HIMSS Final V3.0

© 2008—The Revere Group, an NTT Data Company. All rights reserved.This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes. © 2008—The Revere Group, an NTT Data Company. All rights reserved.This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

Setting Healthcare IT Strategy in a Web 2.0 World

October 23, 2008Presentation to Midwest HIMSS

David Oakley, Florida HospitalMarc Danziger, The Revere Group

© 2008—The Revere Group, an NTT Data Company. All rights reserved.This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

Actually, There IS a Web 3.0

• It’s about using “the semantic web” to structure information

• You have to have Web 2.0 first• So we’re going to talk about Web 2.0 today,

and that will open opportunities for learning about and using Web 3.0

• See! It wasn’t a typo – it’s a future learning opportunity!

2


Intro

• In late 2007 Florida Hospital hired The Revere Group to assist in their portal strategy and requirements

• This is what we both learned


Speakers

• David Oakley• Marc Danziger


David Oakley Bio

• Manager or eHealth Strategies at Florida Hospital

• Marketing with IT “in-the-blood”• Launched several award winning websites for

Florida Hospital including GlobalRoboticsInstitute.com and DisneyChildrens.com


Marc Danziger Bio

• Revere’s National Competency Leader for Social Media and Web 2.0

• Involved in online systems since 1993, when he founded a BBS-based commercial real estate system

• Has worked and consulted for pioneering Internet firms including CarsDirect.com and Physicians Online.

• Has cofounded four startups, two of which currently are active and profitable – Pajamas Media and ExposureManager.com

• Has advised clients including Fast Company and Inc. magazines, Manpower, Florida Hospitals, NBC-Universal, United Health, and Veterinary Pet Insurance on social media strategy and implementation

7© 2008—The Revere Group, an NTT Data Company. All rights reserved.This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

Who is Florida Hospital?

๏ Faith/Mission Based๏ Services๏ 2,100 Beds๏ 8 Orlando Campuses,18 Urgent Care

Centers, Health Plan, Home Health, Ancillary Services

๏ 1,000,000 Patients Served๏ 107,000 IP๏ 350,000 ED

๏ Clinical Initiatives๏ Global Robotics Institute๏ Disney Children’s๏ New Heart Tower๏ Diabetes - With Biotech๏ Advanced Surgical Launch

6


Legacy Apps

USAOrmis11

Where Are We Today?

http://www.misys.com/

http://www.misys.com/

http://www.vurv.com/default.cfm

http://www.vurv.com/default.cfm

http://www.nextgen.com/index.asp

http://www.nextgen.com/index.asp


Patient Experience

12


Marketing

๏ Shift in Marketing and Media Communication

๏ Opportunity to be on Leading Edge

๏ Affinity and Loyalty

13


The Magic Quadrant

Ephemeral /Public

Critical/Private

Dat

a Ty

pe

Level of Control

High/ClosedLow/Open

Cerner HIE PWR

Del.icio.us Links

Blogs

Wellness Community

Scheduling


What the heck do we mean “Web 2.0?”

• Web 2.0 is considered to be the second strategic direction for the web

–Web 1.0 was about distributing content and enabling transactions on the web

–Web 2.0 is about moving from using the web as a megaphone toward using it as a telephone


How does that work?

• Traditional Media: “You pay, I talk, you listen.”• Interactive Media: “Let’s you and I talk.”• Social Media: “You all talk to each other.”


Where can we go see it?

• Google• Blogs• Facebook• Twitter• YouTube• Digg• Del.icio.us


Why does it matter?

• Your customers and employees have been talking back forever, but you could ignore them – and you probably were

• Now they have almost as big a megaphone as you do – and you can’t ignore them any more

• Here’s a story...


June 2005

• Blogger Jeff Jarvis (disclosure: friend of mine) buys a Dell computer, and has some problems

• Dell customer service is – unhelpful• Jeff starts blogging about ‘Dell Hell’

•


November 2005:

• Jeff’s blog post has been cited by Business Week, NY Times, PC World, the Guardian UK, Adweek, and other mainstream media

• Dell’s reaction? It shuts down its message boards and issues press releases

• The market’s reaction? Dell 29.24, HP 28.79

• Dell lost ~$36 Billion in market capitalization


What did Dell do then?

• Dell got smart• Reopened message boards• Started a corporate blog, took its licks and

converted a number of its critics to allies• Decided to start listening to its customers,

and with Salesforce.com, launched ‘Ideastorm’ a Digg-like rating tool that let customers suggest ideas and vote on the ideas suggested


The most popular idea?

• Linux notebooks• Today, you can buy Ubuntu (Linux)

notebooks from Dell• Takeaway? Dell is talking to, and listening to,

its customers


Why did Dell get in trouble?

• Because they didn’t know what their customers thought of them• They talked ‘at’ their customers, they didn’t

converse ‘with’ them• So when the customers tried to tell them they

were unhappy, they had no way of knowing• Until…


Conversation is the Heart of Web 2.0

• Technology and organization that facilitates:–Business conversing with customers–Bosses conversing with employee–Leaders conversing with followers


3 ‘legs’ of Web 2.0

• Technology• Communication• Organization


Web 2.0 Technology

• Systems ‘accrete’ – grow organically• No system is an island – value through

sharing• Data as value, not data manipulation – own

the data


Web 2.0 Communication

• Peer 2 Peer• Personal – not corporate• Immediate – not polished• Persistent, searchable, indexable


Web 2.0 Organization Model“The A Team”


Operaticonal Detachment Alpha – a Special Forces ‘A team’

• Non hierarchical– High levels of trust and conversation within the team – anticipation,

improvisation, responsive to changing conditions

– High levels of trust of the team by leadership – directed by goals, not tasks

– Short OODA (Observe-Orient-Decide-Act) loops

• Works in the context of a traditional organization– …but pushes power to the edges – to the people facing problems

– …but releases team members from tight levels of top-down control

“In command and out of control” – Col. Paul Van Riper


Health 2.0

• The hyperinformed patient• Extending care past the office/ hospital room

walls by connecting patients to caregivers and caregiving information

• Improving patient care by improving transparency


How Could Web 2.0 Concepts, Features & Tools Be Applied to you?

