Ian Petty, Author at Jarrard Inc

Jarrard Phillips Cate & Hancock, Inc. Expands Team by 15 Percent in 2021

Firm continues record growth as healthcare provider organizations start accelerating strategic change.

National healthcare communications consultancy Jarrard Phillips Cate & Hancock, Inc., added seven staff members in recent months, bringing total team growth to 15 percent for 2021, announced firm President and CEO David Jarrard.

The additions, combined with rapid demand for the firm’s strategic positioning and change management work, represent an exciting shift as hospitals, health systems and health services companies begin long-term planning for a post-pandemic era.

“Though the omicron variant continues to strain our healthcare system, we are seeing provider organizations desiring to adjust to the emerging reshaped landscape,” Jarrard said.

That means digging into reputational analysis, workforce engagement, nurse recruitment and retention efforts and broader strategic positioning.

With a healthcare workforce at the breaking point and the stunning financial challenges exacerbated by the past two years, savvy leaders recognize that their organizations must make significant adjustments going forward. It’s a process, Jarrard said, that requires clear communications to bring all stakeholders – employees, patients, the public, lawmakers and regulators – together in support of difficult–but–necessary change.

“We’re proud to have stood with so many provider organizations throughout pandemic crisis and to now work with them to craft the messages they need to highlight and fulfill their mission. Our new team members each bring a unique perspective and expertise to that work, allowing us to support our clients in ever-better ways.”

Featured among the new hires is Associate Vice President Katy Shorkey, an expert in branding, messaging and culture development who resides in the firm’s Health Services Practice. Shorkey is the former director of marketing and engagement at Chicago-based Legacy Healthcare where she oversaw marketing and engagement. Prior to her time at Legacy, Shorkey worked in marketing at Cleveland Clinic Akron General.

In addition to Shorkey, new hires include:

Allyson Carr, senior managing advisor in the Health Services Practice. Carr joined the firm from Renewal Rehab in Chicago, where she served as director of rehabilitation for the physical therapy practice.

Meghan McCarthy, senior managing advisor, Digital Services Practice. McCarthy most recently worked at Hyatt Hotels, where she managed digital strategies for the hospitality chain.
Madison Allen, advisor, Health Services Practice. Allen previously worked in operations at Calvert Street Group, a Nashville-based public affairs firm.
Rachel Jones, advisor, Regional Practice. Prior to joining Jarrard Inc., Jones served at Tennessee Department of Children’s Services where she was involved in event management and campaign development.
Alyssa Pullin, advisor, Health Services Practice. Pullin previously worked as communications manager for Youth & Family Counseling, a Chicago-based mental healthcare organization.
Eva Herron, associate advisor, Regional Practice. Herron joined Jarrard Inc. following her role as a customer service specialist at HealthStream in Nashville.

About Jarrard Inc.

With offices in Nashville, Tenn. and Chicago, Jarrard Phillips Cate & Hancock, Inc. is a U.S. Top 10 strategic communications consulting firm for the nation’s leading healthcare providers experiencing significant change, challenge or opportunity. Founded in 2006, the firm has worked with more than 500 clients in over 40 states and served as a communications advisor on more than $60 billion in announced M&A and partnership transaction communications. The firm specializes in M&A, change management, issue navigation and strategic positioning. Jarrard Inc. is a division of The Chartis Group, one of the nation’s leading healthcare advisory and analytics firms.

For more information, visit jarrardinc.com or follow us @JarrardInc.

Ian Petty In High Stakes, Strategic Positioning

Healthcare’s White Glove Service

Robotic doctor holding a clipboard in front of a blurred hospital background

How two health services organizations are thinking about customized care

Just how do providers (re)build trust among their patients? And how much can technology help?

It’s not that trust has been broken. But we’re witnessing a disconcerting shift in the relationship between people and the organizations where they receive care. And indeed, even in the relationship between healthcare organizations and the individuals within them who provide that care.

The conversation within healthcare about “consumerism” is smack in the center of how providers – and the VC and PE groups funding new models of care – talk about the future of the industry.

Counter to what you might expect from a communications firm, we’re going to suggest that the language is important but just doing the work is far more so. Does it matter if providers call us “consumers” or “patients” if the product they deliver works? In fact, maybe the terminology remains a discussion point because it’s a distraction from the industry’s failure to deliver on seamless, nearly invisible delivery of care. Because designing for people is, somehow, really hard.

Neither Harvard, Oxford nor Cambridge has been able to crack the code of using the wealth of available tools and technology to create a comfortable healthcare system that patients uh, consumers uh, people can fully trust.

City

So says Regan City, the director of the national subspecialty divisions and patient safety organization at Radiology Partners. A certified quality and patient experience professional, City aligns operational imperatives with what healthcare providers and patients actually experience.

She asserts that such alignment is far more complex in healthcare than in other industries. “Product customization isn’t possible in healthcare the way it is elsewhere. Marketing is targeted, but software isn’t,” she said in a recent interview. Simply put, there are too many variables in a patient population to be able to customize everything. You could pick one or two demographic characteristics and make some assumptions, but there are so many other factors that those assumptions might not fit. “You could assume the average 40-year-old woman has a smartphone, tablet or PC and can interact with us in a way we want her to,” explained City. “but if she’s in a lower socioeconomic strata, or doesn’t have time or access to technology, she won’t. We have to recognize that every person is an individual. How do we do that with how we drive our technology? We can’t be that customized.”

That’s the bad news, and while it is bad, it’s also refreshing. Better to name the problem and find a workaround than soft-pedal it and implement solutions that don’t move the needle. So if we can’t customize for everyone, can we offer something that works pretty well for many? Yes. Call it an offshoot of the 80/20 rule. Take things as far as you can for a general user base and then step in with high-touch, possibly manual, solutions to get the rest of the way.

