Companies that Care

A while ago, I wrote about how Wegman’s food markets used their customer database to call and warn customers of products they had purchased that might contain the pistachios that had been recalled, and how excited I was that they cared as much for me after the sale as beforehand.  I had another great experience with this today with another company, my personal favorite office supply company, Levenger.

I am an office supply junkie, for whatever reason, and I have always been pleased with the things I have gotten from Levenger, from the  Lap Desk I picked up at the old Outlet in Delray Beach on a visit to Florida, to the great business cards I get regularly.  I particularly love Levenger’s Circa notebook system, because it’s flexible, and lets  me order and reorder information as I need to.  You can add pages from smaller notebooks to larger ones, and it all stays together and secure.  So the Fitness Journal they carry was something I thought would be just the key to help me stay on track with diet and exercise. ( Any slips have been totally my own fault)

I was surprised today to find a package on my porch from Levenger, knowing I had not ordered anything in a while.  In the package was a refill formy fitness notebook, and a note from Ray Moore, Vice President of Merchandising.  He said that although they check and recheck everything, some of the nutritional information they had included was erroneous.  They were apologizing and sending the refill to me for free, with hopes that this made it right.

I was stunned!  Before I had even noticed any potential problem, having owned the item for over 6 months, to get this in the mail was fantastic!  Since I knew Steve Leveen, the CEO of Levenger was on Twitter, I got right on and sent him a message thanking him for this service.  I got a lovely tweet back as well.

These days, where customer service is often an afterthought, this stands out as an excellent example of proactive customer service- of doing the right thing and more, tracking down cutomers, and making them happy.  I was really glad I could also respond quickly and thank the CEO, to let them know how terrific this was.  The immediacy made it easier for me to give positive feedback in the moment, and to feel connected to a company I already love.

Thanks again, Levenger, Ray Moore, and Steve Leveen, for again showing me how special your company is, above and beyond the fantastic quality of your products, which won my affection a long time ago and keep me coming back time after time.  And for the rest of you, they are having a summer sale now, even on the cool Circa notebooks.

And maybe now, I’ll be even more dedicated to getting that fitness regime off the ground.

Tags: exemplary customer service, levenger, Ray Moore, Steve Leveen

Other People’s Money

I was with a group of friends recently and we were discussing conferences.  One person said “Was it worth it?  Would you have been annoyed if you had spent that much of your own money to attend?”  And it struck me right there and then- we treat the money in our own pockets, and in those of our close friends as if it were gold, but we treat the money from others, from Companies in particular, as if it were as ubiquitous as water.  Why is that?

Companies, small businesses, and individuals all use the same currency to pay for things.  All businesses, from sole proprietors to larger ones can write off conference expenses against their taxes- and this advantage only accrues if you have taxes to pay, of course.  While it’s true that the knowledge imparted at some conferences may have a bigger dollar for dollar payoff- it can be shared with others at the company and leverged for better returns, perhaps- the money used for the conference costs, travel expenses, expense accounts is the same, no matter who you are.

So I’m wondering- why do we continue to assume that if it’s the Company’s money, somehow it’s less valuable than if its our own?

I think it’s incumbent on everyone who attends a conference on someone else’s behalf, or at someone else’s expense to remember this, and treat the experience as if you were spending your own money for the experience.  Treat the sessions and opportunities to meet and mix with others as a rare privilege, and as if it were your money.

I know when I seek out sponsors for events like Podcamp, I make sure the sponsors are receiving good value for their money, and that I spend it carefully- as if it were my own, not just someone else’s money.

Because money is money.  It doesn’t come in two varieties, one corporate and one individual.  It’s still just money that now, more than ever, shouldn’t be treated as a luxury.

Tags: conferences, corporations, money, value

Electronic Medical Records and Impatient Patients

I read a blog post by Andy Kessler today, who has written a book called The End of Medicine, which I have admittedly not read as of yet. The post alleges that the medical industry has created a complete boondoggle of finances, and if we were to employ electronic medical records and their efficiencies, physicians would suffer and therefore, the emphasis and resistance to EMR is merely doctors protecting their own. (Or that’s how I read it.) While the Oliver Stone conspiracy theory plays well to an audience who has increasingly less and less trust in authority, it’s not even close to the facts of the matter. Let’s start out with a few basic facts:

- While many medical technologies like ultrasounds are slowly being digitized, there is no standard language or interface that makes this information easily accessible in a secure form. For example, an ultrasound machine does not automatically save all images onto a SD card and you can’t upload the images easily to Flickr. Add to this that small distortions can be indicative of disease and change a diagnosis, and you have a problem- not only that of having to retool and replace thousands of very expensive diagnostic equipment in every medical practice and hospital across the country, but how do we ensure that these images maintain fidelity when they are transferred between a doctor, a hospital, or over the net? Let’s not even alk about the fact that different EMR’s on the market do not as of yet interface smoothly with one another, let alone the labs- there are not, as of yet, any web-like standards for medical EHR.

