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Communications

I can never stress the value of communication skills to anyone I met regardless of the path they want to go down in life.  I have had the luxury from an early age of public speaking beginning with something called Model United Nations (MUN) where you represent a country in mock-simulations of the UN process.  [We even won a national championship at my high school…and it really isn’t as geeky as it sounds.]

In graduate school, I participated in Toastmasters for a while which I think is great for someone who needs a casual setting to practice and get feedback.  I can even remember using one of the techniques from there (counting “ums”) when my sister told me she was going to be a lay minister in the Catholic church and be giving sermons.  [Note: Feedback on presentation skills isn’t always well received by people not seeking it out.]

I found a couple of presentations on the topic that I thought might be interesting to some of you.  Additionally, you might research the Minto Pyramid Principle which is a structured approach to communicating by an ex-McKinsey consultant.  (It was required reading/training at Ernst & Young years ago.)

This one is a little basic, but I have seen so many bad powerpoint presentations that obviously many people could use the primer.

One last one before getting back to work…Here is one on marketing which obviously has communications at its core.

Working With Clients: Some General Thoughts

One of the best discussions I have heard for account management was by Andrew Sobel. I was digging through some files today and came across some of my notes. I thought I would share a few of my takeaways which I think are good general advice.

  • It is essentially to be trusted.The four attributes of trust that he discussed were Empathy, Generalist, Synthesis, and Integrity.
  • Be an Advisor not an Expert.Experts are afraid to learn anything new.
  • An Expert’s mind believes that there are few options that make sense. A beginner’s mind is open to many options.
  • At 5-years old, we ask about 200 questions per day. By age 20, we only ask about 20 questions a day. Ask more questions. [Reminds me of another piece of advice that said that to “ass-u-me” is to make an “ass out of you and me”.]
  • Perceived competence leads to trust.
  • Empathy means listening, know your own biases, and having humility.
  • Reflection leads to creativity.

He also suggested acting as if you were independently wealthy. [Not always easy, but not worrying about the politics and other issues frees you up to speak your mind.]

He (or his company) laid out the following comparison on their key point which was “Be an Advisor not an Expert”.

sobol.png

It is easy to play the expert. It is much harder to play the role of advisor.

    A Great Communication Example

    google-ad.png

    Don’t get.  Don’t worry.  You’re probably not the target.  This is a Google recruiting advertisement that they put up a few years ago.  It led you to a website which had another puzzle for you to solve.

    Why is this so great?  It’s targeted exactly to the niche of engineers that they wanted to have apply for the jobs.  It’s memorable (i.e., sticky).  It compels you to action (if you’re the person they are looking for).  It creates buzz.

    It is a great single frame if you want to address segmented communications that are successful.

    Another CEO Interview – ABC

    I think a lot of times when I quick say ABC company people think I just mean any “generic” type company (i.e., typical MBA case study speak), but in healthcare, we have AmerisourceBergen Corporation which some people (probably no one in their corporate marketing) refer to as ABC.  It competes with Cardinal Health and McKesson and is in many areas of healthcare especially in prescription drug distribution.  (They are a $57B company in a market where the 3 of these companies control 90% marketshare.)

    SmartMoney had an interview with their CEO (David Yost) in February 2007 (which I am just reading over the holidays).  Since their margins are in the single-digits, the logical question was how do they grow.  He pointed out that generics and specialty drugs represent the big opportunities.  Interestingly on specialty drugs he talked how they can “tell the manufacturers where the patients are and how much insurance companies will probably reimburse on certain drugs.”  This doesn’t strike me as the role I would typically look to them for.

    It was also an interesting discussion around Wal-Mart’s $4 generics.  I have been skeptical of the promotion, but he would have some visibility to data to understand the results.  Regardless, the effort of the pharmacies to lower the cash costs for prescriptions (for those without insurance) is an important effort.

    “The pricing difference Wal-Mart is offering isn’t enough to cause them [patients] to change pharmacies.  Plus, a lot of people are going to Wal-Mart looking for $4 prescriptions and can’t find them.”

    Setting Healthcare Goals

    I have always been a big believer in using New Years as an excuse to think about my goals – what did I accomplish last year, what do I hope to accomplish in 2008, and what are my 5 and 10-year goals. With the exception of a few years, I have done this for most of the past decade. It is a an interesting tale of how my priorities have evolved from very career oriented in the early years after business school to much more balanced now. My goals will now typically include a few career objectives, some family objectives, a financial planning objective, and a few personal objectives (e.g., run a 1:40 half-marathon).

    When I got ready to write this entry, I decided to try and find a story / study that I had heard referenced numerous times about an ivy league class where they tracked the success of people that wrote down their goals versus those that didn’t. Unfortunately, all I found was that it was a myth. I still believe it is a helpful process, and I think telling some of them to others so that they encourage you is also important.

