Strategic Positioning

David Shifrin: I’ll be honest. I’m confused by this story today. It’s from Healthcare Finance News and it’s, you know, I’m confused, but got to talk about it. I want to talk about it. “CVS Files Patent to Sell Goods and Healthcare Services in the Metaverse.” And when you read through the article, it’s not exactly clear exactly what CVS is going to be selling, because if I fall and slice my hand open, I don’t need a metaverse stitching and bandage, I need an actual emergency room. But this is continuing with this rapid rise in stories that we’re seeing about what the metaverse is doing and can do. And of course, Facebook has rebranded to become Meta and virtual reality is here and expanding.

So yeah, what is your take on digital goods and services?

Lee Aase: Yeah, I thought I was confused by it as well, because it says, you know, “CVS Health wants to trademark its logo, establish an online store, create downloadable virtual goods ranging from prescription drugs to beauty and personal care products.” I’m thinking, are we going to have a virtual opioid crisis?

Or what’s the deal? Just like, how does virtual work in that? So I’m not really sure. I think there’s, I mean when it really gets down to it, I think some of the telepresence stuff that was talked about in the other article that we’ll be talking about, and I apologize for jumping ahead with it, but it seems like the, it seems like the immersive experiences for really making that virtual connection be much more like face-to-face.

And perhaps even in some ways because you can have some digital measurement sensors attached with them, I think there are some opportunities to really enhance that experience. I think the main thing, the main thing out of this story is something that does relate to what I’ve advocated for a long time, is that when a platform comes out that it’s really important for big brands to be staking their claim, you know, that they don’t want somebody else to be squatting on their name.

We had an experience when I was at Mayo Clinic that we had, there was a British rock band that set up a page on MySpace called Mayo Clinic and the band’s name was Mayo Clinic from County Mayo in Ireland. And they thought that was cute, I guess, but so that gave us some impetus for being able to say hey, we should set up… This was back when Facebook pages were the new thing. We said let’s set up a page on Facebook to make sure that nobody else claims that. So I think this is just sort of taking that next step on the legal front, that where CVS is saying, okay, metaverse is going to be a thing, so let’s at least stake our claim here, and set out the stakes that we are CVS in the metaverse and nobody else can use that.

David Shifrin: So it’s protective as much as it is proactive.

Lee Aase: I kind of think…so, I mean, that’s what it looks like to me because I have a hard time wrapping my head around how virtual goods can be. I can see virtual services totally. But virtual goods seem a little bit disconnected.

David Shifrin: Yeah. Well, and the article also mentioned that they’re talking about potentially selling NFTs, non-fungible tokens, which is a whole other Pandora’s box that we’re not going to get into right now, but that’s the other big thing. And again, personally I don’t see the value in buying any, I don’t know what kind of NFT CVS is going to offer me that’s going to make me want to spend the money, Bored Ape Yacht Club isn’t even enough to get me interested. So I don’t know what CVS is, but…

Lee Aase: Yeah, I think there’s, you know, NFT and then there’s another acronym that uses both T and F as well, but maybe kinda…

David Shifrin: I think we found the title for this episode.

All right. Before this goes off the rails Lee, let’s move into the second section which, as you telegraphed, is more on the metaverse, again not really a platform specifically, but a digital place. This is from a Forbes contributor named Bernard Marr who writes on enterprise tech. The title is “Amazing Possibilities of Healthcare in the Metaverse” which got us thinking again, the metaphor as a place, as a platform of sorts. There’s sort of three areas that Marr references: telepresence, which you’ve mentioned, digital twins, which is really interesting, and then blockchain technology, which we hinted at there with talking about NFTs, but you know, some of this stuff is pretty immediate—I think like the telepresence of being able to offer telehealth visits in the metaverse or simply just by good old fashioned Zoom call. And then some of it like the digital twins is incredibly fascinating and I think promising, but a much longer play. This is mapping people’s genetics, so they can, we can experiment virtually and to see how we’re going to respond to treatment. So what are you looking at as the metaverse continues to get more, more traction?

Lee Aase: Yeah. I mean, I definitely think the telepresence part has a lot of application right away. And I think that’s where organizations could, especially in things like counseling and therapy sort of approaches, be able to have that much more immersive experience; to have it be much more like being there would be I think that’s a no brainer. And then, and finding…so I’d suggest that for organizations, finding someone, finding an advocate within the organization, within the clinical areas, who’s really interested in applying this, coming around them and helping them to prove the concept and show the value I think is really a good opportunity.