-Part of the problem caused by EMR is that the data needs to be measured the same between doctors and institutions. The quality of the data- not just your hemoglobin, but measurements of say, fundal height, are not nearly as standard as one may assume. Data fidelity is as much an issue as is accuracy. Without more investment in standardization of data collection, sharing data between providers and institutions causes more problems than it solves.

-Paper records are sometimes better at flagging problems and inconsistencies than EMR. Some physicians I know were recently discussing a case where the blood tests of a woman showed conflicting Rh factors between what was in her office chart and what was in the hospital’s chart, which was an EMR. It was a problem tracked down to an error in the lab- but the problem was almost overlooked because there’s no way to put a big yellow post-it note, yet, on most EMR’s to make sure, without a doubt, the physician notes this sort of minor, but critical discrepancy. We need to make sure EMR’s are not just a sea of numbers, but that there’s some reasonable attention-getting mechanism so inconsistencies are readily apparent.

-Kessler talks about the problems that could be solved if all the data were gathered in one place. This is very true. But between HIPPA laws to protect patient privacy and the use iof their data in any sort of medical research, and the thorny issue of who would own, maintain, and allow access to this data, let alone pay for its creation, this is not an easy problem to tackle. A physician I know well just went to ask for some of the stimulus money to help start a data storehouse to solve some of these problems in respect to pregnant women. If the NIH and government own the data, there may be more equal access to it, than say, if a private healthcare company or drug company owns it, and creates an access and monopoly issue- can they cut off access to their competitors? How much money would a project need to buy access to the data? Who pays for the accumulation and submission of the data? How does it get stored? How are redundancies built in so the data is backed up and resilient from both unauthorized access and failure in the event of an emergency?  How do you make sure smaller, poorer hospitals have enough data infrastructure to interface with larger, referral centers, especially in times of emergency?

Healthcare is fragmented more so than our financial services and banking ever have been.  Individual practitioners are like individual small businesses- asking them to create and adopt an EMR for all their patients is like trying to make sure that Target and Kmart communicate to one another regarding your buying preferences, and then provide that data to your favorite pizza joint and dentist.  We’d like our cardiologist and internist to have the same system, but if they do not have hospital based practices, this is highly unlikely at this point in time.

I appreciate the frustration that Mr. Kessler and others feel with the slow transition from paper to pixels in medicine, but the issues are WAY more complicated and nuanced than he lets on.  This is not a conspiracy like the JFK assassination, nor is it a plot for doctors to secure their position as high earners. Most docs I know and I am married to one, would love for the data to be easier to centralize and maintain.  But look at how data fidelity errors could cost people their lives- small errors propagating poor decisions in a diagnostic tree- and look at how fast incorrect data can spread- like the rumors of celebrity death on Twitter- and ask yourself if you want fast, or you want accurate when it comes to your health care.

Ask why doctors make a decent salary- could it be 8 years of advanced education, plus residencies of an additional four or more years, plus the responsibility for the health, well being and very lives of their patients- and ask yourself if you would take on that responsibility for minimum wage.  Not me.  We want doctors to still be magic, yet be as concerned with customer care and treat us like family, yet we want them to do it as cheaply as possible.

My secret concern is that our third party payor system insulates most money issues from coming between a doctor and patient- a doctor can assume he will be paid for his work without running a credit check on you first like other businesses.  But then again, the office, insurance and the hospital are in charge of the billing and negotiating payment, and he may sincerely not know if the meds he is prescribing or the sutures he is using are more expensive than alternative options- they use what is the standard of care, or what the hospital stocks in the OR.  A doctor himself may have very little idea what his patient pays, and while that makes for inefficiencies and possible overuse of more expensive treatments, we have traditionally taken on these costs to prevent ability to pay from determining which tests a doctor may use, and somehow using less sophisticated and cheaper tools for patients of one economic class over another.  Money is important, to be sure, but we all want chemo when we need it, regardless of our ability to pay out of pocket. We already know people forgo treatment of illness and injury if they can’t pay for it, often making their condition worse and more catastrophic.