City made the comparison to fine art. “More than half of the people consuming healthcare, just like attending symphony orchestra performances, are well over 60,” she said. Marketing to Gen-X is largely driving ‘consumerism’ and therefore the technology choices, but they’re not the heaviest users. “My sister works in development for an orchestra in a patron-facing role, and she says there are folks who will not go electronic. They feel they are spending a good amount of money and they simply want to bring their ticket with them.” Similarly, noted City, there are many smaller or rural practices where paper and faxes remain a staple, maybe due to the cost of implementing technology, but also simply because of the difficulty in overcoming the desire for things to stay the same.

The solution is to build technology that can do the work, and then bolster it with people typing notes, sending faxes, printing tickets, answering the phone. Continuing the orchestra analogy, City said that her sister will happily answer the phone any time someone calls. “But what that patron doesn’t know is the person on the other end is entering all the information into the system on their behalf.”

But then there is the need to build a comfortable experience for those who can use and do want an experience rooted in technology. For providers, there are no excuses anymore. The tools are available, and patient preferences are clear. “A tech-savvy user is going to be really happy if he can click around and get his lab results and then message his provider. And if we have a live person answering a phone for the elderly gentleman who isn’t sure where to click on his tablet, we can make him happy too because we’ve given him white-glove service.”

Condliffe

In another realm of medicine, Diana Health is a startup aiming to smooth out the entire pregnancy journey, from prenatal to postpartum care. It offers that white-glove approach in a slightly different way. Underpinning the company’s services is a technology stack that integrates every aspect of care and simplifies both access to and input of health data.

“We’ve spent time building out a technology platform that integrates with our EHR so that if a mom is struggling or has a question about sleep, she’s engaging in our digital app at home,” said Kate Condliffe, co-founder and CEO. “That data transfers into our EHR. It shows up in the encounter note and providers can engage in an operationally efficient way.”

Mele-Algus

Everything Diana Health does, according to head of product Lexi Mele-Algus, is designed “thinking about a human-centered approach married with the evidence. It’s blending the quantitative and the qualitative elements.”

According to both City and the Diana Health team, two things that are signs of success are, simply, fewer clicks and clear next steps – for both patients and providers. In various ways, both organizations define well-designed technology as that which allows everyone to navigate the care continuum more rapidly and know what comes next at each stage. That may mean a more labor-intensive intervention like a phone call or office visit – an analog encounter, as it were. But the technology helps smooth the way while staying out of the way.

That layering can be seen in Diana Health’s graphics depicting the benefits of its platform – note the clear blend of technology and personal relationships.

Going back to that 80/20 idea, clinical decision support is another area where technology can take care far down the road, then get out of the way for clinicians to take it the last mile. At Diana Health, Condliff and Mele-Algus describe tools that allow their clinical teams to develop highly individualized care programs, with variability reduced through evidence-based clinical decision support. The team gets a pretty good idea of what might be going on because that’s what the numbers say, but the trust is built when the personalization is layered on top. Or, as City said, “we need to have nuanced conversations around an individual’s healthcare decision-making and outcomes, but we can use technology to help us learn about what happens to 80% of people with this clinical condition.”

From there, putting caregivers in the right spot is the next critical step to providing seamless care that builds trust and comfort, not creates confusion. This has been an issue in healthcare for decades, but we may be on the verge of a new wrinkle with implementation of the 21^st Century CURES Act and patients’ increased access to their own health records. “Patients should have access,” said City. “But we need to make sure they can consume that information in a meaningful way. Trained healthcare providers are the interpreter.”

For radiology, that means being more proactive in noting findings to other members of the care team. City said, “There’s a saying that radiologists are the physician’s physician. We’ve got to be more forward-thinking than that. What our doctors do directly impacts patients, so we’ve created software that helps radiologists put evidence-based follow-up recommendations and timelines in their reports.” It’s synthesizing all the clinical data plus what the radiologist interprets via imaging and making it clear to the end-user.

On the patient-facing side, Diana Health uses technology for both clinical decision support and to clear the way for more meaningful conversations and smoother handoffs between various members of the care team. Mele-Algus said, “There are all these tests we’ve traditionally had for well-woman visits. But people don’t take the time to think about what the patient is coming in for. What is their agenda?” The simple solution is to ask those questions beforehand – likely through an app – so patients can understand what the visit is about and what the visit could be, including helping them think about questions they may want to ask. And then, giving that information to the provider so they can jump into meaningful conversations.

The final piece of the equation – at least for the purposes of this discussion – is a fully integrated care team. Cross-specialty collaboration has been rising in prominence over the past few years, but it needs to be implemented faster and more widely.

As alluded to above, Radiology Partners is thinking about this in terms of bringing radiologists into the main circle of the care team, rather than sitting on the periphery handing down reports. Diana Health’s model is predicated on intense collaboration among a variety of specialists – Certified Nurse Midwives, OB/GYN physicians, licensed clinical social workers, care navigators and the patient herself. “Shared decision-making is a key element in terms of taking the provider’s evidence-based assessment while involving the patient in every conversation,” said Mele-Algus.

These conversations start from the first encounter. Under the Diana Health model, the care team considers social determinants, risk factors for mental health issues, stress levels and more. That assessment allows the midwife or OB/GYN to quickly recognize that a patient may need to see an LCSW and quickly make the handoff – and that second caregiver can trust the handoff because of the well-defined processes in place.

Condliffe explained, “The way we build collaborative care teams results in certified nurse midwives managing the bulk of routine care and with time to provide that level of engagement women want prenatally, intrapartum and post-partum. And it allows OBs to then make the best use of their time and come in when they’re needed to identify or manage complications, to do surgery. It drives efficiency in the clinical model and creates a level of work-life balance that matters to providers.”

That last point is key because of course provider experience also affects patient experience. With everyone practicing at the top of their license and using well-designed technology that reduces clicks, makes the next steps clear and “takes pixels on a screen to make something eloquent and beautiful,” as City put it, the clinicians themselves will be more comfortable and satisfied. They can focus more on building relationships with their colleagues and patients, maybe even feeling better physically and mentally because they’re no longer dealing with thousands of mouse clicks and endless alerts. They can simply deliver care.

