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From the “Who knew?” desk here at C4C Enterprises

By healthcare industry, technology

I read a lot. I read a lot of healthcare-tech stories, since what will save healthcare in the US (and everywhere else) is technology that eases and facilitates communication between clinicians and patients, clinicians and clinicians, and patients and patients.

A virtuous cycle of open communication, where individual patient data is secure from viewing by anyone who isn’t the patient or a clinician directly involved in the care of that patient. Where payers have to get permission to see patient health and treatment data that they’re not actually paying for.

One of the outlets I read pretty consistently is Fierce Healthcare and Fierce Health IT. The FierceMarkets  media network has a pretty deep bench on a variety of topics, and I personally trust media outlets who are transparent about what they do, why they do it, and who’s doing it for them. As opposed to, say, anything that Rupert Murdoch has a hand in.

But I digress (I am REALLY good at digressing). On to the “who knew?” portion of our program:

Who knew that patient satisfaction was linked to a smooth billing process? Actually, I’m betting that most patients know this. The people who still don’t really understand this are payers and many hospitals. There’s hope, though, as long as they actually pay attention to survey results like this.

Who knew that working long hours led to a greater incidence of medical errors? Talk about breaking news! Not. Anyone who’s ever pulled an all-nighter knows that your IQ falls in direct proportion to the number of hours you’ve been awake. Most of us stopped pulling all-nighters once we were out of college. For doctors and other medical professionals, not recognizing that they become dumber than a bag of hair once they’ve been on the clock for more than 12 hours is the biggest mistake they can make. And the hospital schedules that require them to work these kind of shifts? Dumber than a bag of hair as well.

Who knew that making patients sign gag orders was a bad idea? The Medical Justice League .. um .. Medical Justice *Services* provided doctors and hospitals with blanket gag orders that they were to require patients to sign, saying that they wouldn’t make any negative comments online about the practice/hospital/whatever. I’m all for full-disclosure, in both directions, when it comes to healthcare services. Or any other services, for that matter. However, requiring what’s essentially a surrender of one’s 1st Amendment rights is … crazy? Dumb? Actionable? All of the above, I think.

What did YOU discover in the “who knew?” healthcare category this year? Comments are open – let ‘er rip!

Make Congress work? I’m in!

By media commentary, politics

After spending [redacted] years in network news, covering every Presidential race from 1980 to 2004, my level of exhaustion and cynicism when it comes to politics is … epic. I vote in every election, because dammit-that’s-my-right-as-a-citizen, but often it’s a case of holding my nose and doing the best I can with the (rotten) choices I’m offered.

When I was invited to Capitol Hill last Tuesday, Dec. 13, to be in the room when a new Make Congress Work initiative was announced, I accepted with some of that exhaustion and cynicism. But like the old news warhorse I am, I saddled up and rode up I-95 to see what I could see.

What I saw made me feel like someone who’s been wandering in the wilderness for … ever, who stumbles upon a tidy little town that welcomes the weary wanderer with open arms. And gives her a job: help spread the news about the tidy little town. Help it grow into a big ol’ city.

So think of this as metaphorical political tourism. You can come along on the trip and enjoy the scenery with me.

Oh, come on, work with me, people. I’m a writer, and sometimes a comedian. I’ll bring this all home, I promise.

Here’s what happened: over 400 people showed up in the Caucus Room at the Cannon House Office Building to talk with, and listen to, a literal parade of bipartisan leaders from all points of the political compass.

The point? To break the chains of gridlock that have the folks we elected to represent us in a constant state of get-nothing-done.

That point was tidily contained in a 12-point plan to literally make Congress work. For its pay, for its privileges, and most importantly for the CITIZENS THAT ELECTED THEM TO OFFICE.

OK, I’ll stop shouting. I just get excited at the idea of those do-nothings actually doing something.

