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Ian Petty

The Quick Think: Without Merit

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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.

3-minute read / 20-minute podcast

The Big Story: Brian Flores sues NFL, three teams as former Miami Dolphins coach alleges racism in hiring practices

The recently-fired head coach of the Miami Dolphins just rocked the sports world with a class action lawsuit alleging systemic racism, disparate hiring practices and incentivizing losing. The NFL came back with a near-instant response saying that Flores’ accusations were “without merit.” Dolphins owner Stephen Ross has responded with a statement that includes the very legal terminology of false, malicious and defamatory.” Then on Saturday, the NFL sent around a memo saying the organization was bringing in outside council to review its policies.

Why We’re Writing About It

Why, indeed, is a healthcare communications firm writing about a lawsuit against the NFL?

Because this story encapsulates so much of the work we do, the advice we give and the best practices for how – or how not – to communicate in a crisis. Because sometimes it’s good to look at outside examples to shake us loose and give a fresh perspective on long-standing principles.

Principles such as…

Check your story. Remember all those times we’ve written about how hospitals need to be proactive and tell the story of the good they do for their community? Or, if faced with scrutiny, respond with a compelling story? If so, you’ll also remember the warning that comes along with it: Make sure the story you tell is consistent with what’s actually happening inside your organization. For instance, a hospital can’t brag about helping patients navigate their healthcare finances when they’re suing them for nonpayment.

In the NFL’s case, the organization’s immediate response of calling the accusations “without merit” looks rash since it came within hours of the filing. Was that really enough time to have actually gone through the dozens of pages and confirmed that they were in fact without merit? Put another way, are the NFL and three teams being sued REALLY sure that they’re not behaving as accused?

Take time. Inherent to checking the story is that it takes time to do so. The NFL probably could have afforded to wait just a breath before releasing it’s “without merit” statement. Is it a crisis? Yes. Could they have taken a little longer to review the claims and craft a better message rather than one that looks like it was copied and pasted from some sort of “In Case of Lawsuit Break Glass” document? Also, yes. If you find yourself in a crisis, don’t wait around. But don’t go so fast that you rush past a meaningful response.

On Saturday, the NFL did in fact commit to “reassess and modify” the way it goes about things. But coming days after the initial, definitive statement instead of being the first thing released by the NFL, the memo opened the door for additional skepticism.

Prepare. We’re not talking copy-paste here. But you need to have a crisis plan in place with the basic blocking and tackling components. Think general talking points, FAQ, list of potential spokespeople, overarching underlying message. Armed with that, you can use those critical first moments of a crisis to review and home in on the situation. You’re not going to recycle the same talking points for every situation. But having a plan built around the tools needed and the underlying, mission-based message that you’ll want to convey no matter what is the difference between reflexively saying, “Nothing to see here!” and “We’re committed to serving our community and want to ensure that our actions reflect that. We’ll be investigating <XYZ> thoroughly. In the meantime, here’s what we know right now.” Again, it’s the difference between the NFL’s initial statement and the Saturday memo. Better to start with the latter and not backpedal into it.

Know the limits of your credibility. In addressing a crisis, consider your community’s perception of your organization’s reputation. We all know the NFL doesn’t have the best history when it comes to responding to explosive allegations. Their handling of the concussion scandal (which also included an ugly element of racial bias) and various instances of violence and abuse by players has left the organization without much reservoir of good will. Or benefit of the doubt. That’s another reason the instantaneous “without merit” comment looks hollow. Better, perhaps, to acknowledge previous missteps and use that as a foundation to talk about what comes next.

Know the difference between the people and the organization. This is the White Coats vs Dark Suits element. People love their docs. They love their local hospitals. But they lean skeptical about the big business of healthcare. Likewise, in the NFL, people love their team and particular players on it. But then there’s the perception of the organization, the impression that it often cares more about protecting the brand than doing the right thing, its Big Business operations that burn through trust and credibility. The appreciation the public has for the people doing the work – players/caregivers – doesn’t necessarily radiate out to good feelings for the organization – NFL/hospital. If the organization behaves badly, it won’t have much cover from the individuals.

And so here, we see a highly successful and credible voice who has worked at every level of an organization over the course of two decades. He’s making a powerful, emotional and specific accusation. However it all plays out, the NFL reminds us of the two-fold process facing an organization under scrutiny: First, of course, is actually doing the work and doing the right thing. And then it also means taking the time to communicate in a way that is consistent with the stated mission and values of the organization…or risk leaving room for the implication that those aren’t really the mission and values at all.