    A good term to use in setting goals (work or personal) is S.M.A.R.T. which stands for Specific, Measurable, Attainable, Realistic, and Timely. Just Google “SMART goals” and you will find numerous links. It is often a good idea to have a specific objective or event and/or to reward yourself. (e.g., I want to lower my BMI by X points prior to my annual visit to the doctor and will upgrade the cabin on my next cruise if I achieve this.) And, don’t forget to set a baseline metric for where you are today so you know how much you have improved.

    So what goals should you have a health consumer…here are a few ideas:

    • Know your metrics (BMI, HDL/LDL)
    • Understand your family history and probability of diseases
    • Lose weight or improve your physical fitness
    • Take any preventative measures needed based on age or gender or other attributes
    • Take advantage of any wellness programs offered (wellness goal article)
    • Learn about the food you take into my body
    • Eliminate any unhealthy activities (e.g., smoking)

    And, what goals would we want our healthcare companies to have for the new year:

    • Understand me as an individual and how I want to be communicated with
    • Improve your customer service so it is proactive and I only have to tell you once who I am
    • Make your communications understandable to me not only to a medical professional
    • Help me manage my data
    • Give me tools to make decisions don’t just shift risk and responsibility to me
    • Help me with prevention and wellness and other long-term activities

    With that in mind, it should be interesting to see if Revolution Health gets some traction with their new offering – Resolutions 2.0. From what I have read and seen, it looks like they have created an online tool for setting and tracking goals and combined that with two things – social interaction to build encouragement and expert insight to provide hints and advice. It will be interesting to see the adoption and use. It would be great if they could track it versus a control group to see the improvement in achievement of goals.

    “The beginning of a new year always brings with it a fresh start and the best of intentions to change one’s life for the better,” said Steve Case, chairman and CEO of Revolution Health. “We all make New Year’s resolutions but going it alone can often make those good intentions a grind. By adding the power of friend-to-friend support along with expert information, RevolutionHealth.com is offering a simple, fun and free way for people to achieve goals they never have before.”

    The expert “groups” they have created include the following which although broader in scope than I expected seem to have something for all of us:

    1. Improve My Relationship/Marriage
    2. Keep My Family Active
    3. Take Charge of Your Life
    4. Become A Complaint Free Person
    5. Eat Right and Stay Slim
    6. Walk More to Lose Weight
    7. Sleep At Least 7 Hours A Night
    8. Have a Smoke Free Day
    9. Lose Up to 20 lbs By Spring
    10. De-stress

    Are You Growing Your Vegetables

    I read this interesting analogy this morning about marketing and comparing it to gardening.  I think the author’s points are very relevant when you think about patient retention within healthcare.  A few of the points that come through in the blog entry are:

    1.  It takes effort.  (i.e., vegetables don’t just grow by themselves)
    2. You have to be consistent.  (i.e., you can’t overwater one day and not water for weeks)
    3. Not all vegetables are the same.  (e.g., some like more water or light than others)
    4. You do get better with practice. 
    5. There is lots of competition (e.g., bugs, animals), but it is healthy.  You can’t simply kill the competition with pesticide (i.e., price war).

    Two points that the author didn’t make which I think are relevant are:

    1. You can’t grow all vegetables at once.  (i.e., you have to focus on what will respond given your soil, environment, etc.)
    2. You have to plan long-term.  (e.g., some professional farmers rotate fields to optimize yield over multiple years)

    When Leaving a Message Isn’t Optimal

    I heard two quick examples yesterday that seemed relevant to share.  Sometimes it is good to learn through others mistakes…

    1. An executive at a company decided that they didn’t want to fill a particular drug since they were losing money per prescription.  After the decision was made, he called the CEO of the manufacturer and left a voicemail saying “call me back in 24 hours with a lower price or we will stop filling your drug”.
      • What about their other drugs?
      • What about all the patients that you have in queue?
      • Do you think the CEO might be busy?
    2. In another case, a person in procurement called a vendor and said that every time the sales people called or made a suggestion that they were just going to send it on to their competitor and grow that relationship.  [Steve – This is you guys.]
      • Is that really what your business people want?  They don’t want new ideas?
      • Any worry that you might be breaking confidentiality by sharing this information?
      • Did you ever realize that this is a small world?  Don’t burn a bridge if you can avoid it.

    Sometimes, you just should try talking to the person live and thinking through the conversation.

    BAH on Demographic Changes

    BAH (Booz Allen Hamilton) has a business publication called Strategy and Business which has some great research.  I found this recent article on the changing demographics worldwide to be interesting and relevant to what we see in the US (which has a big implication on healthcare).

    Here are a couple of quotes and facts from the article:

    “To prepare for the implications of aging populations, individuals, organizations, and society as a whole must confront assumptions that are no longer valid.”