The digital twinning does sound fascinating. I just think it’s hard to…I think it’s problematic in just even as you note, as you map the whole genome, how do you know exactly whether you’re taking into account the right factors as you’re fast forwarding through 10 years, about what happens with, you know, the whole idea of like, you take a twin and you say, okay, maybe you could run a thousand simulations and be able to then come up with a… Actually as I think it through, I think that might be it, the Monte Carlo simulation with digital.

So it’s not just digital twins, it’s digital…you’re creating a population out of the twins. So just as with Moore’s law and the power of computing increasing exponentially, probably eventually at some point you’d be able to run those sorts of simulations that might give you a better sense of what the range of possibilities would be, given a different intervention.

David Shifrin: Okay. In the meantime of that while the scientists and the data folks are trying to figure out how to do all of that – and we just talked about kind of staking a claim in wherever you are as an organization – the metaverse becoming a more powerful place for brands to engage.

And so any other prep work that folks should be thinking about? Whether that’s with HIPAA compliance, training clinicians to be thinking about one day possibly entering virtual reality to deliver telehealth, anything along those lines?

Lee Aase: As I alluded to a little earlier, I think the key is to find the champions, to find the early adopters who are willing to experiment and learn. Willing to help sort out what the issues are going to be, so that then the organization can apply it on a broader scale.

So it’s part, and this kind of relates, probably segues into our ROI discussion for this time, that, as I mentioned before in my thesis, that as the I approaches zero ROI approaches infinity. One of the big ways that you keep the I low is by getting people to volunteer—by getting people who are already on staff to say wow, this is really cool and I want to focus my energy on this. I’m willing to dive in and put in my own effort on it.

And so that’s that kind of makes the organization more like a startup, you know, even an established organization where you’ve got a lot of people that are psychically betting on exercising options, so to speak. I mean, they’re trying to, they’re creating some psychic ownership in a new trend and because of the personal satisfaction that they get out of leadership in an area like that. So I think finding, identifying and recruiting people from within the organization that you already have to say would you like to play? would you like to be involved in this? is a way to be able to demonstrate that the potential to demonstrate the return without a major outlay of additional resources so that you can prove the concept and then hopefully make the case for a broader adoption.

David Shifrin: Okay, in our next conversation, we may, maybe we’ll talk about kind of setting up how you set up a sandbox with enough guardrails to be careful but also giving people the freedom to test that out.

In the meantime: digital ROI part two and talking about how healthcare marketers position digital programming to justify that ROI.

And you’ve talked about it last time, and then just before this is the last thing you said there was hopefully take the results on to the rest of the organization and leadership and show the value. What does that look like? How should digital marketers think about helping to get their leadership teams bought into these programs that they’re testing out?

Lee Aase: I think the first thing is they have to be solving a real problem that the organization is either spending money on now or creating new opportunities for generating income. So it’s either, how can you concretely save money through some of these digital innovations?

So for instance, if it’s telepresence, okay, you’re saving time on travel in between meetings and you’re enabling people to be able to be more…have less overhead in terms of those face-to-face relationships and interactions. So figuring out ways that you can measure and make the case for that, for the savings that are coming there. But then also beyond that in testing and learning and seeing where the additional revenue opportunities are, and by trying this out are we able to make additional connections that will lead to patient volume, will lead to memberships or whatever the model is of acquisition?

David Shifrin: Alright, Lee, well, thanks!

David Shifrin: Alright, Lee good to see you again. The story that we’re going to kick this off with is from Healthcare Dive titled ‘On high alert’: Hospitals wary of cyber threats from Russia-Ukraine war.It’s a kind of an odd one because you wouldn’t really necessarily expect there to be sort of a healthcare angle to the cyber warfare that we know is taking place.

And frankly, day to day, we don’t even know where this, where the invasion is going and what’s really happening there. So, there’s so much uncertainty, but we have seen kind of similar stories here and there that, Russia seems to be active and you never know where somebody, whether it’s them or anybody else is going to show up.

And frankly, just a week ago, a buddy of mine who’s a PA and he said, you know, we got a ransomware attack and they’re asking for a bunch of cash and we’re locked down and we’re back to paper. It happens all the time, in peaceful times and in bad times. so what should provider organizations be thinking about when it comes to cybersecurity?