I don’t think we really want doctors spending all their time constructing a consumer reports of medical equipment, looking for the cheapest stuff available- we want them to use reliable equipment at a reasonable cost, to do their jobs well.  If we add the burden onto docs to be full time cost containment vehicles, what will we be losing as a result?

The health care problems in this Country are thorny at all levels.  I just think all of those who think the answers are as easy as putting your med records into a word file or in the cloud don’t know enough about medicine to appreciate some of the more difficult issues out there.  It’s only by having doctors and geeks in the same room that we’ll be able to solve these problems globally.  That, and making sure we have some data standardization that all ancillary medical equipment businesses would be willing to adopt, so the infrastructure works well.  Until then, we have a mess of puzzle pieces that don’t easily fit together.

Tags: andy kessler, decisions, economic pressure, electronic medical records, EMR, health care, health insurance, healthcare IT, medicine, third party payor

The Lines are Blurred

On a recent trip to Europe, I was amazed that the Daily Show with Jon Stewart is broadcast in an “international version” along with a disclaimer that it’s “satirical news”.  While the satire part seems self-evident, the recent change in press standards is making the line between satire and reality harder for all of us to distinguish.

I’ve been a huge fan of the Daily Show for years.  It’s something I record on the DVR religiously, and watch online in the morning on the web.  The only downside to this was last year, when my then fourth grader was asked for names of who was running for president, and he pointed out Stephen Colbert was on the ballot in South Carolina.  I think his teacher began to suspect the child was being exposed to more than the Cartoon Network at home.  (Maybe we shouldn’t tell her his favorite songs are from the Capitol Steps.)  But the Daily Show has become more than just snarky comments about the news- it’s doing serious stories we should all care about.

Jon Stewart’s interview with Jim Cramer from CNBC is one notable example (the extended interview is available online in three separate segments.)  This was journalism I wish we could see more of on mainstream news channels.  Stewart remarked that CNBC had a great opportunity to educate people about the market, but have somewhat abdicated their responsibility.  Stewart asked Jim Cramer to defend some of the things they did on CNBC,  and says “I know you want to make finance entertaining, but it’s not a f**&ing game.”  Cramer responded,  (and I am paraphrasing here, so please check out the video for the exact wording)  “There’s a market for this [type of entertainent financial news]” and Jon Stewart remarked back- “There’s a market for cocaine and hookers.” (around 11 minute mark).

Then, there’s the Daily Show’s last set of reports from Iran.  Very moving, and humanizes a part of the world we often see as the “other”- it’s full of family and kids and people trying to scrape by.  They are just like us.  Why does it take a comedy news spoof to show us the moving pieces, to show us the news we can use?  It’s like the Daily Show has ended up being more honest, through comedy and as Stewart puts it, “goofy faces and fart noises” than the actual journalists we’re supposed to trust to bring us the facts- to be that balance that keeps governments honest and in line.

Last night, the news of Michael Jackson’s death was reported on twitter, later confirmed by news outlets.  Likewise, there were rumors of the demise of other celebrities that looked like link-bait scams of the highest order.  Somewhere in here, the line between immediacy and accuracy is being lost.  The line between heresay, rumor and news is being lost.  The line between journalism and cocktail party chatter is blurring.  And it’s the reason why reputation and trust are going to become even more important than ever before.

And it’s the reason I’m looking forward to seeing what Julien Smith and Chris Brogan have to say in their new book, Trust Agents.  We may need this book more than ever.

Tags: chris brogan, daily show, jon stewart, journalism, julien smith, news, trust agents

News Flash

Today, people gathered on twitter to discuss the deaths of Farrah Fawcett and Michael Jackson.  Other rumors swirled that maybe Harrison Ford or Jeff Goldblum also shuffled off the mortal coil.  But here’s the thing….

Crowd psychology being what it is, it would take very little for a hacker to put up a rumor site, have people stop by, and either a)benevolently gain traffic and money through affiliate links or b) maliciously dump cookies, spyware, tracking codes, etc. on the target computer.  While this isn’t within my skill set, think if you were only looking to drive traffic, all you have to do is watch twitter for trending topics, and link bait, and there you are.

We have to be careful not to be the sheep, not to be so easily distracted and led.  Who knows what wolves are waiting in the bushes to pounce.