Listen on Apple Podcasts

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.

The Quick Think: Nursing Gigs and Workplace Culture

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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.

3-minute read

The Big Story: The gig economy is trying to solve health care’s burnout crisis

Nursing on demand? Is it shape of things to come?

Startups are building platforms to plug nurses looking for shifts into organizations with shifts to fill. Sorta like if you needed a ride and there was an app to connect you to a driver. (Someone should look into that.)

Point is, tech platforms can ostensibly help organizations staff up to the levels they need while giving nurses more control over where and when they work.

What It Means for Provider Organizations

Seeing caregivers leave for more flexible roles is one of many things putting a pit in the stomachs of healthcare executives. It’s painful for acute care providers, yet the idea of a nursing gig economy makes a lot of sense when we look at the convergence of two ongoing trends. And the ball is in organizations’ court to respond in a way that attracts, retains and supports those looking for more control.

We know nurses are burned out. Many feel disconnected from their employers. And 40 percent of healthcare workers employed within a health system don’t see that environment as their ideal. Instead, they’d prefer travel nursing, health tech, maybe even those enticing flexible gig jobs.

We also know hospitals are getting flak for being greedy Big Business. A recent New York Times video blames the deficit of hospital caregivers on hospitals’ intentional understaffing to increase their margins. These examples go right to the heart of what our research shows is a perceived gap between hospitals’ missions and their approaches to the business of healthcare. And that gap is part symptom and part source of the unsettled workforce.

When it comes to nurses, the problem is that if you can’t give these thoughtful, mission-oriented individuals an environment where they feel supported, connected or even sure that you’re prioritizing patients over money then they’ll look to leave for higher pay, a more comfortable work environment or both. Who wouldn’t?

This presents a brilliant opportunity for health services and health tech companies. If healthcare workers aren’t sure a big hospital is their ideal, then other types of providers can that professional home. Which means that today the competition between provider organizations is real and, unfortunately, there’s a zero-sum element to the whole thing.

Question is: How can we use this great reshuffling and try to get away from a zero-sum recruiting battle? Can we better support caregivers and help the right people land in the right roles, whether that’s at a huge national system or an innovative specialty clinic?

We think so, and the approach is right up Marcom’s alley:

Build personas. Consider the people you need in those nursing roles and who might want them. Younger nurses may be harder for hospitals to recruit now if they’re not tied to one place and would like to travel and make more money while doing it? Others may relish an exciting stint as a staff nurse in your level one trauma unit. Nurses with families or later in their career may be looking for the stability and consistency. Different personas are looking for different things. Know what those things are.

Learn about preferences. The best way to find out exactly what people are looking for is to ask. Yes, money may be one of the things that comes up, and it’s fair to note the discrepancy between a staff nurse’s hourly pay and that of the travel nurse filling a vacancy in the next room. But it’s not always money. We’ve heard from health systems that, based on their surveys, what employees are looking for is relatively simple. They want to be heard and recognized for the work they do. And they want to know what’s going on with the organization. Yes, financial compensation is sometimes part of it, but not all.

Show what you can offer those targeted personas. Maybe it’s the benefits and career advancement available in a large system. Or the entrepreneurial vibe and relative independence of a young health services company. Highlight how you’re unique and speak directly to those who find those characteristics compelling. Basic marketing.

Solidify your culture. Concurrent with your recruiting efforts, reinforce your good culture so current employees stay and newcomers join – and stay. You can’t fake culture. For hospitals, that means not just paying lip service to something like “having a direct relationship with our nurses.” It’s actually having a direct relationship with nurses and being able to point to exactly how you’re doing it.

A note on sustainability: Building meaningful culture requires talking and listening to employees on a regular basis. It entails aligning your recruiting and HR efforts. Organizations with success in their staffing campaigns have a chief nursing officer working closely with HR and the strategy team. With the reality of limited resources, efficiency will be a watchword in healthcare going forward. Make sure you’re aligning everyone towards the common goal of staffing.

Want more? Listen to partner Kim Fox and senior vice president Tim Stewart discuss culture and communications in our latest podcast.

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.

FTC Goes “Modern” On Mergers

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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.

2-minute read

The Big Story: FTC, DOJ ask for public input in antitrust ‘overhaul’

In a move entirely consistent with the executive branch’s stated goals on M&A, the feds are ramping up an effort to “bolster merger oversight” and “modernize enforcement.” They’re particularly concerned about vertical integration which, they say, may not lead to the efficiencies often promised. Plus, they’re eyeballing scaling health systems’ smaller acquisitions, as those transactions may “skirt regulatory review.”