Here are the 12 points:

  1. No budget, no pay. [This is a personal favorite. If I don’t produce for my clients, I don’t get paid. Why should Congress?]
  2. Up-or-down vote on Presidential appointments. [Must vote within 90 days. No vote? Confirmed by default!]
  3. Fix the filibuster. [Sentimental memories of Jimmy Stewart in Mr. Smith Goes to Washington are Hollywood fiction. What really happens is a process hijacking. It has to end in order for the business of our country to move forward.]
  4. Empower the sensible majority. [Simply stated: don’t let the wing-nuts run away with the game.]
  5. Make members come to work. [Love this one. They quote Woody Allen: 90% of life is just showing up. So … SHOW UP.]
  6. Question time for the President. [Britain’s Parliament has Q&A sessions, in public, with the Prime Minister. As should the President and Congress. Just sayin’ … ]
  7. Fiscal report to Congress: Hear it. Read it. Sign it. [The Comptroller General should give a where-we’re-at report annually. With real numbers. What a concept.]
  8. No pledge but the oath of office. [LOVE THIS. Grover Norquist and his ilk can go sit down and shut up.]
  9. Monthly bi-partisan gatherings. [It’s harder to demonize or vilify someone you actually know. ‘Nuf said.]
  10. Bi-partisan seating. [Sitting next to a member of the opposition makes you a little less likely to call him/her a dirtbag. Really.]
  11. Bi-partisan Leadership Committee. [No more R or D pep rallies. Leadership means making progress, even when the going gets tough.]
  12. No negative campaigns against incumbents. [What this means is that Senator Whoever with an R after his/her name can’t campaign against Senator Whichever with a D after his/her name. Stop the attack-ad insanity.]

Want to come hang out in the tidy little town? Join the No Labels movement. Share the message on Facebook, Twitter, your blog, skywriting, cave painting, whatever.

Let’s make this tidy town a bustling city. And get Congress to work for US for a change.

That’s my story, and I’m stickin’ to it …

 

 

Year-end career-end in review

By PR

This year has seen some really stunning examples of how to completely screw oneself, and one’s career, in public. Here’s a review of some of my favorites:

  •  Anthony Weiner’s wiener: Do not take a picture of your package and post it on Twitter. This is a rule for everyone. If you do this, be prepared to watch the job you’ve had for 12 years disappear in a bright, shiny flash. And to become a never-ending joke in the process.
  • Aflac duck drowns in tsunami: Gilbert Gottfried managed to tank his career with some very ill-advised tweets in the days immediately after the Fukushima tsunami. Note to self: when hired to provide humor and comedy material for a client, insult comedy is the *wrong* approach.
  • GoDaddy CEO shoots elephant, wounds brand: Bob Parsons shot an elephant, and almost brought down the mastodon that is the GoDaddy brand in the process. When your business is high-profile, low-profile hobbies are a good bet. Take up golf. Much less likelihood of killing your brand with a 5-iron.
  • Ashton Kutcher is a no-talent jerk. Who knew? Well, actually, I think a lot of us knew. But when he leapt to Joe Paterno’s defense in the hours after the Penn State pederasty parade started up, he showed just how clueless and tone-deaf he is. Along with that total lack of talent. I almost felt sorry for Demi. Almost.

Some rules to live by: don’t do or say anything on social media that you wouldn’t want on the 1st page, above the fold, of the New York Times. Because that’s exactly what could happen, even if you’re not Anthony Weiner, Gilbert Gottfried, Bob Parsons, Ashton Kutcher, or countless other social media idiots.

That’s my story and I’m stickin’ to it …

 

Don’t wind up on the least-wanted list

By Uncategorized

unfortunate xmas decisionsYes, kids, it’s that time of year again.

ChristmaHanaKwanzaKah is once again in the hearts and on the minds of everyone from sea to shining sea – and beyond – so it’s time for a remedial lesson on How to Succeed in Business Without Really Lying.

