The Act of Becoming: Branding on Social Media

March 15, 2012 7 comments
Social Influencers

Malcolm Gladwell wrote The Tipping Factor. He showed that trends are not spread by the many, but by a few influential connectors.  Marketers identify and leverage these connectors or social influencers to build their brands in the social marketplace.  As  brands engage with these key customers and taste makers, what are they hearing? The social marketplace is no place for brands who don’t have a firm grasp of their identity. Social media marketing is an exacting science and but it can also be a rude awakening.

The Exacting Science Part

Like the ripples of water from a rock thrown in a pond, marketers identify each degree of separation and influence. There are  power influencers, idea starters, amplifiers, etc.

Marketing agencies and research firms have developed innumerable measurement and analysis tools. From buzz analysis to tweet and blog level,  Klout to PeerIndex we know who to court and woo. We seek favor for the brand with a blog or podcast mention. We know the demography and social media profile of  second level influencers, the “brand ambassadors” and on to the next. Let the word of mouth begin.

The beauty of social media marketing is that you can learn which programs, messages and offers work and which don’t.  ROI is a snap.  For new brands and small marketing budgets, it’s the only way to go. For many big brands, it’s an effective way to keep their customer base. Ford Motor Company is revitalizing their brand with an improved product line and great social marketing.

The Rude Awakening Part

The world of social media has no tolerance for executive, top down brands.  Traditional brand messaging does not resonate in this world. Today’s consumers are on information overload. They want to make brand decisions on their own terms, filtered through their network.

Consumers use social media to create a cultural context that has meaning for them, a “collective I”, as Alex Wipperfurth describes it.  The brand must become something with meaning and authenticity to take part in that world. Who are you and what do you stand for?  It’s surprising, but many companies don’t really know.

Luxury brands that rely on cache have not done well in the democratic arena of social. Campaigns with even a hint of controversy can go viral negative in days. The California Milk Board’s “PMS” campaign polled positive, but stirred a firestorm of negative social media backlash. Relevance and resonance displace reach as the prescription for success in social media marketplace.

To quote Mr. Wipperfurth again, “It’s no longer about positioning…it’s about taking a position.”

Please let me know your thoughts by clicking on the “Leave a Comment” link at the top of the post.

Why is Health Information Exchange so Hard?

March 13, 2012 1 comment

US Healthcare Information Technology is still paper based

Fatal Communications Breakdown

Josie King died at Johns Hopkins Hospital in 2001 – age eighteen months. She did not die from her condition but from dehydration coupled with non-indicated use of narcotics. She died from poor communication and coordination of care at one of the best hospitals in the world.

Every year, almost 100,000 people die from medical errors in the US. The Joint Commission‘s Annual Report on Quality and Safety 2007 found that inadequate communication between healthcare providers, or between providers and the patient/family was the root cause of over half the serious adverse events in accredited hospitals. The instantaneous movement and sharing of information is part of daily life in the US. The lack of the same capability in our healthcare system is appalling.

Interoperability: the Biggest Challenge

The US has a private medical system. Healthcare delivery happens locally and regionally. IT implementation grew organically in that model and today is a crazy quilt of antiquated incompatible systems. The US is building a healthcare IT infrastructure to connect these systems together. IT Infrastructure is the central nervous system, a conduit for medical information to flow from anywhere to anywhere. Interoperability is an enormous problem in a fast-changing world of wired and wireless devices.  Standards committees work on two-year timetables while our innovation economy pours new devices into the marketplace at a dizzying rate.

Glacial Progress

The priority for HIT gained traction in 2004-2005, but since then progress has slowed to a crawl.

  • 2004 – H.R. 4880 The Josie King Act introduced to spur growth of national HIT infrastructure – bill died in committee.
  • 2004 – HHS Secretary Tommy Thompson launched the “Decade of Health Information Technology“.
  • 2005, IBM announced it was investing $250 million in R&D to design a national IT infrastructure.

It took until 2009 to enact meaningful legislation.The HITECH act invested nearly $30 billion in health IT to improve the quality, safety and efficiency of health care. Most of this money went to the CMS for incentives to healthcare providers to accelerate implementation of electronic health records (EHR). Widespread adoption of EHR’s  in the healthcare system is a key enabler to achieve cost and quality reforms.

Three years after passage of  HITECH, less than 20% of the healthcare is delivered electronically in the US. According to Charles P. Friedman, CSO for the Office of the National Coordinator for Health IT, adoption of EHR’s will become more or less “national” in 2019 when penetration will hit 80%. Can we wait that long?

