

The insights and recommendations need to be delivered carefully and strategically to be heard and take hold. Even if these influential voices are only echoing what James already said, when management hears it from them, it has a different impact.   It shifts the perception of risk away from stepping into new territory, and toward missing the boat by not moving forward with Jame’s idea.

There’s a lot of science and research behind how and why this works from studies of persuasion and decision-making. But bottom line, and like-it-or-not, James needs to marshall additional resources to persuade his upper management to move forward and with sufficient investment. The end result is management’s initial fears of change are allayed, they feel reasonably confident that they are moving forward in the right direction, and most likely, they say yes!

Patient Engagement: What Is It Really?

patient_engagementWhen a patient worries about their health condition, is that engagement? What about when a patient tracks their condition with wearables? Is a provider required for patient engagement to happen? Or is it only engagement when a patient is taking action to improve their condition?

A few years ago, health IT strategist Leonard Kish called patient engagement the “blockbuster drug of the century.” At HIMSS last week, there were numerous presentations on patient engagement and countless vendors offering patient engagement solutions. Yet, there is still no clear agreement as to what exactly patient engagement is, what it does, and how to measure it.

Let’s try to fix that. This first post in the series will focus on what patient engagement is.

We’ll start by defining what a patient is. (Interestingly, the word “patient” originally meant ‘one who suffers’ according to Wikipedia). The most common definition of a patient is simply someone receiving medical care. Note there is a connotation of passiveness in the notion of receiving care. The other relevant point is that receiving care requires interaction with someone who is providing the care. That means patient engagement requires a provider, not just a patient alone. So to be a patient, all someone needs to do is accept care from a provider.

What is engagement? I see engagement in degrees, from caring to understanding to acting. A patient is minimally engaged by virtue of caring about her health. She is more engaged when you actively work to understand her health. And she is deeply engaged when she is taking action – doing things – with the intent of improving her health.

One more component to add: Most patient engagement definitions include: a) participation, use of resources, and interaction with a provider, b) a goal of positive health behaviors, and c) an end result of health management or health improvement.

Put in all together and we have this definition of patient engagement:

Active participation of a person in their health and healthcare, which includes using resources, working with their provider, and taking action to understand, manage and improve their health condition.

How does this definition work for you? Any suggestions for improvement?

Now that we have a good working definition, we can move on to what patient engagement does, and how to measure it. Stay tuned!

Hot at HIMSS 2016: Interoperability, Population Health, Telehealth, Patient Engagement

I just got back from a jam-packed few days in Vegas for HIMSS 2016. Just me and 40,000 of my closest HIT friends.himss16

The mix was 2/3 vendors, 1/3 healthcare systems, I heard. Lots of excitement, lots of energy, lots of promise. Lots of walking.

As I step back, I see four main themes jump out: Interoperability, population health, telehealth, patient engagement. Here’s my quick take on each.

Interoperability: Getting devices to talk to each other, share data, and play nicely together for the higher good- better care, better outcomes. Along with improving mediating outcomes like workflow and reducing errors. Kudos to device and IT companies for sharing and letting go of turf. It’s certainly time.

Population health: All about prediction to figure out whom to provide what services to. Seems to be a modern version of managed care in terms of bottom line purpose, but driven by predictive analytics and with far more tailoring of care. The key piece still under-estimated is how hard it can be to get people to change health behaviors.

Telehealth: Keeps evolving to let more and more care and monitoring happen remotely (or “out-of-person” vs. “in-person”). Now it’s not just connecting provider and patient, it covers connecting providers and providers, providers, payers, and patients, etc. This will challenge our paradigm about what monitoring, diagnosing, and treating can only be done in-person. I think the litmus test for clinical care is empathy – to what extent can a provider truly empathize and thereby deeply understand a patient through mediating technology.

Patient engagement: Though it’s been around since the earliest days of healthcare, it now means all kinds of things and is catalyzing a wide variety of new products and services. Key issues here are about defining what it is and isn’t, developing objective metrics, and making it not a separate “thing,” but an integral and unavoidable part of every healthcare interaction.

Better interoperability behind the scenes, plus telehealth to enhance and extend relationships, combined with population health to focus resources, improves patient engagement to make it all matter.

What Is A Customer?

customerWhat is a Customer?

The simplest definition is: Someone who buys things from a business.

A better definition comes from Sam Walton, founder of Walmart. He says the customer is “… the boss. And he can fire everybody in the company, from the chairman on down, simply by spending his money somewhere else.”

Another good definition makes us think in human terms:  “Consumers are statistics. Customers are people.”

And finally a definition of customer that speaks to choice:  A party that receives or consumes products (goods or services) and has the ability to choose between different products and suppliers.

Pulling it all together, here’s my definition of customers for your consideration, which adds the dimension of why we make products to begin with.