    • According to United Nations projections, the proportion of the global population over 65 years old will triple between now and 2100, from 7 percent to 21 percent.
    • Assumption 1: We’ll work long enough to pay for our retirement. …But suveys show that, until the age of 75 or so, people consistently underestimate the length of their retirement and under-provide for it financially.
    • Assumption 2: As our society gets richer, we can afford to retire earlier. The basic flaw in this is that people are not taking into account increasing longevity and its associated higher costs.

    • Assumption 3: It is useful to retire people early, because there are not enough jobs for everyone.

    • Assumption 4: Income and status at work rise linearly, and people retire at their most senior position.

    • Assumption 5: We accumulate assets while working and spend them during retirement.

    • Assumption 6: During retirement we won’t change residences more than once.

    • Assumption 7: The state will provide social and health-care services for us in our later years, allowing our children to inherit a significant portion of our estate.

    • For a couple who reach the age of 65, there is a 50 percent chance one of them will survive to the age of 90, and a 17 percent chance that one will reach 100.

    “Restricting compulsory retirement will foster — or force — changes in work culture and minimize ageism. Our mental model is already changing from one of a ‘cliff edge,’ with an abrupt change from work to retirement, to more of a ‘plateau.’ “

    All of this will have big implications on how we pay for healthcare, what types of services are needed, how we interact with these groups, etc. 

    Student Ideas

    entrepreneur_2002_cover.jpgWhen I got my MBA at Washington University, we had a business plan competition.  [Which I won one year and took second the other year.]  It was fun and challenging.  You got to present to a group of CEOs at the end.  (Mine included Chuck Knight (Emerson Electric) and Andy Taylor (Enterprise Rent-a-Car)  But, it was more an exercise than starting a company.

    As entrepreneurship has become a big focus in business school, this has taken on a life of its own.  Wash U, like many schools, has staff dedicated to this.  The business plan competition has corporate sponsors and now VCs come to look at the ideas.  Additionally, entrepreneurs give their ideas to students to work on for 6 months and flush them out for them. 

    What I found interesting was the number of business plans written this year that had a healthcare focus.  They have a website called IdeaBounce where all of these are posted.  I took a few bullets from there to highlight here: [to see the specific ideas from this competition on IdeaBounce sort it based on programs [Olin Cup] on the right hand side of the screen]

    • Medi-bite is a medical device company that has developed technology to facilitate the recovery of people affected by temporomandibular (jaw) joint injury.   Temporomandibular joint injury affects 100,000 people in the U.S. annually. Injury makes eating difficult, interferes with speech, and often reduces one’s effectiveness on the job. The standard of care involves physical therapy sessions, and is often painful, inconvenient and insufficient to treat the condition fully. Medi-bite has developed technology to address these unmet needs.

    • Medobo is a company that provides services and tools for medical patients to holistically manage their health online. medobo retrieves medical records and consolidates them into an easy-to-use, secure, and private online personal health record (PHR). medobo also provides appointment and prescription management tools, a library of medical research, and a targeted medical web search engine.

    • Over 6,000,000 patients enter US emergency rooms annually complaining of abdominal pain. Current method of diagnosis of appendicitis is difficult because of considerable overlap with other clinical conditions, (15-40% error rate)! We are developing a blood test to accurately diagnose appendicitis within 5 minutes. Our company is working on identifying biomarkers from clinical samples. We hope to develop low cost, point-of-care, disposable diagnostic strips to clinicians in emergency room. We are an early stage company looking for financial, business & logistical support to execute our plan

    • You’re sick and at your doctor’s office – why not pick up your prescription while there? MedBox offers a Web-enabled, robotically controlled, videoconferenced dispensing pharmacy for doctor’s offices, run by local pharmacies. In the $200 billion prescription marketplace, where no company has more than 10% market share, this new paradigm places diagnosis and treatment in the same place – convenient for consumers. MedBox is easier for patients and doctors, attractive to insurance companies and profitable for pharmacies by streamlining an antiquated healthcare system.

    • Personal Pediatrics is a platform by which pediatricians in its network can dramatically take control of their practice. Physicians who adopt its retainer-based house call practice method provide HIPAA-compliant, boutique, patient-focused health care. Dr. Hodge has developed the Personal Pediatrics care model in her St. Louis practice for more than two years, tailoring offerings to consumer needs and designing technology solutions to replace high physician overhead.

    Some of the biotech ideas were also impressive.  It has come a long way from where it was in the early 90s.

    What Have You Failed At Today?

    I caught this story on ABC last night about entrepreuners.  It made an interesting point about the need to fail and learn from your failure.  In summary, it was basically saying that people who took risks, failed, and spent the time to learn from their failures ended up more successful.

    I think that is very relevant to the world of healthcare communications.  Any program should have a test plan of ideas that are constantly being varied to see what works best.  Each micro-niche of the population is going to respond differently.  If you aren’t out there trying different things, you won’t optimize the success of your programs.

