Lesson: Wait for the marshmallow.

Any decent buffet has foods that please 85% of the population. Meats, cheeses, potatoes... the typical fare.

Once your business hits a natural plateau, it’s tempting to invest in getting more people to come. And what most buffets do is double down. Now, they have bacon, plus they have beans with bacon and turkey-wrapped bacon. Now, instead of one chocolate cake, they have three.

This is essentially useless. You haven’t done anything to grow your audience. The base might be a little more pleased, but not enough to bring in any new business. And the disenfranchised (the vegans, the weight watchers, the healthy eaters, the kosher crowd) remain unmoved and uninterested. And one person like this out of a party of six is enough to keep all six  away.

So, there are two ways to go. Much deeper, or a bit wider.

from Seth Godin.

Wider or deeper? In concert with deep quantitative analysis of service line performance, your future lies in an ability (or inability) to answer the 'wider/deeper' qualitative questions.

What is 'value' in the hospital setting?

1. It is numbers/figures based on income generated per service line (assuming you've got *some in the black).

2. It is trending needs/wants from the community you serve.

Ignore either and you're liable to end up like GM or the multiplicity of newspaper organizations cutting coverage en masse.

What would America look like without the general hospital? Who knows.

But if you don't ask the 'wider/deeper' questions, we may have the opportunity to find out.

Pretty often. Stigma and profiling run rampant. I'd like to say I never formed visually-based, stereotyped impressions about a patient as a patient advocate. But I'd be lying.

The virtual equivalent? Hiding behind the "health disparities" or "lack of health literacy" arguments. The ER equivalent? "I'm in pain" always = drug-seeking.

We need traffic triage rules for interacting in healthcare delivery settings, but the elementary lessons work just fine:

1. Stop.

2. Look.

3. LISTEN.

You know what they say about assuming...

Brilliant film Rx via recommendation from @davidrosenman. Follow filmmaker @johnmchu on Twitter: http://twitter.com/jonmchu.>

Six in 10 Americans don’t believe that their medical records or personal information will remain confidential if they are stored and made accessible online, according to a recent survey on health-related issues conducted by NPR, Kaiser Family Foundation, and Harvard School of Public Health.

More than that, 76 percent of those surveyed believe that an unauthorized person could gain access to their electronically stored and shareable health records.

This is good news in disguise:

1. 3/4 of the American public surveyed (1,238 randomly selected participants over 18) is being very realistic about challenges with privacy/security related to EHRs and PHRs.

2. Reflects larger trend towards sharing, less "confidentiality" online (although privacy, security, and confidentiality are all different but interconnected metastasized issues to consider and confront).

3. Americans as a whole are being more pragmatic than Congress (shocker!) about the potential of EHRs (standing alone, magic-bullet style) to 'save' healthcare... "22 percent of those surveyed felt that the overall cost of healthcare in this country would go down if one were adopted."

I'd like to see this survey compared to a similar survey performed, say, 3 years after Citibank offered online banking. Or comparatively reviewed when to articles and surveys about Ebay and PayPal.

The scary part:

"Half of respondents reported that their physicians do not currently enter health information into a computer while they are present. Most respondents feel that it’s at least somewhat important for healthcare providers to use EHRs instead of paper records, but 90 percent said that they’ve never tried or been able to access medical test results online."

And the money quote:

"Seven in 10 respondents said that their doctors would do a better job coordinating their care if an EHR system were adopted."

70% think docs would do a better job with EHRs. 80% searching for health information online (via Pew, @susannahfox - new research due June 9th).

Any questions?

And now, after some intense field research, a team of experts have uncovered six facts about the female orgasm

Umm....

Not sure I want to hear about the field research methodology...

The Indiana University Health Center in February started offering students the opportunity to create and maintain personal health records via a secure page on the Bloomington-based school's student Web portal.

The university is using NoMoreClipboard software. Congrats to CEO Dr. William Cast, whom I met at last year's World Healthcare Congress in Washington, DC.

If universities can implement successfully...what are we waiting for?

Japanese researchers swear there are useful implications for this research, including tracking Parkinson's and Huntington's.

Either that or there was too much sippin' the sake at the last strategy meeting...

An urgent review of data security in the NHS has been ordered after the personal medical records of tens of thousands of people were lost by the health service.

A total of 140 security breaches were reported within the NHS between January and April this year, the Department of Health confirmed today.

These included computers containing medical records left in skips or stolen, and passwords taped on encrypted discs with sensitive information, according to The Independent newspaper.

Over the last six months, the information commissioner, Richard Thomas, has been forced to take action against 14 NHS bodies for breaching data regulations.

140 breaches. In just 120 days. 1.17 breaches/day on average.

If we enact a national data center network of PHI (RHIOs, etc) controlled/regulated by the US government, rather than patients and providers, as part of comprehensive healthcare reform, do we have these kinds of emergency audits to look forward to?

What do patients want? Despite the technological promises of the Health 2.0 movement, in some ways it's really no different today than it was forty years ago.

R-E-S-P-E-C-T, find out what it means to me...

I met Tim Berners-Lee at a conference on "hypertext" in 1991 in San Antonio. The conference organizers had rejected his paper, relegating it to the poster session--usually a spot reserved for graduate students and fringe types. Few of the people who looked at the Web early on regarded it as technically elegant or a brilliant invention.

Don't give up. That is all.