Our specific focus is on the intersection of health care design and how the industry uses all types of media, from social channels, brochures to medication labels, to fully engage patients in healthcare.

To start, Stuart Wainstock, contributor to the MDWebPro blog, understands that for most physicians—leveraging social media is overwhelming. However, to be effective, Wainstock confirms that users don’t have to spend every moment of their lives tweeting, liking and sharing. Instead, providers should focus on growing their presence in a genuine, authentic way. This means sharing content on the topics that matter most to you and your audience, asking thoughtful questions, and distributing information that patients will benefit from. Physician bloggers Brian Vartanbedian and KevinMD offer additional social media best practices and resources for the medical community.

The combination of effective design and a passionate social media community can also lead to a widespread movement. Take Regina Holliday, medical advocate and painter, as a top example. Regina uses her artistic abilities to advocate for the patient’s right to access their medical record, a necessity that cost her husband’s life. Dozens of people now wear jackets with Holliday’s depictions. (Follow the #theWalkinggallery on Twitter to see her work in action).

Designers are also making huge contributions to improving health literacy, a challenge for 9 out of 10 individuals. Earlier this year, Christina Thielst shared her experience creating an avatar, Gabby, to educate teenage girls about contraception. The avatar does not replace clinicians, but instead adds to the care team, reiterating important treatment information in an entertaining format.

For more example’s of how good design—from websites to labels—can strengthen patient engagement, check out this TED talk from Wired’s Thomas Geotz on medical data design and Joan Justice’s Healthworks Collective post on the elements of patient-centered website.

Additionally, design can make the process of “getting better” fun, satisfying and—most of all—possible. Jane McGonigal, founder of SuperBetter, is working to do just that. Her goal: to create games that enhance people’s lives.

As you can see—you do not have to be a clinician to make a difference in health care. Assets are designed to educate and empower patients are crucial for making lasting change in the provider and patient experience.

What designers are changing our health care system for the better? Share with us below or on Twitter.

Stay tuned for the next Health Care Social Media Review, April 24, to be hosted by Sarah Sonies on Wing of Zock.

This week, we are focusing on the intersection of healthcare and design.

The topic came to us after hearing Jacob Reider, MD, Chief Medical Officer of the Office of the National Coordinator, speak about his career epiphany during the Health Experience Design Conference (HXD) last month. Reider recalled an incident during one of his first medical internships when the doctor he worked under prescribed a patient the incorrect medication, causing the patient to experience an allergic reaction. “Promise me one thing,” the patient said, suspecting Reider had a long road ahead in the medical community, “Never prescribe a patient something she doesn’t need.”

Reider nodded and agreed to her request, and after tireless research he concluded that effective clinical decision-making is highly dependent upon the centeredness and preparedness of the physician. As patient demand rises and physician availability shrinks, it’s challenging for healthcare providers to stay centered and prepared in the face complex diseases and endless regulations. To make matters worse, communication and medical data sharing in and outside of healthcare organizations is a deeply complicated affair—often supported by snail mail and fax machines.

At the end of his speech, Reider spoke of the importance of designing tools and technology that enable providers to make better decisions and empower patients to lead healthy lives.

At HXD, plenty of thought leaders gathered to discuss the progress already being made in healthcare design and technologies. Jane McGonigal, leading American game designer, discussed Super Better, a game where users work to face life challenges in small, incremental steps and track their progress. Sandy Hilfiker and Molly McLeod from CommunicateHealth revealed ways in which designers can improve health literacy (an issue for 9 out of 10 people) by developing materials that are easy for patients to understand and act on. Their stories confirmed that good design—from motivational apps to user-friendly EHR systems, can make the healthcare industry more efficient and cost effective, and ultimately save lives.

Now it’s your turn. Share your favorite stories, blog posts and articles about the designers who are enabling physicians to stay centered in the midst of overwhelming demands, and empowering individuals to find strength in challenging situations. You can send us your suggestions in an email or give myself or Lora a shout on Twitter. We’ll highlight the top posts Wednesday, April 10 on our blog.

Huge thanks to David Harlow and Joan Justice for their work in making the Healthcare Social Media Review possible. We’re thrilled to be a part of it!

The driver, a tattoo-covered man sipping a super-sized Pepsi, took me back to my apartment in Jamaica Plain. He apologized for the wait and told me about his previous customer: a woman who made a five-minute job take three hours, and who, at the end of the ordeal proclaimed, “you must HATE what you do!”

He didn’t hate his job, not one bit. He said that he loved his work. He loved the twelve hours and seven days a week that he spent repairing what most people could not repair themselves. He liked that this was a job he could do anywhere, and he had. He’d lived in six cities over the past ten years and only went two weeks without employment.

