Originally Posted August 2, 2006

In the launch of Dollar Philanthropy, where I have offically outted myself as a blogger to family, friends, neighbors and acquaintances, I have discovered that there are a number of people who still look upon blogging with skeptical eyes. Many don’t understand the facination and others are convinced that blogging is just an outlet for angry, troubled, and hostile adults or that it is just something for kids.

With the announcement, I also received responses from a number of folks who had not ventured into the blogosphere, but who admitted that they had been curious. A few have been willing to suspend judgement and have agreed to tip their toe into the world of blogs. With that said, I wanted to take a few moments to wax philosophical about blogging.

so……….I think it is important for individuals to refrain from defining blogging by the individuals that do it. Instead, people should look at it as a technology and a tool that can be used to communicate information that can be accessed 24/7.

You Don’t Have to be Like Ann Coulter

Blogging can be used for other things besides boldly expressing your opinion. One example of this is a newly published blog, by an experienced blogger and 5th grade teacher, for her students and students’ families. Stoddert5 is the blog of Rachel Henighan who is returning to her Washington DC school after a fellowship in Mongolia. The tone of her blog mimics the intercom announcements I remember from school where the principal gave important information for the day. Rachel introduces herself and gives some important and interesting information about her life. She also describes what a blog is and how she plans on using the technology to add depth to the classroom experience.

She also encourages the blog to be a forum and clearly is using the technology as one part of her classroom communication strategy.

You can also use the blog as a way to communicate with me. The “e-mail me” link connects directly to my address. You can also “Post a Comment” that can be viewed on the site by all visitors. This might be a good way to support a student’s work. I will also be happy to post notes you need to communicate with other classroom parents.

Whatever is posted here on Stoddert5 will also be available in hard copy for families who have limited access to the internet. I am also happy to spend time helping family members learn how to navigate this blog if it seems too challenging.

“It is hard to teach an old dog new tricks.”

This is just a BIG FAT LIE! If you are open to using blogging technologies in creative ways, you will learn that they have the potential of making communication much, much easier. They do this by:

• being available 24 hours a day and 7 days a week. This means that people can find information when they are looking for it.
• being syndicated which means that people subscribe to a feed (bloglines or newsgator) and get the information delivered to them at the time they are prepared to listen
• being a searchable archived set of content. This means that you enter the information once and the information is available as the need arises.

In my view, blogs are perfect for educating and keeping people informed. If you are buying this notion, then you will see how blogs can be used in many areas for many different groups. They can be used by:

• managed care companies for providing information about processes and plan updates
• teachers and schools for classroom and parent communication
• nonprofits for announcements, cause related news, fundraising events and donor communication
• healthcare organizations for introducing new providers, patient education and information about accessing services
• professional speakers and authors for giving people glimpses into you as a person and the topics on which you speak

So if you are new to reading blogs, considering starting a blog or are one of those people who proclaims that blogs are stupid, consider the technology and the creative ways you can use it.

Tags: blogs, teachers, classroom communication, healthcare communication, nonprofit communication, managed care, education, classroom, school

Lately, I had a few moments to sit down and indulge in some absurd hours of quality TV time catching up on all of my missed episodes of Poirot and Midsomer Murders. During that time, commercials came, were muted and then I was returned back to my indulgent, guilty pleasure of doing nothing and watching TV.

At that time, one series of commercials always scared me and made me gasp– even after the second and third run. I have not seen them since, but I still remember the company and product. They were Volkswagon commercials where there are a car full of people driving along talking about mundane things (the funniest being the men talking about the side effects disclaimer of DTC advertising of ED medications) and then from out of nowhere– CRASH! Head on, side impact– in the filming the other car just appears. Then the commercial closes with everyone out of the car, shocked but ok— illustrating the safety of the vehicles. Click here and select “Like” to see one of the ads.

In a new spin on using the unexpected, State Farm has started the “Now What” ad campaign. They are using a series of short films where bad things unexpectedly happen to people’s property and then you see the logo and webaddress for the “Now What” campaign. Which — in no longer than it took to fire up old bessie, had me typing in the web address and seeing what all of this is about.

Why does this work so well and how can we use it in healthcare?

In Chip and Dan Heath’s book, Made to Stick: Why Some Ideas Survive and Others Die, they spend a whole chapter on explaining why surprise works in marketing. One reason why the unexpected works is that it grabs a person’s attention and stimulates an emotion within the person. Such is my experience with the VW ad.

