Tag Archives: Alexandra Drane

Implementing the ACA: What will 2013 bring?

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2013 is the year when ACA implementation kicks into full gear.  What’s it going to take to push it forward? Will its goals be achieved?  And what will healthcare look like when the dust settles?

Charlie Baker, Entrepreneur in Residence at General Catalyst Partners and former CEO of Harvard Pilgrim Health Care; Jeff Goldsmith, one of the nation’s foremost health industry analysts; and Alexandra Drane, Founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation (and TEDMED 2010 speaker), sat down to talk over what’s in store for the coming year.

To give you a hint of where this goes, we’ll just quote one of the first comments, from Goldsmith: “The people who framed this bill could not possibly have made it more complicated.”

Among their topics:

* Are projected ACA costs accurate and if not, how will can employers, patients and the government afford it?

* What are some hidden factors contributing to skyrocketing healthcare costs, and will the situation improve?

“…We’ve been paying for people to react.  We’ve been paying for visits that are initiated by a complaint.  We’ve been paying for interventions.  We’ve been paying for hospital admissions.  We’ve been paying for procedures.  What we really need to be paying for is relationships.  And those relationships differ depending on the patients’ needs.  There’s some people that really don’t need much of a relationship but need access, need questions answered, need problems solved…” - Jeff Goldsmith

* Are states ready for health exchanges?  Is the Fed?

“There’s a lot of money being spent by the private sector right now to put these private exchanges up and I think they have the potential to be really game changing on this…” - Charlie Baker

* Can physician groups and ACOs compete with large hospitals by offering advanced care?

* How would simplified payment systems improve productivity and cut costs, and ameliorate the effects of the predicted upcoming primary physician shortage?

* Will exchanges give patients a truly consumer-driven marketplace, with increased choices and potential cost savings?

* How is the provider community responding to all of the uncertainty? Is anyone demonstrating the use of decisions support tools, alternative incentive structures and/or marketing initiatives well?  What are they doing?

Download the full discussion here.

 

 

Health leaders respond to TEDMED’s Great Challenges

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What do some of health and medicine’s leading thinkers have to say about our most pressing challenges?

Over the past month, we’ve hosted online conversations on the Great Challenges of Health and Medicine, which are particularly widespread, obstinate issues that demand varied points of view and creative approaches to address.

Readers have submitted questions and comments on the Challenges to leaders from industry and advocacy groups, and the first groups have responded via video, presentations, and artfully written answers — bringing their own creativity to the table. A sampling:

What are the top ten factors affecting the Caregiving Crisis?  Alan Blaustein, Founder of CarePlanners, responds (with help from a few small friends). And Joe Nadglowski, President of the Obesity Action Coalition, gives an example of a community-wide approach to fighting obesity.

Alexandra Drane, Founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation, pursued a graphic approach while explaining top contributors to the changing Role of the Patient:

Speaking also to that Challenge, Ted Eytan, an MD and a director of Kaiser Permanente, tackled: “What are reasonable and unreasonable expectations of patient responsibility in the delivery of health care?” His answer:

I am not a fan of the idea that patients are reasonable or not reasonable. The health system is designed in service to patients and to society, so that they can be productive people, family, community members, and citizens. Therefore, whatever is in the scope of allowing them to be these people is reasonable.

Sometimes it’s a matter of understanding what’s capable, and as it is said, if two people have the same information, they are likely to come to the same conclusion. We should get at, and eliminate, information asymmetry so that in the end, everything is reasonable because everyone had the same ability to understand the world around them.

 

To see more, visit challenges.tedmed.com.

Visionaries: Alexandra Drane engages with grace

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Following is Part Three of our email interview with Alexandra Drane, TEDMED 2010 speaker and founder of Eliza Corporation. Here are Part One and Part Two. In this final installment, Drane discusses work she considers critically important both personally and nationally, and what she does to maintain her own good health and considerable vitality.

Engage with Grace, the movement you co-founded to help families be better informed about and to cope with end-of-life decisions, is a force behind National Healthcare Decisions Day on April 16th. Can you talk about which current challenges in health and medicine have made these decisions more critical than ever?

We just don’t do end-of-life well in this country – and that stinks for a lot of reasons.

First, you only die once. Thank you, Atul Gawande, for making that incredibly straightforward point – among others – in this remarkable New Yorker piece about making our last days as pleasant as possible.

Second, since you only die once, die the way you want, and make sure your loved ones get that same honor. It’s a gruesome concept – except it’s not.  Stay here for a minute. We live with such intent, why wouldn’t we want the end of our lives to have that same grace? Why wouldn’t we want to make sure our loved ones are treated with that same dignity?

Third, doing end-of-life well is a gift that keeps on giving, for the person who has a far better experience at the end of a life well lived, but as importantly for those who are left behind. There is no worse hell than second-guessing how you supported a beloved in his or her last days, particularly when what the system often provides – not by willful mal-intent, just by not knowing how to do anything else – is unnecessary and I would even say inhumane.

Fourth, with the demographics shifting the way they are, the magnitude of this problem is quickly going to become unmanageable. It’s bad for us as humans. It’s bad for us as a country.

