Inoculate Yourself with Information

It all started with a conversation with my gynecologist....about Ebola. We talked late in 2014 in about how people we completely terrified about the Ebola outbreak and didn't seem to remember much about the basics of infectious disease. She said "Someone should write something about this for the general public." I agreed. Then I realized she meant me. 

So I wrote a story about this for the magazine I write for, The Health Journal, and then got an invitation to speak at The College of William and Mary about the topic. Unfortunately, we got snowed out that spring, and by the time I presented in the fall...no one seemed to care about Ebola. It didn't become an epidemic in the US.

But, luckily by that time, I was smart enough to add a virologist to my presentation, Dr. Kurt Williamson from William and Mary. He handled the virus and infection specifics, and I talked about how important it is to consume health information with a skeptical mind. It was a great chance to clarify some concepts for the general public, and for me, too! 

The Bridge or The Translator?

When talking to people who aren't in health care, I often describe myself as a translator of health information, from doctor to patient and patient to doctor. In fact, it's WAY more complicated than that.

One of the huge gaps right now in health care is that no one is talking to the caregivers and the caregivers, who are often a group rather than an individual, are frustrated about not being heard and not having a way to communicate. For example, my 90-year-old grandmother has eight living children, and she lives at home with one of them. Three of them live out of state. One of them is an RN, and one is a nursing home director. Her grandchildren number almost 30, and a number of them are health care professionals. How can Grandma's care team communicate effectively with all of these stakeholders? They often aren't even communicating effectively between her gastrointestinal specialist and her cardiologist and her physical therapist. 

If her daughter the RN is at the appointment, she knows the meds and the sx hx (surgical history) and the jargon.  If it's her engineering son, he wants to know about her hip function and rehab options. If it's her daughter from the nursing home, she wants to know how to engage her brain and hands for improved cognition. And whoever interacts with the care team for that appointment needs to know how best to communicate with the family. It's not easy dealing with elderly, frail patients with multiple conditions. Nor is it easy to understand that her support system is full of adults with their own ways of viewing the situation -- plus they need to talk to their other siblings about "what's going on with Mom?"

This "soft work" matters. Gaps in care and coordination grow most costly over time, and opportunities to maximize health care outcomes and costs is lost. We've grown accustomed to the concept of the health care team, but let's recognize there's a team behind the patient, too. 

For me, I've discovered I'm passionate about bridging clinical and patient communications in all the variations: from doctor to patient, caregiver to care team, health educator to low health literacy learner, patient advocacy to physicians, and more. The conversation needs to continue happening, at all the levels. If I can help as a translator, a collector of information and a facilitator of conversations, I will. If I need to bend to be the bridge, I'll figure out how.

Patient-Centered Research

Last week, I was able to go to the PCORI Merit Review as a patient / caregiver reviewer and it was fantastic. I can't say anything about the applications, because that's confidential, but I'm so delighted with the concept and process that I have to share that.

Each funding application is reviewed, not just by doctors and scientists, but by patients, caregivers and other stakeholders. Stakeholders is sometimes a buzzword -- in this case, it was patient advocacy group members or people who work for hospitals. I went as person deeply interested in how "care is delivered," the information we have to base decisions on and the effects on the patient and their family. 

I can't say enough about PCORI, which is innovative in something that seems quite obvious to most people -- that patients and their caregivers are stakeholders in medical research. We want to know. We need good information to make decisions. Health matters to us. It's based on democratic principles, that people have a say in things that affect them. 

To read more about PCORI, go to www.pcori.org

Entrepreneurship -- Hard to Spell, Hard to Do

I never thought I'd be an entrepreneur.

I still need to check my spelling on it -- there are a lot of e's!

Given that no one in my immediate family had ever started their own business, it was a little foreign to suddenly be able to just do it. Say I was starting a business, and do it. And, it's a little addicting. I am decisive, and there are a lot of decisions to be made. I'm a promoter, and that's always a plus, for me and my clients.

But it can be overwhelming just how many choices there are to made every day. That's why getting together with other entrepreneurs is great. They get it. We're all busy. We're all juggling priorities. I'm excited about going to a coworking meet up today, and I'm always excited to see small business owners at the Cobblers' Collective, the group that meets weekly at Work Nimbly.

Lots of places want to encourage entrepreneurship, but it can be like catching lightening in a bottle. We move fast, we want to get going and not wait for it to be discussed in committee. That means creative ideas come fast and furious, but it's hard to get us to go to 18 months of committee meetings.

It's an interesting, never boring life of entrepreneuring! 

Health Care Marketing...Who needs that?