The pace of change will remain glacial unless health IT is given the national importance it deserves. The effort to create a robust interoperable health information backbone deserves the same urgency that built the interstate highway system or US space program. Instead the popular political dialog focuses on the health insurance mandate.

We lack the threat of Russian ICBM’s orbiting the earth to motivate us in this goal, yet our need is urgent. Efficient healthcare information exchange will not only improve patient safety, it will improve outcomes and cost-effective care. Without it, access to care may one day depend on one’s ability to pay for it.

Please let me know your thoughts by clicking on the “Leave a Comment” link at the top of the post.


“Jumpstart Startups” Act Passes in the House

March 9, 2012 3 comments
Sarbanes-Oxley Stifles Innovation, Job Growth

After the Enron, WorldCom and Tyco scandals Congress passed Sarbanes-Oxley Act in 2002. The “SOX” act intended to protect shareholders from shady corporate disclosures and overstated earnings reports.

What SOX actually did was paralyze innovation and job growth. It imposed a heavy capital burden on growth companies seeking to go public.  Pre-SOX, the average time to IPO was 5 years, post-SOX it is 12 years. For companies that did go public, many defected to a foreign exchange.

For large companies, Sarbanes-Oxley preoccupied C-suites and boards of directors with accounting rules and SEC compliance. As Dr. Chandra Mishra wrote in the Orlando Sun Sentinel, “Sarbanes-Oxley has created a trillion-dollar industry, consisting of lawyers, accountants, compliance officers and programmers, pushing for more bureaucratic procedures and criminal penalties for company management and entrepreneurs, creating fear and confusion, and discouraging risk-taking and corporate growth.”

For small and medium-sized companies seeking to go public, complying with SOX rules adds roughly $4.2 million to their capital requirements.

Even representative Michael Oxley, one of the original sponsors of the bill, said “Frankly, I would have written it differently…Everyone felt like Rome was burning.”

Legislation Passes the House, Senate Yet to Vote

Last year bills in the house and senate addressed this issue and failed. Yesterday H.R. 3606, sponsored by Rep. Stephen Fincher,  passed overwhelmingly in the House of  Representatives.. This bill will cut the costs of going public for small and medium-sized companies buy phasing in SOX requirements over five years.  It also ends SEC rules prohibiting crowdsourcing and advertising to raise capital.

As congressman Fincher said, “Small companies are our nation’s best job creators, but have been the hardest hit by burdensome regulations. On average, 92% of a company’s job growth occurs after an IPO.  It is imperative we reduce regulations to help these small companies create private jobs for Americans.”

The Senate has not yet voted on its corresponding bill, but passage this legislative session looks good according to Senator Charles Schumer.

Graphic credit: Forbes Magazine

Uncertain Future for Growth in Life Sciences

March 6, 2012 2 comments
Clusters Create Competitive Advantage

 Michael Porter, in his essay Clusters and Competition describes a virtuous geographic relationship among government, finance, education and industry which combine to create competitive advantage. Think high performance autos in southern Germany, high fashion shoes in Italy, tulips in Holland. Think life sciences in Massachusetts.

Life sciences are the engine behind Massachusetts’ growth economy. But they might face an uncertain future due to:

  • Reduced appetite for venture funding of life science
  • Fewer IPO‘s, more acquisition activity
  • Shortage of trained “middle workers”
  • The high cost of healthcare
Prospects for the New England Life Sciences Cluster

State Economic Development czar Greg BialeckiPeter Abair from MassBio and David Pierson from Foley Hoag met on a panel at NEHEN to discuss the long-term health of life sciences in Massachusetts. I’ve summarized their views below.  Much of the data presented lies in a PWC MoneyTree Report on data supplied by Thompson Reuters.

By all accounts, growth in the life sciences sector saved Massachusetts’ economy from tanking in the great recession. Venture funding fell; it bottomed out in 2009. But NIH funding remains high, higher than any other state except California.  And on a per capita basis, NIH funding in Massachusetts is off the charts. Momentum in the sector is strong, yet there are clouds on the horizon.

Venture Funding Down for Biotech

By 2011 venture capital rebounded, but not for biotech companies. High tech is booming behind new business models fueled by cloud computing, social media and smart phones. These start-ups get the lion’s share of deals.

There are fewer venture funds today and fewer investors in those funds. There is a focus on capital efficiency, faster exits. Biotech is not an efficient investment. New products are slow to market and the failure rate is high.