Corum

Jim Corum, co-founder and COO of Diana Health, summed it up well in reflecting on his colleague’s comments: “Kate talks often about the desire of patients to be heard. And so it’s about setting up an environment and a framework and making the time. Because then you have the right clinician, the right support person there at the right time, and it’s all underpinned by this technology that gives that opportunity. Good things happen when that’s the case.

Ian Petty In Change Management, High Stakes, , Quick Think

Bite Your Tongue or Speak Up?

Orange text that reads "The Quick Think" over a kaleidoscope-patterned background

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: The CEO “Talking Trap”

CEOs, you might want to bite your tongues.

A new survey from the Brunswick Group says you’re overestimating the necessity and effectiveness of your organization’s communication on social issues. Yes, there’s enormous pressure on organizations to respond to everything that’s happening. But doing so without careful consideration can come off to the public as inauthentic. “The effort may come from a place of earnest engagement, but it is not being perceived that way,” the report observes. So if you choose to talk the talk, your organization needs to walk the walk.

What it Means for Your Health System

For leaders, the decision to speak is fraught. The Brunswick Group refers to it as “the talking trap.”

Basically, while corporate intentions around speaking up on hot social issues may be well-intentioned, audiences are disregarding these efforts due to “the broad alienation that most Americans (Democrats and Republicans) feel toward people and institutions of power.” If communications about an issue are poorly received, there’s the potential for them to be reputationally harmful.

Yet at the same time, we know there are times when leaders do need to speak. That’s part of being a leader, isn’t it? And with everything going on in the world, the range of topics on which they might be asked to weigh in is wider than ever.

So then how to do it effectively? The Brunswick Group report closes with excellent general recommendations to avoid the talking trap. Read them all – after you finish this note with ideas tailored for healthcare leaders and marcom officials.

It all boils down to integrated communications, similar to integrated care teams. The core structural issue is to know who’s in what lane and to coordinate appropriately. When clinicians aren’t aligned, they step on each other’s toes, information gets lost and patient care suffers. Similarly, communications efforts can be derailed by too many people trying to offer their own version of the message or offer it at the wrong time. When dealing with sensitive topics like social issues, the results can be damaging.

Consider these steps to ensure your message is received with the authenticity intended.

Speak well – within your lane. You and your organization are experts on healthcare, and the public does want to hear from you on the things you know. Previous Jarrard Inc. surveys have shown that the public expects providers to speak up on healthcare topics. So before getting deeply involved in a range of issues, ensure that you are clear and consistent, firm yet humble, on the topics directly related to your work.
Do well – within your lane. Back up your message with actions. Better yet, back up your actions with your message. The Brunswick Group emphasizes the importance of tangible and significant investment (financial or otherwise) in causes related to the issue. For hospitals, that’s likely community partnerships and charity care. It’s also your work to support employees, professional development opportunities, and defined, financially-backed programs to help close racial disparities within the organization. Your mission is strong, so make sure the work you do reflects it.
Recognize that there is more than one lane. “Health” encompasses so many issues, and we’re seeing a growing conversation about how social issues are health issues. Granted, we just suggested building credibility by staying in your lane. But that’s a lot harder when your lane is very wide – or when there are multiple lanes. Basically, your team needs to define the terms and come to some internal consensus on how you view the continuum of health and the myriad factors that contribute to it.
Define who can and should be speaking out in each lane. One way to handle the complexity and the expectations is pretty standard: Break the work up into manageable bites. Within your organization you have nurses, administrators, physicians, social workers, care navigators and so many others. Find the right individuals within these roles to talk about the issues most closely aligned with their work. Social workers can talk about mental health or homelessness. Leadership can talk about the delivery of care to different communities. With people in the right spot, there’s minimal stepping on toes.
Coordinate, prepare and activate. Whether it’s one person who will be speaking or five, define the expectations. For example, what’s appropriate for people to say as representatives of your organization – versus on their own time? As always, bring in outside voices like community leaders to help inform your thinking on the issue and your approach. Set up mechanisms for feedback – even if it’s uncomfortable. That in itself goes a long way towards demonstrating your authenticity and commitment. Finally, go out and speak – humbly, kindly, quietly but firmly – acknowledging what you know to be true and what you’re still learning, as well as how you and your organization are responding.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think

One-to-One: Building Community & Pursuing Equity

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Read: Together – The Healing Power of Human Connection in a Sometimes Lonely World

We usually link to a quick article. But hey, we’re going into a holiday week so of course you have time to read a whole book, right? Surgeon General Vivek Murthy’s work, which was published last April, caught our attention as we’ve been thinking a lot about myriad issues that rise to the surface during the holidays – relationships and connection, equity, community and gratitude.

What it Means for Us

(a two-minute read)

Today we’re leaving the boardroom, C-suite and exam rooms.

Health and community belong to all of us. We frequently talk about social determinants and what can be done at the institutional level. Moving into the holiday season, we’re reminded of the power of our individual, one-on-one actions to support others and our ability to directly impact – for better or worse – their health.

On paper, many of the issues facing healthcare seem disparate. But looking closer, the common thread is a need for human connection. Take the health system whose employees are burnt out and threatening to quit. Or the community hospital where marginalized populations have higher readmission rates – if they were able to access care in the first place. And then there’s the metro facility where food services employees feel left behind and look toward unionization. In each, a fundamental problem is that the people involved don’t feel seen or heard. So, the solution starts with the same first step: Listening in personal, thoughtful settings.