Customers are people that products and services are designed to please. They choose what they buy and who they buy from,  which determines the success of companies that make and sell the products and services.

How do you define customers?

Let’s Stop Confusing Strategy and Tactics in Healthcare

strategyI can’t tell you how many times we’ve seen very smart healthcare companies – med tech companies, payers, provider organizations, etc., confuse strategy and tactics. And it reduces their effectiveness every time.

Why do strategy and tactics get confused? First, sometimes there is not clarity about what the real objective is and why. This subjects companies to the paradox Lewis Carroll described this way: “If you don’t know where you’re going, any road will get you there.”  Without a clear end point in mind, develop meaningful strategy to get there is very difficult.

Second, there is so much pressure to get new things to market, it makes it hard to carve out time and think strategically. There’s only time to “do” — even if what is being done doesn’t make good sense.

So what’s the difference? Strategy determines how you will achieve your goal. It represents which map you will use to get where you are going. Tactics are the map details and are all about the doing.

Let’s start with a couple military examples: 1) Divide and conquer is a strategy. Sending half the troops in a frontal assault and half on flanking maneuvers are the tactics that executes on the strategy. 2) Go big, go long, or go home, were the three strategies being considered in the Iraq war. How many troops would be where and when were the tactics, and that’s what got all the media coverage.

Marketing examples: 1) Be first to market is a strategy. Be a fast follower is an alternative strategy. The specific products or services you take to market, the resources you allocate, and the timing are all tactics. 2) First get prospects in the door with a low barrier to entry, then engage them to be customers is a strategy. How you will go about getting them in the door and converting them into customers are the tactics.

 

Don’t be one of the many companies that spend millions of dollars and years of effort on something only because their competitors are doing it. Have a good compelling reason. That way you know where you’re going and why.

Next be clear about what your strategy is, and why. Make sure your strategy is really strategy — and not tactics with the word  strategy attached. Then get into the tactics that execute on the strategy.

Lastly, make sure your team knows the difference between strategy and tactics and why it matters.

Bottom(s) Up! How a Benefits Ladder Can Help You Get Your Marketing Right

Medtech companies, health insurers, and healthcare systems talk a lot about data. My belief is no healthcare executives, providers, or consumers really care about “data.” What they do care about is making good decisions that will measurably improve healthcare and health outcomes, and make or save money. And they see data as a means to those ends, a tool for making those things happen.

So how do you meaningfully connect data with decisions and decisions with outcomes? How do you work in the interim outcomes like improved workflow and increased productivity? How do you know which features and benefits to emphasize and which not to emphasize or even mention? How do you determine what elements to consider including in your value proposition?

One powerful technique we use to identify and prioritize benefits is laddering. We use it in deep dives with clients, and in testing or validating hypotheses during customer research.

Here’s how it works:

At the bottom of the ladder is the essential feature. At the top is the highest level benefit or result.

But first, let’s clarify the difference between features and benefits: Features=description. Benefits=satisfaction. Data is a feature. Good decisions, better workflow, improved quality of care – those are benefits. Those are results that provide satisfaction.

And there are different kinds of benefits (some overlapping): There are core benefits, functional benefits, aesthetic benefits, self-expressive benefits, emotional benefits, and more.

Benefits are what customers care about. But sometimes inside the company, executives, product managers, and marketing managers care more about features. That’s a problem that laddering can help ameliorate.

Here’s what a simple benefits ladder might look like for streaming analytics within health IT, to appeal to healthcare providers.

TOP

  • Improved Outcomes
  • Safer Patients
  • Enhanced Reputation
  • Better Care
  • Faster Decisions
  • Prediction
  • Analytics
  • Data

BOTTOM

Note that the core fundamental feature – data – is on the bottom. Just above that is the next level feature – analytics. Next we move up into benefits, starting with the functional benefit of prediction, which then leads to faster decisions. This set of four captures very concretely what the product is and does. And if we were to unpack these four further, we would get into workflow, efficiency, and productivity.

However as a set, the bottom four rungs on the ladder do not convey aspirations or emotions. And they do not express higher order benefits or results. For that, we need to go higher up the ladder.

A result of faster and therefore better decisions is better care. Which leads to multiple higher order benefits – like enhanced reputation, healthier patients, and better outcomes. And again, unpack these further and you’ll find patient satisfaction, HEDIS scores, etc. Some of these benefits may be produced concurrently, but for simplicity the ladder shows them in linear fashion.

When we go through this process in internal deep dives, we’ll invite clients to attach a heart to the one benefit they believe is the most compelling emotional hook for the product. For providers and streaming analytics… is it faster decisions, enhanced reputation, better outcomes? Is it improved workflow or its outgrowth, saving time?

The ladder they create and the emotional hook they select are well-educated hypotheses. We rely on the voice of the customer for validation or correction.

