Despite all the buzz around user-generated content and visitors to social networking sites, consumers actually spend a relatively small share (only 7.5%) of their time online with community sites, according to the Online Publishers Association's Internet Activity Index. The latest index results break online destinations into five categories: search, content, commerce, communication and community. Of these sites, 42.7% of consumer time online is spent with content sites, 28.6% is with communication sites, 16.1% with commerce sites and 5 percent on search sites.
A new analysis of online consumer data shows that large Web companies are learning more about people than ever from what they search for and do on the Internet. These companies gather clues about the tastes and preferences of a typical user several hundred times a month, and use that information to predict what content and advertisements people most likely want to see.
Every week, it seems, I read a different prediction about consumer-driven healthcare. It's already here. It'll be here any minute now. It's on the horizon. It's on the distant horizon. It's a passing fad. It's a bunch of hooey. The truth, I suspect, lies somewhere in between "already here" and "hooey."
I can't help but look at the issue as a consumer--one who takes the time to research providers and medical conditions online, who is willing to pay more for better quality care, who isn't afraid to fire a provider if he or she doesn't meet my expectations and who will tell everyone within earshot about negative or positive experiences at the local hospital, including my primary care physician. But I'm just one person. And for some strange reason the pundits aren't basing their predictions solely on me.
One of the latest predictions about the consumer revolution comes from Don Seymour, president of Don Seymour and Associates in Winchester, MA. "The transition to consumer-driven healthcare will be evolutionary, not revolutionary, and cost, not quality, has been the driver to date," he writes in the introduction to Futurescan 2008, an annual report from the Society for Healthcare Strategy and Market Development (SHSMD) on a wide range of healthcare trends and their implications for strategic marketers, planners, and senior leaders.
If you look at more than a decade of these reports, Seymour writes, there is a clear, overarching message to the nation's hospitals: "Take care of more people who have growing expectations and more complex medical needs while providing increasingly sophisticated care with relatively fewer resources."
But, he adds, "lest consumerism become to the 2000s what capitation was to the 1990s--overhyped and precipitously reacted to--Futurescan readers are advised to proceed with a dose of caution." Among the data he points to: Out-of-pocket costs are relatively low, employer interest in consumer-driven products remains low, and decision-support for consumers is limited.
"Although the Internet is an important source of health information, barriers to its use include a lack of standardized performance measures, a lack of comprehensive information, and inconsistent information," he writes.
And that's where he loses me.
I get that consumerism isn't here yet, that it might not even be here any minute now. I get that health savings accounts aren't as ubiquitous as 401(K) plans. I get that not everybody's like me. But I don't think that the lack of standardized information online is going to stop people from making a decision about whether or not they want to go to your hospital, use your physicians and specialists, or tell everyone they know about their experience there.
In fact, all the lack of standardized information means is that people are going to make decisions based on whatever they can dig up online--be it nasty blog posts from a disgruntled employee, the story in the local paper about traffic hassles caused by the construction of your new building, or the fact that your competition is printing price and quality information on its own site, even if that information is oversimplified or misleading.
One of the six "magatrends" cited in the Futurescan report, in addition to consumerism, is competition. It seems to me that increased competition would be more of a minitrend if consumerism wasn't at play. Consumers who care about reputation and word-of-mouth might question a referral from their primary care physician. Patients who care about price might consider medical tourism, while patients who care about quality would think twice about getting surgery in a country where they can't drink the water.
OK, there's the issue of margaritas and sandy beaches. But that's a kind of consumer experience, too.
I respect the thought leaders who work hard to sift through data and reports, talk to industry insiders, and tap their own deep understanding of the healthcare market to create the annual Futurescan report. I wonder, though, what future reports will say about consumerism. Will the consumer revolution ever begin in earnest? Or will it turn out to be a bunch of hooey?
Many community and rural hospitals rely heavily on Medicare and Medicaid reimbursement, so I doubt that any of you were too surprised by President Bush's budget proposal, which seeks to rein in Medicare costs by reducing payments to hospitals. Even if hospitals receive a reprieve from reimbursement cuts this year, the current reimbursement rates likely won't last too much longer. Medicare's projected 75-year shortfall is $34 trillion, and according to a recent article in Fortune, Alan Greenspan cited Medicare as the greatest threat to the U.S. economy.