As for the “Now What” campaign, it worked for me because it surprised me and then left me hanging. The Heath brothers explain this in the terms of The Gap Theory of Curiosity- originally articulated by George Lowenstein of Carneigie Mellon. Simply put– this theory states that curiosity occurs when we perceive a gap in our knowledge. These gaps produce subjective discomfort that requires some sort of action to dispell — similar to having an itch that we need to scratch.

This theory likely explains why I love to luxuriate in mystery TV marathons. Those shows expertly tap-dance on my curiosity buttons and I keep watching because I want to gather more information. I suppose secretly, I think I can best Poirot or Barnaby in figuring out who-done-it.

In healthcare, we can really use this tactic to our benefit. One’s individual health is a very personal and emotional issue to most. So–like I am obviously are a sucker for having my curiosity stimulated, most people have a sensitivity to being engaged in anything that relates to their own health interests. I think the statistics about people seeking health information on the internet speak to the validity of this notion.

By using surprise and creating a perception of a gap in knowlege, we can increase the likelyhood that individuals will be “drawn” to us as resource. What we then need to focus on is creating an environment (virtual or live) that will encourage and educate seekers to take action/ implement behavior changes that can have a positive impact on their health.

If done well and people are able to find the answers they seek, then the subtle emotional experience of that is that ‘we’ care and are able to meet needs. This, in turn, can increase reputation, provide content for word-of-mouth referrals, increase the subjective perception of wanting to be one of ‘those people’ who get their care from THE BEST and otherwise get people in your door to see what you are about. If the quality of care they receive is consistent with the perception, you are on your way to creating loyal customers that no longer need to be ‘won’.

Tags: Made To Stick healthcare marketing unexpected volkswagon NowWhat Chip Heath Dan Heath

Originally Posted in October 2006

I happened across the website DoGooder TV at the beginning of September. I looked around and was intriqued by what I saw.

I quickly shot off an e-mail to see if I could find out more. In the true beauty of the blogosphere and this delightful time of new businesses understanding the value of interactive marketing, I was delighted when I got a message back from Michael Hoffman, the CEO of See3, the parent company of DoGooder TV.

Now– Michael is no slouch (quite an entrepreneur and has significant nonprofit experience) and he’s got quite an impressive set of talent working with him. He also seems to be a nice fellow who really has a genuine passion for nonprofits, causes and the social sector. I think like many of us, he sees the exciting and emerging potential for interactive and social media to really transform how DoGooder’s do business.

So I’ll share our discussion…

Carol: Tell me about the business and philosophy behind See3.

Michael:I was a nonprofit fundraiser in Washington, responsible for about $10 million in annual gifts from mostly family foundations. What stuck with me was that there is a gap, sometimes small, sometime huge, between what a donor sees and what the hard-working people on the ground were doing. We had these study tours, where donors could go to the places where the work was happening, meet the people on the ground, get inspired. These were so powerful and the folks who went on these trips were always the most dedicated supporters, even if they didn’t start out that way. Of course only a small percentage of people were able to participate in these tours and I have always been thinking about how we can close the gap between the daily work and the information nonprofits get out to their stakeholders.

Post-bubble 2001 I [was] looking for something to do and my friends at the Charles and Lynn Schusterman Family Foundation asked if I could do some consulting about nonprofits and technology. Then I was asked to build a website and ended up building a web development shop, specializing in working with nonprofits, that now has 20 employees.

About a year-and-a-half ago my partner Danny Alpert and I had that eureka moment. I was telling him that the web is changing, that broadband will change how we think about the web and websites. That the broadband web was not the same as the web we have known until now. That what I do as a web development company for nonprofits will change quickly. I told him that, mark-my-words, we will be seeing video all over the web very soon.

Danny, an Academy Award and Emmy Award nominated filmmaker, [PBS film (A Doula Story) (http://www.adoulastory.org)] was telling me how film, emotionally powerful stories, can move people to action and be the centerpiece of campaigns to raise money, raise awareness and educate. See3 was born from this conversation.

The company combines my experience on the web and Danny’s experience as a filmmaker. Our philosophy is that organizations need to think beyond the gala dinner video and understand that the web opens up many additional opportunities to use video. That not every video needs to be super-produced, and that media materials – audio, video and photography – need to take more and more of those print budgets.

Carol: What is DoGooder TV and how did it come about?

Michael:Our clients have said to us, how do we maximize the investment we are making in video? We make a great video, and we show it at our events, and then what? Our answer to this question is what lead us to the development of DoGooderTV.