• Strategic direction – lightweight business models and rapid evolution in response to patient and stakeholder preferences

• Strategic direction – opening content to patients and stakeholders, rather than tightly controlling it

• Technical direction – lightweight tools and services as the primary deliverables

• Challenge – maintaining brand identity and regulatory compliance in an environment where tight control is not possible. Institutional limits on how far healthcare companies can go


Web 2.0 as a Methodology and Software and as Business Design

Philosophy


3 Common Fatal Missteps

• Don’t make it someone’s job• Assume you can just buy tools and it will

happen• Don’t align the 2.0 implementation strategy –

in branding, technology, marketing – with corporate strategy


The Magic Quadrant Reprise

Ephemeral / Public

Critical/Private

Dat

a Ty

pe

Level of Control

High/ClosedLow/Open

Cerner HIE PWR

Del.icio.us Links

Blogs

Wellness Community

Scheduling


Interactive: What is your institution looking to do in

social media?


Healthcare is highly regulated• Healthcare is highly regulated• Healthcare management is multipolar

The challenges of setting a strategic direction in Healthcare IT with Web 2.0


Healthcare Web Technology and Web 2.0

• Most major healthcare system providers are providing some web access to their systems, and some (Epic, McKesson) are moving toward creating patient portals

• This offers one direction to providing outside web access to patients

• What are the pros and cons of this?

38


Managing the interfaces between legacy systems and Web 2.0 systems

• Healthcare is deeply enmeshed in legacy technology

• And facing the need to change dramatically• Can Web 2.0 help?


One Concept of How it Might

Legacy Transactional Applications

Public Internet

Portals

Data Translation Layer

Scheduling API Demographic API Clinical API

Custom Connectors

(Loosely Coupled)

(Tightly Coupled)


What was the Project that FHS and Revere Did Together


Florida Hospital Ask

• Define & align requirements for an Enterprise Portal solution– Understand

future state operating model

– Identify functions that can be enabled with information technology, including the Web 2.0


Project Methodology

Conduct interviews and observe current state operations (2-4 hrs each x 16)

Facilitate a series of up to 6-7 focus groups (up to 1/2 day each) among clusters of the constituent groups. Goal is to understand current operations at a high level, planned changes and opportunities for improvement in related areas

Synthesize major processes drivers of each business unit and identify technology enablers including portal functionality

Facilitate a work session (Clarity 1) with the senior leadership and the Portal Steering Committee to summarize and validate the uniquely important enterprise portal requirements (common needs and those unique to business units)

Key Activities

Working Inventory of Key Requirements

Preliminary mapping of requirements to technology & market available components

Key Outcomes

6-7 weeks, beginning November 1

Duration

What are the uniquely important business functions across Florida Hospital? How might those functions be enabled with information technology, including the

web? And with what benefit?

Requirements

Definition


DISCUSSION FORUMS

TARGETTED MARKETING

COMMUNICATION

TARGETED ADVERTISING

EXERCISE PROGRAM

© 2008—The Revere Group, an NTT Data Company. All rights reserved.

PROLOGUE: Ann’s private home page… Ann’s homepage allows her to keep track of her personal information and communicate with members with similar conditions. It also gives her access to useful programs the hospital may be offering for her condition. She is able to make all of her donationa online as she pleases.

PERSONAL HEALTH RECORD

Ann’s caregivers have access to her Personal Health Record and can check on the status of her exercise program to ensure she is on the right track. They also have the ability to communicate with her via secure messaging.

Ann can access her secure medical information as well as the information about her family that she is authorized to view. She also gets refill and appointment reminders.

Ann’s Health Provider team has access to her medical information and also gets alerted if any appointments are overdue or when test results come in.

TARGETTED FOUNDATION

COMMUNICATION

Diagrams modified from Microsoft Health Vault

Ann can schedule appointments and pre-register through her home page. When she registers, she is emailed a map of how to get there and any pre-appointment directions. There is an estimate of the cost of this appointment to her after taking into consideration how her health plan with reimburse.


How Florida Hospital Is Applying the Project


Florida Hospital Vision

• Combine Consumer Generated, Editorial, and Clinical Content

• Foster Ownership / Motivate Engagement / Nurture Loyalty

• Web 2.0 and beyond

Singular Vision - Executive Leadership


myFloridaHospital


Integration into Current Sites


Personal Page Development

IntegrationNo Integration

Support GroupsRecommend ContentContent Bookmarks

Share your StoryCommunity Calendar

Creation Health DevotionalBookmark Content

Forum PostsGames

One-Way MessagingeCommerce

Bi-Directional MessagingRealtime Scheduling

Bill NotificationPersonal Health Record

Physician DirectoryER Wait Times

Physician PagesRecommend a PhysicianPharmacy eCommerce

DME eCommerce

Site Stickiness


• Tear Down Silos• Talk - Establish Your Vision• It Ain’t Easy

– Cultural Differences– Language Barriers– Trust Building

Joint Team


Interactive Game


PlatformSocial Networking

“Right Now” ProjectsManagement

CultureStrategy

53


PlatformSocial Networking

“Right Now” ProjectsManagement

CultureStrategy

54

Health & Medicine

HIMSS Final V3.0