Social media experience at Mayo Clinic

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[cross posted at FASTforward blog]

At last week’s Blogwell 2 conference in Chicago, Lee Aase from the Mayo Clinic shared their efforts to use social media to continue to share the Clinic’s message with the existing extended community tightly and loosely surrounding them. The Mayo Clinic has built a worldwide reputation over the course of many decades. Fundamentally, that reputation is a function of word of mouth. That makes social media in all forms a natural fit for Mayo.

They are working across multiple fronts included a fan page on Facebook, multiple blogs, a YouTube channel, and Twitter. At the conference, Lee announced their most recent effort, Sharing Mayo Clinic, which is intended as a place to share people stories about the Clinic and to serve as a hub around which other social media efforts and coalesce.

i was struck by a number of things in Lee’s presentation and Mayo’s overall efforts. First and foremost was the value of simply diving in and learning from their experiences. Coupled with that was the additional leverage found in thinking systemically. The heart of their strategy here is to find and share the human stories connected to the Clinic every day. The technologies serve as multiple ways to get the story out and Lee and his team (which is much smaller than I would have predicted) are smart enough to not get in the way of those stories.

For example, although they are making extensive use of video in their storytelling, they are using the Flip Video Camcorder instead of a more complex (and intimidating) video set up. What they are learning is that the Flip provides good enough production values and doesn’t get in the way of the storytelling. I suspect that there’s more craft involved than Lee let on, but not so much that it is out of reach for any organization that’s willing to make a few mistakes in the early stages.

Lee closed with an intriguing observation about the value of Mayo’s investments in social media. Here’s how he put it:

As I approaches 0, ROI approaches infinity

I suspect that the average CFO would be a bit suspicious, but there’s an important point here. The financial investments in social media can start at zero and don’t need to get terribly far away. The real investments are in organizational time and attention and what Lee and others are demonstrating is that those costs are also readily manageable. Answering questions about ROI does not necessarily entail using a spreadsheet.


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Blogwell 2 conference in Chicago – simple works

In recent years I’ve taken to avoiding conferences unless I find my way onto the agenda or some other active role. Too many conferences have become thinly and poorly veiled marketing exercises by sponsors who seem to believe that the participants cannot distinguish between substantive content and a sales pitch. Or perhaps don’t particularly care what participants think.

I broke my rule last week and decided to attend the Blogwell conference in Chicago, organized by Andy Sernovitz and the folks at GasPedal. Fortunately, Blogwell broke the rules as well and it proved to be a worthwhile afternoon that justified the investment of my time and attention. The conference design that made this work was trivially simple. The conference organizers collected eight users of blogs, Twitter, and other social media and let them share their stories. Some of them were good story tellers; some had useful lessons learned. A couple managed to combine both. But all did a good job of providing concrete reports from the field. There’s been a good deal of discussion during and after the conference on Twitter; the best way to track that is via Twitter Search.

Thanks to Andy Sernovitz and the folks at GasPedal for keeping it simple.


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Webinar with Clay Shirky: Preview of FASTforward’09

Clay Shirky

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I’m looking forward to meeting and hearing Clay Shirky at the upcoming FASTforward ’09 conference, even if it is happening in Las Vegas. I’ll be attending in my role as one of the contributors to the the FASTforward blog. I’m being lazy and simply passing along the notice posted by Hylton Jolliffe there.

Please join us next Tuesday, January 27th, at 2:00 p.m. ET for a webinar with a name surely familiar to followers of this blog Clay Shirky, the keen commentator on all things Internet and author of Here Comes Everybody: The Power of Organizing Without Organizations .

Clay, who ll be a keynote speaker at FASTforward 09, will explore topics of great interest to us all: the effects of open networks, collaboration, and user-created and disseminated content on organizations and industries and the need for enhanced solutions that meet today s new information management challenges.

To reserve a spot for the webinar, please register here.

And to find out more and join us in Las Vegas for FASTforward 09 from February 9-11, head to the conference s website. The contributors to this blog will all be there as will a host of other interesting participants such as Charlene Li and Don Tapscott.

Find out more and register today!

Webinar with Clay Shirky: Preview of FASTforward 09
Hylton Jolliffe
Wed, 21 Jan 2009 16:03:40 GMT

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Business models for health care: Andy Kessler’s take on the future of medicine

The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor, Kessler, Andy


Andy Kessler is a former Wall Street investment analyst turned author. He learned his trade following Silicon Valley and its successful, long-term, obsession with Moore’s Law. In that world, as technology scales, costs fall predictably, and new markets emerge. In The End of Medicine, Kessler takes to the world of health care and medicine to discover how and where that underlying investment model might apply. It’s an interesting premise and, despite some annoying stylistic quirks, Kessler delivers some real value. It doesn’t get to anything remotely like an answer, but it collects and organizes a lot of useful information that might help us get closer to one.

Kessler opts for a highly anecdotal style; presumably to put a more human face on a large, complex, subject. For me, he overshoots the mark and loses the big picture. The color commentary overwhelms the underlying story line, which was my primary interest. But there is a good story line that is worth finding and holding on to.