I thought of this moment again yesterday, when I discovered The Minimalists, a blog by Joshua Fields Millburn and Ryan Nicodemus, two men who gave away their careers and most of their possessions, moved from a high-roller life to a cabin in Montana and now blog about what it means to live simply. To them, minimalism isn’t about giving up everything that you own, escaping to the woods, or turning off the electricity. Minimalism is about freeing yourself from the anxieties that come from wanting more stuff. It’s about going through your day with intention, recognizing your purpose, and putting in the time and the effort to do what you love. Minimalism is different for everyone, which is what makes it so exciting, and what has given these guys a huge following over the past few years.

Those who take this philosophy to heart, living with deliberation and recognizing what matters seem to succeed in all that they do—from the tow truck driver who scoops up stranded drivers, to Harold Schulz, CEO of Starbucks, who led a leading brand through the an economic crisis, driven by a commitment to his employees and their families.

Only when we know our goals, maintain a genuine passion for our community, and recognize our place within that community, will we be able to create something meaningful, something that endures.

What’s important to you in 2013? Tell us about it below or on Facebook or Twitter.

Michael Palmer, NYT best-selling thriller author, live in Swampscott, MA.

This past October, Lora (principal at Scratch) and I met Michael Palmer, NYT best-selling thriller author at Chili’s in Burlington. When we walked into the restaurant Michael was already seated at a table, sipping a coke, waiting for us. We exchanged hugs and joined him in cowering over the book size, laminated menu. Then, Michael introduced us to Stephanie, our waitress. That’s is the kind of guy Michael Palmer is: a person who always takes the opportunity to learn your name.

We’ve been working with Michael for almost four years now, helping him to promote his medical/political suspense novels and connect him with new fans and readers. His latest, POLITICAL SUICIDE, came out in stores and online Tuesday December 11, 2012. This is Michael’s 18^th novel, and the second to feature Lou Welcome, an ER doctor and associate at the Physician’s Wellness Office, where he helps physicians cope with mental illness and addiction. In the novel, Lou finds himself entangled in a high-level murder case involving one of his clients, Gary McHugh, known around Washington D.C. as the “society doc”. Gary is accused of killing Congressman Elias Colston, husband of the woman with whom Gary was having an affair.

If I heard that the guy formally sleeping with the congressman’s wife was found near the scene of the murder, I’d think he was guilty. But, this is a book of mystery and suspense, so not surprisingly—there’s another story lurking beneath the surface. Lou, being the nice guy that he is, offers to help prove Gary innocent, and inadvertently unravels a high-level government conspiracy involving the top dogs at the Department of Defense–a group that the late-congressman had worked hard to cut federal funding from.

Michael is very familiar with the world he writes about: the buzzing of the hospital waiting rooms, the fatigue that comes when working through the early morning hours. He is a practicing physician himself. After spending 20 years working in emergency and internal medicine, Michael now holds a similar position as his book’s hero at the Massachusetts Medical Society’s physician’s health program, helping doctors cope with the demands of medicine in healthy and balanced ways.

Michael got the idea for the book after reading an opinion piece that a friend sent him exploring the possibility that suicide bombers had something chemically altered in their brain that kept them from feeling and following through with the most basic human instinct: self preservation. In Political Suicide, Michael explores what could happen if we were able to rid ourselves of fear, and ethical implications surrounding it. In reading, we are reminded of what is core to our humanity, and how oftentimes those qualities are brushed aside as flaws. Political Suicide proves that bravery is not a blind willingness to give everything up, but the strength to make decisions, move forward, and draw conclusions in gray and uncertain circumstances.

Saying anymore would give away the story—so I’ll just let you go read it. Michael will make a few appearances in the Boston area in the coming weeks, including one at the Brookline Booksmith on Tuesday, January 8^th  with his son and thriller author, Daniel Palmer. There will be snacks, wine and musical instruments. Hope you can join us.

Cognitive Dissonance: From ACOs to Avatars

The first session I attended was a discussion on ACOs by Elliot Fisher, MD MPH of Dartmouth. During his talk, he eloquently made a case for connected health, discussing how there has been a flawed perception that health is produced during face-to-face visits. Yet the fee-for-service system that has grown up around this has led to high variability, poor coordination, overuse, and cost. Enter ACOs. But immediately after this discussion, I moved to a session highlighting a diverse array of innovators in the digital health arena. This included avatars for gamifying health. And speech behavior analysis on mobile phones. And sensors and apps to tackle asthma.

In the wake of a policy discussion on ACOs, it’s hard not to feel some cognitive dissonance when you start talking avatars, apps and sensors. How do these ‘micro-level’ solutions fit together with the macro-level problems in our healthcare system? I was struck by the potential amongst the innovators at this event, but also by the challenges that they face – how to scale in such a dynamic, uncertain healthcare environment.

