GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

Would displaying the calorie count of menu items make you eat healthier food? Does weighing yourself every day make you lose weight? Does having a Fitbit or pedometer make you exercise more? The answer is probably no, but, that does not necessarily mean we should throw the baby out with the bathwater, According to some, there are some tactics that can help data motivate people to change

1. Finding our what data matters to a particular person.
2. Using peer pressure when sharing and comparing data
3. Displaying the data in a format. time and place that is more impactful to a person than another way
4. Timing the delivery of the data e.g. at the point of care via EMRs
5. The proper use of warnings and alerts that don’t create alarm fatigue
6. Personalized carrots and sticks that link the data to incentives or disincentives to change
7. Finding people who have the most pain and are willing to change to nudge them over the edge
8. Behavioral economic techniques e .g. gamification.
9. Linking data to emotional triggers driving change
10. Using techniques to remove unconscious bias in making decisions
11. Finding the right technologies, like infrared sensors in spigots,to monitoring hand washing before entering an ICU
12. Spreading good habits and interfering with bad habits using social media to create social contagion.
13. Clarifying the “why” change is necessary
14. Creating a vision of the result of the “what if”
15. Involving end users early in helping to design the change process

To move people you have to WATER the planted

1. They have to be willing, preferably internally motivated
2. They have to be able
3. They have to have a trigger
4. They have to have an expectancy of a reward
5. They have to be reinforced so they don’t lapse back into bad behaviors.

Here are some more tips on how to break up with your bad habits.

Everyone knows that changing your own or someone else’s behavior is a Herculean task. Sick care data scientists and population health entrepreneurs driving the connected health movement will need a lot more tools than just displaying data to make a difference. Plus, achieving he quintuple aim will mean not just changing doctor and patient behavior, but also making sure that the new behavior translates into value.

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GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

If you work for a big, established company, you’ve probably been noticing the sudden rise of a new trend: the innovation lab. Companies as diverse as Delta Air Lines, Target, Google, Pfizer, Marriott, Autodesk, Fidelity Investments, Ford, Verizon, and Stanley Black & Decker are jumping on the bandwagon. Most don’t deliver.

Open innovation labs like this bring The Garage Experience inside the four walls of the corporate business environment – freely available for everyone to use and experience.

Univerisities have joined the parade, creating undergraduate and graduate innovation and entrepreneurship centers, despite the fact that there is scant evidence that they work.

The new thing in sick care administration is to create healthcare innovation centers, modeled somewhat after other industry R/D and skunk works. Their goal, ostensibly, is to innovate our way out of the sick care and health care mess. They focus mostly on quality, cost, process improvement, patient experience, sometimes doctor experience and access to care and range in size, scope and vision. A recent review identified 50 hospital innovation centers. Steve Blank calls it innovation theater

Considering how deeply companies rely on innovation, it is astonishing how bad most of them are at finding, developing, and implementing new ideas. Global companies pour roughly $1 trillion yearly into innovation; estimates are that at least 10% of that sum — $100 billion — is completely wasted.

Here is an example of one that is successful. Some have combined designers and, can you imagine, are also asking patients what they want.

Here is a building dedicated to sick care innovation in Denver.

Now,even the AMA is in the game and has anted-up $15M.

As you would expect, there are now conferences, webinars and white papers about health innovation centers, best practices and their impact to date. Accelerators are changing to accomodate the realities of the sickcare industry.

Corporations are creating innovation outposts to stay ahead of the curve.

Sick care (over 90% of the US “healthcare” spend is for taking care of sick people) innovation center leaders and participants will need to address some issues to be effective and deliver impact:

1. The last mile. All the systems engineering in the world won’t make a difference until we crack the code on how to change human behavior.

2. The rules. Most will have relatively limited impact until and unless the reimbursement rules substantially change. Rules drive ecosystems that create business models that deploy and scale innovation. Right now innovation centers are trying to use new tactics but can only deploy limited innovation strategies without a new playing field. They are living in the no man’s land between the now and the new.

3. Systems thinking overcoming silos. Healthcare is notoriously siloed at almost every level, from department to department to one sick care system to the next.

4. Patient willingness and ability to engage. The assumption is that more patient “engagement” will be mean better outcomes. That needs to be validated and we need to do a better job of targeted patient segments who want to take responsibility for their care and assume the consequences for the results.