Healthcare inequity takes many forms: gender gaps, racial inequity, mental health stigma, socioeconomics, access to care and so much more. As we think about our personal role in solving inequities, we must first ask, “What’s the win?” How do I define progress? How do I build this human connection to understand the needs? Here’s a place to start:

Approach people with an authentic desire to build connection. What’s their story? What do they value, and what do they need from us to feel valued? We listen to understand, and we listen so others will feel seen and heard.
Elevate marginalized voices. Take what you learn from your conversations and bring it to those who have the agency and tools to drive change, whether it’s the CEO or employee supervisor or neighborhood group. Help them create structures that open two-way communications, dismantle communications barriers and empower the marginalized to be heard by those decision makers.
Partner with those affected by our decisions. People are more accepting of a decision or change when they feel heard, even if the change isn’t what they wanted. Moreover, without the input of those who are directly affected, there’s never a complete solution. Of course, no decision will satisfy everyone. But we can listen to every voice and let everyone feel heard and seen.
Remember that giving someone a voice doesn’t mean taking it away from others. We’re adding to the conversation and creating richer experiences for all. We’re widening our personal and institutional perspective so that we can find better solutions that benefit everyone.

Human-to-human connections have been devastated by almost two years of physical separation and growing polarization. We as individuals and as representatives of our various organizations need to be cultivating relationships between people, both for our sake and theirs. It’s a way to repair some of the damage of the past and the burnout many are feeling now.

We can’t solve every problem, the solutions to get better aren’t simple and we won’t please everyone. But we can make progress with people who are willing and eager to partner with us – if we give them the opportunity and are willing to partner with them. And that’s a win.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think, Strategic Positioning

Health, Not Healthcare

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: CVS Health Launches $25 Million Ad Campaign Focused on ‘Healthy’

The idea of “health” is too complicated, too fragmented. That isn’t going to work in an environment where expectations for simple, convenient and integrated experiences continue to grow. CVS is one example of a provider organization working to make health – and, by extension, the healthcare they provide – more accessible to patients consumers.

What it Means for Your Health System

“People often feel overwhelmed by the concept of ‘healthy.’”

Pause on that quote from the linked article, just for a moment.

Seriously. What the hell are we doing? We’ve overcomplicated healthcare to the point that people are “overwhelmed” by the idea of eating a salad and taking walking breaks. And they’re frustrated by it.

According to the latest American Consumer Satisfaction Index, healthcare – including ambulatory care, hospitals and insurance – retains the trust of the public but lags other industries in customer satisfaction. In fact, healthcare and hospitals reached their lowest index score in nearly two decades, per the study. (Health economist Jane Sarasohn-Kahn covered the study in a recent blog post worth reading.)

We all know consumers are frustrated by the fragmentation. Good news is that forward-thinking health enterprises are already bringing everything under one roof. That includes risk, care delivery, education, tech and health-related consumer goods.

And that’s why companies like CVS-Aetna are doing so well. They’re pushing hard on giving the public a reframed, integrated perspective on health while also finding the service lines and payment models to make it profitable. A retail chain buys a health insurance giant and now offers everything from urgent care to mental health services to renal care. And they’re marketing those services in a way that fits the customer journey.

Clever startups and health services companies are building technology platforms and care delivery models that are based on collaboration, interoperability and user experience.

On the business side, money and planning is going into integration so that control of the entire care continuum stays under that one roof. On Tuesday, Fierce Healthcare covered a recent survey from HFMA that found three-fifths of health systems are looking to bring more risk management in house by diving into Medicare Advantage. This approach, the article points out, parallels payers who have stepped into care delivery.

And finally, private equity has been – and looks ready to continue – pouring record money into healthcare in 2021. It’s a trend Paul Keckley reviews in his latest newsletter.

Time, energy and money are being deployed to integrate health(care). Each category of player has advantages in that work:

PE has money, operational acumen and enthusiasm – they don’t have to drive change, they get to.
Traditional providers have public trust based on proven expertise in care delivery and the medical acumen.
Startups and health services are quick, flexible and have fresh thinking on technology and patient experience.
Retail has consumer perspective and data, along with technological power. Moreover, people are already spending time in retail settings so it’s easy and familiar. And you can find a parking space at CVS.

There’s another fundamental difference that underpins the CVS ad campaign. Traditional healthcare providers see people as patients, whereas the new entrants and retail-based providers view them as consumer. Though hospitals are expanding beyond just offering sick care, the historical approach has been, “We know medicine. Come to us when you have a problem, we’ll take care of you.”

On the other hand, the underlying philosophy behind the CVS ad campaign is that a consumer-centric mindset puts more responsibility on people to care for themselves.

Whatever angle a provider organization is coming from, that patient-as-consumer must be the destination. Integrating the business and technology and risk management is the operational mechanism to do so, but the work must be built on a culture that prioritizes integration and experience.

Investor-backed providers have the flexibility of starting from scratch but lack the institutional knowledge; traditional providers have the institutional knowledge but have to retrofit the tools.

As you work to triangulate on the right solutions to streamline care and redefine “health,” here are some questions to ask about your organization’s culture in terms of innovation and integration to get the conversation rolling. These questions can lead to solutions that can help you render “health” an accessible concept, not one to fear.

Do you think about things like “integration” and “transparency” in the context of CMS or other regulation? Or in the context of patient and provider experience?
Do conversations about other categories of providers focus on how to defend against their encroachment or what can be learned from them?
Similarly, does your approach lend itself to collaboration and partnership? Or does it insulate your organization?
Do you check in regularly with clinical and back-office staff to learn about bottlenecks and hear their ideas?
Practically, are you integrating processes and software?
How long does it take you to test and evaluate a new system? Can you shorten that timeline?
As a health service company or startup, do you have a clear story to tell traditional providers about how you can support existing systems? Do you understand the constraints they’re under?
As a traditional provider, do you listen to the new entrants with an open mind rather than a concern about what can’t be done?
Do you have educational and marketing materials that simplify and humanize you to your patients and that put them at the center of the story?
Do you have people testing the experience patients and employees have when they interact with you?