It's fairly common for people to say to me something like this: "but why do hospitals need marketing? Don't people just go to the nearest hospital when they are sick?"

Well, it's so much more complicated than that. Yes, a person having a heart attack will probably go to the nearest hospital, in an ambulance. But what about someone who wakes up with a sore throat? Will they go to an urgent care center? Will they go see their doctor? Will they go to the drugstore and buy cough syrup? These are all choices, and each has a dollar value associated with them. In this scenario, these are real competitors, as the money doesn't go to the same source.

Health care consumers are unusual, in that nearly everyone is one, but very few of them know how to work in such a complicated system. Some health care marketing is just helping people know where to start and what to do next. Sometimes it's sharing what new research might mean for patients or caregivers. Other times, it is actually competition between health systems for patients for a specific service -- a la "Our cardiac care is the best!"  or "Our orthopedic doctors will get you back on your feet!" 

There are lots of ways to communicate -- it can be marketing, or communications, or publicity. (PS I do it all) But health care is full of choices, and there is a lot of money to be channeled...so that's why there's a field of professionals that do it!

What is a "Grant Scout?"

A few years ago, I took on a client project where I searched for grant opportunities in health care. I'm a writer by trade, and had taken some grant writing classes and workshops. I used my interviewing skills to find out what people were working on and then created a list of search terms based on that. Along the way, I coined this work "grant scouting." 

What's interesting though, is that now, when I say it -- people's eyes get big. They want my card. Grant scouting isn't all I do, but it's a niche I've created for my business. Do you know why the idea of having a grant scout is so appealing? Because there.are.so.many.grants out there, and it takes ages to sort through them all. The federal ones are pages long, and full of oblique requirements and recommendations. The private ones have requirements like "must be located in Michigan, Zimbabwe or Siberia" or "must have attended dinner party at the Vanderbilts in 1945 to apply." So, you see that there's an avalanche of information to sort through. I distill it down into the likeliest candidates.

It's not easy, but it's a service! I also provide "grant shepherding" -- more on that later!

I Thought They Could Fix Anything....I Was Wrong.

A few weeks ago, I saw a great patient video discussing a woman in the MidWest talking about her snowmobile accident and she gave great feedback for the staff. But she also said "I knew I was hurt but I thought, 'it's 2015, I thought they could fix anything.'" She lost two of her fingers permanently. During the interview, she mostly kept her right hand over the left hand with the missing fingers. She talked about the confusion when her doctor told her that the fingers were beyond saving. But her comment on the perception of most people that hospitals in America can fix anything has stuck with me. We do have amazing trauma teams. We have technology that diagnosis quickly, stabilizes and can mimic functions that the body can't manage on its own. We have blood transfusions and intense surgical techniques. 

But we still can't do it all. When I gave a presentation recently on infectious diseases, I reiterated this to the audience -- avoiding getting sick is still really important. We can kill bacterial infections with antibiotics, but it's getting harder. We can't kill viruses with antibiotics though, and there are few anti-virals available. We have to be smart and avoid injury and disease -- and be grateful for the advances in medicine should we ever need them.  

The Art of Yellow Shoes

As a bona fide extrovert, I love going to conferences. But, apparently not everyone does. There's a psyching up that needs to happen. At the most recent conference I went to (#SHSMD2015), I found a brilliant marketing idea. I was in line for a drink with two gentleman, and I of course started talking to them about their names, my favorite topic. But then I noticed they were wearing yellow Oxford shoes. Both of them. 

Not only was this a great way to have an instant ice breaker with the thousand-plus attendees, it tied in to their booth in the exhibit hall, also full of bright yellow accents. The entire staff had yellow shoes: pumps, moccasins, sneakers. So, on brand, attention-getting and unique. A brilliant plan for standing out in a sea of competition. Nice work Lift 1428!

Infectious!

After giving a presentation this week on infectious diseases and deciphering health information, plus attending an excellent SHSMD session on the handling of the Ebola panic, I have a few thoughts. 

1. Even if all of us who work in the medical field think that people should know something, it's best to go back to the basics. Like the super-basic foundations of science -- for example, that a virus and a bacteria are different things but both can make us sick. Or, that one study does not science make!

2. Internal communication is ultra-important in a crisis. It's not enough to reassure the public. You must communicate to your staff, your board members, your volunteers and anyone working in your hospital. Because your credibility goes in the toilet when you say "We're prepared" but the reporter interviewing nurses on the loading dock hears "We've had no training on this."

3, Fear is a strong motivator, even if people know they shouldn't be afraid. They are, and they want to play it safe. I heard from someone who was thinking of firing her nanny because the nanny's mom was a nurse. It sounds like an overreaction now, but if you recall earlier this year, we were a nation on the edge of our seats as to whether we'd have an outbreak or not.