5. Shifting value factors. Medical care is becoming commoditized. Patients can’t judge quality and cost since they are so opaque so they use service, speed, convenience and experience as proxies. There is relatively little correlation between satisfied patients and the quality of care they receive.

6. Data integration and interoperability. Resolving the protect but share dictum will be challenging.

7. Measuring and defining innovation. Big orbit change is necessary, not incrementalism. Innovation is a measure of the multiple of user defined value that results when compared to the existing competitive offering.

8. Lead innovators, don’t manage innovation. We need leaderpreneurs and followers with an entrepreneurial mindset willing to fail at low cost.

9. Innovation management systems. There are many ways to foster, package, test, validate, prioritize and deploy components of an R/D portfolio. The process needs to efficient, effective and transparent to the users .

10. Execution. Inspiration and perspiration. In the end, no idea, invention, discovery, or process is worth much without a team who can execute or deploy it.

11. Long sales cycles prolonged processes of decision making.

12. Different business models to develop digital health and process improvement products

13.Overcoming the main barriers to physician adoption: a)evidence based safety and effectiveness, b) concerns about liability, c)getting paid to do whatever you propose that d) will not interfere with workflow, take more time and further abbreviate face time with patients.

14. Entrepreneurs outperform intrapreneurs

Here is an example of a “different” model. We need scalerators, not accelerators.

Healthcare innovation centers seem to have a different focus than community based entrepreneurship centers. Yet, they should both be focused on the same thing: transfering value to patients. Physician centered value centers should have the following features:

1. Focus on creating value transfer to patients, not startups

2. Create a separate value proposition for the different kinds of physician entrepreneurs: private practitioners, technopreneurs, intrapreneurs, investors, consultants.

3 Include rapid prototyping facilities

4. Integrate non-MDs from other industries to create a larger, more eclectic community of interest

5. Include patients and others who might help with the customer discovery and development process

6. Include human subjects trial support

7. Accomodate the schedules of practicing clinicians

8. Use state of the art teaching technologies

9. Have an active and effective mentoring process

10. Create a business model that doctors will buy

A recent study provides details for the 10 top success factors for hospital innovation:

1.      Use a clear step-by-step innovation method

2.      Establish an Advisory Group to guide innovation concepts and proposals

3.      Focus on consumer needs, rather than technologies to direct the innovation

4.      Generate Big ideas by focusing on core outcomes, not the symptoms

5.      Minimize early funding by focusing on a minimal viable product

6.      Support projects with innovation experts (design, engineering, business)

7.      Utilize an iterative prototyping to quickly build and test the best product

8.      Nurture publicity and storytelling to raise visibility, excitement and funding

9.      Include industry experts/ vendors/ investors to support commercialization

10.  Develop power users to give hands-on training and coaching for innovations to build key behaviors and practical experience

“What is the source of this hostility to innovation?”, “Is the under-performance in innovation episodic or systemic?” and, “What is causing this value-destroying gap between stated intent and actual reality?” Here are 3 reasons.

In fact, like many industry innovation centers, my guess is that few sickcare innovation centers are creating much impact and should be closed, particularly if they are just high priced, high tech suggest boxes. Here are five reasons why they should be shuttered.

In addition, the establishment of university-affiliated incubators is often followed by a reduction in the quality of university innovations, according to a new study co-authored by a Baylor University entrepreneurship professor.

Here are some reasons why it is so hard for BIG MEDICINE to innovate

Most don’t and that’s part of the reason doctors have been disintermediated and marginalized from the value creation process.

We need to rethink accelerators and incubators given their marginal success record of creating scaleable companies. Scale up expert Sherry Coutu believes that most innovation facilities today are failing in their duty to help startups and corporates work effectively together and bring products to market at scale. Whether in terms of running successful proof-of-concepts, giving access to talent and finance, or even providing the hardware required to scale up their work, these things are traditionally lacking from the modern incubator.