Lee Aase: Yeah. I think it just really highlights that cybersecurity should always be a priority because it doesn’t matter where it came from. The Russia, Ukraine conflict might be a precipitating thing. If the United States is involved on the Ukrainian side and if Russia retaliates or wants to find ways of gumming up the American system then yeah, that could be one precipitating event for why hospitals would be under threat, but there’s lots of other threats. There’s always bad actors that are out there. And I think it just really highlights the importance of good processes, good hygiene, good just taking basic security measures. The key one that I think was highlighted in this article and that I’ve felt is really important as well is two-factor authentication. Because anybody can steal passwords or you can guess a password, but with the two-factor authentication, when you have to have a timely provision of that second code, like within 60 seconds, that’s the kind of thing that’s going to be super helpful in heading this stuff off.

I think the other part is just really good training with staff. Helping them to be alert to phishing scams, for instance. I know back in my days at Mayo Clinic, we would have authorized phishing simulations that would be sent out by our IT security team and, you know, it got to be a game where you’d say, yeah, I think that’s one of those when you had forwarded it.

But occasionally you would forward those suspicious emails and they’d say, yeah, that was a real threat, that was really something. And having people be on the alert for it is really important. And yeah, then just the training, the alerting people that this is something that you have to be aware of and have to be careful.

David Shifrin: So you mentioned, you talked about training, Lee. And one of the, one of the quotes that stood out to me in the article was from a chief technology officer at a cybersecurity company talking about how there’s a huge amount of turnover, which is just not…something that I’m not familiar with, the IT world, but anything there when it comes to personnel?

Lee Aase: Yeah, I think it’s really, I noticed that in the article as well, that when there’s…if you have turnover in your key staff that are responsible for these security initiatives that you do put yourself more at risk. And yeah, I think we’ve seen, whether it’s because of people getting terminated because of non-vaccine compliance or whatever, that there have been various reasons for that. But there was the great resignation that everyone was talking about as well. So I think having some lack of continuity among staff responsible in these areas could also put systems at risk.

David Shifrin: Lee let’s use that to roll into the second section which isn’t exactly a platform, but in thinking about both cybersecurity, but then also reputation and the reputational damage that can occur certainly if a breach happens or any other kind of crisis hits.

And we’re talking about the turnover and just the resources that different organizations have. How do you think about what you keep in house? What you outsource, where you draw the line, how do you manage the limited resources that different organizations have recognizing that this is going to vary if it’s an independent community hospital versus a large national healthcare system.

Lee Aase: Larger health systems do have a lot more resources. They also have a bigger footprint. They also have a lot more angles, a lot more service lines that they’re trying to be ranking highly in and where people are expressing their opinions. So it scales up, the need scales up with the size of the organization as well.

I think for any of them, it depends on their stance toward using one of these platforms or doing it on their own, depends on what other priorities they have, where they need to be devoting their resources and what capacity they have. My general predisposition has been to say that people need to have ownership of their online reputation and that the service line folks or individuals who are concerned about what happens when people Google them that the best thing they can do is…

To have an active social media presence. To have an active digital presence that will tend to be over time ranked highly in Google and will show up effectively. So I guess depending on what resources people are willing to put into this they can either outsource it and try to have things managed that way, or they can take a more active and organic role in managing their reputation.

I am just naturally I guess predisposed to the latter solution and to really authentically engaging in these platforms, but can definitely understand how people say, yeah, I just want to write a check or I want to have somebody else take over that day-to-day responsibility because I have other priorities that I need to deal with.

David Shifrin: For our insight this week, Lee, we’re going to have a two-part miniseries. And in talking to my colleagues here at Jarrard, they sort of flagged that they had some conversations with you about digital ROI. And being the content mercenary that I am, I thought it sounded really useful for our audience.

And so this is going to be pivoting away from reputation and cybersecurity and everything, but the conversation is about digital ROI. And the first question for today is what your take is on measuring ROI and how that differs between teams, marketing folks at local hospitals versus at larger health systems or different corporate entities.

Lee Aase: Yeah. I was saying, you know, at the smaller health systems or the local hospitals, you typically have marketers who need to be much more of a jack of all trades, need to be much more nimble and resourceful, much more like MacGyver in trying to get results.

And that has upsides and has downsides. The one of the absolute downsides is the lack of, general lack of resources. But the second then is the priority that puts on and the premium that puts on that resourcefulness, on that creativity, on experimentation.

When I was a…so this would be back in 2009, I published a document that I call my 35 theses on social media. And there were three of these that kind of relate here. And I think that’s what I was talking with our Jarrard folks about is that, number 17, social media freedom, in an ordinary sense of the word.

