All for One, One for All: Using Social Media to Enhance Health Outcomes

In a recent blog from Social Media For Healthcare, by Albert Maruggi, Nov. 7, 2011, the author states, “Healthcare as an industry has a premium on content and web search, with search for healthcare being the third most popular use of the web. Healthcare also has an ample number of social media participants in health related communities that range in topics from nutrition to pregnancy, to cancer. Content services are best used to supplement the core expertise of a health care delivery facility or from a healthcare payer’s perspective, provide information that will help direct consumer behavior that impacts outcomes.”

I do not disagree with this statement.  However, it isn’t any different from the same one-directional push of information classically provided on the web in website after website.  Yes, people are looking for reliable information, and the ability to discuss it, share it, and even append it, has demonstrated some impact on outcomes.  But it is becoming a commodity, and also somewhat of a disappointment.

I’ve been involved with numerous teams for social marketing and communications projects in healthcare and other industries.  In healthcare, they have common aims:  1) to provide reliable information resources to a patient population from a healthcare provider they trust, 2) to give as many opportunities as possible for patients and healthcare providers to get to know one another better online and in-life, and 3) to give patients extended access to their healthcare provider, in many forms, beyond the office visit, again both online and in-life. 

Dependable medical information is tantamount, and personal presence and interaction, particularly in healthcare, have demonstrated repeatedly to improve patient activation as a patient’s relationship with their healthcare provider improves. Making that personal presence and interaction meaningful presents its obvious challenges, notably online.  But even if you are able to collect lots of fans, comments, shares, backlinks and polling results, the challenge remains consistently the same:  how to get beyond the conversation and into the realm of action where we can demonstrate what we are really after:  improved outcomes.

A repeated theme consistently pops up in evaluation of these projects:  What does it really take to motivate a patient to assume more responsibility for prevention or management of chronic disease?  More and more the discussion ends up being about small group psychology.

Suppose for example a group of people share a common chronic health issue, such as being overweight, smoking, or poor nutrition.  The standard approach is to provide each individual with the tools and information they need to go out on their own and set goals, modify behavior, and improve their outcome.  Many online tools help with this, and even provide the means for creating support groups of people to help the patient on their way.  But where most of these tools fail is in the lack of accountability.  The individual is left standing there, holding their bag of tricks alone, disappointed in the results, with a new understanding of the fact that, as communal beings, when we are held accountable to no one but ourselves, we struggle, whether we’re talking about managing our diet, running for elected office, working out in the gym, or driving on the highway with a radar detector.

Suppose that same group of people comes together to create a common goal for the group as a whole.  Each individual still has their own goals; however, their performance along the way directly affects the ability of the group to achieve its goal.  Teachers who set up students to do group presentations know the value of this scenario.  No one wants to be responsible for making everyone else get a poor grade, and individual performance is often markedly improved. In fact in a recent article from about shared medical appointments, healthcare providers at the Jeanie Schmidt Free Clinic listed the following expectations:   

• lower blood pressure readings in 60% of participating high blood pressure patients
• lower blood sugar levels in 60% of participating diabetes patients.

Move beyond grades into something more dramatic, such as a basketball championship, and now heroes are born.  But lets stick to healthcare, where things are more serious - for example, managing a chronic disease like diabetes.  The power of that level of accountability dramatically increases.  To make it even more effective, put together groups of people who know one another well and are emotionally invested in one another’s well-being.  Not only is the individual improving their own health, they are now accountable for contributing to the health outcome of the entire group – a network of people they care about at a high level because they work with them, go to school with them, live with them, or are good friends with them.

Healthcare has understandably been confined to very private channels.  This approach of small population management will have its challenges.  But if we truly want to motivate people to make hard change in their life, we can increase their chances of success by innovating ways to group them together in collective effort.  What better way to do that than through the use of social media?

All for one, and one for all.

Connect with Maureen on Linked In

Molly Katchpole -- the woman who brought Bank of America to its knees

Once again, customer anger and the power of social media carries the day for the American consumer.

Recently, Bank of America announced that it would begin charging debit card users a $5 monthly fee to use the service. Other banks were lining up to do the same. Enter Molly Katchpole, a recent college graduate holding down two part-time jobs, who decided enough is enough.