The challenge for enterprises looking to make strides then is to back up their innovation strategy with the organizational capability to scale up the experiment i.e minimally viable pilots.. Hagel and Seely Brown advocate a seven-step process:

1. Locate your edge, which is likely to be an emerging business opportunity that has great potential to scale up rapidly.
2. Identify your changemaker/s who fully understand and will embrace this opportunity.
3. Position this individual/s outside the core of the organization.
4. Take a lean startup style approach and experiment relentlessly in order to accelerate learning.
5. Deprive the team of much in the way of support or resources.
6. Encourage the team to connect and partner with other parties outside of the organization to gain the support they need.
7. The new venture should look to create a new product or service and not cannibalize the core business, at least to begin with

Sick care organizations can also learn some lessons from other industry corporations that are trying to partner with startups.

Sick care innovation centers might be a fad or an important tool for fixing what’s broken. We’ll have to see. In the meantime, enjoy yourself at all those conferences.

 
Image Credit: Pixabay

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GUEST POST from Arlen Meyers

If and when you decide to start your own company or work with a client, you will have to have a plan to evolve as a leaderpreneur i.e. someone who know how to lead innovators. Doing so will require that you periodically assess your personal and oganzational roles, holes and goals to see if you are still the right person to do the jobs that need to be done.

Roles have to do with which position you will play on the startup, scaleup or grown up team? Is it a problem seeker, a problem solver, a money finder, a business builder, a customer finder, a scorekeeper, a legal eagle, a people connector or some other role that your title may or may not completely convey?

Holes have to do with which problems you are tasked to solve not just in your organization, but where you have personal knowledge, skills,attitude and competency gaps as well. What are the expectations?

Mindset is but one of many entrepreneurial competencies you will need to succeed. Others include:

Opportunity recognition pertains to one’s ability to scan and search for new information, connect the dots between incidents that appear to be unrelated with limited cues, and recognize patterns or ideas that suggest potential opportunities in the myriad cues or signals that they receive (Baron, 2006).

Conveying a compelling vision/seeing the future reflects an individual’s proclivity for effective communication where he or she can translate his or her vision into condensed, clear, and intriguing messages to important stakeholders (Chen, Yao, & Kotha 2009).

Ability to maintain focus yet adapt speaks to the entrepreneurial experience. This ccan include considerable ambiguity and uncertainty, significant obstacles, ongoing emergence of new opportunities, and continuous change in circumstances (Morris et al., 2012). The entrepreneur must continuously adapt, change, modify, and switch while maintaining a self-regulated focus in the midst of volatile conditions (Haynie & Shepherd, 2009)

Resilience captures the cognitive tendency of an individual to cope with stressful, adverse, and devastating situations, to be able to recover from failures, and to constructively sustain his or her efforts to pursue goals. In reality, successful entrepreneurs are not easily beaten by distress or rejections. Instead, they are able to remain or resume a calm state of mind, to tactically frame and analyze problems, dig into the root cause of failures, and to search for ways to get back on track again (Sinclair & Wallston, 2004).

Interdisciplinary teamwork and collaboration refers to the ability of individuals to form partnerships with a team of professionally diverse individuals in a participatory, collaborative, and coordinated approach to share decisionmaking around issues as the means to achieving improved health outcomes (Orchard & Curran, 2003).

Assessing the feasibility of an opportunity emphasizes the need for innovators to make evaluations or judgments on whether emerging information or changes would lead to viable opportunities with profit potential (McMullen & Shepherd, 2006).

Self-Efficacy/Confidence relates to an entrepreneur’s self-confidence and selfassurance about his or her ability to take on challenges, to perform certain set of tasks as needed or expected, and to control processes, contingencies, or consequences in the entrepreneurial pursuit (Bandura, 1997; Baron & Markman, 2005; Tierney & Farmer, 2002).

Building and using networks concerns one’s ability to establish, maintain, and structure his or her contact network(s) in ways that foster relationships, enhance access to opportunities and/or resources, and potentially lead to realization of his or her objectives (Aldrich, 1999).

Tenacity/Perseverance refers to the extent to which entrepreneurs are committed to seeing their vision through, to endure the long journey to carry out venture creation, to work fervently despite challenges or adversity, to maintain interests, and persist with efforts in achieving goals (Duckworth & Quinn 2009; Hmieleski & Corbett, 2006).

Understanding of healthcare systems entails having a firm grasp of the various components of the health system and an understanding of the major issues faced by the stakeholders.