    Of course, this is easier said than done. You need a culture that believes in failure.  You need a way to learn from your mistakes.  You need people that are willing to admit they were wrong.  You need a measurement tool to document the success of one attempt versus the other.  And, you need to understand what can be varied to drive change.

    Let’s take a simple example here.  In the world of automated voice communications, you can vary dozens of things:

    • Which voice should you use – gender, age, accent?
    • How should the voice speak – casually, formally, authoritarian, consultative?
    • What speed should the voice be at – normal pace, fast, slow?
    • What time of day should you call?
    • What day of the week should you call?
    • Should you leave a message or call back?
    • How many times should you attempt to reach the patient?  Within what window?
    • How long should the call be?
    • Should the call be complemented by letters or other outreach?
    • Should the call offer to connect them to a live agent?

    I could go on, but I think you see the point.  Experimentation is key and makes a difference.  I am not even getting into the thousands of variables in the messages. 

    So, go out and fail at some new program to communicate and engage with your patients.  Learning faster is your best way to succeed. 

    Text Google for the 411

    Google seems to be everywhere. It is probably the one site that I have to teach my kids to know to get anywhere. Perhaps they need a “Google Kids” which offers games, safe content, etc.

    Anyways, this is more of a tip than anything about healthcare, but I was fascinated to find out about Google’s SMS service (aka text message) yesterday. I tried it a few times this morning right before I got on the flight. If you go to Google’s page at sms.google.com, you can find out more.

    All you really need to know is that if you send a text message to Google (466453) you get information back almost instantly.

    For example, I sent a text message saying “weather Boston” and before I could even type my next message, I had the weather report. Then I sent in another text for “AA 1577” (American Airlines flight 1577) and instantly had information on flight status and what gate it was leaving from. You can do it for scores (e.g., “Red Sox”) and many other things. If you are like me and on the go a lot and hate to pay fees for 411, this is great.

    Confusing Stock Market Reaction

    So, Walgreens announced that they were going to miss earnings because of generics (oh and higher expenses).   All of a sudden, the PBM stocks (e.g., Medco and Express Scripts) took a hit which makes no sense to me.  [BTW – I own none of these individual stocks although they may be in mutual funds that I own.]

    Walgreen Co., one of the nation’s biggest drugstore chain operators, said Monday its fourth-quarter profit dropped nearly 4 percent because of lower reimbursements for some popular generic drugs and increased store and staff costs.  (See all)

    “If Walgreen is receiving lower reimbursement for some generics, it means that PBMs are paying the company less for generic drugs,” Wachovia analyst Matt Perry surmised on Tuesday. “In other words, the PBMs’ drug purchasing costs have gone down. We think the selloff in shares of Medco and Express Scripts is unwarranted.” (see entire article)

    At least one analyst understood.  But, why would the market response this way.  There are only a few reasons that these could be correlated positively.  My hypothesis would have been that if Walgreens is getting less than the PBMs are making more or are neutral.  This would make sense because if the PBMs paid Walgreens less they wouldn’t immediately pass that on to their clients assuming they make spread on those claims and have multi-year contracts with employers and managed care companies.  And, if they simply passed on the retail costs to their clients, it would have no impact on them.

    How could it be true that Walgreens and the PBMs made less?

    1. The acquisition cost of generics could have gone up which would likely only happen if the wholesalers (e.g., McKesson or Cardinal) changed their prices dramatically or the generic manufacturers increased their prices (not likely).
    2. A significant number of PBM clients (or major managed care companies with their own PBMs like Aetna, Cigna, Wellpoint, Humana) requested price concessions on generics which forced the reimbursement rates down for the retail pharmacies and the mail order pharmacies.  (possible, but clearly not what you hear from the other players)
    3. Costs for a specific generic (with material marketshare) changed dramatically from what was forecasted (shame on the planner).  The worse case here would be if they struck a sweetheart deal (i.e., guaranteed supply at a lower than market price) and then saw the price drop out with a new manufacturer come to the table.

    Generics are definitely a key profit driver for the pharmacy industry.  The average AWP (average wholesale price) is $40 (for a 30-day supply).  Companies pay less than 50% of this.  The actual costs are typically less than 80%.  And cash customers pay greater than 100%.  Lots of spread.

    Now, of course, there are costs to fill each prescription so it is not that simple.

    Small Business Impact of Health Coverage

    Wells Fargo and Gallup put out the results of a poll of small business owners last week that underscores just how challenging it is for them to provide healthcare coverage for their employees even though they clearly know this is an important benefit in attracting the right type of talent.

    A few of the key facts from the study are:

    • 9 of 10 say the healthcare system needs to change
    • 6 of 10 say a complete overhaul is necessary
    • 81% said health insurance improves employee loyalty
    • 55% do not offer health insurance with 45% of those citing cost as the issue

    Here is a good quote from a Wells Fargo executive:

    “The majority of small business owners recognize the benefits of offering affordable healthcare coverage to their employees, but many feel they cannot afford to do so,” said Rebecca Macieira-Kaufmann, executive vice president and head of Wells Fargo’s small business segment. “A third of small business owners are cutting back on non-capital investments so they can provide healthcare for their employees. For several years health insurance has been a major concern for small business owners, and its impact is significant.”