4. Communication takes time. It can be laborious when you want to be doing (let's go!!!) but it will save you time in the long run. Return people's calls (especially reporters!) even if you don't have anything new to share. Tell your employees what to expect. I agree with Doug Levy (formerly of Columbia University Health System) who said "Communication can't solve everything but it puts you in the best position to catch flaws in your plan." 

Infectious diseases are a tough topic, but one that we will continually revisit. They won't go away -- but we can educate and we can prepare. Oh, and we can communicate! 

SHSMD 2015

It's great to be here at the American Hospital Association conference for the Society for Healthcare Strategy and Market Development. While these are "my people" since I work mainly in hospital and health system marketing, I've met some people working in interesting niches. Like those people who just work in planning and strategy -- like all day, every day. I love that these roles exist. I think one of the biggest gaps in corporate health care right now it that everyone is trying to be good at everything -- and it's not only a huge waste of time and money, it's drains energy from what a truly focused organization could be achieving. Values matter, and you need to unearth a ton of extra stuff to get down to that bedrock of what you value and your strengths.

Another big theme I'm seeing is value over volume. The keynote yesterday mentioned this huge industry shift, and it's part of the reason there's so much churn in health care right now. How can we turn a group of care providers, facilities, systems, support staff and practices the metaphorical size of an aircraft carrier? How can we turn back time to when patients were eating healthy and exercising, before they started pairing soda with every SuperSized meal, before their blood pressure rose and their waistlines ballooned. 

There's a lot happening and it's exciting to be in the middle of discussing it, in depth -- that's the value of breaking from the everyday work to sort out what we know and add to what we don't. 

Once You Are in the Forest...

There used to a store in my town called London's. It had a bold font for the logo, with a kind of British flag motif behind it. I knew where it was (near my favorite lunch place) but not what they sold. Their slogan was: Love London's! They did a short radio ad that included their name and location...but not what they sold! You know what finally got me in to the store? Their going-out-of-business sale. Turns out, it was a British soap, lotion and tea shop. 

To me, this illustrates one of the most common failures of marketing -- forgetting that while you are extremely excited and proud of your business, other people don't know what you do. Sometimes when you are so deep in the forest, you think that what you do is self-explanatory, or that you've already explained it. But potential new customers are always passing by at different times. Your name, logo, slogan and location should be engaging, but not mysterious (unless that is your specific strategy!)

One of the ways that I'm able to provide value to my clients is to point out that patients don't understand medical jargon, or a standard process, or even how to get around the campus of the medical center. Once you are inside, you forget that the quirky elevator buttons are confusing. (Floor 00 or Floor 0?) You might not realize that the visitors don't know to check in at the lab first, or that they need to give the valet their keys. This is the added value of using outside consultants -- they can tell you what people coming through the forest will need to know! 

It's also helpful to go somewhere else and try to navigate it yourself -- take a trip to a hospital in a different city and see how you fare, or go see a doctor in a different health system.  Get out of the forest! 

The First Rule of Publicity

I do a lot of work with PR for my clients, and also for the coworking space that I run with my two partners. We recently launched an event called HipsterHunt2015 that's a small business scavenger hunt to celebrate our business anniversary. We got GREAT coverage. People keep asking me how we did it. (I have a whole presentation on media interaction...but here's the short version.)

#1 Do something new and interesting. 

Seriously, if what you are doing isn't interesting or it's been done before, it's not news. There are lots of ways to make old news interesting and there are lots of ways to freshen up what you are working on, but it all come down to that one rule. Trust me. 

I heard Peter Shankman call it...(6 years ago.)

I've been following Peter Shankman since I saw him speak in Williamsburg, Virginia six years ago at a Public Relations Society of America meeting. He said "I believe that in the next 50 years we’re going to see PR becoming less about ‘public relations’ and more about ‘personal recommendations’." (Just like he says in this recent article.)

He is absolutely right that the word of mouth marketing that marketers are always trying to bottle is now "social word of digital opinions." A recent vacation dinner with my cousins was nearly decided on a Yelp vs Google Places debate, until someone piped in with actual experience of having been there. Bam! "I was there" weighs more than "this review says..." any day.  

Additionally, I am part of an online moms' group and we regularly share how something ACTUALLY worked for us, not how it was advertised to work. With the expense and proliferation of parenting gadgets, I want to hear how it worked for you...the cost, the instructions, the colors, the durability, the functionality (and often, the washability. Gross.) 