Resource leveraging/Bootstrapping describes the need to overcome resource constraints by leveraging resources from others. It also reflects a tendency for innovators to demonstrate an inclination towards effectual rather than causal reasoning in bringing together unique resource combinations (Greene &Brown, 1997; Honig, 2001; Politis, Winborg, & Dahlstrand, 2011).

Creative problem solving/Imaginativeness is characterized by Schumpeter (1942), who posited that creative destruction plays a key role in the innovation process. Innovators who start something are engaged in a process of creative imagination in which opportunities are exploited by continuously combining resources in new ways (Kirzner, 1973; Chiles, Bluedorn, & Gupta, 2007).

Design thinking is a human-centered, prototype-driven process for innovation that can be applied to product, service, and business design. It is the process of questioning, observing, and experimenting, so that you can become better equipped to capture valuable information and develop new business ideas. It requires experimentation in order to understand how things work, to test new business ideas or different approaches, and to look for valuable insights that may emerge in the process (Brown, 2008).

Guerrilla skills is a label adapted from a warfare context, describing approaches that center on clever ways to take advantage of one’s surroundings, do more with less, to rely upon unconventional tactics, and to utilize resources not recognized by others in accomplishing tasks within entrepreneurial firms (Schindehutte, Morris & Pitt, 2008).

Risk management/mitigation involves the systematic monitoring, assessing, hedging, transferring, and/or exploiting multifaceted risks encountered as an innovation initiative unfolds. Risk-aversive attitudes discourage individuals from innovative activities (Cramera et al., 2002), while successful entrepreneurs are willing to first recognize and bear the uncertainty or risk needed to take entrepreneurial actions, and are able to manage risk rather than simply trying to avoid risk (McMullen & Shepherd, 2006).

Cross disciplinary knowledge refers to an understanding of the connections, interrelations, and interactions between different fields of knowledge (Mosseri, 2006).

Change management is the ability to understand and manage driving forces, visions, and processes that fuel large-scale transformation (Kottler, 2011).

Information management is the collection and management of information from one or more sources and the distribution of that information to one or more audiences.

Behavioral economics refers to an understanding of psychological, social, cognitive, and emotional factors on the economic decisions of individuals and institutions, and the consequences for market prices, returns, and resource allocation (Lin, 2012). It is the understanding that drives decision making.

Leadership There is a strong link between leadership and innovation

Mindset Innovation starts with the right mindset

Goals have to do with your personal and organizational key performance indicators , objectives and key results.

Your compensation will often be tied to how you answer these questions, so be sure you understand and agree with the answers before joining the team.

Your roles, holes and goals will evolve as an enterprise grows ( or be irrelevant if your enterprise fails) so you will need to evolve with them. Here are some tips on how to change your personal leadership strategy as things inevitably change.

It is but one of many startup and scaleup challenges

Here’s how to keep your job as your or your client’s company grows:

Creating, scaling and reinventing a business is a movie, not a snapshop. So is your personal development, so pay attention to both and create a plan for next steps or someone will find it for you. Sometimes that’s the exit.

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GUEST POST from Arlen Meyers

Some doctors are getting restless. Whether they are part of the young and the restless, the desperados or the old and the grumpy, they are thinking about limited career half-lives or how to help patients in a way other than seeing 20 a day for forty years.

We’ve all heard about the mid-life crisis. It’s that “is this all there is ?” moment. But, did you know that the quarter life crisis, is, according to some experts (particularly those interested in getting you use their products) an epidemic?

But, let’s first define the quarter-life crisis quickly in case you’re not aware of it. “Many people have heard of the quarter-life crisis, a period of insecurity and doubt surrounding careers, relationships and finances experienced by people in their mid 20s to early 30s ”

For most doctors, this is the period when they are just starting their medical careers due to the 12-15 years required to complete premed, medical school and residency. Then, it takes another 5 years in clinical practice to just find the bathroom.

As if becoming secure in medical practice isn’t enough, now you have to deal with questionable relationships, a mountain of debt and an iffy career pathway given all the changes in medicine and the lack of corporate loyalty and generational attitudes about job security, the gig economy and work-life balance. Add to that, you are skiing down the happiness curve.

What should you do?