Bottom line, laddering is a great way to think through what your product or service delivers that matters to customers so you can improve your marketing. Do one for each of your main target audiences. When you do, you’ll notice the bottom rungs of the ladder are the same, it’s typically the higher order benefits that change.

Whether you’re bringing a new product or service to market or need to get better uptake with what you’re already selling, try laddering. It will enable you to transform your thinking, empathize with your customer point of view, inform your value proposition, and set yourself up for marketing success.

What’s your ladder??

Customer or Money: Which Comes First in Med Tech?

As a strategic-thinking med device marketing or sales professional, you know it’s all about putting the customer first. But how do you get your company executives behind you if they’re solely focused on hitting the quarterly numbers and only paying lip service to being customer-centric?

This was the focus of a session I presented yesterday with Mark Kesti at the first Medical Device Marketing Summit, put together by the inimitable Joe Hage.

The goal was to stir up fresh thinking and provide both practical and contrarian tools to win greater company support for practicing customer intimacy and putting the customer first in marketing and communications work. The participants were seasoned and smart. Lively discussion generated good, practical ideas.

Here are five key takeaways:

  1. First means first: Putting the customer first literally means just that- putting the customer first. How? Give the customer a voice when it matters. That translates into giving the customer a voice before you decide on what products to invest in, before you determine technical feasibility for your device or software, before you put your messaging together, and before your sales force hit the streets.
  2. Problems not solutions: When you do give your customers a voice, be sure you’re not asking them to design the solution. That’s your job. Ask them to talk about what is and isn’t working, what problems they want solved, and what a better end state would be like. Don’t ask them what the product should be or what your marketing should look like. NTJ (not their job)!
  3. Direct connection: Get your technical people – scientists and engineers – involved with customers early on. Let them hear problems, concerns, likes and dislikes directly from the customer, not mediated through a report you give them. Help your technical team to experience customer pain points as much as possible. This is where qualitative research methodologies shine.
  4. Money metrics: Not all dollars are equal. Some come at the expense of long-term customer relationships, like through hitting your numbers by heavy end of year discounts. In companies committed to customer intimacy, the lifetime value of a customer trumps hitting quarterly numbers every time. Caveat: Shareholders may not agree. You have to balance the sometimes conflicting needs of two masters in that case: shareholders and customers. Ideally you have shareholders who see the value of long-term gains.
  5. Behavior before beliefs: Let’s say your CEO, doesn’t believe in putting the customer first. He’s all about the money and that mindset pervades the culture. You can beat this too. But don’t try to change his beliefs at first. Get his behaviors to change. Pitch putting the customer first as all about making more money. Speak in ROI terms. Because it’s true. Putting the customer first does make more money.

__________

More here:

3 Powerful “B4’s” that Put First Things First in Winning Innovation

“But We’ve Always Done It That Way” – Zen, Zero-Based Thinking, and a Fresh Approach

How to Get to Breakthrough Innovation: Desirability First!

Brains, Brawn, or Beauty: What’s Your Value Prop?

brain-brawn-beautyIn today’s hyper-competitive healthcare marketplace, getting your value prop right is critical to position your product to win. To open your thinking about the myriad of value prop possibilities, consider the triad popularized in popular entertainment: Brains, brawn, and beauty.

Yup, brains, brawn, and beauty. Like it or not, there’s lots that we in healthcare marketing can learn from what sells in popular entertainment.

For example, the long-running competitive reality TV show Survivor groups its castaways into tribes, like this:

The members of the “Brains” tribe use their intellect to get by in life; while the members of the “Beauty” tribe use their looks and social skills, and the members of the “Brawn” tribe use their brute strength. When put all three traits together, they actually make up the Survivor motto: Outwit (“Brains”), Outplay (“Beauty”), Outlast (“Brawn”).

Now apply the “brains, brawn, beauty” trope to see if it usefully expands your thinking about value proposition possibilities. Of course, do the customer and competitive research to both generate ideas to explore and verify what works.

As a starting point, recognize that most med tech value props emphasize “brains” in terms of smarter technology of some sort. Instead, consider winning at “brawn.” That would center your value prop on the idea of being the workhorse device or the most powerful technology, not necessarily the one that deals with the most complex situations.

Alternatively, you might win at “beauty” by having the most aesthetically pleasing and user-friendly product. This requires being able to score “cool” points and might mean you don’t provide advanced functionalities.

That said, in both cases, you still need to demonstrate parity in “brains” – or at least sufficient table stakes, to be considered a serious contender. However, it may lead to a value prop that stands out based on a meaningful and distinctive strength, and that doesn’t get lost with a “me too” claim with no emotional resonance.

Bottom line, think outside the box about what makes your offering unique and valuable. Will you win with brains, brawn, or beauty??