What it Means for Your Health System

The FTC isn’t just giving lip service to looking more closely at mergers. They’re also digging deeper during the review process. Regulators are requesting more information from health systems and healthcare companies than usual and they’re soliciting public comment. Both, of course, slow down any given transaction.

That’s sure to raise eyebrows at any health system considering a partnership. And there are many of them talking about it in their board rooms right now. Some put a deal on hold due to the pandemic and are coming back to it. Others weren’t looking to partner until pandemic pressure created the need.

All in all, the ball is rolling downhill for the antitrust crowd. They have their target in sight and they’ll be flooding the comments. It’ll be tough for healthcare organizations to push back, but we at Jarrard Inc. don’t think it’s an impossible task. The goal, for starters, should be to balance the comments in a meaningful way and point out where the critics have the narrative wrong. Here’s what that looks like:

Be ready to engage. Don’t wait for anyone to jump in on your behalf. While there’s certainly value in coordinating with associations, you have a distinct story to tell about your organization and community. Focus there and don’t assume that aggregated advocacy will suffice. And when you do appropriately engage in the public comments process, be proactive, not defensive.

Engage with real stories. The prevailing narrative is that consolidation leads to higher prices, lower quality and reduced access. But what about the real stories about mergers that saved healthcare in communities, saved access and improved patient care? Tell those stories and explain how it will work in your community. Your adversaries are using both academic studies and emotional patient narratives. Numbers backed by real faces on camera are a powerful cocktail. You should do the same.

Be specific. Price, quality and access are the areas that FTC is scrutinizing. Hospitals need to give very specific examples of how their proposed deal would address those concerns. That means avoiding platitudes like “We’re going to transform healthcare,” or “This partnership will ensure care for years to come.” Instead, say, “We are going to ensure high quality care by…” and “We will improve access through…” Similarly, where there may be changes – like L&D services leaving a low-volume rural hospital – explain exactly why it may happen and how you’re going to help expectant mothers. When they speak, your critics give specifics rather than rely on vague allusions. Take the lesson and apply it.

*A note on the cost of care: Everything in society is getting more expensive, and according to our latest consumer survey, the cost of healthcare is one of the public’s top concerns. Price is a line of attack hospital critics bring out at every opportunity. When discussing the effects of a proposed merger, be ready with necessary nuance. Talk about how and why prices won’t go up due to the partnership, why it won’t be the merger that further accelerates the increase. If you are the buyside, be ready to show (or defend) your track record of prior mergers and how cost of care played out. And if increases are going to happen, be upfront about the reasons.

Drive change and educate. Talk frequently about the innovation your organization will continue or pursue thanks to the partnership. Get into the specific things you can do to control costs or improve access. Help the public understand that healthcare overall is working toward better utilization of care. Focus on ways that your organization is investing (or will invest) in getting people the right level of care at the right time. Explain that this doesn’t always mean more services, but rather helping patients avoid overutilizing expensive or unnecessary services. The bonus: This helps people understand how they can make better choices that benefit them.

Start internally. When talking about a merger, ensure your employees and physicians truly understand what it means. Our latest survey found that healthcare workers are somewhat more skeptical of mergers than the public, so it’s critical to allay the fears of those on the inside. Provide crystal-clear messaging about how it will work and how it will and will not affect them. Speak in terms that people can understand and give them opportunities to respond and question. Then do the same publicly.

Always answer the question, “Why is this good for the patient?” Need we say more?

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.

National Online Healthcare Survey Report – Dark Suits and White Coats: Healthcare’s Acute Divide

Firm News

High levels of public trust in healthcare workers and hospitals only goes so far in insulating provider organizations from mixed feelings about how hospitals prioritize between money and patients, how they handle access and equity and how they support their staff, according to a new survey produced by healthcare strategic communications firm Jarrard Phillips Cate & Hancock, Inc. and Public Opinion Strategies.

Two years into the pandemic, hospitals retain a high level of trust when it comes to providing critical healthcare information, and a majority of adults have a positive perception of the quality of care available in the US. However, barely half feel strongly that their preferred hospital fulfills its mission or provides equitable care, with even fewer feeling strongly that their hospital is a good community partner.