Medicine’s roots are in making the sick and injured better. Triage is baked into the system at all levels. Observe symptoms, diagnose problem, apply treatment, repeat. Over time we’ve increased our capacity to observe symptoms and have gotten more sophisticated in the treatments we can apply, but the underlying logic is based on pathology. Also over time, a collection of industries have evolved around this core logic and these industries have grown in particularly organic and unsystematic ways.

Kessler runs into these roots and this logic throughout his journey. However, coming from the semiconductor and computer industries, as he does, he doesn’t fully pick up on their relevance. As industries, computers and semiconductors are infants compared to medicine and health care. Not only do Kessler’s industries operate according to Moore’s Law, but they are structurally designed around it. His analysis of health care identifies a number of crucial pieces, but he stops short of assembling a picture of the puzzle.

Kessler focuses much of his attention on developments in imaging and diagnostics. Both areas have seen tremendous advances and hold out promises of continued technological development similar to what we’ve seen in semiconductors.

Imaging is a computationally intensive area that benefits fully as an application of computing technologies. What is far less clear is whether the current structure of the health care industry will be able to absorb advances in imaging technologies at the pace that will let Moore’s Law play out in full force.

There is a second problem with imaging technologies that applies equally to other diagnostic improvement efforts. As we get better and better at capturing detail, we run into the problem of correctly distinguishing normal from pathological. While we may know what a tumor looks like on a mammogram what we really want to know is whether that fuzzy patch is an early warning sign of a future tumor or something we can safely ignore. The better we get at detecting and resolving the details of smaller and smaller fuzzy patches, the more we run into the problem of false positives; finding indicators of what might be a tumor that turn out on closer inspection to be false alarms. Our health care system is organized around pathologies; we fix things that are broken. Because of that, the data samples we work with are skewed; we have a much fuzzier picture of what normal looks like than what broken looks like.

This is the underlying conceptual problem that efforts to improve diagnostics and early detection have to tackle. Kessler devotes much of his later stories to this problem. He profiles the work of Don Listwin, successful Silicon Valley entrepreneur, and his Canary Fund efforts. Here’s the conundrum. If you detect cancers early, treatment is generally straightforward and highly successful. If you catch them later, treatment is difficult and success is problematic. Figuring out how to reliably detect cancer early has a huge potential payoff.

The kicker is the word “reliably” and the problem of false positives, especially as you begin screening larger and larger populations. If you have a test that is 99% accurate, then for every 100 people you screen you will get the answer wrong for one person. The test will either report a false positive – that you have cancer when, in fact, you don’t – or a false negative – that you are cancer-free when you aren’t. As you pursue early detection, the false positive problem becomes the bigger problem. Screen a million people and you will have 10,000 mistakes to deal with, the vast majority of which will be false positives. That represents a lot of worry and a lot of unnecessary expense to get to the right answer.

Kessler brings us to this point but doesn’t push through to a satisfactory analysis of the implications. Implicitly, he leaves it as an exercise for the reader. His suggestion is that this transition will present an opportunity for the scaling laws he is familiar with to operate. I think that shows an insufficient appreciation for the complexities of industry structure in health care. Nonetheless, Kessler’s book is worth your time in spite of its flaws.

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Simple competence as an overarching theme for 2009

I’m increasingly fond of Bob Sutton’s work at Stanford. Here’s a recent post of his on a critical observation from organizational theorist James March.

After working with Stanford’s bureaucracy for month and months to try to get a scholar appointed and paid (we have the money, that is not the problem), and still not having luck, I was reminded of a lovely and rather obscure article by James March   It was based on an address that he gave to academic administrators at the University of Illinois in 1980.  This excerpt seems especially appropriate at the moment:

“The importance of simple competence in the routines of organizational life is often overlooked when we sing the grand arias of management, but effective bureaucracies are rarely dramatic…. Much of what distinguishes a good bureaucracy from a bad one is how it accomplishes the trivia of day-to-day relations with clients and day-to-day problems in maintaining and operating its technology.  Accomplishing these trivia may involve considerable planning, complex coordination, and central direction, but is more commonly linked to the effectiveness of large numbers of people doing minor things competently. As a result, it is probably true that the conspicuous differences around the world in the quality of bureaucratic performance are due primarily to variance in the competence of the ordinary clerk, bureaucrat, and lower manager, and to the effectiveness of routine procedures for dealing with problems at a local level.  This appears to be true of armies, factories, postal services, hotels, and universities.”

Right now, some simple competence sounds pretty damn good to me. As you may have gathered, March is not much of a fan of heroic leaders, he believes more in well-designed systems filled with competent people.  His quote also reminds me of one I heard from the folks at the Institute for Health Improvement (they credited the Army Corp of Engineers): Strategy is for amateurs; execution is for professionals. 

The above quote is from “How We Talk and How We Act: Administrative Theory and Administrative Life,” which March published here. For a general tour of his work, check out Decisions and Organizations and The Pursuit of Organizational Intelligence.

P.S. The post is dedicated to that very patient scholar!

In Praise of Simple Competence
Sat, 27 Dec 2008 00:01:14 GMT

Helping individuals and organizations operate more competently seems to be an excellent underlying goal for 2009.

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