First, we tell people that when they produce video for their gala dinner, for example, that they also need to create additional videos from the same footage. For example, that dinner video might have three stories in it, and these three stories can live independently integrated into different sections of your website, or attached to your regular e-newsletter. Once they have this material, we show them how to bring stakeholders to these videos by integrating it into their existing communications programs.

We have answered that question in a couple ways. First, we help organizations get their video on YouTube and MySpace and Google Video and all of the other free places to post video. But lets be honest – if you don’t have a super-compelling, edgy, snarky, funny, video – then no one will see you on YouTube, except the people you send there.

Many organizations have raised another point about these sites; Does putting our video – which deals with serious subjects – among videos of stupid pet tricks and teenagers lip-synching to some heavy metal song, help us? Is this good for our brand? Is there a place where grown-ups who are interested in things that matter go to see video online?

That’s how we got to DoGooderTV. A place where the audience has a proven interest in issues and the organizations working on those issues. We can call them more qualified leads, to use marketing language. For us, the nonprofit is our client, and DoGooderTV is being created to service their interests.The primary interest of organizations in this regard is exposure to people who are likely to become interested, to act on policy questions, to donate, and to other wise get involved.

Carol: What can DoGooder TV do for nonprofits?

Michael: DoGooderTV is being built as a community for people who care about issues and organizations. Our goal is to bring this qualified audience into the work of organizations through. Once emotionally hooked by watching their videos, the audience will be able to act – to donate, sign-up or learn more.

DoGooderTV gives all of those gala dinner videos a new lease on life, and organizations a way to leverage the existing investments they have made in video material by getting it in front of new audiences.

• In addition, DoGooderTV will be supported through sponsorship. The sponsorship revenue will be split, 50-50, with the nonprofits who post video.

• Best of all… we will be syndicating nonprofit video content across the web! We are very excited about this. The DoGooderTV audience will decide what videos they like the most. These videos (and PSAs) will then be made available, at no charge to the nonprofit, across a network of video web sites. This video network currently has 50 million members and includes the sites of major media companies. All of our legal agreements are not in place yet, so I can’t give more details than this, but those organizations that take the time and effort to create good video content will be rewarded with large audiences.

• And, last but certainly not least, DoGooderTV will allow nonprofits to embed their video, without sponsorship, within their own websites on a pay-as-you-go basis. Meaning, organizations can post all their video to DoGooderTV and any piece they want on their own site can be moved with a few clicks. This high-quality hosting (built on the Akamai network) will be available to organizations so they can have a single integrated hosting source.

Carol: What is your biggest dream for DoGooderTV?

Michael:My biggest dream is that DoGooderTV leads to a kind of renaissance in nonprofit support in this country, attracting millions of people who otherwise would not be exposed to the great work being done and moves them to donate and get involved.

A smaller dream is to move the nonprofit world to understand the benefits of video and, through DoGooderTV, see a real increase in nonprofit investment in this kind of communications program.