Shortly after the Bank of America announced its plans, Molly created a petition on Change.org, a nonpartisan website that allows individuals and advocacy groups to launch campaigns on any topic. More than 300,000 people signed the petition.


The petition read, in part: "The American people bailed out Bank of America during a financial crisis the banks helped create. ... How can you justify squeezing another $60 a year from your debit card customers? This is despicable."

The Bank of America was apparently listening to Molly and her friends. The $5 monthly fee quickly went away.

This is another example of how companies are misjudging their customers, much like Netflix did when it tried to divide its DVD-rental and online streaming businesses. It's also another example of how customers' voices are now being heard by these companies when they are amplified through the megaphone of social media.

To learn more about Molly Katchpole and her fight against the Bank of America, follow this link:

http://www.google.com/hostednews/ap/article/ALeqM5h0tUVNNHK66-3Orkt-KehY1MTndw?docId=2c278e04267f4f76bca42ffe57c2e7d5

President Obama mentions Brent Spence Bridge in Congressional Address

Our firm, Strategic Advisers, LLC, works with the Bridge Builders Coalition, a group that includes the Northern Kentucky and Greater Cincinnati Chambers of Commerce, OKI, and businesses, which is working together to obtain federal funding for a new bridge carrying traffic on I-75 and I-71 across the Ohio River. The current bridge, the Brent Spence Bridge, is functionally obsolete.

In his address to a Joint Session of Congress last week, President Obama specifically mentioned this bridge as an important infrastructure project that needs to be built. We produced a video about the president's comments and the need for a replacement and placed it on Youtube the next day. Here it is:

Isn't it time that our tax money is returned to our community for important projects like this rather than building bridges and roads in Afghanistan and Iraq? If you agree, let your Congressional representative know how you feel.

Half of U.S. adults now use social-networking sites

For the first time, half of all adults in the United States said they use a social networking site, according to a survey released Friday by the Pew Research Center.

That’s 50 percent of all Americans, not just those who say they are online. Six years ago, when Pew first conducted a similar survey, only 5 percent of all adults said they used social sites, like Facebook, LinkedIn or MySpace.

For more information, see this story in the New York Times:


http://bits.blogs.nytimes.com/2011/08/26/half-of-america-is-using-social-networks/?ref=technology

Customer-Centric Strategy and Leadership

“Every system is perfectly designed to get the results it gets.” Paul Battalden, Institute for Healthcare Improvement, retired CEO and President

The Four Obsessions of an Extraordinary Executive by Patrick Lencioni:
1. Build and Maintain a Cohesive Leadership Team
2. Create Organizational Clarity
3. Over-Communicate Organizational Clarity
4. Reinforce Organizational Clarity

“Systems, strategy and leadership” might seem like overkill to many people leading a small company. However, in any effort, no matter the size, the process used to achieve results is critical. The process, and how clearly it helps accomplish the vision for the organization as a whole, makes the difference between failure and success.

One thing is true about process... if you focus on it, it will show you the true nature of your organization. The reality is that while your enterprise may look small on the outside, it is more than likely powered by a significant community of employees, families, customers, friends, vendors, and maybe even volunteers and donors as stakeholders.  That network can potentially touch thousands and even tens of thousands, and you could be at the helm of a very large ship, coordinating the efforts of far more people than you realize.  In this space, customer focus, transparency, collective strategy, empowerment, and community management will be crucial to your success.

Borrowing from the clinical microsystems approach of Eugene Nelson, Paul Batalden and Marjorie Godfrey in their book Quality Design – A Clinical Microsystems Approach, the critical questions for organizational management and strategy are centered around each of the microsystems involved in the overall effort. Taking on each microsystem one at a time to ask the hard questions and collect accurate data makes all the difference, and you will discover certain key aspects of successful groups which overlap significantly with Nelson, Batalden and Godfrey’s findings:

1. Responsible leadership that can delegate effectively and allow team members to have ownership.
2. Effective communications on a consistent basis that are based on conversation.
3. Clear goals for the microsystem which clearly support the organization’s overall client-driven mission.
4. Proper technological resources for efficient and effective work for all stakeholders.
5. Streamlined processes eliminating duplication of effort or competition between groups.
6. Initial and ongoing training.
7. Freedom to make mistakes and move forward.
8. Proper market research and monitoring needed for evidence-based decisions and outcome-focused evaluation.
9. Recognition of success and properly rewarding collaboration.
10. Planning ahead with stakeholder (including clients) input and adapting for next year.