And that was true back then, anyway. Now, you definitely have to have some money to be on these platforms typically to be able to get the reach. But then the second one that was related to that is that I, as in I in the ROI equation approaches zero, ROI approaches infinity. If you keep getting the I smaller and smaller, that means you don’t have to show as much in terms of benefit for it too be, “Wow. That really works.” So the fact that in all these platforms that if you’re trying to MacGyver it, and that was the 19th thesis is MacGyver is the model for social media success, that you have to be creative and you can get the proof of concept really pretty easily, or at least you can experiment with things to say, So does this work or not?” without risking a whole lot. And that’s actually some of the benefit of the smaller organizations, are in the way they can be thinking about this as that, you know, when you’re working on behalf of a large, resourced organization or with the super-strong reputation, there’s more risk associated with it.

The risk/reward thing in the equation is a little bit skewed in those cases, because what if it doesn’t work? On the other hand, if you’re in a smaller organization you have a lot more upside potential, and also because these digital tools have fewer resources needed to do something that’s actually pretty solid that is a reasonably high quality, like these digital mics, these add-ons that you can get for your phone and to be able to really reduce the cost of production. It lets you try things and then prove their benefit, which can help you make the case for more resources.

David Shifrin: Great. Okay. So next time then we will talk about how healthcare marketers position digital programming to justify that ROI, which is a clear extension of this, and you’ve already talked about that a bit, but I’m looking forward to that conversation next time.

David Shifrin: So the headline that we’re going to be talking about this week, the news story is titled, it’s from HIMSS Healthcare IT news, and it says, “Like Banks, Healthcare will become Digital-First in 2022.”

And there’s a comma and the rest of the title is “Zoom Healthcare Lead Says.” So Lee, I saw this, and thought there’s a headline I have seen in some form or fashion, probably every four months for as long as I’ve been doing this, which hasn’t been that long, but it’s been more than 2022. And it even starts with digital transformation as the topic du jour in healthcare today.

So we’re all talking about it. And everybody’s talking about the digital front door and care delivery being pursued through digital means and hospital at home and all the rest. Is 2022 really the point at which healthcare goes digital first, or is this the optimistic view of a guy from Zoom who has a vested interest in that being true?

Lee Aase: Stock options and stuff, right?

David Shifrin: And stuff, trying to boost things after things have come back down to earth after the pandemic, the pandemic bounce.

Lee Aase: Well, so I think digital first is overstating it. I think digital first is, yeah, it is that thing that a Zoomer would say. I think it’s, there’s no doubt that with COVID digital has made huge strides. That’s just clear. Back when I was working at Mayo clinic, we had some goals for digital going into 2020, and then it was astonishing how quickly things moved because they had to, necessity being the mother of invention. The offspring were a whole bunch of innovations that really were, it made a difference. I think the way reimbursements have changed or did change at least during COVID to say that you didn’t have to be face-to-face to get reimbursed at a reasonable level.

And so because of that it made the telemedicine, made the virtual care much more attractive, much more viable, just economically viable for organizations. I would like to say digitally enhanced is the way of 2022 and hopefully beyond, because I think it needs to be human first.

So the analogy that was used in this article was about banks. Okay. People care about their bank. People care about their money. Not as much as their health and it’s not as personal to them. Banking is much more transactional. And for example, I just deposited a check with my mobile app and that’s perfect.

And like the whole thing about not… just before we were on today, ATMs used to be the big thing. Wow, you don’t even have to stand in line at the teller. I mean, so that the convenience of that, and that’s what it really has to be all about, ‘Is it for the patient’s convenience?’

Is it for the good of the patient or is it just to drive profitability and make it more efficient for providers? So I think from my perspective, I know in a future episode we’ll talk about the other little venture that I’m working on right now personally, but really with that, we’re wanting to establish that human relationship and then use digital where it makes sense for the patients.

If it makes sense to do a phone call or a video visit, because it would be inconvenient to bring the kids in for…to be seen, then yeah. But we don’t want to say if you want your lab results, you need to log into the portal and here are the instructions as to how to do that. No, you can actually talk to a nurse. We’re glad to talk, or your doctor who’ll talk to you.

So I think digital can be a, can and will be a huge enabler and can create some huge efficient…in fact, a lot of the stuff that we’re doing with this new clinic that I’m helping my good friend start, my physician friend start, a lot of what we’re doing wouldn’t have been possible without digital, just in terms of being able to get this going. Having electronic medical record that is cloud-based and that we like, don’t have to have the huge IT expenses; it’s pretty astonishing what digital can make happen. But if that becomes first, digital first is a buzzword, and that’s what the HIMSS guys and the Zoom guys are gonna go for.

But if we lose sight of the human relationship then, and if it becomes not just, not a means to the end of more satisfied patients then we’ll be missing the mark.