    Since small business is where much of our job growth has been over the past decade, this should raise flags for us.  I think it is critical that we find a solution that creates easily accessible healthcare for everyone, but I think it is ridiculous that working families can’t afford care or aren’t provided care.

    Number 366

    I mentioned the Top 100 Healthcare Blogs a few weeks ago.  Well, I made it to the honorable mention at number 366.  So, if you like what you read here, help me move up the rankings by:

    1. Subscribing to the blog
    2. Adding a link to my blog on your site or blog roll

    Thanks.

    New Agency Role – White Paper

    “One of the great communications tragedies is to watch an organization go through a careful planning exercise, step by step, complete with charts and graphs and then turn the strategy over to the ‘creatives’ for execution. They, in turn, apply their skills and the strategy disappears in a cloud of technique, never to be recognized again.”
    —from Positioning: The Battle for your Mind by Jack Trout & Al Ries, 1981

    An acquaintance of mine just put out a white paper on the role of agencies. I thought it made some great points:

    1. Organizations aren’t getting the strategic support they need.
    2. There is a weak link between strategy and execution.
    3. People want a new approach that links these two and increases effectiveness.

    Since this is exactly the conversations that one of my clients (Silverlink) has been having in the healthcare space with PBMs, MCOs, and providers, I found this paper a good reinforcement of their value proposition.

    New Blog

    I have been blogging most of this year on the topic of Business Process Management (BPM) at BPM Business.  In doing that, I continued to go back to my previous experience in healthcare and gained a fresh perspective on the healthcare consumer and their interaction with the complex heathcare processes.  (I have always been a big believer in stepping away from the day to day (or current industry) to get a new innovative perspective.)

    With that in mind, I have chosen to focus my blogging on consumerism in healthcare.  To me, this is taking a consumer packaged goods framework on marketing and applying it to healthcare (think micro-segmentation, data mining, multi-channel strategy). 

    Today,  most healthcare companies think about patients as claims.  The market is finally going to push them to think about patients as consumers and treat them that way.  No longer is a confusing letter with lots of legal and medical terms going to float.  Consumers are going to demand that they can understand the message and take action.

    So, with that in mind, I will begin focusing my thoughts here on The Patient Advocate.  I did pull in some of my old blog postings, and I will continue to get off-topic every once and a while to talk about general business, leadership, and other topics that interest me. 

    Myths of Innovation

    Guy Kawasaki has another great interview on his blog.  This is an interview with Scott Berkun, author of “The Myths of Innovation”.  If you are fascinated with innovation, this is a good read.  I have tried innovation internally and externally.  These last few start-ups which I have worked on have been great.  This article addresses some of the things I have learned the hard way. 

    “Innovators are born and made
    Innovators face lots of challenges outside the creative process – support
    Get out of the ivory tower and “tinker”

    Problem definition (i.e., asking the right questions) is key  (At HOK, we used to use a book called Problem Seeking for architectural requirements which is a helpful framework here.)

    There is a lot more here.  I think companies often miss the importance of “sponsoring” innovation through several actions:

    • Encouraging people to try things and having a culture that allows risk
    • Capturing ideas and having people who look across ideas for new combinations of things
    • Having funds allocated to try things…if VCs who get their pick of ideas only expect 2 of 10 to flush out, why do companies look for 10 of 10
    • Bringing in people with diversity (background, culture, education, industry)

    Innovation is a critical process for companies.  Thinking about how you create it, capture ideas, and manage your portfolio is important.  In this blog, I have talked about P-TRIZ and Return on Time (ROT) which are both relevant here. 

    Picture is worth a thousand words (at least)

    As a former architect, I am a big believer that pictures have significant value in the business world.  I have been asked dozens of times to take complex ideas and simplify them down to a single-frame image that people can post in their cube or use in a meeting.  These images can be powerful.

    At Express Scripts, we choose to take on the battle of moving market share from Lipitor to Zocor a few years ago.  This was set up to save clients and patients billions of dollars as the Zocor patent expired.  We had a list of 50 ideas which we paired down to 30.  The challenge was how to get people to think about and rally around the 30.  I came up with what was initially called the “bubble chart” which showed the 30 ideas in swim lanes and then time-mapped horizontally against key milestones.  This became used everywhere and even presented to the street.

    This is important to BPM in several ways:

    1. If BPM is to be transformational, you need a future state vision that can be captured and disseminated across the company.
    2. If process mapping is part of your communication strategy, a simple to understand process map is critical.