So you know that one of your largest payers will probably be paying you less in the near future. What are you going to do about it?
If you answered "I don't know," you'd better figure it out soon. But the thing is, focusing on long-range issues is easier said than done for many small hospital leaders. One of the phrases that I hear repeatedly among hospital executives and industry experts is, "Rural hospital leaders wear multiple hats." Yes, that's one of the most overused phrases in healthcare--right behind, "There is no silver bullet." But that doesn't make it any less true. Senior leaders in small community and rural hospitals do in fact juggle multiple responsibilities that can leave them mired in the daily operations of the hospital.
But an effective leader needs to spend more time focusing on the future than solving day-to-day problems, industry experts say--even though breaking free from the daily grind can be a challenge. Last year I spoke with Jill Fuller, chief nursing officer at 70-staffed-bed Prairie Lakes Healthcare System in Watertown, SD, on what is needed for hospitals to be successful. She says that executives have to learn how to give up control and quit viewing the organization as a machine, because the delivery of healthcare is a complex system with many moving parts. "I think that a lot of us are out of the old machine age, and we have to change that," says Fuller.
Experts contend that senior leaders should set the direction of the organization, motivate employees around those goals, and empower managers to figure out the details. This means that hospital executives should be prepared to be surprised every once in a while, notes Fuller, whose hospital is actively involved in the Transforming Care at the Bedside initiative sponsored by The Robert Wood Johnson Foundation and the Institute for Healthcare Improvement. TCAB seeks innovative ways to improve the quality of patient care and increase nursing staff engagement.
Surprises or not, senior leaders have bigger things to focus on than hashing out the details of a new nursing-care delivery model or a plan to reduce inpatient falls--like, how to keep the lights on when your largest payer cuts your reimbursement.
I would like to hear how you plan to diversify your hospital's revenue stream in the face of reduced Medicare payments. Please drop me a line at the e-mail below.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com
Is your fundraising or awareness campaign not going as well as you may have hoped? St. Baldrick's, the world's largest volunteer-driven fundraising event for childhood cancer research, has found a unique way to educate the masses and get people involved.
St. Baldrick's started in March of 2000 as a fundraising event centered on volunteers raising money to "go bald" in support of children and families affected by cancer. Now in its ninth year, the event has successfully raised more than $34 million for childhood cancer research and has shaved over 46,000 heads from 18 countries and 46 U.S. states in the process.
According to the St. Baldrick's Foundation, "Thousands of brave, bold, and bald shavees step up to be shorn year after year, becoming walking billboards for the cause of childhood cancer."
Another St. Baldrick's fundraising strategy allows supporters to raise awareness all year round. A company called ReActee.com has developed a system of raising awareness through T-shirts and texting. The T-shirts all have different sayings and different keywords on them. One T-shirt says, "Ask me why I'm bald" with a call-to-action: "Text Bald to 41411 to find out why."
Playing on people's sense of curiosity in an age of technological advancement, texting the keyword prompts an automatic response: "Because I stand in solidarity w/ the 160,000 kids who are diagnosed w/ cancer each year. Go to StBaldricks.org to help!"
Another shirt says, "Get Bald" with the call-to-action, "Text Baldie to 41411." That keyword prompts the message: "Cancer's the #1 disease killer of kids in the U.S. Be brave, get bald, & help Conquer Kids Cancer. Go to StBaldricks.org to help."
"So far it's been a big hit," says Rachel Black, media relations coordinator for St. Baldrick's. "Looking at our numbers from ReActee we've had nearly 80 transactions. That means this alone has raised nearly $800. It's really a great opportunity and a new way to spread the word." In addition to be an inventive way of raising awareness, 20 percent of each T-shirt sale goes to the foundation's cause.
Kandace McLaughlin is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kmclaughlin@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
In a meeting near Washington, DC, leaders from the Mayo Clinic listed the steps they hope the next president will take to fix the U.S. healthcare system. Mayo's list touches on issues regularly debated by presidential candidates, but also ones that are not, such as changing the way care is paid for to reward better-performing doctors and hospitals.