Scaling Challenge #1: Finding a monetization foothold

There was a strong theme amongst the conversations I had with innovators… monetization strategy. Many entrepreneurs seem to be on islands right now deciding which direction to swim – toward providers, payers, pharma, employers, or perhaps just directly to patients. It was rare to meet an innovator focused on just one of these markets. Indeed, this is because it is hard to know which customer group will open up to what innovation, whether it will it be adequate, and when such a ‘tipping point’ will happen.

You have to start somewhere, and there were prominent folks from each customer group there to offer insights. Naomi Fried, Chief Innovation Officer at Boston Children’s Hospital, gave her advice:

• Solve a problem that needs solving: Yes, simple. Obvious? Maybe, but isn’t not doing this the main reason so many start-ups fail? Chances are that if you are addressing a problem your target customers have, they will talk to you.
• Find an internal champion: Fried spoke to the importance of relationships. An internal champion can help navigate the large, complex organizations. Helpful for providers – but also payers, pharma, and large employers.
• Prove your value: Ultimately, this means collecting data, likely through clinical pilots. Another case for an internal champion. They can help you get these pilots off the ground.

Fried gave this advice in the context of working with providers, but it really applies regardless of which audience innovators target.

Scaling Challenge #2: Dealing with the Details

One of the most successfully scaled programs in the field of connected health can be found within the US Department of Veteran Affairs. They now reach over 460K veterans with telehealth services, and are forecast to reach over 800K in a few years. Adam Darkins, Chief Consultant for Telehealth Services at the VA, spoke to what enabled this success:

• Strong processes: Eventually you have to replace relationships with processes, because relationships aren’t scalable.
• Excellent user experience: Make sure things are well worked-through before you try to scale. He referenced the infamous Steve Jobs example. His point – truly ‘serve’ your customers by understanding and mastering your user’s experience.
• Passionate people: While the processes must be there, people must be passionate about creating and spreading them. You must instill passion to enable this.

Scaling Challenge #3: The System-Level Swing Factor

During his talk, Elliot Fisher made the poignant remark that if there is no tension within a system, there is no catalyst for change. Healthcare certainly is riddled with tension.

How long will providers be able to make good money in the traditional fee-for-service model? When will ACOs become commonplace? Will they? How long will it be before consumers reach a tipping point and are actually in a driver’s seat when it comes to healthcare decisions? When premiums rise even more? How much? If they do, will there be enough cost transparency to enable rational decision-making?

So what can entrepreneurs do in the face of such uncertainty? For a start, heed Fried’s advice and focus on solving a significant problem. Then prove that you have solved it. Establish this foothold, seek scale, but do stay nimble.

And finally, build and maintain diverse connections that you can tap into during changing times. Luckily – as witnessed at the symposium – there is a mass of passionate people eager to help digital health entrepreneurs. From incubators like Rock Health, Blueprint Health, and HealthBox, to an array of foundations, service providers and financiers… and of course those at the Center for Connected Health that pulled this amazing event together. Thank you!

Last Tuesday I attended FutureM, where I sat in on a retail technology presentation and a social media panel. The topics were very different – “The Store of the Future” and “The Future of Social is Action and ROI” – but they also shared a lot of similarities. Both represent currently struggling areas, with only 12% of companies considering themselves effective users of social media, and retailers rapidly losing market share to the 66% of online shoppers who prefer eCommerce to in-store shopping. Both see increasing adoption of technology as a threat and opportunity. And both need to incorporate technology into their core plan to achieve specific, measurable business objectives. This post will focus on “The Store of the Future”, covering what the coming years will bring in the retail world.

The Store of the Future

Let me say one thing up front: the store of the future is going to be absolutely insane. Have you seen Minority Report? Because their futuristic view of retail, with Tom Cruise seeing personalized digital ads addressing him by name as he walks by, was closer to reality than science fiction. Dan Shust, Executive Director of RI: Lab, and Gary Lombardo, Solutions Marketing Lead for Demandware, walked us through the future predictions in retail.

The future of brick-and-mortar sales may look disconcertingly similar to Minority Report’s vision

Beyond standard brick-and-mortar improvements like incorporating in-store ratings and reviews – four out of five people surveyed said positive reviews influenced them to buy items online – technology is already transforming the interactive in-store experience. To avoid boring you, I’ll only include the most exciting highlights.

Current technology in retail

LL Bean’s shoes have RFID (radio-frequency identification) tags in them that correspond to in-store displays. When a customer picks up a pair of shoes, a nearby monitor on the wall immediately displays info and images of that shoe, making for a much more interactive shoe-buying experience. This technology isn’t a gimmick; LL Bean saw a 28% lift in sales of shoes tagged this way.

Intel developed camera technology that can distinguish an individual’s basic features such as gender, height, weight, and ethnicity. This technology is similar to Minority Report’s entirely customized digital ad experience. As the camera feeds that information to a digital display, the display then shows the consumer an ad based on their information. Awesome? Yes. Creepy? Yes.