Another disturbing trend in biotech start-ups is that fewer successful ones ever reach an IPO.  They get gobbled up by larger firms. M&A exits far outpace IPO’s in this space, and the trend has increased. More big pharma companies take an ownership stake after Phase I or II. Often, an acquisition means relocating the company and its jobs out-of-state.

Should we be concerned about the loss of local investment on the long-term health of the biotech cluster? Porter argues, “The ultimate test of the health of a cluster is its rate of innovation.”

There is no shortage of innovation in the state. Incubators and accelerators are full and growing. But the high cost of doing business in Massachusetts and the lack of a vibrant, skilled middle work force makes it hard to scale a company here.

So far, the high cost of discovery has paid off because of the healthcare system’s willingness to pay a high price for new products. As the ACA, payers and employers conspire to lower the cost of care, there will be less room in the budget for high-priced innovation unless it creates a better outcome and a lower cost per care dollar spent.

Government, Education Key to Health of Sector

How to improve the prospects for a healthy biotech sector and a healthy state economy? Porter’s cluster theory points to the role of government as potentially making the biggest difference. Investment will follow the path of least resistance and greatest return. Our university system is world-class and likely to stay that way. But the lack of affordable housing and a qualified workforce is an addressable problem.

Local zoning ordinances often get in the way of increasing access to affordable housing. Put innovative legislation like Massachusetts’ Comprehensive Permit Law and incentives like Connecticut’s Incentive Housing Zones on the front burner to create a more comprehensive approach for solving this problem.

Much of the emphasis of our education system is toward earning a 4 year college degree. But educators should pay more attention to encouraging  high school graduates who might not otherwise continue their education to earn an associate degree or attend a technical school in one of the STEM areas. These are the skills which are in short supply and a primary reason biotech companies outsource jobs.

There is no guarantee that our vibrant biotech sector will persist.  We need only remember the legacy of our once bustling high-tech sector as a reminder.

Story Time on Facebook

March 1, 2012 1 comment
Facebook’s New Marketing Platform: Big Changes for Users

Today, Facebook introduced its new offering called Facebook Premium to advertisers at its Facebook Marketing Conference. They added Sponsored Stories to Brand Pages. Facebook wants advertisers to engage with fans, to tell their brand story.

Up to now, we had to “like” a brand to get exposure to each promotion.  Not very engaging, except to promotion enthusiasts. This feature has kept my Facebook News Feed remarkably free of ads.

Facebook Premium inserts brand stories on the News Feeds of fans of a brand, next to news from their family and friends. You say you are a fan of Target stores? You get Target stories between news tidbits from your college buddies.

Bedtime Stories from Mountain Dew

Storytelling was a hot topic in social marketing circles this past year, but we didn’t see much of it. Now, I fear a festival of brand storytelling is about the begin. I wonder to what depths brand marketers will sink to engage me with their story.

Don’t get me wrong, I love a good story. Moby Dick knocked me out. But what kind of stories will I hear from Mountain Dew?

My last post, “Mission-Driven Social Media” praised the Mayo Clinic for using its founding mission as inspiration for its social media strategy.  The CEO told a great story about how the Mayo brothers reinvented medicine in a way to build a network of care around the patient.  This became group medical practice.  They shared this new idea by travelling the world to tell how it worked. You can’t tell a more authentic brand story.

The question is, how many authentic-feeling brand stories can marketers conjure up? According to one report on The Next Web, “Facebook’s vision for marketers is that brands will be able to interact with customers in ways just as rich and dynamic as family and friends.” Maybe some fans will come to like their brands more than family and friends.

Agency response

I read a post in Forbes today from Jamie Tedford.  He’s CEO and founder of social media agency Brand Networks. He says, “All brands have a story.” His agency banished the word “posts” from their lexicon and replaced it with “stories”.  They reorganized account teams around Story Planners. They use analytics to figure out which stories resonate.

Sounds like a plan. I’m sure it will work…for a while and for some brands. If things go as usual in agency-land, this will get overdone. Like tourists on a whale watch, everyone will rush to one side of the boat. Brand managers – don’t trial and error this to death. Your fans are your best customers. This has the potential to wear on the user and create blow back.

Oh and one more thing. Facebook also announced that once users log off the site, ads and promos will flood the page before it closes – on desktop, mobile and tablet. Wake me when it’s over.

Mission-Driven Social Media

February 28, 2012 7 comments

A few years ago I took a consulting assignment for an incoming college dean.  My job – write the school’s new communications plan.  In my first meeting I asked what the school’s mission was.  “Every college and university has basically the same mission,” she said.  I explained that a unique mission is key to a high quality communications program.