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, , Quick Think, Strategic Positioning

Non-Profit Health Systems Fighting in an InHospitable Environment

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: InHospitable Documentary to Launch November 13

InHospitable, according to its website, “is a documentary feature film that exposes American hospitals’ significant role in our broken healthcare system by documenting patients and activists as they band together” to go up against a large non-profit health system. We’ve only seen the trailers, but the film appears to be a full-throated attack on non-profit health systems, featuring patients allegedly harmed by the featured organizations, activists and academics known to be critical of hospitals.

What it Means for Your Health System

We consider InHospitable the latest warning shot at how our screwed-up industry delivers and funds care, and hospitals and health systems are in the crosshairs. If you’re not ready, get ready.

We’ve known for a while the film is coming, and now we have an official date for a premiere. It may not be Michael Moore or Werner Herzog, but the film is real and the trailers include compelling imagery. In one regard it’s not that big of a deal – an indie documentary with 159 Twitter followers and not a lot of traction on Google. But health system leaders should pay close attention.

InHospitable is a recent example of emotional, sharp-tongued critiques of hospitals and health systems that have gained momentum over the last few years. Some of it well deserved, we must say.

You know the issues: The crazy and inconsistent cost of care, “profits over patients,” incomprehensible financial and billing practices, strong-arming payers, insufficient and inequitable access to care, suing poor patients for a nickel, and more. In addition, we’ve written here about the increased scrutiny by the feds of health system consolidation and the chatter of whether not-for-profit providers deserve their tax-exempt status.

By focusing its fire primarily on a single organization exhibiting bad behavior (it appears to focus on UPMC), the film will be all the more effective at elevating those questions for the broader industry.

The screening at DOC NYC is likely intended to generate enough buzz to get the film a slot on a streaming service sometime next year – when the pandemic will theoretically be behind us, and it’ll be easier to ramp up attacks on providers. Even if it isn’t a major success in itself (and, who knows, it could be), it will become part of the self-referential cannon used by hospital critics in their campaign.

So whatever your gut reaction to the film, you need to be ready to push back on the pushback. Here’s how:

Inform Your Board. They may not know any of this is coming. While providers were focused on keeping COVID-19 patients alive, the critics were honing their anti-consolidation arguments and putting the final touches on illustrations portraying hospitals as assembly (or disassembly?) lines.

Make sure your board knows about the growing storm, including the existence of this documentary and where it fits into the larger conversation. Last thing you want is for them to be caught flat-footed next summer when InHospitable appears on Netflix.

The education should include specifics about the attacks. We’re seeing more and more portrayals of healthcare providers as Big Business, with all the loaded connotations that idea carries. Big Business is predatory. Big Business cares more about profits than mission. Knowing that’s the representation should help inform the response. Equip your board with messages that explain why growth is beneficial for patients and communities and employees. It’s not enough to say, “That’s not us.” You have to say, “Here’s who we really are.”

Review Your Practices. Or, Know Thyself. Don’t sue patients. Don’t do the things that would lead an entrepreneurial filmmaker to paint you as predatory. Getting bigger doesn’t just make it easier to be accused of bad behavior; it makes it easier for things to slip through the cracks. Always make sure you’re operating in the most patient-friendly way possible.

Activate Your Board. Once they know what’s going on and everyone feels confident there aren’t any dark secrets, your board needs to get out there and engage. Healthcare board members have strong networks. Use them. Push them to reach out to the influential leaders in their orbit and humanize the organization’s work – to connect back to the mission, talk about the benefits of growth, show how they’re supporting the community and employees and either get ahead of or counter the attacks. Also, push them to connect with lawmakers and build or use the relationships necessary to ensure providers have a voice in whatever happens next. This is why you have board members. Time to get them organized.

Build Your Defenses. Now. We know InHospitable will premier in November and could easily get picked up for streaming sometime next year. It focuses on one health system but may name drop others as it looks to connect the dots to the industry at large. Whatever national context is created could lead to regional and local attention, so expect calls from the media. Look through the damaging coverage hospitals have received over the past couple of years (including 2019) and develop responses to those sorts of issues. Make sure your leadership team and board have a copy, as well. Whether or not you see any likelihood that your organization will get pulled into the conversation, prepare as if you will.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, Quick Think, Strategic Positioning

The Heart-Pumping Scoop on Stories

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: Storytelling Makes Hearts Beat As One

Turns out Disney and Amazon were on to something with their virtual watch parties. Want to sync up with friends? You can do it without ever laying eyes on them. A group of biomedical engineers, psychologists and neuroscientists found that people’s heart rates “rise and fall in unison” when experiencing the same story, even when they’re in separate locations.

(No subscription to The Wall Street Journal? Here’s another option. Or, if you’re feeling ambitious, here’s the original study.)

What it Means for Your Health System

We know. “Storytelling” has become so much a part of the marketing and communications jargon that it’s easy to skate right past it. There’s an entire industry of speakers, consultants and tools focused on helping organizations get their message across. We’re doing it right now.

And yes, this new study itself represents the perfect story: hard data about a compelling subject, wrapped in a romantic narrative. Elegant science showing that people in distinct locations can be brought together in a profound way through something so simple. This paper simultaneously proves and embodies the point.

Funny thing is, we came across this study while working through your feedback from last week’s survey on misinformation. (See our Special Report dropping next week.) Your comments reiterated the effectiveness of storytelling when it comes to misinformation. Because what we’re seeing today are dry facts presented in absolute terms by white coats on one side, with clever, substance-free narratives (some might say, “Lies”) appealing to emotion on the other. People are dying because the clever narratives have done a better job claiming to connect dots and explain the world than the dry facts. In effect, they’ve made hearts beat together as one. As Jarrard Inc. Partner Kim Fox asked rhetorically, “What’s easier to absorb – a bold headline or a list of data points from a scientific study?”

In other cases, like many of those we’ve highlighted in this newsletter (Power to the Patients, INHOSPITABLE, the Lown Institute report on community benefits, criticism of healthcare M&A), there’s legit data backing up a deeply emotional appeal centered on individual harm at the hands of a big, unaccountable villain.