Lastly, the Tesco grocery store chain in South Korea uses QR technology to create popup stores on billboards. Imagine coming home after a busy day and waiting in the subway for the next train. You’re too busy to go grocery shopping, but you notice an ad on the train platform with pictures of various food items. You pull out your phone and start scanning QR codes for the items you want, and then complete an easy-checkout process with your saved credit card information. The items are delivered to your house the next day.

Image 1: Tesco customers in South Korea can do their grocery shopping anytime, anywhere

Completing your entire shopping experience using hand gestures in front of a giant screen, at-home scanning and visualization of how clothes and accessories would look on you, and 3D printing of trial (and eventually full) products? It’s all going to happen, and sooner than you think.

The store of the future will combine the best aspects of online and in-person shopping to offer customers convenience, personalization, engagement, and exceptional customer service.

Until next year

The pace of technological innovation continues to increase, and consumers readily adopting technological changes force brands to follow suit or be left behind. Would you prefer in-store shopping to eCommerce if retailers incorporated all of the technology mentioned above? Let me know! For now, I’ll continue my shopping addiction with Amazon.com.

What if we could avoid all that by telecommuting?  According to a new infographic by Carinsurance.org, not only can we enjoy working in the comfort of our homes, but it actually benefits all involved parties. From healthier workers, to drastically reduced oil consumption, to more productive days, working from home a few days a week seems like an all-around win.

Here at Scratch we already benefit from work-from-home Fridays, so it’s good to know we’re on the right track!

Does your company incorporate work-from-home into its corporate life? Do you think the benefits outweigh potential issues such as boredom or unmotivated employees? Let us know!

David Harlow, guest speaker at Let’s Talk #HIT.

This is a needed change, especially in a healthcare system where providers earn a living based on the services they provide, rather than the outcomes they drive. David Harlow, founder of the Harlow Group LLC and author of the HealthBlawg, helped us look more closely at this model and what it means for the healthcare system at our October healthcare technology event, Let’s Talk #HIT. He described ACOs as the ‘unicorn’ in the room: no one has ever seen one, but everyone knows what they look like.

Unicorns aside, defining them and subsequently relying on them can be incredibly difficult. As the ACO field has evolved, regulations and technology standards have also needed to evolve. This includes the implementation of robust solutions that support a secure and seamless flow of patient information and updated payment rules that allow providers to share costs.

Driving change in a system made up of billions of individuals each with their own goals, needs and challenges is not an easy task, but David, an experienced healthcare attorney in the private and public sector, is optimistic. David has a solid understanding of the intricate details of the healthcare system. He’s believes the industry—historically lacking transparency—is moving in the right direction. With 150 existing Medicare ACOs serving over 2 million members, we have made progress in last year and accumulated 2 billion in savings. But with the health economy in the United States valued at over $2 trillion, we have a long way to go before the model delivers the needed results.

What stuck out most to me in David’s talk is the potential that the ACO concept and other emerging healthcare delivery models have to empower providers to practice Population Health, or a healthcare approach loosely defined as a the measurement of the collective ability for a group to adapt to, respond to, and/or control life’s challenges. Rather than building a healthcare system solely dedicated to fighting disease, repairing broken bones, and testing for diagnoses with vague symptoms, a model rooted in collaboration could equip patients to lead healthier lives and anticipate issues before they arise.

Thanks again to David for joining us last week; we learned a tremendous amount. We hope to see you all at our next Let’s Talk HIT event on December 5, 2012.

How do you think healthcare has changed since the birth of ACOs? Share your thoughts with us below, or sound off on Facebook and Twitter

Halle Tecco, co-founder of Rock Health, an organization that brings together the brightest minds in medicine and technology to drive positive change in the healthcare today, did some investigating. The graduate of Harvard Business School and one of CNN’s 12 entrepreneurs reinventing healthcare took a close look at the gender breakdown (and the subsequent implications of this) within the healthcare industry. According to the Bureau of Labor Statistics she found that of the 73% of women in the healthcare system, only 4% of them are CEOs at healthcare companies. Although many elements contribute to this trend, she worried that the lack of women leaders created limited opportunities for women-to-women mentorship.

That’s why Tecco launched XX in Health, an organization that brings together female leaders and rising stars in healthcare to discuss issues that are important to them—from maintaining a work-life balance to securing start-up funds. They’ve hosted events in San Francisco, Chicago and New York. Next Wednesday October 24, 2012, they’re coming to Boston for a reception at the Boston Park Plaza, and are encouraging women leaders in the Boston healthcare community to stop by. Tickets are donation based, and can be purchased on Eventbrite.

Women: How has the gender breakdown in your workplace impacted your ability to advance? Continue the conversation on Twitter under #xxinhealth.

Hope to see you on Wednesday.