There was an effort among the senior faculty to write a mission statement but it became the product of consensus.  I’ve learned it takes a lot of hard work to create a mission statement, particularly if you’re not a founding father.

It was a missed opportunity to create something powerful.  Mission-driven communications integrate naturally; stories gain context.  They are the basis of great brands like IBM and Apple.

I remembered that time when I learned about a unique and powerful social media strategy at the Mayo Clinic, The Center for Social Media.  A video presentation by CEO John Noseworthy, M.D.  introduces the center as extending their founders’ mission, now over 100 years old.  Drs. William and Charles Mayo wrote, “The best interest of the patient is the only interest to be considered and in order that the sick have the benefit of advancing knowledge, union of forces is necessary.”

Dr. Noseworthy explains how that mission came to life in the early years of the Mayo clinic, “It drove the Mayo brothers to invent the concept of group medical practice at a time when the notion was considered a breach of physicians’ individual responsibility.” They used that concept to create other best practices and shared them with physicians around the world.

How does this tie in with social media? Social media are a great way to assure that the patient receives a continuum of coordinated care.

One early Mayo innovation was the unified patient medical record. “It’s goal is to build a network around the patient.” says Dr. Noseworthy. That is the opportunity for social media. Networks of physicians, support staff and other patients may improve outcomes when coordinated through the clinic.

Lee Aase is the director of the center.  In a “Conversations on Health Care” podcast, Mr. Aase details the many ways in which the center’s programs define excellence in patient centered care through social media.  In each case, the linkage to the Mayo Clinic mission is clear to see.

Visit the center’s website, see the video blogs from physicians, read the patient stories. There is nothing slick or artificial. An aura of authenticity surrounds this program.  This its true in part because of its connection to the clinic’s mission.  Other academic medical centers have similar programs and they are well executed.  But the visceral connection to the institution is often missing.  The whole is lesser than the sum.

Well done Mayo Clinic.

Photo credit: Salvatore Vuono

The Perils of Free Market Healthcare

February 22, 2012 6 comments

Affordable Care

Increases in healthcare spending have slowed to near the rate of general inflation in recent years. Why has this happened? Is it a sign that the market is gaining traction and we don’t need big government to rein in spending?  J. D. Kleinke of the American Enterprise Institute thinks so.  In his Wall St. Journal opinion piece, The Myth of Runaway Health Spending ,  Mr. Kleinke states that market forces are conspiring to regulate spending and “… it puts the lie to the claim that we need government to put the brakes on an “out-of-control” health-care system.”

Here’s the lowdown on these market forces. Employers and insurers reacted to a decade of healthcare inflation by introducing tiered hospital access, tiered pharmacy payments, and high deductible insurance plans.  “You want top-notch care and better drugs?  You pay for them, and by the way, whatever choices you make, the first $5,000 is out of your pocket.”

The result – consumers today decide how much healthcare they consume, and where they consume it.  Are they qualified to make those decisions?  What is the cost of poor decision-making?

Physician office visits declined by 4% from 2009 to 2010 according to IMS Institute for Healthcare Informatics. JP Morgan analyst John Rex reported an 8% decrease in visits from 2010 to 2011.  A Commonwealth Fund study of 18,000 adults in 11 countries, posted Nov. 9, 2011 on the Health Affairs website, showed “sicker” American adults intentionally missed doctor visits, did not fill prescriptions, skipped doses of medication and went without recommended care.

Half of U.S. adults under 65 (51%) went without care because of costs, compared to 19 percent of adults age 65 or older; 35 percent of those under 65 had problems with medical bills, compared with only 6 percent of adults 65 or older. One in four (27%) American adults said they had trouble paying for care or could not cover medical bills.  These draconian “market” solutions to health costs may actually increase health spending as more Americans develop chronic illness from lack of care.

There are positive market forces at work lowering costs.  In Massachusetts, insurers and hospitals renegotiated existing contracts and agreed to bundled payments systems that reward outcomes, not volume.  Accountable Care Organizations and Patient Centered Medical Homes are spreading throughout the system.  The impetus for these changes? The Affordable Care Act.

There’s no doubt the healthcare system would have morphed into something resembling the structure outlined by the ACA. But how long would it take to become an effective nationwide continuum of care?

The ACA is not a magic bullet, but it started the ball rolling in the right direction.  Payers and providers saw the writing on the wall.  ACA gave it shape and focus.  Now the market is pushing ahead of the schedule and hopefully patients will not have to choose between eating and seeing their caregiver.

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