One of the most challenging aspects of leadership in my experience has been motivating people to learn to
accept change. It is just so easy to relax into the status quo and sing “everything is gonna be alright.” However, as Jim Collins so eloquently states in his monograph Good to Great and the Social Sectors, “No matter how much you have achieved, you will always be merely good relative to what you can become. Greatness is an inherently dynamic process, not an end point. The moment you think of yourself as great, your slide toward mediocrity will already have begun.” 

The other equally important issue at hand, which is a distinction Collins also makes, is that change requires clear vision and an understanding that the mission and welfare of the organization must be the top concern of everyone – always – and it must be crystal clear. Clarity, clarity, clarity. My previous employer, Frank Albi, founder and CEO of BIS, Inc., a small business in Cincinnati, is a master of this, and of coaching everyone his business touches to advocate the same vision, especially his clients. He taught me many things about the value of that collaboration. Collins’ point is well taken in both business and the non-profit sector. Even though Frank Albi owns the company - its his business, his building, his product and his money, he knows this is a delicate matter with regard to customers, especially in this digital age.  Today’s technology-saavy adults are no longer an audience to be lured with merely pretty pictures or catchy jingles.  They want to be involved, touch, mold and unfold their own version of your brand’s reality.  They are active participants shaping the course of innovation – and even the nature of your brand – through experiencing it as much as possible before they buy into it.  They morph quickly as they are in turn shaped by the opportunities presented to them by technology. Today your offering has to be their vision as much as yours.  Ultimately that is what is best for the organization in order for it to succeed.

In a recent conference I attended, the speaker’s advice to everyone present was to be sure to work for an organization whose mission they could devote themselves to 100%. Well, isn’t that true for leaders in any organization, business or social sector? That is how you earn your following. That is how you lead and inspire others to do the same, by starting there yourself. In his definition of the pinnacle of leadership (Level 5), Collins states, “Level 5 leaders differ from Level 4 leaders in that they are ambitious first and foremost for the cause, the movement, the mission, the work – not themselves – and they have the will to do whatever it takes (whatever it takes) to make good on that ambition.”

Are you willing to do what it takes to be truly transparent and open your strategy up to your customers?  Do you have a vision you communicate effectively, and build consensus around?  Have you succeeded in inspiring your employees and customers to be as concerned as you are for what is best for the enterprise, so they will work with you to build a strategy together for everyone's success?

If there is anything today's evolving, socially-driven world is teaching me these days, it is the same thing I remember reading from Thomas Merton decades ago in college philosophy class, "My successes are not my own.  They are built upon the success of others." 

Social media from Egypt to the corner bakery

Two interesting news articles in today's Wall Street Journal about social media. The first article, Egypt's Revolution by Social Media, is an interesting op-ed piece about how social media drove Revolution 2.0 at Tahrir Square and around the country in Egypt. This columnist compares this social-media effort to Thomas Paine's "Common Sense" pamphlet that was published in 1776 and galvanized the columnists in their fight against England.

http://online.wsj.com/article/SB20001424052748703786804576137980252177072.html

The other story, A Bakery Gets Sweet Returns From Social-Media Blitz, relates how a local bakery in New York used social media and half-price hot drinks to get customers to visit the bakery when the city was buried under two feet of snow.


http://online.wsj.com/article/SB20001424052748704723104576061900588958180.html

Just another couple of examples of how social-media pervades our life every day -- from unifying an entire nation to selling more doughnuts.

Moving business forward in real time: How real-time engagement reset the market: PRSA

Moving business forward in real time: How real-time engagement reset the market: PRSA

Leaping Forward by Working Backwards

Outcome-Based Planning is a Critical Success Factor for Social Media Strategy

Brian Solis, Principal of Future Works, and author of one of the world’s leading social media online resources BrianSolis.com, points out in his Jan. 6, 2011 blog, “failing to plan is planning to fail.” In his book, Engage!, he also explains that, “you can’t fail in anything if success is never defined.”