To be clear: It’s not misinformation that sells. It’s the order and emotional release provided by misinformation that gets people to buy in. Facts be damned. But if you have facts to back the story? Even better. Think of it this way: Story is the Trojan Horse that lets the data in.

So then, how do we use this for good? Narrative is an effective structure to get a point across; are you using it for what you need to accomplish?

…

Are you sure?

In our experience working with clients across the healthcare spectrum, there’s a tendency to drift to one extreme or the other. Human nature, right? Providers either showcase the Hallmark movie story or the bar chart and trendline. An effective campaign, though, lies in finding Both/And. Marry critical health information with a great narrative and deliver it through a messenger with high credibility. The result is this video from Miami Children’s Hospital. Dr. Burke gives a tour of an emotionally fraught situation while dropping in vital facts like his team’s certifications and experience so subtly you barely notice it’s happening.

We’ll challenge you to take a moment and really evaluate how your team approaches storytelling. Again, it’s easy to pay lip service because it’s so ingrained in marketing 101. Don’t let that happen. There is powerful, evidence-based practice taking place across your organization every day. Patients are leaving your facilities better off than when they arrived. Your care teams are using cutting-edge technology to care for people. Sometimes, they’re ingeniously developing new techniques on the fly because that’s what it takes to save a life. Don’t skip past that. Look down at the numbers and find the trendline. Then, look up at the people walking by who represent that trendline in real life. That’s the marriage of data and story.

Let’s simplify it even further. Maybe we’re taking this too far but think about how your hospital operates and talks about its work.

On the one hand: Is there anything going on that would lead a group of people, watching on TV, to simultaneously sit up and say, “Ohhh, that’s bad”?

On the other: Are you showcasing the good work you’re doing in a way that would lead a group of people, watching on TV, simultaneously sit up and cheer?

We always say that if you don’t tell your story, someone will do it for you. That’s the risk. And that’s the opportunity.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think, Strategic Positioning

Mad Dash to Digital Turns to a Trot

Text that reads "Quick Think" on a navy background with a lightly shaded light bulb icon

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: One big reason healthcare access is hard

“Healthcare brands invest enormous sums of money in marketing campaigns, websites, and apps that will never be effective until a consumer can overcome the data barriers to healthcare access.” And that deficit could have ripple effects as consumers get frustrated with providers.

What it Means for Your Health System

(2-minute read, 15-minute podcast)

Providers are juggling more challenges than ever… ICUs full of the unvaccinated. Media coverage of questionable billing practices. Disruptors from tech and retail growing their investments and pushing the envelope. The ongoing push-pull narrative regarding the effects of consolidation. Breaking through the perpetual avalanche of bad news to highlight the good is no easy task for marcom pros today.

The frustration builds when big-name companies without a history of delivering care get rosy headlines, while traditional providers face seemingly endless scrutiny from the media, regulators and parts of the public. Scrutiny – warranted or not – then leads people weary of traditional healthcare to look for someone else to do it better. Enter a company like Amazon, which fits the bill because it knows people, what they want and how to get it to them. Not because it “knows healthcare.”

Healthcare organizations are certainly aware of the challenge. Providers ramped up their use of digital tools last year, moving towards a more patient-friendly system out of necessity. But the advance has slowed, according to a recent study. Providers who lose momentum are not only missing out on a chance to streamline care, but also to counter some of the negative press pointing fingers at those delivering it.

So then how to flip the script? How do you leverage the current moment, building trust and telegraphing a better future? Here are six patient-friendly questions to ask your organization to help ID areas to bolster or to brag about:

How are you making it simpler to receive care? This covers tools to seek, schedule and manage care. It starts with the table stakes that so many patients complain about but few providers get right – basics like online scheduling tools and check-ins. It extends to back-office functions like billing processes that affect the underlying efficiency of patients’ care. Anything to cut down on the number of disparate tools and to better integrate those you need.
Where are you providing care? A silver lining to the pandemic? The rise of alternative models of care. However, that means programs like telehealth and ambulatory surgery centers are no longer differentiators in 2021. (Yep, back to table stakes.) You’ll need to push a lot further to show what’s unique about your version of those offerings. Now if your organization is one of the few which have ramped up “advanced” models like hospital-at-home or mobile care, talk about those. A lot.
How are you targeting care for your specific community? Put your marketing cap on for this. Depending on geography, infrastructure and patient demographics, the same tool could either help or hinder a patient’s trust and comfort. Telehealth can make sense for different reasons: time saved fighting traffic, ability to seek care when you don’t have access to transportation, ease in scheduling, expanded hours and more. And those reasons can vary for an urbanite, a rural dweller, a family with small children, an elderly person, a blue collar worker, etc. Your marketing should be precise in what it says and in exactly whom it is targeting. People will trust you more if they see you offering services and communicating in ways that work for them.
How are you making it simpler to understand care? People don’t trust what they can’t understand. Now is a good time to scrub your communications materials for simplicity and to clearly define terms. If you want to take it up a level, look at how your organization trains patient-facing staff to ensure they’re communicating clearly and simply with patients. Always be asking, “Are we talking to consumers in a way that helps them make a good decision quickly?”
How are you making the financial process easier? So much of the scrutiny of hospitals today comes from questionable or downright bad billing practices. Merely setting up a simple billing portal will not negate the previous damage caused by suing patients over unpaid bills. However, setting expectations early on about things like financial responsibilities and billing process, tools and options, will go a long way in avoiding situations that are traumatic to patients and reflect poorly on your organization. Work with your front office and rev cycle teams to educate patients on the finances of healthcare, offer proactive communications about what they could owe and yes, give them easy ways to pay.
How are you improving access and health equity? Your mission is to provide the best possible care for the people in your community, which means that in some way everything you do comes back to access and equity. People are paying more attention to the issue than ever before. So are you. So talk about it. Northwell Health, for example, highlighted the importance of its new partnership with Walgreens for health equity. Other benefits like efficiency and convenience were framed as contributors to access and equity, rather than standalone features. That’s a playbook worth copying.