David Shifrin: Let’s take a look at the platform or the platforms of the week and in the notes I sent over, it’s Parler, but as you’ve pointed out before, there’s a bunch of these, and we’ve some folks ask about quote unquote, that Twitter alternative, which we assume to be Parler, but that could just be a catch all for things that aren’t the Instagram, Facebook, Twitter.

Lee Aase: Yep.

David Shifrin: With a lot of these, and we talked about this in the previous episode, these are coming about because people feel like they don’t have a place to talk about issues that matter to them. So they are highly politicized, and Parler in particular, tend to cater to specific political segments.

And that also does feed into, I think, to an extent into more of a mistrust of institutions of healthcare. I don’t know if you want a say an establishment, but that potentially that’s there too. So, you know, as you look at all, all these upstart platforms, because at one point Twitter was an upstart and Facebook was and everything else – RIP MySpace – do you see any indication that these are places that healthcare providers should be getting involved in? Is it flash in the pan? What are you thinking about?

Lee Aase: I would suggest this is a – to use the medical term – it’s as a watchful waiting approach that you would apply here. But also I’d start by listening. you can create an account personally if you’re a healthcare marketer or communicator. Get familiar with what’s happening there.

You don’t have to speak, you can be one of the lurkers and just see what people are saying. And maybe try some experiments if you think it makes sense, but I think not paying attention to them at all as the wrong approach.

But I also think given the tenor that will likely be there in most of these platforms, running out there with a whole bunch of establishment kind of messages you’re probably getting the equivalent of a ratio there.

David Shifrin: Yeah.

Lee Aase: On those platforms too. But I do think it’s like, you know, in politics you have to get 50% plus one. Marketers are all about tenths of a percent of market share at the lower end of things and making a big difference in their bottom line by how well they’re reaching people. And so, unless you want to say that this segment of the population is just, we just shouldn’t, don’t even want to treat their kind, you know, then you should be paying attention.

You should at least be hearing what they’re saying and seeing if there’s a way that you could effectively communicate there. But I wouldn’t, I wouldn’t rush into it and say okay, everybody has to have a Rumble page, a Rumble channel and put all their videos on Rumble too.

But I think not at least listening is you know, making the problem worse.

David Shifrin: All right. Last one. The tip let’s…we’ve talked about social media policies, and let’s talk here more specifically about good ways for leadership as individuals to use social media. How do folks in leadership positions in the executive suite build trust and credibility and come across as real people while also presenting valuable information about the brand or the organization as they need to?

And I mentioned before we started recording that I’d love to continue on this thread at some point about how almost the flip side of that is how brands can leverage the corporate voice versus the individual voice.

But let’s start sort of if you’re a healthcare leader how do you balance that and come across as a real person?

Lee Aase: Yeah well, I mean I think healthcare leaders who are going to be or have personal accounts on social media need to be engaged with them, need to be paying attention to them. There are certainly…any public figure who has a social media account is having other people help manage the account just because there’s such a volume of messages.

David Shifrin: Sure.

Lee Aase: But it needs to come across as authentic and that there needs to be some level of the person himself or herself speaking and engaging. And that if it’s all, if it’s all managed and not an individual being involved at all, it’s not going to be genuine. It’s not going to feel genuine and real.

And I think that’s part of what people are thirsting for, is that there would be that ability to, that this is a real person who personifies the brand who personifies the values of the organization. So I think one way, I mean, a lot of that can be accomplished through video by having just the CEO or other leader talking about things but I would say much more like a livestream and “ask me anything kind of thing” versus a highly produced thing with the drone footage, you know, where they’re, they’re coming

David Shifrin: Swooping into the CEO suite.

Lee Aase: Swooping into a CEO suite. It’s like, I mean, I understand there, are different brands that have the different fields and for some that might be just the, like maybe for Elon Musk.

Well, I mean, just let’s think like Elon Musk, okay. I mean, another good example of someone who you’re pretty sure that that’s authentic to who he is and he’s done okay for himself mostly.

David Shifrin: Yeah, it would be hard to ghost write for Elon Musk, he has his own style. That’s a good example because it does show and he does say some things that you can really “Wow, bro.” But he, as you say, he is incredibly successful and he has built real products and he has advanced his brand.

So it does show that people are interested in the human behind the brand. And in some cases they might be inextricable, but it’s not necessarily a bad thing.

Lee Aase: Yep.

David Shifrin: Okay.

Lee Aase: So that’s what I have to say about that.

David Shifrin: All right. Thanks, Lee.