In the April 2009 article The Power of KPI – the Only Measurement that Matters, Rodger Roeser, president of Eisen Management Group, one of the largest and highest rated investor and public relations firms in the United States, focuses on tying objectives to measurable business goals directly related to familiar outcomes: margin, volume, profitability.  His point is that any other measurements in business can be, well, pointless: if project performance cannot be measured relative to bottom line goals, then why would you do it?

Jeremiah Owyang, partner of Customer Strategy at Altimeter Group, and author of  Web Strategy, another one of the top analyst blogs of the social media and strategic planning industry, will relate things just a little differently, explaining that while “no single set of objectives can accommodate all business models or corporate initiatives…four objectives serve as a foundation for effectively measuring social marketing:  fostering dialog, promoting advocacy, facilitating support, spurring innovation.”  He will also tell you that “companies should step back and approach social business like any other business program: with a plan.” 

Erik Qualman, Global Vice President of Online Marketing of EF Education, author of the bestselling book, Socialnomics, and creator of Social Media Revolution, one of the most viral videos of 2010, advises social media strategists to “define what success looks like before you start.”  In his book he also names four objectives to set for your social media strategy: 1) listen, 2) interact, 3) react and 4) soft sell.

I could keep going with the Who’s Who list of social media experts, and every single one of them will tell you the same thing:  companies that enter into the social media arena without proper planning and intent for success, will fail.  The point is that you have to set goals.  Not only must you have an outcome-based strategy for social media, but it has to be framed within the overall strategic plan for your organization.

So, starting with the end in mind is critical. I once heard it referred to as “working backwards”, but its really working ahead.   Goals don’t mean much if you don’t know when you’ve accomplished them. How are you going to know when you are succeeding and when you are not?

In his discussion of this topic in Engage!, Brian Solis defers to the expertise of the “Queen of Measurement”, K.D. Paine, CEO of KDPaine & Partners, and author of KDPaine’s PR Measurement Blog.  She refers to her KBI Development System (not KPI - Key Performance Indicators, but KBI - Kick Butt Index).  She also created the Measurement Program Checklist, which is based on five basic steps:

1.    Define your measurement of success (outcomes, KPI, benchmarks)

2.    Select a listening/monitoring tool (based on channels and the qualitative and quantitative data you wish to collect).

3.    Select a web analytic or CRM tool.

4.    Select a survey tool.

5.    Analyze and report results.

Strategic Advisers LLC  tells its social media clients that once you’ve identified your overall strategy, your key performance indicators will be based on the objectives you’ve chosen:  they must be customer-centered, building upon the foundations of sound marketing and effective customer-relationship management (CRM).  Taking all these experts’ advice into consideration, and knowing that every client’s business and consequently social media strategy is unique, Strategic Advisers LLC suggests a common starting place for our clients.  These are key objectives for any successful social networking plan:

1. Dialogue – get people to talk to you and each other through your media channels.  This starts by listening to what they are saying.  Carefully.

2. Advocacy – get people to talk about you and recommend you to their friends.  This starts with interaction.  Be helpful.  Be client-focused.  People will spread the word about your good deeds!

3. Forum – open the box and welcome the comments; good or bad, make sure you are listening, you talk back, and you resolve any problems as soon as possible.  How you react, especially to the challenge of negative issues, is directly related to your credibility and therefore critical to your survival.

4. Innovation – ask customers what they want; surveys, contests, questions of the day.  This is the “soft sell” approach that will keep your channels customer-focused.

These objectives then determine your choice of Key Performance Indicators (KPIs).  KPIs must be well-defined, actionable (within a company’s ability to control) and simple measures that target realistic , attainable goals and help you set clear benchmarks for the ROI you need to justify the expense required by social media.  They are critical to your ability to measure outcomes, assess progress and make tactical adjustments.  KPIs can fall into many categories :

• Quantitative indicators present as a number; e.g., sales volume.
• Operational indicators characterize existing company processes; e.g., production line down time related to training.
• Directional indicators specify whether an organization is getting better or not; e.g., customer retention.
• Financial indicators relate performance to return and margin

In social media it can be very difficult to pinpoint ROI because of the nature of what is being accomplished: building relationships and social capital is difficult to directly quantify.  However, there are indicators of success that can be closely monitored.  First, using the four main objectives, choose data that can be gathered to make an assessment.