    I started thinking about this when I received an e-mail newsletter from BentonsEdge which is a company that helps you frame out your value proposition.  I have met with Dan Davison, the CEO, several times.  He seems to have a great process and good understanding of helping clients get to a simple story about their value proposition.

    One example is below.  It is a little busy, but it captures all the complexities of raising capital in a one-page slide which is amazing.

    http://www.tellingyourstory.com/content_library/files/whitepapers/RaisingCapital.pdf

    Bentonsedge_startup

    Continue reading

    Misc Articles to Read

    I have been trying to keep up with my reading and falling behind.  There are a lot of articles that I skim and take something from, but that I hoped to synthesize and share.  Rather than get too far in the hole, I am going to share a few here.

    Two sources I would recommend for reading are Align Journal (new magazine) and BPTrends.  They both have great process related articles.

    1. McKinsey on applying lean to application development
    2. McKinsey survey on IT Strategy
    3. Several McKinsey articles on pricing
    4. Good overview of DFSS (Design for Six Sigma)
    5. Article on the book Payback and Innovation
    6. Article on Experience Mapping in Healthcare
    7. Article on Business Process Innovation (BPI) at TransUnion
    8. Top 10 Technology Projects
    9. Article on whether to fix before you outsource
    10. Creating a process centered organization
    11. Creating a business process approach to management
    12. ITIL and Six Sigma
    13. What is TRIZ
    14. Compliance and BPM
    15. Lean for Service Processes
    16. Sub-processes
    17. Value mapping vs. detailed process mapping
    18. Skills of a business process expert

    Asking a 90-year Old to Use E-mail

    You can use business rules in many ways.  I think one of the most important areas is in customer segmentation.  There is initial segmentation around which customers to target with which offering (e.g., cross-selling, multi-variate analysis).  There is secondary segmentation around which message will compel them to act on an offering (e.g., campaign management).  Additionally, there is segmentation around which channel they are likely to respond to (i.e., e-mail, text message, letter, call, web, TV, radio).

    My 90-year old grandmother who does Masters swimming called earlier this week because she had a letter asking her to send in some information to them via e-mail.  She can barely use a phone without silver dollar size numbers so asking her to respond using e-mail is ridiculous.

    As you design processes that spawn communications or create messaging, thinking through the multiple levels of segmentation and the supporting rules is critical.  Ideally, some type of “artificial intelligence” by which the rules are automatically updated as the system learns is ideal.  Linking success (i.e., outcomes) to the logic used allows you to refine and improve your communications and marketing over time.

    The Art of Ware

    I was just skimming a story from Guy Kawasaki’s blog about The Art of ‘Ware by Bruce Webster.  I was a little skeptic, but Guy always has great instincts.  I read a few of the chapters in the book and think you would enjoy it.  Especially if you work with or at a software company.

    Here is some text from the home page about The Art of ‘Ware…

    Back in the early 1990s, I [Bruce Webster] wrote and published The Art of ‘Ware (M&T Books, 1995), a reinterpretation of Sun Tzu’s The Art of War, a 6th century BC treatise on conflict and warfare. My reinterpretation of Sun Tzu’s maxims applied to developing and marketing information technology products, most particularly software. Here’s an example:

    • Sun Tzu (Chapter 2, ‘Waging War’, 1910 Lionel Giles translation): Now, when your weapons are dulled, your ardor damped, your strength exhausted and your treasure spent, other chieftains will spring up to take advantage of your extremity. Then no man, however wise, will be able to avert the consequences that must ensue.
    • The Art of ‘Ware (Chapter 2, ‘Supporting Development’, 1995 edition): When your developers are burned out, your technology aging, your resources diminished, and your advantages gone, then others will take advantage of your weaknesses and cut into your market. Even expensive consultants and new CEOs won’t be able to turn things around.

    Generation Y Summary…for BPM

    “They’re ambitious, they’re demanding and they question everything, so if there isn’t a good reason for that long commute or late night, don’t expect them to do it. When it comes to loyalty, the companies they work for are last on their list – behind their families, their friends, their communities, their co-workers and, of course, themselves.”

    This is from a Fortune article titled “Attracting the twentysomthing worker” by Nadira Hira from May 15, 2007.  Here are a few of the highlights from the article…then I will tie it back to BPM and why you care.

    • Someone born between 1977 and 1995
    • 79.8M of them (versus 78.5M Boomers)
    • “Most high-maintenance workforce in history” (see RainmakerThinking for more)
    • They go to the gym.
    • Over 1/3 have tatoos.
    • 30% have piercings (other than in their ears).
    • Accustomed to diversity.
    • Electronic.
    • Not just willing to work long hours for the sake of facetime.
    • Communicate different ways (e.g., text messaging).
    • Live at home after college.
    • Involve their parents in the decision of the job more.

    So why do you care as you think about BPM?