1. Start building a side gig
2. Have a financial plan to pay off your debt, save for retirement, live within your means and protect your assets
3. Adopt an entrepreneurial mindset and develop and practice entrepreneurial habits
4. Expand your networks, particularly with people who are not doctors. Are you Linkedout?
5. Have a Plan B career option. You probably won’t want to pay someone to help you, but find a coach if possible.
6. Adjust your expectations
7. Develop resilience in the face of headwinds and PISS on burnout
8. Find a mentor, sponsor or friend who you can trust
9. Have a sit down with your spouse or partner
10. Take advantage of the multiple free resources available
11. Build your social support network and engage them face to face and online
12. Get experience doing something other than clinical medicine.

Count on it. There will be hard day ahead.

The Medicare trust fund will be depleted in 2026, the administration said. By contrast, the government said last year that the trust fund would be exhausted in 2029.

In a companion report, federal officials said the Social Security Trust Funds for old-age benefits and disability insurance, taken together, could be depleted in 2034, the same year projected in last year’s report. The fund that helps tens of millions of retirees is expected to be depleted a year earlier than projected last year, while the outlook for the disability trust fund is more favorable.

The bottom line is prepare yourself, your relationships and your career for what lies ahead. Don’t die with regrets.

Wouldn’t it be great if you had the choice of practicing medicine for free, moving on to something else or being able to be on the 10/20/30 plan ?

Now that the snow is starting to fall, you might also want to buy a new pair of skis.

 o Twitter@ArlenMD and Co-editor of Digital Health Entrepreneurship

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GUEST POST from Arlen Meyers

Everyone seems interested in getting the most impact out of their innovation efforts. Collaborative Innovation Networks (COINs) have mushroomed since the invention of the Internet and cheap mobile communications. Community based innovation and biomedical and health online innovation networks have the potential to speed new product development, offer alternative financing platforms for early stage ventures, provide education, information and support to those with particular diseases and help to lower the costs and speed of clinical trials. A recently announced collaboration between the FDA and PatientsLIkeMe will make it easier to do post marketing surveillance for drugs.

However, questions remain about their effectiveness in creating value, security, commercial and clinical validity, legal status and sustainability.

A important question is whether COINs, particularly in biosience and health, create lasting impact, and , if so, under what circumstances. Based on my experience co-founding a non-profit COIN and contributing to efforts to transform it into a sustainable entity that meets its mission i.e. getting biomedical and health ideas to patients, leaderpreneurs need to overcome several hurdles:

1. A relentless focus on advancing a clearly defined, easy to understand mission.

2. Creating and validating a business model that generates enough revenue to sustain the organization.

3. A marketing effort that uses state of the art social media techniques to target those most interested in supporting your mission.

4. Minimizing spending on things that don’t add user defined value.

5. Continually offering new products and services as part of the platform.

6. Telling your story in a way that it appeals to the heart, not the head of potential supporters.

7. Engaging and building the community of interest until it reaches a tipping point.

8. Transitioning from working in the COIN to working on the COIN once it has reached a critical mass.

9. Cheaply creating and killing experiments early when it is clear they won’t yield positive results

10. Expanding your influence to interface or open networks with overlapping interests. COINs need to be COPINs-collaborative open innovation networks

Building collaborative open innovation networks requires:

1. An organization with leadership to coordinate, grow and engage the community of interest
2. A compelling value proposition that meets the jobs, gains and pains of participant stakeholders
3. A communications plan that uses various message delivery channels

4. Metrics and a dashboard to measure both inputs and valid outputs

5. A viable business model

6. Leadership

7. Network engagement and advocacy

8. Innovation

9. Branding

10. A sustainable competitive advantage

Open innovation is about encouraging your teams and leaders to expand their internald external networks, make diversity and inclusion part of the corporate culture, encourage people to have outside interests and understant that your industry cannot be changed from inside only.

Collaborative, or open innovation, collaborative innovation, are “…activities organizations use to improve their rates of innovation and problem solving by more effectively leveraging the diverse ideas and insights of employees, customers and partners.” Here are some ways to measure their efficiency and effectiveness.

There are four essential steps to open innovation.

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GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

The 4th Industrial Revolution has happened, but it is taking a very long time for it to create the sick care spring . The convergence of technologies has already impacted many industries, including heavily regulated industries like financial services, mining, energy and the automotive industry. Take that self-driving Googlemobile you see speeding down your block and you’ll experience what I mean.