Dialogue:

·         Who is everyone talking about? (research the market for your product or service – who’s got the most mindshare?)

·         How often is it you? (your market share)

·         At what level are they engaged? (likes, comments, sharing, conversations…)

·         In what ways are you engaging with them? Do you have a response plan?

·         Are they positive or negative?

Advocacy:

·         Who’s talking?

·         Who are they talking to?

·         What are they talking about?

·         What impact is it having?

·         What recommendations are they giving?

Forum:

·         Process for monitoring and responding

·         Success rate

·         Response time: total resolution time

·         Follow-up satisfaction score

Innovation:

·         Topics

·         Trends

·         Interest level (response rate)

·         Impact/relevance on customers

After you have gathered that data, determine which business processes will be affected by changes in those numbers.  For example, in the case of the first objective of establishing dialogue, what will happen when more customers start talking about your product or service?  Here are some likely outcomes:

·         Increased customer support calls from existing customers.

·         Increased inquiries to the sales department.

·         More problems to resolve.

·         Increased sales!

In each case you can identify a likely consequence, look to see if it comes true, and then take it to the next level.  In many cases, new opportunities to use social media will arise as new processes unfold.  For example, if your customer support department complaint volume has increased, what is your resolution rate?  In what ways could you use social media to improve it?

A myriad of social-media analytical tools are available on the market. For most companies, standard tools offered by proprietary platforms like Google Analytics and Facebook are excellent ways to monitor progress and the effectiveness of your content; e.g., how many people are opening your emails, how many are following your blogs, how many times are they forwarding them on to friends? Both Blogger and Wordpress offer their own analytical tools to measure reach (how many people read your blogs), retention (how many people keep reading your blogs), engagement (how many people comment on your blogs), and advocacy  (how many people are sharing and recommending your blogs with others).  

These tools can be used at any time, and should be tracked as often as you post new content, which should be weekly at a minimum for some channels, and daily for others.  They also track changes over time, and by specific date, so you can identify which content creates the most interest, and also spot trends.

It is relevant here to remember these other important factors:

1. Channel Selection - The proper mix of social-media channels using the right content will leverage KPIs to their full potential.  For example, if one of your KPIs is increased posting of photos or videos by customers, facebook would obviously be a better choice than twitter or a blog, but you’re also going to want a YouTube Channel so you can collect them, along with your own, in a central location.
2.  Organizational Integration – every part of your organization should be engaged and have clear roles and responsibilities for social media and for marketing.  Traditionally, marketing plans focus mainly on sales, marketing and customer support departments. However, companies who understand that marketing must live and breathe “down in the trenches where the rubber meets the road” are bound for success.  Every department will be affected, so each one should have its own set of objectives, KPIs, measurement tools, and reports.
3. Social Media Policy – makes it crystal clear what you expect of your employees and contractors regarding engagement with customers and the general public as representatives of your company.  The rules must be clear so that your outcomes are not tainted by poor response variables, or carelessly worded responses.
4. Engagement – random posts and lack of response to constituent input is not enough.  Focusing on tools, technology and cool applications is not enough.  Talking about yourself is not enough.  Your customers must be engaged by your organization.  You must be willing to allow them to interact with you one-on-one and get to know you.  You have to build and then belong to your community, and then continue to nurture authentic relationships by focusing on your customers’ stories.

In summary, take some general advice from Strategic Advisers LLC:

1. Build a social-media plan strategically, one careful step at a time.
2. Start with the end in mind and work backwards: identify best methods for measurement, and align media channels and metrics with goals in mind.
3. Construct a diverse, interactive channel selection congruently over time in order to obtain the furthest reach. Leverage these assets to create a competitive advantage by helping differentiate your organization in the marketplace so it can be more flexible and responsive than its competitors. 
4.  A social media network built upon a solid foundation of email newsletters, in-person events, focused direct mail, and a central website hub will get the word out most effectively.
5. Measureable business objectives provide opportunities to learn about customers, their preferred interactions, their understanding of brand, and value received.
6. Finally, don’t try to reinvent the wheel.  Consult the experts. We consult with one another, so why shouldn’t you?