Here are the Mighty Casey Media rules for surviving the holidays with your sanity – and your client list – intact:

  • Don’t be a grinch. If you’re not a big fan of the holidays, don’t trash those who are. You don’t have to go overboard and wear a pair of reindeer antlers all month, yet neither do you have to tell the office Christmas Elf that s/he is crazy for loving the holidays.
  • Be a gracious guest. If you’re invited to a holiday celebration by a client or a colleague, accept with thanks. Attend with intent to find the cheer. Bring a friend along who could be a good prospect for the business. Holiday gifts can come in the form of customers. Take it from one who knows.
  • Be a thoughtful host. If you host a holiday gathering, make sure to keep the conversation and connection flowing. Configure your party so there’s plenty of opportunity to interact, and make the rounds continually to ensure that everyone is enjoying themselves. And have a defined end-time for the party, which saves having to shovel folks out the door.
  • If you can’t deal, deal yourself out. If the holidays drive you nuts, that seems like a great excuse to take off on a vacation, a retreat, or a sabbatical. Deal yourself out of the holiday merry-go-round, and return to the game refreshed after Santa’s blown town.

Merry ChristmaHanaKwanzaKah to all, and to all a way to make the end-of-year insanity work for you!

Mobile medicine: movable feast or meaningless motion?

By e-patients, healthcare industry, media commentary, politics, technology

The concept of mobile health and mobile medicine is enticing. “There’s an app for that” when applied to managing a chronic condition like diabetes, or navigating cancer treatment, sounds like real 21st century healthcare, doesn’t it?

Tomorrow (Dec. 1, 2011) I’m on a panel that’s part of mHealthCon at Rutgers University, a conference where a plethora of mobile app developers and thought leaders will be talking both the idea and the practical app of mobile in healthcare.

Our panel is self-described as the American Idol judges – I’m Simon, including the scowl potential – and we’re expected to give meaningful and frank feedback to the app developers that are in the session preceding us. Leading the conversation will be my buddy Bob Brooks of WEGO Health, and sitting with me in judgement will be Amy Gurowitz (who’s gonna channel either J-Lo or Ellen, she hasn’t decided yet) of MS-OL and MS SoftServe, as well as the founder of DivabeticMax Szadek (he’s Paula).

The challenges that mobile health development face were summed up brilliantly by Dr. Kenny Linn in a post on the US News health blog:

Apps have … advantages over traditional medical texts. The information is always current, whereas many textbooks are already dated by the time they hit shelves. If I have a question, I can look up the answer on my smartphone without leaving my patient’s side. 

But smartphone apps also have downsides—despite their enormous potential to improve the quality and convenience of healthcare. While textbooks undergo rigorous review by experts, apps vary in quality and don’t have to be vetted for accuracy or safety.

That point was driven home to me recently when a colleague shared a nifty app she’d downloaded that acted as a mobile electrocardiogram (ECG) monitor: Just place your finger tip on the smartphone’s camera, and your heart rate and electrical rhythm appear on screen. Visions of chucking our office’s bulky and temperamental ECG machine briefly danced in my head—until I tried the app out and found the readings to be completely wrong.

That’s a pretty clear indication that mobile apps, particularly those meant to be used by clinicians, or to be used by patients to provide data that clinicians can use in their clinical decision making, need to be vetted as thoroughly as a medical text must be.

What would your requirement(s) for a healthcare mobile app be? You can answer as a patient, as a caregiver, as a clinician, or as all three.

I really do want your answers, and even if you’re not seeing this until days/weeks/months after it posts, please share your thoughts in the comments.

I have the ear, the eye, and the attention of a whole host of people who are working on creating meaningfully useful apps for doctors, nurses, lab techs, patients, caregivers, and more.

Let ‘er rip!

Forget Wall Street. Occupy K Street.

By media commentary, politics
Angry Birds occupy Capitol Hill?

(c) 2011 Walt Handelsman | Newsday

Heaving scrums from coast to coast are occupying public squares to protest what seems to be the greatest concentration of personal wealth since the Gilded Age at the end of the 19th century. Their ire is directed at Wall Street, which does bear some of the blame for the epic meltdown of the US – and global – economy over the last four years.

The biggest share of the blame, however, really belongs on another street entirely: K Street. The street of lobbying dreams, chock full of high-dollar law and PR firms that work Capitol Hill relentlessly on behalf of everything from AARP to zoologists.