Can or should the sick care industry experience ever have something comparable to the self-driving doctor or the self-driving patient? There are barriers and sick care ain’t Uber.

1. AI in sick care comes with its own issues not the least of which are the lack of large data sets.
2. Sickcare has overlooked 5 basic digital principles
3. We are still trying to balance whether to ask for forgiveness or permission
4. We lack a whole product Healthcare IT solution. Instead we have smokestacked bits and pieces: a sickcare haphazard IT solution (SHIT)
5. Trying to balance high tech with high touch and maintaining some semblance of a doctor-patient relationship when the forces seem to be more centrifugal than centripetal
6. The lack of data scientists who understand sick care
7. Too much sick care and not enough healthcare
8. The costs of IT solutions that are severely impacting the hospital and practitioner bottom line and, in some instances, driving them bankrupt.
9. Patients and doctors who are unable. fearful or unwilling to ride in a self driving car and assume the risk of being in one
10. Regulators and status quotidiens who are resisting the inevitability of it all.

The two technologies – electric vehicles and digital health – and their market and industry dynamics seem to running parallel courses:

1. Both function in highly regulated industries.

2. Both require large capital expenditures to be scaled.

3. Both are driven by technology innovation, particularly, in the case of EVs, battery storage.

4. Both are supported or hindered by rules and regulations and the economic incentives to buy, lease or use them.

5. Both are dominated by a few major industry players.

6. Both are facing similar technology adoption and penetration challenges.

7. Both rely on supporting ecosystems, like charging stations around the US, to sustain growth.

8. Both have high-profile entrepreneurs wearing the sneakers who are rabid earlyvangelists.

9. Both are challenging heavily entrenched status quotidiens.

10. Both will have many unintended consequences that are impossible to predict.

Just like smarter cars will be traveling on smarter roads, smarter patients and doctors will need smarter ways to help them navigate the complex sick care highways.

Of course, the pace of change is relentless and one of these days DIY medicine, AI and machine learning and the internet of things will be mandatory courses (online of course) for all first year medical students. Just be sure you are wearing something civil when the driverless Sickcaremobile is parked in front of your house and puts your picture on Sickcare Earth.

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GUEST POST from Arlen Meyers

Disrupting competitors or an industry essentially means doing something to take market share away from your competitors or get non-users to buy your product or service at at profit. There are many examples of sickcare entrepreneurs doing it and usually the tactic is to introduce new technologies. However, according to one researcher, most disruption comes from inprovements in how you change and improve the value chain.

Value chain analysis means looking at each of your customers or potential customers and mapping out all of the activities that they are need to do in order to acquire products and services. For example, here is pharmaceutical company value chain:

Value chain analysis is a way to visually analyze a company’s business activities to see how the company can create a competitive advantage for itself. Value chain analysis helps a company understands how it adds value to something and subsequently how it can sell its product or service for more than the cost of adding the value, thereby generating a profit margin. In other words, if they are run efficiently the value obtained should exceed the costs of running them i.e. customers should return to the organisation and transact freely and willingly.

Conceptually, this was an industrialized view of how a company works. The arrow starts with the supply chain, with the customer at the end. Most S&P index companies founded before the internet era still operate with this value chain mindset.

A Business Model (BM) describes the way a company returns profit/value to the business while delivering the product to customers. A Business Model shows as such how a company makesprofit from its products. Creating a VAST business model in sick care is elusive for many reasons. Not having one is one of the main reasons why your business will fail.

Defining the value chain to a customer helps you indentify and exploit potential business model opportunities. Here is how the value chain informs the business model canvas.

Here are some differences between the two and a brief history of how these terms have evolved.

In sick care delivery, there are three basic ways for doctors or other sickcare professionals to innovate their way out of the mess we’ve caused: technology innovation or adoption, execution and customer/patient experience. In most instances, changing the value chain or business model is more effective than technology diffusion and implementation.

If you are trying to change sick care to healthcare, seek to understand before being understood. One step in that process is to be a problem seeker , not a problem solver and that means understand the value chain. You’ll find it valuable.

 
Image Credit: Pixabay

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