Want more? Check out the 15-minute conversation with Reed Smith, Jarrard Inc.’s VP of Digital Services.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think, Strategic Positioning

A Win for Patients…and Rural Providers

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: New study finds consolidation lowered mortality in rural hospitals

“Rural hospitals that merged with or were acquired into larger health systems are associated with greater reductions in mortality for conditions like heart failure, stroke and pneumonia compared to facilities that remained independent, according to a new study.

What it Means for Your Health System

(2-minute read, 13-minute podcast)

Some good news for those trying to make the case in favor of rural hospital M&A. For too long, insurance companies, policymakers and some parts of the media have been filling the “cons” column with negative consequences – real, alleged and everything in-between – of rural providers joining up with former competitors and larger systems alike. Now, this study, published in one of the reputable journals within the JAMA constellation, offers a solid datapoint for the “pro” column.

We’ve been encouraging providers pursuing partnerships to tell their story by explaining the value that partnership will create. We’ve also advocated for finding data that can undergird those arguments. And so for many reasons it was encouraging to see lives saved – mortality from heart attacks was cut nearly in half following an acquisition, mortality due to stroke decreased by about a third.

Whether your organization is looking to acquire, be acquired or simply help change the narrative around consolidation, add this study to your stack of materials. Here are some considerations as you do.

Be motivated. Nothing in the data guarantees an outcome, but rather shows what’s possible. That possibility can serve as a goal for everyone involved. “They cut mortality by half? It can be done – and let’s take it further!” It’s a way to connect back to your mission and give your people hope through the promise of making healthcare better.

Learn from the results. Use the overall data as the impetus to look at how other providers have succeeded. It’s the action to follow the motivation. That means spending time to reverse engineer the improved outcomes following an acquisition, then working to apply and explain those lessons for your specific situation. Who knows? Even hospitals who aren’t in the middle of a deal might find some valuable ideas.

Go on offense. A risk with positive data such is that it can become fetishized, something that advocates for a deal instinctively point to every time criticism comes their way. Don’t give in to the temptation. For one thing, you run the risk of muddying the waters by getting into a tit-for-tat argument. “They showed that costs went up? Well, we showed that mortality went down!” Technically accurate, maybe, but not helpful. In addition, if you use data defensively you are, by definition, reacting to the opposition. Instead, be positive and proactive by using the numbers to explain why you’re moving towards a deal and what you plan to accomplish.

Don’t expect a magic bullet. First, what does it tell us? That done well, a merger or acquisition can lead to meaningful improvements. What does it not tell us? That a partnership will lead to meaningful improvement. Be very careful to not overstate results. Getting to better outcomes will take a lot more than just partnering up and letting things run their course. It’s years of careful, mission-driven work to get the desired outcome.

Be patient. The Modern Healthcare article about the paper noted that many of the improvements “were not seen until after three to five years post-merger.” That’s a tough pill to swallow in an instant-gratification society, especially for something as acute and personal as medical care. As you proceed through a deal, it’s critical to set expectations about what is and isn’t possible, including when people can reasonably expect to see the results. But at the same time, explain to people the meaningful benchmarks along the way so they can track your progress towards the goal.

Rural hospitals are struggling and need a path forward. Recognizing those difficulties and mapping the way is the impetus for groups like Rural Healthcare Initiative. Here we have a bit of light, showing that there is a way to improve care for these communities through strong relationships. It takes time and energy to find that right partner, but here we have strong, reliable data that it can be done.

Want to learn more about the study and what it means for rural M&A? Check out the 13-minute conversation with Jarrard Inc. Partner Isaac Squyres.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, , Quick Think

Tired of Being Your Hero

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

Healthcare workers are leaving.

They’re citing burnout, stress, safety, moral harm – and in some cases a desire for “personal freedom” over all else. They’re answering the question, “Is it worth it?” with a decisive, “No.”

Many are leaving because they cannot spend another day watching patient after patient die unnecessarily. Others have decided their career isn’t worth the vaccine. Logs on that particular fire? President Biden’s new mandate for large employers that will force even more people to make a choice. All told, the consequences for healthcare are severe – moral injury for healthcare workers, frightening staff shortages for providers and the public and long-term questions that will likely affect how all of us receive care.

Our latest Special Report homes in on the massively complex problem of clinician burnout. It’s a big read with some strong takeaways – definitely worth taking 15 minutes to digest.

Meanwhile, for a fascinating behind-the-curtain look at how doctors and nurses are expressing their burnout online, check out our Q&A below with Dean Browell. He’s a digital ethnographer and principal at Feedback, a social listening firm that digs into how what we say in the digital realm translates into how we behave in the physical world. And, he’s been tracking the issue of burnout among the healthcare workforce for years.

The Genie’s Out of the Bottle: What Clinicians Are Really Saying Online

(Five-minute read)

Jarrard Inc.: You’ve been tracking burnout in the healthcare workforce for years. Give us a bit of the back story.

Dean Browell: There’s been two different arcs with nurses and physicians, which have developed a little differently over the past 18 months.

Browell

Starting with nurses, about this time last year there was a larger burnout effect that in some ways was getting stoked by the heroes messaging that was finally starting to get a little stale. The pushback started with nurses, who are the most vocal group in healthcare, maybe even more than patients. They have their own message boards and have for years. They had some of the first Facebook groups because they all had .edu email addresses.

This time last year there was this perception that all of healthcare was being treated the same publicly, but in those groups, nurses were asking whether it really was the same to work in one organization or the other. For providers this meant that nurses considering a move represented an opportunity to attract and retain or a threat that the grass might be greener somewhere else.

Jarrard: What are the nurses expressing today?