Individual taxpayers have no access to K Steet influence, unless they’re members of an interest group – like the aforementioned AARP – that has enough chedda to hire a lobbying firm.

Congress, both the House and the Senate, depend on special interest money to mount successful election campaigns.

The electorate – the taxpayers, we individual voters who head to the polls to hold our noses and do the best we can with the choices offered – are offered those choices for national office based on who can raise the most money, and spend it to get our attention.

And now that corporations are people – thank you, Citizens United – they are under no restraint whatsoever when it comes to political donations.

Have you completed the calculation yet? Here’s what it boils down to:

Corporate $ + K Street (Congress) = We’re Screwed

That may seem simplistic, but it captures the essence.

Do not mistake me – I am a capitalist. I believe that every citizen – including corporate ones – has the right to appeal on behalf of his or her interests to elected officials. Where we find ourselves today, though, is at a very broken place.

Most Americans see their financial futures as, if not stormy, at least cloudy with a chance of bankruptcy. They see their children’s future prospects sinking, since the college degree required for an entry level corporate gig will now saddle those kids with a level of debt that will keep them living on ramen noodles well into their 30s.

How does the American Dream work in that scenario? How does hard work – to get a degree, to start a career, to start a business – actually work to advance your cause if most of the marketplace is on the ragged edge of broke?

A commitment to re-tooling our educational system to a 21st century model (instead of the 19th century “train factory workers” model currently in place) and a simultaneous commitment to bringing our national infrastructure up to date would be a step in the right direction. Unfortunately, the occupants of Capitol Hill are more interested in bleating about the lack of jobs than actually creating jobs by taking those actions.

We have a broken bureaucratic biosphere, and we’re choking on sewage. The gridlock on Capitol Hill has reached Nero-with-a-fiddle proportions, with no progress in sight on any issue. Congress isn’t actively doing anything other than saying why it can’t (won’t?) do anything, and we’re at a statis point until the 2012 election … ?

What’s missing here is balance. There has to be a balance struck between totally unrestrained free markets – can you say Enron? – and government redistribution of wealth via the tax system. There has to be a balance struck between “do for yourself” and a safety net for the most helpless among us.

The only path that I see to that balance is term limits … for Congress. They were real good at setting term limits on the occupants of 1600 Pennsylvania Avenue: two terms, yer out. Winning a House or a Senate seat, however, can mean lifetime employment as long as you can keep getting re-elected.

Even if you can’t keep getting re-elected ad infinitum, you can take advantage of the revolving door connecting the US Capitol to K Street.

The real problem? The folks who have to draft and pass term limits legislation are … Congress. Yeah, they’d have to stamp themselves with expiration dates. Which they are demonstrably loath to do.

And their re-election ad campaigns – financed largely by their buddies on K Street and their pals in state capitals across the land – will work hard to scare us into the horrors that will befall us should we fail to vote them back in to “finish the job.” Which “job” is likely to be more gridlock, followed by another round of “re-elect me to finish the job.

A quote attributed to Winston Churchill says that “America will always do the right thing, but only after exhausting all other options.”

I hope we are about to exhaust the last of our options before demanding that Congress actually conduct the business of the people. Let’s occupy K Street to help drive that message home.

That’s my story, and I’m stickin’ to it …

Things that make you go “thanks”

By e-patients, media commentary, politics

Let’s not be turkeys this Thanksgiving.

Let’s not start fights with the relatives while we’re together for the weekend.

Don’t let it matter that someone voted for Obama, or is backing Newt.

Let it ride that somebody’s a Dallas Cowboys fan (that’s work for me) or passionate about defending Penn State (it’s a great school, with a great history).

Accept the fact that Aunt [whoever] will always bring the thing you absolutely hate to eat. Put a teaspoonful on your plate, and suck it up. Or hide it under some mashed potatoes.

Surrender to the idea that, at Thanksgiving, we are brought together to be thankful.