These findings highlight an opportunity and need for hospitals to build on their strengths to improve public perception and understanding regarding how thoughtful business practices allow them to meet their mission.

“Dark Suits & White Coats: Healthcare’s Acute Divide” is Jarrard Inc.’s fourth national healthcare consumer pulse check since the pandemic began. Fielded in December, the response pool included 800 adults and 200 who work in healthcare.

Key themes that emerged involve the business of care, trust and burnout.

The Business of Care

Though 62 percent of respondents think the quality of care in the US is good and meets their needs, only 50 percent strongly feel that their preferred hospital fulfills its mission. Many respondents are ambivalent or unsure about these issues, which provides an opportunity for hospitals to increase support for their approach to the business of care.

“We know hospitals and other provider organizations are doing incredible work to serve patients while operating in an extremely challenging environment,” said David Jarrard, CEO of Jarrard Inc. “In light of that, hospitals would benefit from an even greater public focus on mission to underscore their commitment to patients over finances. They can’t assume that because people prefer to receive care at a specific hospital or are happy with the quality of care that they feel good about the organization and its business practices.”

Jarrard said such soft support in the survey renders patients – and employees – vulnerable to being swayed by critics and competitors. It puts hospitals at risk of lower loyalty and open to reputational damage.

“Hospitals must go beyond looking at metrics of volume and patient loyalty and develop ways to connect even more deeply with the public in fulfillment of their mission,” he said.

Related Data Points:

  • Only 41 percent strongly feel that their preferred hospital is a good community partner.
  • Only 35 percent strongly feel that their preferred hospital handles patient-related financial issues well.
  • Only 42 percent of consumers and 38 percent of healthcare workers, feel strongly that their preferred hospital focuses more on its patients than on its business.


Trust in doctors and nurses remains high at around 85 percent, according to the survey. And though consumer trust in hospitals did drop six points in the past year to 76 percent, they join nurses and doctors as the most trusted sources when it comes to critical healthcare information.

“Provider organizations can use that public trust to speak to and combat some of the skepticism about the business of healthcare,” said Jarrard. “That means being open about how they operate, what they’re doing to contribute to their community and how they’re delivering on their mission of care. And when missteps are made, hospitals must own them and make clear, meaningful change that people can see.”

Jarrard said organizations should also engage with nurses and doctors to speak on behalf of their organization. But before doing so, healthcare leaders must ensure that they are truly supporting and engaging team members, who are exhausted after two years of pandemic work and somewhat skeptical of hospitals.

Related Data Points:

  • Consumers trust hospitals more than health officials (64 percent) and the CDC (60 percent).
  • Nine in 10 consumers trust their preferred hospital, compared with 74 percent who trust health systems in general.
  • Trust in hospitals has declined more among Republican voters (31 percent) than Democratic voters (17 percent).


The study found more than half of healthcare workers are experiencing significant burnout. Nearly a third feel disconnected from their employer, and more than one in 10 are unlikely to remain in healthcare.

“Hospital leadership across the country has recognized the strain on the workforce and has gone to great lengths to help,” Jarrard observed. “They’re looking at compensation models, technology to streamline operations or free up resources and they’re seeking to improve recruitment and more to mitigate the challenge.”

He added that the healthcare industry may be headed toward a realignment of staff and clinicians, particularly nurses, moving away from acute care.

“In particular, if healthcare workers don’t feel connected to their employer, don’t think their employer values their mental health or have concerns that their hospital prioritizes money over patients – the bond that links them has been significantly weakened,” Jarrard said.

Related Data Points:

  • 52 percent of healthcare workers are experiencing significant burnout
  • More nurses (55 percent) are experiencing burnout than doctors (43 percent.)
  • Some 30 percent of healthcare workers feel their employer doesn’t value their mental health.
  • While 52 percent of survey respondents work in a hospital/clinic within a health system, only 32 percent said that is their ideal work environment. By contrast, only 2 percent of respondents work for travel nursing companies and health tech companies, but 6 percent and 11 percent respectively, said those options would be their ideal.

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 600 clients in over 45 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

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

Firm News

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 difficultbutnecessary 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 or follow us @JarrardInc. 

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.


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.”


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.”


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 21st 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.


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.

Bite Your Tongue or Speak Up?

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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.

  1. 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. 
  2. 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.
  3. 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.
  4. 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.
  5. 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.

One-to-One: Building Community & Pursuing Equity

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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.

Health, Not Healthcare

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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.

Non-Profit Health Systems Fighting in an InHospitable Environment

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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.