    1. You have to hire them to work on your project.  Like Myers-Briggs, understanding personality, motivation, and interests helps you build a high-performance team.
    2. They will be part of your process so you need to think about how they experience the job and how they will interact with technology.  Your solution is for the future not necessarily for the past.
    3. This should make you think about generational differences – X, Y, Boomers.  All of this is important when you facilitate an event to flush out the process.
    4. They may someday be your boss.  (It is an interesting experience the first time you realize you are old enough to have a boss younger than you and more successful than you.)
    5. They will get BPMS and wonder why you use paper and don’t have integrated systems today.  They can help drive change.

    The McKinsey Way

    You can certainly never go wrong looking at McKinsey. Their consultants are usually very top notch and their process of thinking and root cause analysis is great. Although this post is more about how you analyze a problem (i.e., business process innovation), it also makes a point about how important process and methodology is. The only way of delivering consistent, high-quality advice worldwide is to have a process of training and consulting that leverages smart people and delivers them to clients.

    (Never mind the fact that McKinsey once told me that they only interview people with a 4.0 or people with a 3.8 and above from a top 5 business school. I didn’t fit the bill, but I have several good friends who were there. I have lots of respect for them.)

    The McKinsey Way is actually a book so you can see some insight into the company. I have read the book and recommend it. Rather than re-type all my notes, I found comments about the book at MeansBusiness and on blog called Brian Groth’s Life at Microsoft and looked at notes on MECE (mutually exclusive, collectively exhaustive) from a book review on The McKinsey Mind.

    My old boss who worked for McKinsey was a genius at asking the probing questions. She knew how to get to root cause better than anyone I worked for. This is essential in diagnosing any problem not least of which are process problems. (Since I assume you only look at BPM to drive value where you have some type of problem.)

    So MECE, as Brian states in his blog, it suggests you should do the following:

    1. Identify the problem using a mutually exclusive, collectively exhaustive framework and then map the problem out using some type of logic tree (see example).
    2. Create a hypothesis (or hypotheses) about the solution…this drives your analysis.
    3. Analyze the data…remember that the only thing that is right is data (assuming some data integrity).
    4. Repeat steps 3 & 4 until you find a fact-based solution that makes sense.

    From the book, some of the other key points are:

    1. “The most brilliant solution, backed up by libraries of data and promising billions in extra profits, is useless if your client or business can’t implement it.”
    2. “Most business problems resemble each other more than they differ.”
    3. “If you get your facts together and do you analyses, the solution will come to you.”
    4. “If you keep your eyes peeled for examples of 80/20 in your business, you will come up with ways to improve it.”
    5. “Know your solution so thoroughly that you can explain it clearly and precisely to your client in 30 seconds.”
    6. “It’s much better to get to first base consistently than to try to hit a home run and strike out 9 times out of 10.”
    7. “Just as you shouldn’t accept I have no idea from others, so you shouldn’t accept it from yourself, or expect others to accept it from you. This is the flip side of I don’t know.”
    8. “When you’re picking people’s brains, ask questions and then let them do the talking. Keep the interview on track by breaking in when necessary.”

    5 Patterns of Extraordinary Careers

    At Express Scripts, all of us on the leadership team (top 1.5%) were given the book The 5 Patterns of Extraordinary Careers.  It was a good book with several relevant tips especially for someone in the BPM space that is likely playing the role of change agent or somone whose career might include an objective of becoming the Chief Process Officer or Chief Innovation Officer.

    From the website, I have pulled in the 5 Patterns.  They also have an online quiz which gives you feedback on whether you are on your way to an extraordinary career.

    1. Understand the Value of You
    People with extraordinary careers understand how value is created in the workplace, and translate that knowledge into action, building their personal value over each phase of their careers.

    2. Practice Benevolent Leadership
    People with extraordinary careers do not claw their way to the top, they are carried there.

    3. Overcome the Permission Paradox
    People with extraordinary careers overcome one of the great Catch-22s of business: you can’t get the job without experience and you can’t get the experience without the job.

    4. Differentiate Using the 20/80 Principle of Performance
    People with extraordinary careers do their defined jobs exceptionally well but don’t stop there. They storm past pre-determined objectives to create breakthrough ideas and deliver unexpected impact.

    5. Find the Right Fit (Strengths, Passions & People)
    People with extraordinary careers make decisions with the long-term in mind.  They willfully migrate towards positions that fit their natural strengths and passions and where they can work with people they like and respect.

    Creative Rigor and Planned Spontaneity

    I had been debating starting a second (or technically third) blog.  As you may already know, BPM Enterprise is another site which I originally posted blogs on, but now they have been kind enough to simply repost my blogs.  This gets me access to about 5,000 people which is great.

    The newest blog was going to be more around leadership and business in general.  For years, I have used two expressions to synthesize my approach to business.