Here’s my list:

  • My family, who I love to death (even if sometimes one or the other of you will get on my last nerve)
  • My friends, who are from all points of the globe and give me hope that I’ll visit each and every one of you (promise? threat? you decide.)
  • My customers, who have kept me afloat in some really interesting-in-the-Chinese-curse-way times (divorce + cancer = challenging fiscal cocktail. Trust me on that one.)
  • My healthcare team, who kept (and keep) me firmly planted on the planet (they all help me find the funny)

A short list, but it’s got some serious meat on its gratitude-fueled bones.

What are you grateful for this year?

Be grateful for too much turkey, if you’ve got that. Be grateful for annoying family, because it means you’re not alone. Be grateful for living in a free country, if you do – if you don’t, you can earn the undying gratitude of your community by driving an Arab Spring within your borders.

Be grateful that you’re alive. I have studied history, and the human race is at a point where we can learn to link together in a true global village, and make life vibrant and rewarding for each and every one of us.

Let’s get to work.

Thanks.

Change management lessons from Congress. Who knew?

By media commentary

congressional sealOK. So they’re not really managing change on Capitol Hill. They’re resisting change, hard, on both sides of the aisle.

Therein lies the lesson.

In order for any organization, from the corner grocery to the US Congress, to successfully transform itself to meet a changing environment, there are a few don’ts. Here they are, in no particular order:

  1. Don’t enter the process with a list of sacred cows. That might seem like a no-brainer, but think about every negotiation you’ve been privy to. From the NBA’s failure to have a 2011-2012 season to Congress’ failure to have a meaningful budget discussion, sacred cows – also known variously as “deal breakers” or “temper tantrums” – doom the process from the outset.
  2. Don’t forget why you’re there. You’re not there to score points, to prove you’re right, or to prove the other side’s wrong. You’re there – all of you, everyone – to move a culture forward. That means that everyone has to be willing to actually move. Which  means you can’t stand in the way just because you’re not running the game.
  3. Don’t fail to listen to the outliers. Are there any visionaries at your table? Particularly the kind that are looking so hard down the road that they don’t get caught up in turf fights? Ask them what they’re seeing in the process, and where they see opportunities to break stalemates. Be aware that these are often people who don’t speak up first. Or even second. So ask, and then listen.
  4. Don’t make it a fight. If the discussion gets heated, take a break. If it gets heated every single time there’s a meeting, identify the flamethrowers and deny them fuel. Take away their sacred cows, remind them of their stake in making actual progress. Or fire them. If they’re the CEO … quit.

The saddest thing about the current lack of change leadership in Washington is that the entire crew has forgotten that, in their zeal to hew to their party’s platform, they’re trampling the customers: us. They’re not listening to the frustration of their market – taxpayers – and making meaningful change that will move the organization forward to at least a shot at what might pass for a balanced budget.

So if you’re looking to drive meaningful change in your organization, here’s the last and biggest don’t: don’t act like the jerk-tards on Capitol Hill.

That’s my story, and I’m stickin’ to it …

 

New Golden Rule: See something? SAY SOMETHING.

By media commentary

bathroom bolshevik breedingRecent events have led me to believe that the world is populated by blind people. Or at least people who are easily sold on crazy.

One of those recent developments is the unfolding drama at Penn State, where icons of college sports – both the college and the coach – have been revealed to have been, if not active perpetrators, at least willing-to-look-the-other-way co-conspirators in child sexual abuse.

I use the image on the right because (a) it’s one of my favorite ad posters ever and (b) what happened at Penn State happened in a washroom.

If you see something, SAY SOMETHING. Even if you don’t/can’t/won’t DO something, at least speak up. And don’t take “it’s just [insert utterly unacceptable excuse here], don’t worry, I’ll take care of it” as an adequate response.

SAY something to someone who can/will DO something. Not the bishop that the pedophile priest works for. Not the coach who’s the supervisor of the guy who’s raping a child in the shower.

SAY SOMETHING to the cops.

“If you see something, say something” is the tag-line for a current Dept. of Homeland Security awareness campaign, aimed at stopping terrorist activity before it becomes an actual attack.