Today's successful companies should always go back to authenticity. I very much like the return to "artisan" items because I believe we can't be good at everything. Pick your niche and own it. Even if I'm not into mead or handcrafted saddles, I will admire your gusto! 

Post-Traumatic...Growth?

In reading a magazine article about Post-Traumatic Growth, I was struck by this quote: 

"In healthcare, we've always been more interested in identifying dysfunction than superior functioning," says Jack Tsai, PhD, assistant professor of psychiatry at Yale School of Medicine, who has studied PTG in veterans. "Only in the last few decades have we begun redefining health as not just the absence of disease but also the promotion of well-being." 

In a previous job, I worked with people who'd been diagnosed with chronic conditions and they often surprised me with their belief that their diagnosis changed their life for the better. Over time, I came to see that although negative at first, they changed in ways they never would have without it. They re-prioritized. They were forced to become healthier in other ways. They told people what they thought, what they wanted and what they meant to them. 

In many ways, we do a disservice to people who have "bad things" happen to them because we all fear they could happen to us and we want to distance ourselves from it. So, the sooner they "get over it" the better. 
 

How does the growth happen? It's a change of path usually, and if it's an external force, people must change, even if they don't want to. So they adapt, and it can open the door to more change. Maybe it's the heart attack that makes them realize that they want to stay healthy for their grandkids. And then it becomes wanting to spend more time with the grandkids and moving closer to them. Or it's a divorce that forces a career change. 

Americans need to break up with their fear of failure. It can make us better. It can make us stronger. But first we must admit that we all fail and we can all recover -- resiliency is in short supply, in my opinion. 
 

Dentists and Lions, Oh My!

Having done practice marketing previously, I am deeply empathetic to whichever marketing person must try to deal with the epic PR disaster that is Dr. Walter Palmer, lion hunter. They likely never expected to have a non-dental related international disaster on their hands.

I always recommend to all clients, big and small, to have a crisis communication plan for all of the potential disasters that may come their way. It's not fun, but it is valuable to sit down and see your weak points and your industry's controversial angles. For a typical dental practice, we might review a scenario about someone having a bad reaction to anesthesia, for example, or a cosmetic procedure gone awry. 

Although the fervor is a bit unreal, it's a good reminder that all it takes is one Internet photo to change your business forever. If you've been working on building your Yelp presence and sending out press releases, stop what you are doing and sit down with that crisis sheet, seriously.

Sometimes Health Communications is...calling 911

Coming from a family of health care providers (I was discussing cardiac catheters in depth with my cousin on vacation) means that i often feel that my non-clinical experience is not as practical. Sure, I know CPR and first aid, but how am I an emergency?

Well, yesterday at work I got to find out. A woman coming into our building fell on the sidewalk and was gushing blood from her head and face. While my office mates found the first aid kit and wet wipes, I called 911. I was clear and direct, giving my assessment of the severity of situation. 

Because vasovagal syncope (see, I know big medical words!) runs in my family, dealing with bleeding people is on the reasons that I did not pursue a clinical career. So I focus on what I CAN do, which in this case was to call in the professionals as quickly as possible, armed with the most information I could provide. 

I realized later that this is "health communications," what I proclaim that I'm a specialist at -- and it's part of the whole health care experience. Not everyone can bandage the wounds, sometimes they just facilitate getting the person who can to the person who needs it.  I'll call that a win. 

"I think the doctor said..."

I just read an article in the Journal of Patient Experience with this statistic in it: 

"Miscommunication between physicians and patients is the most common cause of medical errors and is responsible for more than 60 percent of sentinel events that lead to increased mortality or injury among hospital patients." 

Think about that. More than half of errors are caused by two people trying to communicate but failing to do so. And, I'm sure you've been there. I know I have. The doctor says to do something, in a regular tone of voice, and I'm not sure if it's a suggestion or an imperative statement. Or the doctor says "make sure to..." and I'm so overwhelmed by trying to remember it that I get confused. If you aren't in the habit of repeating it or writing it down, you may very well forget it. 

The journal article was about AIDET training (created by the Studer Group) for physicians. It seems simple but patients know that many of these steps are missed. 

A: Acknowledge (address each person in the room)

I: Introduce yourself  (and your role and your specialty)

D: Duration (how long will you be in the room, is there a procedure happening?)

E: Explanation (what's the treatment? what's the diagnosis?)

T: Thank You (appreciation for their time, questions, etc.)

In a hospital environment, these common courtesies can easily be overlooked, because everyone is in a rush. But it matters. It matters to patients, and it may prevent medical errors and miscommunication. That seems like a great reason to take the time to do it.