DB: There’s more outright discussion that, “Maybe this entire industry isn’t for me.” What was first anger towards a larger or more nebulous idea – like administrators or how people are handling things on a macro level – is now towards the patient. Before, it was being angry at the virus and potentially how your hospital handled something. Today people are wondering if they can continue and serve a public that is, in their mind, willingly putting themselves at risk and creating this situation. It’s a very different burnout. And it’s a much harder equation from a retention and a recruitment standpoint for providers.

Jarrard: How are nurses talking about those concerns?

DB: In the beginning, nurses often had two distinct online personalities. There’s the online personality of “capital N” Nurse in front of everyone on Facebook versus on the American Nurses Association message board where they’re talking amongst themselves. Last year, those two faces began to collide. What we saw for the first time last fall was nurses on Facebook talking about union meetings. Typically, that would be relegated to the nurse message boards or discreet groups. We saw nurses not just take the platitudes about heroes and say, “Thank you. It’s been a lot. We have to push through this” like they did last summer. Instead, suddenly, you had them openly criticizing things they normally never would have discussed with their public-facing persona.

Jarrard: What’s the background on physicians?

DB: Usually what we saw is that physicians would pop up every now and then during a career change asking about the schools or nightlife in a particular city they were considering. “Hey, I’m thinking about moving to the city, what’s the orthopedic scene like?”

In August of last year, though, we saw physicians poking their heads up for the first time with the general public. They were offering their own statements and being a bit more forward with their own name at stake. That was different. And we saw this happening in some unusual places like threads of Reddit – that almost never happened before.

Jarrard: Same question – where are physicians today?

DB: They stepped out last August and they’ve stayed out in the public square since then. Now, like nurses, we’re seeing that they’re not just saying, “Hey, I have a stake in this, and I’m trying to help you navigate misinformation.” It’s not just a benign educational leadership approach like it would have been a year ago. Now it’s taken on an angrier or more exasperated tone that we haven’t heard out loud.

Jarrard: Nurses and doctors are coming from different professional and financial statuses. Does that affect how they’re able to respond?

DB: It manifests in the freedom to talk in a certain way. The physician discussion we’ve seen has still been very high level. “Here’s my take on what’s happening” as if they’re giving a comprehensive analysis of the moment. Contrast that with the nurse that says, “I just took my first break in eight hours.” Physicians take more of a punditry angle, whereas the nurses’ perspective is more in the moment.

Jarrard: Is this shift in tone and the level of engagement permanent or will it recede?

DB: For the most part I expect the physicians-as-pundits to eventually fade. Their level of connection online may stay, they may reappear when there’s something big they want to speak their mind about. But from a day-to-day perspective I’d expect that genie to go back into the bottle.

On the nurse side, I doubt the genie that will go back in the bottle – because of how open nurses are being today – is this idea of the two personas. There’s the happy-go-lucky, “I love that I’m in healthcare!” and “Here’s why I’m a nurse,” that is presented to family and friends, versus what they were saying in private among peers. You can’t unwind that clock now that they’ve been this exasperated publicly.

Jarrard: What does it all mean for the healthcare workforce going forward?

DB: This will have a freezing effect of some sort. It’ll be fascinating to watch enrollment in nursing programs. It was on a fast track for the last three years in order to meet the demands. We do a lot in higher education and there are some robust nursing programs having trouble meeting their enrollment numbers.

The question is turning into, “Who do you want to do this for?” And the feelings of betrayal and burnout change that conversation. I think it’ll have a freezing effect on the creation of a new nurse population.

Jarrard: We’re also seeing indications that people at the other end of their career are getting out. What does the situation you’ve described mean for them?

DB: It’s how many people leave the industry completely and how many leave the center of the industry. It’s people saying, “I’m going to find a nice, quiet CVS somewhere.” There’s this idea of decentralization of demand for healthcare services where it’s coming out of the hospitals and moving to those outer rings. It’s dangerous for hospitals because there was already attrition due to these alternative models. But now and over the next 18 months the threat is greater with people looking to leave completely or say, “How about I just not stand in the center of the storm?”

Jarrard: How can healthcare providers respond to this shift?

DB: Health systems have an opportunity to do better because of their sheer size. They can talk about what it’s like to work for the system in different roles. People will gripe about robbing Peter to pay Paul, but showcasing lateral movements that improve quality of life is one way that systems can cope.

Jarrard: What about smaller hospitals?

DB: Community hospitals will be the hardest hit because there’s almost no lateral movement available. For them, it will be about improving the situation. Maybe it’s investment in telehealth or to try and not be so ER-focused to remove some of that constant pressure. But it’s not an easy solution.

Jarrard: Last category: What’s the approach for those non-traditional or health services providers that aren’t in the center of the storm?

DB: We just finished a study for an orthopedic group that’s branching out towards a major metro area where they’ll be competing with some big systems. They’re going to have a fantastic story because they can recruit nurses who are desperate to get out of the ER by showing them what it’s like in an ortho urgent care by comparison. For these specialty practices it’s saying, “Hey, stay in nursing but come out of the storm.”

Jarrard: One of the consistent themes in our interviews is that it’s not about the money, but money is a major factor. Where does compensation come into all of this?

DB: Something that hasn’t come to healthcare is the concept of hazard pay. Of all industries you’d think it would be there for healthcare. That may start to happen, especially in systems that can only offer so much lateral movement. Maybe it comes into play between telehealth and in-person care in the ER or trauma.

Jarrard: Anything else? What are we missing?

DB: We may see an effect on M&A, too. If a system is looking at three different hospitals with similar profiles but one is an absolute powder keg in terms of its workforce, that would probably make it very easy to choose a different acquisition. It’s a different metric than most systems have looked at in the past. The focus has been on heads in beds. But looking at the distressed asset from the workforce standpoint will change the game a bit. The question will be, “What can our system sustain in terms of volatility, whether it’s attitude or behavior? Can we repair the culture or, even though it makes sense on paper, should we walk away because it will never fit?”