Riders on the (brain) storm to creativity

At Strategic Advisers, we do a lot of brainstorming with and for our clients to help them achieve their strategic objectives. One of our favorite exercises is to use "mind maps" to collect ideas and visually understand how these ideas are connected to one another.


One of the key elements of brainstorming is to let loose of your ideas -- no matter how crazy they may seem at the time -- and not judging those ideas during the brainstorming process. (That can be done much later in the process.)

An idea generated by one person during a brainstorming session may create sparks in the other brains around the table to suggest still other ideas, which can continue to build upon each other like an "idea" snowball rolling down a hill. When that snowball smashes into the tree at the bottom of the hill, upon close inspection, you often will see some very creative solutions lying around that you had never considered before. Each of us think differently and we bring, quite literally, different and uniquely wired brains to the brainstorming table.


During my studies in the Executive Leadership and Organization Change masters program at Northern Kentucky University's College of Business, I was fortunate to attend a presentation about creativity and innovation by Craig Wynett, the chief creative officer at Proctor and Gamble. Wynett takes what he calls a “science-based view of creativity.” In his presentation, he cited Edward Deming as saying: “Experience not backed by theory teaches us nothing.” By using innovation and creativity, Wynett suggests that companies can grow profits at twice the rate of sales (organic profit growth). In recent years, P&G and other innovative companies are proving that point.

An interesting concept discussed by Wynett was “cognition = categorization.” In other words, cognition (thinking) is all about categorization. Thinking is usually an act of comparison. When we think, we usually ask ourselves, “What existing mental category is this a member of?” or “What is that person/thing/situation most similar to of the things that I have experienced in my life.”

To prove this concept, Wynett showed our class a slide with a bottle of Coke sitting on a stack of paper. For many, it was just a bottle of Coke sitting on paper, but for others, using this comparison/analogy technique, they equated the Coke to a brick, and saw the soft drink as a paperweight instead.

Wynett also discussed the concept of “breakthrough thinking” -- which he says is an unforeseeable solution to a novel problem, an abrupt shift from nonsense to sense, from not knowing to knowing. Breakthrough thinking does not just happen, like seen in the movies.

Breakthrough thinking cannot be solved by routine knowledge, and is obvious only in retrospect, he said. Wynett said that our learning system is “expectation driven” and “the number one requirement for learning is ‘expectation failure’” – what you were expecting to happen did not happen.

What I learned from Wynett is that there is no idea whatsoever that is not already rooted in something we already know. An prime example of this is the Dyson vacuum, which came to British inventor James Dyson after he visited a lumberyard and saw a cyclone machine using centrifugal force to collect sawdust. Another example was the creation of Velcro, which came to its inventor after examining how a burr worked when it attached to clothing.

According to Wynett, analogy is the key to creativity. To be creative, one needs to see beyond surface features (actors, objects) to identify underlying roles/relationships (plot), find similarities between the situations despite differences that may separate them, and then synthesize new concepts by taking the old concepts and putting them together in new ways. 

Last month in The New York Times Sunday Magazine, in its 10th-anniversary special of "The Year in Ideas," David Segal wrote a great story titled, "In the Pursuit of [The Perfect Brainstorm]," about how companies are using brainstorming to spur creativity and innovation, which in turn makes them more competitive in the marketplace. I've included a link to this story here:


In Pursuit of [the Perfect Brainstorm]

How Videogames are Changing the Economy and Advancing Technology

A great column in today's Wall Street Journal about how the videogame entertainment industry has supplanted the government in terms of creating innovation in the area of technology. To read the column, click on the link below.


How Videogames Are Changing the Economy
http://online.wsj.com/article/SB20001424052970203418804576040103609214400.html

After reading this column, I am happy to report that my 15-year-old son's addiction to Call of Duty, and now, Microsoft Kinect is helping our economy and moving technology forward.