    1. Creative Rigor – This is my blend of right and left brain thinking.  I was classically trained as an architect (buildings not systems).  My biggest takeaways from architecture were (a) how to listen and capture requirements and (b) the fact that there is no right answer only an optimal answer.  When I blend this with my pre-disposition to math and my MBA training, I find that I approach problem solving very different than others.
    2. Planned Spontaneity – This is my approach to consulting.  You have to be 2-3 steps ahead of your client and able to whiteboard out something real-time.  Ideally, you have already thought through the idea beforehand to understand the pros and cons.  Not easy, but it works great when you are ready.

    So, I am going to start adding some of my musings and thought around business here.  I hope to someday publish them in a book, but that may be a ways off unless I can use this medium to capture and begin synthesizing the concepts.

    9 Biggest Myths of the Workplace (non-BPM)

    One of my favorite bloggers (and authors and speakers) is Guy Kawasaki.  He does a great job and his latest blog is no different.  This is totally off topic for BPM, but I think it is always a topic that many of us think about – the workplace.

    He highlights The Nine Biggest Myths of the Workplace based on the work of Penelope Trunk.  It talks about things like the glass ceiling being dead…and not because it’s shattered but because no one cares for whats on the other side.  It talks about backstabbing not being what gets you ahead (although we all know that person for which it seems to).  It says the average person has 8 jobs before they are 30 (amazing).  I think you will like it.

    Personality Typing In Venture Capital

    Matt Winn, an associate at Chrysalis Ventures, writes a blog with many interesting comments. His blog also points you to several other young VCs who are blogging about different topics.

    I thought his blog yesterday about using Predictive Index to assess management teams was interesting as is the original WSJ article about it.

    Chrysalis is a very good VC firm that I talked with several times. They are very active in the healthcare space and their managing partner (David Jones) is the non-executive chairman of Humana (and son of the founder of Humana). I would recommend them highly.

    Mgmt Tools (off subject)

    This is a little off topic, but I get asked the question a lot about why the LinkedIn link is on the blog or about what tools I use to help me manage connections and information.  There are a lot out there, but I have stuck with three for the past few years.  I was about to add a fourth (Spinvox) which takes your voicemails, translates them to text, and e-mails them to you, but it doesn’t work with my phone service right now.

    1. LinkedIn – This is a great professional version of Friendster or MySpace.  It allows you to post your profile and link to connections of yours.  It takes the whole concept of Six Degrees of Separation and makes it real.  I was skeptical at first, but I jumped in and uploaded my Outlook contacts.  When I found out that 50 of my friends already used the tool, I was hooked.  I introduced the tool to one friend, and within a month, he had 5,000 of his contacts “LinkedIn”.  It has been great for networking and reconnecting.  And, There was a recent article in Business 2.0 that talked about LinkedIn finally getting over the 3M active user hump.
    2. Plaxo – I am sure I don’t use this to the fullest, but it allows me to post my electronic business card and send automatic updates.  If two people have signed up for Plaxo, the service automatically updates your Outlook (or other service) with any changes to the person’s card.  With all the job changes (internal and external) these days, this is very helpful.
    3. Google desktop – Although I am a fairly organized person, I can’t keep up with everything these days.  Not to mention that what seems like a good typology one day may not make sense a month from now or during a fire drill.  So I use Google’s desktop tool which indexes your hard drive and allows you to keyword search every file you have and all the websites you have visited.  It is great.

    So much for the digression, but I recommend all the tools.

    Innovation – IBM Study

    I am a big believer that innovation is a critical part of any business strategy.  This has come into vogue in the past few years, but I have focused on this ever since I pursued a joint architecture / business education.  One site that I have followed for the past 18 months has been the Business Innovation Factory.  This morning, I was reading several things there, but the IBM CEO Study caught my attention.

    1. It talks a lot about innovation from the outside in from customers, business partners, consultants, and trade groups.
    2. Innovation is very focused on business model versus product innovation.

    “It’s very clear that CEOs today are looking at new kinds of innovation to drive substantial organizational change and business growth,” says Ginni Rometty, Senior Vice President, IBM Enterprise Business Services. “It’s not just about product innovation any more. It’s about understanding how to innovate a business model, or an operational process, or management behavior.”.  View IBM Global CEO Study 2006 Event Presentation.

    Another article on the site that appeared in Forbes talks about service industry innovation using traditional product design concepts.  (See article)

    All of this is relevant to BPM for two reasons: (1) process innovation is an area of real opportunity for many companies and is akin to business model innovation (just ask all the Business Process Outsourcing (BPO) companies) and (2) there is lots of talk about using BPM to identify exceptions and notice trends that could create new product innovation opportunities.

    Art of Visualization

    This is off topic, but wow.  Anyone who struggles with the business challenge of visualizing complex ideas will enjoy this.  Guy Kawasaki, whose blog I subscribe to, put out a blog today about the Art of Visualization.  In it, he provides a link to A Periodic Table of Visualization Methods which is a fascinating tool.

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