If rape isn’t terrorism, I don’t know what is. All crimes against persons – assault, rape, mugging, et al – is terrorism on a small scale, leaving marks as deep as surviving a bus bombing. In some ways, these very personal attacks leave deeper marks, because an entire community doesn’t share the victim’s experience. The person is left to deal with the aftermath alone. Just as the Penn State victim – he’s been dealing with the aftermath since 2002, essentially alone. And now the whole world is watching.

If you see something – someone hitting a child, slapping their spouse, raping a child in a freakin’ locker room – SAY SOMETHING. If you see it in your house. If you see it on your street. If you see it in the office. If you see it at your school.

See bullying? Say something. See domestic violence? Say something. See a theft, or an assault? Say something.

Find someone with a badge and a gun – and not just a university/school cop, either – and report what you saw. Keep talking until they listen.

If you see someone with a badge or a gun perpetrating a crime, call the FBI. Use your cellphone camera, and take it to the media.

See something? SAY SOMETHING.

All that it takes for the triumph of evil is for good men (and women) to do nothing. That’s always true, and never more true than in the situation where both the Catholic church and Penn State find themselves. An institution that’s trusted with the care and education of children has no excuse: if you see something, say something. Otherwise you’re approving the act.

It’s that simple.

That’s my story, and I’m stickin’ to it …

DNA: it’s not just for cop shows any more

By e-patients, healthcare industry, media commentary, politics

“It’s in my DNA.” 

You hear people say that all the time about something they love to do, a passion, an attitude.

There are things that actually are in your DNA that could save you money, and even save your life. Those things are the P-450 enzymes CYP-2C19, CYP-2C6, CYP-2D9  – pay attention, there’ll be a test later – which can predict your response to a wide array of drugs. Statins, blood thinners, anti-anxiety meds, anti-fungals, anti-depressants, antihistamines, beta blockers, and more – in all, about 50% of the pharmaceutical menu.

So why isn’t this being offered at every doctor’s office and pharmacy throughout the land?

I’ve asked this question in arenas as diverse as women’s health events and healthcare industry conferences, and have gotten a combination of responses:

  • Really?
  • Physicians don’t know enough about it.
  • Patients don’t know about it.
  • Does insurance cover it?

The answers to those, in order:

On the insurance question: even if you don’t have insurance, the test itself only costs about $400. And you only have to have it done once. Unless you wind up in a Fukushima-level radiation accident or have massive radiation treatment for cancer.

A question: why isn’t pharma, which is so good at saying “ask your doctor about [insert name-brand drug here],” trumpeting DNA drug-response testing? That approach wouldn’t impact their bottom line negatively, even if it works out that some patients need less of the standard dosage of a drug. Because there will be plenty of cases where the standard dose of that same drug won’t be enough for someone else.

Another question: why aren’t health insurers pushing this? They can save money with wider use of DNA drug-response testing, because over- and under-medicating leads to poor outcomes. If you get more of a blood thinning drug than you need, that could have dire consequences. As could not getting enough of the same drug. The right dose, right from the start, saves money that would have to be spent on hospitalizations due to the wrong dosage.

Doctors do know about DNA drug-response testing, but it’s not on the standard order set. Yet. It needs to be, if only to ensure better outcomes. Which is the whole point of healthcare, isn’t it?

There are a number of companies offering DNA drug-response testing, more than enough to make testing available to anyone who wants it. There’s one that’s headquartered right down the road from me: Genetworx.

If you’re a doctor or nurse practitioner, start telling your patients about it, and keep test kits in your office.

If you’re a pharmacist, stock test kits and reach out to the doctors you fill prescriptions for to tell them the tests are available at your pharmacy.

If you’re a health plan/benefits administrator, let everyone you cover know that testing is available, and encourage the providers – doctors, nurse practitioners, pharmacists – on your list to start using DNA drug-response testing as a must-do step when they’re prescribing a new drug for someone you cover.

It seems really simple to me. Doesn’t it seem simple to you?

That logic thing. It’s in my DNA.