We want to be able to say, look at what our work did for this organization. See how they grew, see how they were able to achieve their mission through the support of people who experienced their work through video.

~~~~~~

Michael was quite generous with his time and I have much more to share with you– so please stay tuned for for part 2. In the meantime, if you are a nonprofit organization interested in looking into this new way of getting the word out about your organization, please drop by DoGooderTV .

Please know that more features will be launched in November 2006.

Tags: DogooderTV, Michael Hoffman, YouTube, Videos, Nonprofits, Social media, charity

Originally Posted September 1, 2006

What is a medical advocate, you ask… A medical advocate is a person who helps patients navigate our complex, fragmented healthcare system. With last week’s announcement by Wellpoint about their widespread launch of consumer driven health plans (Read my thoughts here), it is likely that this service industry is on the edge of becoming really huge. Just this week, The Philadelphia Inquirer ran an article that highlighted the growing medical advocate industry.  According to the article, more and more employers are adding this service to their benefit menus.  According to the article:

Health Advocate, which is contracted by employers nationwide, has increased its client list from 10 businesses in 2002 to 1,700 today, the Inquirer reports. Large corporations pay a $1.25 monthly fee per employee, and small businesses pay $4.95 per employee.

Typically being highly trained nurses, medical or patient advocates assist patients by finding and getting appointments with the best doctors for certain diseases/illnesses, translating complex doctor speak so that patients are empowered to make good health decisions, working with the patient to complete complex insurance certification processes, promoting healthy lifestyle changes, and handling claims and billing problems– just to name a few things.

The benefits to employers likely are worth the small monthly cost as they enable the worker to focus on his or her job. So in essence, the productivity of the employee is preserved.  Additionally, patient advocates also create the potential of saving the company hard healthcare dollars by reducing the risk of misdiagnosis, unnecessary procedures, office visits, and duplicated services.

With the patient empowerment and self-education requirements of consumer-driven health plans, patient advocates do fill a very real need.  They will also likely help physicians and facilities bridge the gap that will occur as patients begin to switch to these plans. With their ability to really recommend facilities and providers, facilities and medical practices would be wise to be proactive in developing plans to coordinate and collaborate with patient advocates.  Afterall, they will likely help in reducing some of the obstacles of care and reimbursement, as well as, encourage patients to follow treatment plans and take action to improve their health.

Tags: patient advocates, healthcare, consumer-driven health plans, patient empowerment

Originally Posted in November 2006

Once the decision has been made to start a blog, the next question that comes to mind is how will I get people to read it. If seeking to garner a national or a global audience, one can find a plethora of advice on where to register a blog and how to promote it to a internet savvy audience.

However, if the blog is a healthcare business blog or a blog to educate your patients, the more appropriate goal is to seek a local readership. Here are a few tips that can help you to focus in on this specific group of people.

1. Include the blog URL on appointment cards, stationery, email signatures and printed materials.
2. Have staff and providers recommend content and give patients the URL (of course this means that you need to consider the content needs for staff, providers and patients)
3. Place brochures, posters, and flyers in waiting rooms
4. Consider a direct mail campaign to known customers that positions the blog as a value added service.
5. Contact local bloggers (including reporters who have blogs) and ask them to announce the blog or review the content.
6. If you have e-mail addresses for customers, consider an email marketing campaign to announce the blog.
7. Craft a press release and distribute to local media outlets.
8. Be sure your blogroll links to prominent local blogs.
9. If you have a website, be sure you announce/link your blog on the front page.
10. Attend local health/wellness events (healthfairs, tennis tournaments, 5K Run/Walks, community education workshops & etc.) to distribute information on your facility/practice along with cards with a brief description of the blog and the URL.

Please feel free to add to this list by leaving a comment or linking to this post when you craft your own list. Also consider coming to the Healthcare Blogging Summit in Washington DC to find out more.

Yesterday I trundled on down to the mailroom at our office complex in an effort to help out. What I found was simply an excessive amount of high dollar direct mail items with the aim of detailing doctors on medications.

Now– I’m used to seeing a flyer and phamphlet here or there. But By-Mail detailing has gone to whole new levels. The most excessive ones are packaged in boxes and shipped to look like you are getting a book, schwag or something of value. I suppose all those focus groups conducted by Pharma have helped them learn that it is pretty easy to sniff out old time marketing material. Thus its fate is to go unopened directly to the trash bin. I suppose this new packaging is likely to get opened just to make sure that nothing of value is thrown away.

However, folks– the gig is up. Imagine my surprise when I got to the mail room to hear a disembodied voice coming out of our mail drawer. Apparently, the lastest parcel used the annoying talking greeting card technology (Guys– this is annoying for birthdays and other celebrations– why on Earth did you think it was a good idea for marketing?!?!). It had gotten squished by a larger parcel and had activated the push button mechanism which provides you with a voice to detail you on various aspects of the drug. Thankfully it shut up soon after I pulled it out of the drawer. I honestly do not think I could get on the elevator with that thing going off in my arms. Although now, working in psychiatry, I suppose a disembodied voice in an elevator could have been a good way of drumming up some business.

