Fryer's Blog in the Mountains

The problem with Apple Medical ID: Healthcare POA

As a caregiver who is taking care of a family member, taking them to an emergency room or calling for an EMT is a stressful time. It gets more complicated when the caregiver is not physically present at the time. Apple Medical ID is geared to a phone belonging to the patient. What is missing is the Healthcare POA (including contact information) and Healthcare Directive (including POLST). I have personal experience that this lack of timely information can have adverse effects for the patient, such a DNR order not known and the patient is intubated.

It would be helpful if this information could be included in the Apple Medical ID and be shared on caregiver phones.

Universally Accepted Patient ID: No More Portals?

Last week I visited my provider. Two weeks ago I had visited a provider in another healthcare system. Since my information was in two different portals, not only did I have to fill out the intake questionnaire, again, I had no way to show my two week old health information to the provider.

As a patient consumer, I have rights to all my health information, but since I have different providers with different patient ids, they have no way to aggregate my information if they don't have a BAA with every provider.

The industry keeps proposing creating a universal patient id. Lazy thinking and it failed years ago when they used your social security card.

Instead of a Universal Patient ID, we need a Universally Accepted Patient ID. Think of a QR code on your phone, which on registration is automatically recognized and allows the provider to automatically pull relevant information.

Pie in the sky thinking?

No, it is actually being built now.  Healthcare Digital Identity Federation

#carinalliance #patientid

 

Misunderstanding TAM SAM SOM

I'm looking at a software product that gets a new healthcare facility, IT ready. Previously another consultant said the US Total Addressable Market (TAM) was $29B a year. Wow, that sound great. Until I looked at their work.  They counted 100% of all non-residential construction. Oh my. Apples and oranges.

Here's a refresher course. First off figure out your product's MSRP. Let's say it's $100 for a bundle of napkins for restaurants. Next, estimate the number of restaurants in the world and how many bundles of napkins they use. Multiply that by $100. That's your TAM. You'll never get there, but if it is a good sized TAM you have some room to pivot.

The Service Addressable Market (SAM) is a tight description of the exact type of restaurant that is a perfect fit for your napkins and geographically where they are located. Estimate how many bundles they would need. Multiply by $100. That's your SAM.

Next comes the tricky part. The Service Obtainable Market (SOM) is a bottom up approach based on your Go To Market plans. The SOM is how many units you will sell (times $100) in specific time frame, like 3 years.  If you tell me you will capture 4% of the SAM market in three years w/o a Go To Market, then I run away.

 

Average and Normal are for Lazy Product Managers

After fitting thousands of boots for skiers I quickly learned that there is no such thing as an average or normal body type. I also learned that the difficult cases are the most rewarding because you have to focus intensely on one person and when you get it right, they are so happy.

It's the same in product design. Many product managers shy away from the edge cases. But those are the most under served people in your market. By delighting those users, you also bring in a lot of adjacent users and end up standing out from competitors who only focus on average / normal users.

Just In Time Healthcare Failure

Healthcare in the U.S. historically has been reimbursement driven. This resulted in efficiency in healthcare delivery: high utilization, lowest cost delivery. With the move to value based delivery, population management and outcomes are rising in importance. Again, driven by reimbursement.

Efficiency and Efficacy drive heathcare. The holy grail.

Then along comes a pandemic and shows the brittleness of this system. There is no resiliency and the healthcare system is overloaded and financially under water.

Why?

First off, the healthcare systems goals are not aligned with national goals of the well being of the population. Just in time makes it worse, as there is no reward for supply chain redundancy, or ICU beds surge capacity, or staffing surge capacity. Covid-19 also shows the uneven distribution of healthcare delivery to rural and economic disparity made worse by the lack of a Federal strategy (or execution), and resulted in thousands of preventable deaths. And future preventable deaths.

What's the answer? I don't know. But we need to seriously have a discussion about what the future of healthcare in the U.S. should be, and not a headlong rush back to the old status-quo.

Agile + New Products + Milestones = Problems

"Build projects around motivated individuals.
Give them the environment and support they need,
and trust them to get the job done."

When you are building a new product in your startup or company, you need to have a launch date or you have milestone dates that must be met. Your epics are done but since your team is usually new, no one knows the team velocity. Quite a conundrum.

This seems to conflict with standard Agile tools, but it does not conflict with Agile principles. Just add a dash of project management.

1. Bring the team together and estimate the time for each Epic.
2. Group the Epics into your milestones and calculate the dates.
3. Put the milestones into a project schedule and determine the negative float.
4. Themes are your friend. Examine the themes, epics and user stories and rank them.
5. Apply lean startup techniques to validate each key hypothesis.
6. Add and subtract stories.
7. Get to work and start calculating velocity.

Remember this is a team project, but you need to be willing to ruthlessly drop stories and epics if they don't directly contribute to your core value proposition.

 

The fatal flaw in machine learning AI

Machine learning is a great thing. The fatal flaw is our expectations of their capabilities exceed the ability of these systems as designed. Especially when they interact with people. Take the news feed on LinkedIn or Facebook for instance. Their design goal is "show people what they like to see". People will stay longer on the platform and consume more advertising. It works very well. The problem is it collapses everyone's worldview and they can no longer absorb new ideas and viewpoints. Just the opposite of being well read. The social good diminishes.

My point being is that whatever the AI designer's target goal is, that will become extremely efficient. But like all computer systems, they are extremely inflexible in looking at macro impacts, yet we deploy them without understanding the unintended consequences. I like collusion avoidance in a car because it enhances my driving skills. I don't like autonomous driving systems because it makes me a stupid, disconnected driver. 

 

Centurylink not connecting with Comcast 800 numbers

A couple of days ago I got my latest Comcast bill and noticed it went up. So I called the 800 number. Got a fast busy. Tried the next morning and same thing.

Tweeted Comcast Care and they said everything was fine. It wasn't.

Talked to CenturyLink (yes, I still have a landline) and turns out Comcast switched long distance carriers and didn't test to see if analog connections worked . The CenturyLink CO did not recognize them. It is now fixed.

Another fine example of how everything impacts customer experience.

My 7" 40GB $62 Traveling Tablet: Amazon Fire

On a trip to Indianapolis, I left my iPad on the plane. Tracking it did no good. I was not happy. For Christmas this year I got the cheapo Fire with a wimpy 8GB of storage. For $12 I added a 32GB card. Total cost = $62.

It's a great traveling companion. The screen's not the absolute best but works just fine for watching streaming movies (supports all the streaming services I use) and with 40GB downloaded movies. And yes you can read books, play games and store a lot of music. Since it has Bluetooth I use my Bluetooth stereo buds. To protect the screen I slipped it into a standard shoe shining mitt you get at the hotel.

The problem with using your phone on a trip is the battery consumption. Sometimes on a trip to NYC I've depleted the battery so much, I'm afraid I won't have enough to run the Lyft app. Now I turn my phone completely off and just use the Fire. If I happen to leave it on a plane again, I don't think I'll have as much angst.

Marketing: Less Stalking, More Talking

Many businesses have decided the best way to sell is by stalking people across the Internet and inserting ads.  Many people find this very disturbing (hence the rise of ad blockers like Ghostery and Privacy Badger.)  Other businesses build relationships with people and hear their stories (using tools like InMoment). 

What the stalkers forget is the customer lifetime value (CLV).  Building relationships increase CLV while reducing Customer Acquisition Costs (CAC) because not only people talk to other people, but engaged customers also reduce churn.  This is especially true in the B2B market and enterprises is why they are investing in Customer Experience (CX).  I believe this is the future of business because markets are conversations.