Let me just cut to the chase… pharmaceutical detailing by mail is a waste of money! Unless you employ some sort of intermittent reinforcement (i.e. periodically sending something that is actually helpful) the items never get opened and end up in the trash bin. Oh yea– if you are going to send something helpful– ask before you unilaterally decide cause you pharma marketing guys and gals just don’t get it.

A lady called physician’s office with whom I am working. She was distressed because all of a sudden she was unable to get one of her medicines because she needed our office to submit a prior approval application.

She was frustrated, upset and worried about what she was going to do since she was almost out of medication. She was also feeling singled out and picked on by the insurance company.

With that experience fresh in my mind, here are 10 things to know about the medication prior approval process.

1. You certainly are not alone. Increasingly, insurance companies and pharmacy benefit managers are implementing prior approval requirements for certain medications (mostly brand names where generic alternatives are available).
2. Every insurance plan has their own custom prior approval requirements. Many think that their insurance plan is the name of the company that insurance plus the product (example: Blue Cross Blue Shield PPO, Aetna HMO, Blue Cross Blue Shield POS). Actually, your plan is customized for your group. So there may literally be thousands of different plans underneath the umbrella of the type of insurance you have. Subsequently, it is next to impossible for your prescriber to know which medications need prior approval and what the approval criteria is for specific medications.
3. Brand name medications that are used to treat attention deficit disorder, insomnia, asthma, allergies, erectile dysfunction, irritable bowel syndrome, rheumatoid arthritis, osteoporosis, osteoarthritis and elevated cholesterol levels often require prior approval.
4. To get drugs approved, most pharmacy benefit companies have forms that must be completed by the doctor. Some companies do have phone numbers to call, but here again, this needs to be done by someone in your doctor’s office.
5. Medication prior approvals usually expire after a year.
6. Some medication prior approvals are for specific doses of medications. If the dosage changes, you may be required to seek another prior approval.
7. Because of the increasing numbers of medicines being added to prior approval lists, medical offices are very busy responding to requests for prior approval. Please give your provider’s office at least a week to complete the process.
8. Once the medical office completes the process, sometimes it takes up to three days for the approval to get into the system so that the pharmacy can fill the prescription.
9. Information that is needed for medication prior approvals can include: your name, your insurance subscriber number, your birthday, your diagnosis, and prior medications used to treat your condition, dates of treatment and reasons they were discontinued.
10. Patients/consumers can really be of assistance by keeping up with the expiration dates of medication prior approvals. Many prescribers are happy to help a patient that is trying to make this process easier.

I had a weekend reprieve from the insurance questions, but just after a long Monday, I find that there seems to be an endless number of faces and voices that need help or explanation.

All I have to say is— Gee… I wish employers had done a better job educating their employees about the changes afoot in the health plans they were offering.

Honestly, I can’t really blame patients for their frustration. For years, they have mindlessly sought care, paid their copay and not even wondered about contracted rates, discounted rates, co-insurance, deductibles and etc. I even had one lady bring in her EOMB to me and ask me to explain it. She was SHOCKED that eventhough the doctor billed $125 for her med check, that he only got $60 plus her $6.00 (10% of the contracted rate) copay.

Yep… there’s a lot people don’t know.

In the hope of compiling a list of resources to hand out, I took a few moments last night to travel around to various sites that have come up in the last few months who are seeking to help patients navigate this maze in which they have been unceremoniously dropped.

1. Vimo: Probably the most mature of the products I toured. This is really focused on helping people shop their insurance and physicians. However, their “Learn” section did provide a good primer on essentials of these new health plans.

2. RevolutionHealth (in Preview) will be available soon. They seem to be focusing on helping people become more engaged in their health. They have a fair number of wellness promotion tools and they support SimoHealth’s medical bill tracking tool and and help you estabilish personal health record ‘portfolio’.

I haven’t opened up a SimoHealth account (despite the 30 days free offer, $39 after that), so I don’t know if SimoHealth offeres some good explanation of the basics of the CDHC Insurance game.

3. MedBillManager. I’ve been through several tours of this product, thanks to an invite from Christopher a few months ago. I’ve offered some (sometimes stern) feedback on their product and they have always taken it and turned the comments into thoughtful functionality. It is still a pretty green product, as their alpha status indicates, but it is a pretty good start. The cool thing is that it is free for up to two people.

Here again, this is a tracking tool to help people understand where their healthcare dollars are going. MedBillManager does not really explain CDHCs or insurance basics in layman’s terms, but it does provide a cost effective tool to become more educated about your own personal healthcare expenditures.

Since it is free — drop by and try it out. Also give Christopher and the guys copious amounts of feedback. They don’t have enough to do…

Update:  Unity Stokes over at Organized Wisdom has conducted a podcast with Christopher at MedBillManager.

While I’m updating— please check out Organized Wisdom as a community to help people to get information on the various treatment options for certain diseases.  It also helps individuals to gain support and ‘been there– done that” knowledge and education on specific diseases.
Feel free to add to this list through commenting. I’d like to learn more because I will definitely pass it on to the patients (of course after trying it out myself).

Tags:CDHC, Health Insurance, VIMO, RevolutionHealth, SimoHealth, Healthcare Tools