And this is one of the only places in healthcare where we are all naturally aligned! Most people want less care at the end of life (70% of people want to die at home, yet only 30% do), and less traditional/intensive care usually produces better outcomes and a higher quality of life. Check out stats from the Coalition to Transform Advanced Care. The potential savings are enormous.

In other words, just by designing a system/process where people are informed and get what they want, we get better outcomes, and massive savings.  Here’s the most beautiful thing about it, though. We don’t even have to bring up the cost savings!  While they are relevant to those concerned with the disaster-pointing cost trajectories of our shifting demographics under current care models, just by getting people what they want, the savings will take care of themselves. So don’t focus on the cost; it takes away from the beauty of the story! Instead, focus on this: Just by giving informed people what they want at the end of their lives, we get better outcomes and a better quality of life. Why would we not want that?

When the ‘Death Panel’ fiasco came along, a lot of people, understandably confused by the baloney that was trumpeted about, stood up and articulated that they did not want Death Panels. Based on their understanding, they were right. But they missed the opportunity to stand up for what they did want. And every day that we let the current reality of how end-of-life usually happens continue, we all miss that opportunity.

Let’s agree together to do this better – for ourselves, for our loved ones, for everyone.  Let’s articulate clearly, and loudly, a better reality.  Doctors, we want to know what’s going on with us and with our loved ones in an advanced illness situation. We don’t want false hope, we just want you to be direct, and gentle in how you share with us.  We want to hear our options, all of them, not just the ones that include more and more traditional care delivered in a hospital.  We want you to involve our friends and family in these discussions. Let’s think together based on what options exist in these hard situations.  We want our doctors to be okay with our choices – even if they include intentionally requesting less invasive care in return for a better quality of life.  And most importantly?  Most of us just want to go home.

This discussion matters. We need to have it on a national level, and we need to have it as individuals, as mothers and fathers and children and siblings and cousins and co-workers and friends, and as a population that cares a whole heck of a lot about living a good life, because the end of each of our stories should be just as glorious.

Engage with Grace.

What’s one thing you do every day (or as often as possible) to maintain your own health?

I laugh – all the time – at myself, at the inanity of how many mistakes I make, at how hard this all is, at how beautiful we all are with our extraordinary complexity and yet insane simplicity.

I say inappropriate things, because I can’t help myself, and because they are usually true, and because having real conversations is just fun.  And people are generally more productive when you’re starting from a baseline of authenticity and joy and soul and humor.

I revel in the humility of the great joy that we, at this very moment, are alive. And that in and of itself is a gift. One to be cherished, one to be leveraged, one to be celebrated.  I’m realizing in my old age that being successful is not about being perfect, or sometimes even particularly good at what you do. It’s about being slightly less screwed up than everyone else – at least for this moment – and caring a whole lot in the process.  When you remind yourself that you’re lucky to be alive, that it’s never going to be perfect (for anyone), and then focus on the importance of what you’re trying to achieve, you just feel better.

And finally, I try to sleep more, love my family a lot, and remember to seduce my man on a regular basis.

I guess that’s more than one.

For more from Alexandra Drane, watch her TEDMED 2010 talk.  

Visionaries: Alexandra Drane on crafting seductive health messages

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Alexandra Drane

In Part Two of our email interview with Alexandra Drane of Eliza Corporation, she talks about how most health messaging fails miserably at inspiring change in behavior.

Here’s Part One of the interview.

Your latest new venture, Seduce Health, talks about why so many health messages, both in the private and public sectors, fail miserably to change behavior. What are they missing?  What’s your favorite example of a bad message, in form or content? A good one? 

One of the most gorgeous things about the healthcare space is almost everyone in it is here because they care. They are mission driven to make this world a better place for people – particularly as it relates to health. And that’s a good thing!!  But it’s also our Achilles’ heel. We often project that fanatical level of interest in health and healthy behaviors on the people we are trying to influence, as if they too are spending most of their waking hours thinking about and obsessing over what creates better health-related outcomes. Sadly for all of us, they’re not. In fact, the average person would rather eat worms than read my thoughts on healthcare! They’re out reading about who slept with whom or which team won what or feeling secretly delighted that Facebook’s stock is down because they don’t own any and they don’t work there (at least, that’s what I’m doing).

By virtue of the fact that we sometimes think we’re ‘all that,’ we seek to influence people in ways that don’t resonate because we presume a level of baseline interest or engagement that is just not there. One of my favorite examples is to look at the advertising and marketing efforts of the food, tobacco and beverage companies, and then compare them to most of ours. We send pictures of diseased kidneys; they feature smokin’ hot models with grease from a bacon double cheese burger running down their arms.  Hmmmm – who’s going to win there?  That’s not always true, but you get the point.

My pleasures are fleeting.

The problem (opportunity?) is also compounded when you consider that we as an industry spend 30 cents for every $30 our ‘competition’ (those same food tobacco and beverage companies) have at their disposal. They’re simply spending more money. And with a greater self-awareness about what sells, what resonates, what inspires and seduces and beguiles. And not to pile on, but to be fair – their job is easier! I can sell the pants off how good a donut would taste right now (or Fritos, or a sausage, or …), but convincing you that carrots will hit that same spot?  Slightly more challenging.

So, is the answer to just use beautiful models in all that we do? Of course not. It’s far more complicated than that. But it does require that we inhale more humility about what the average person finds intriguing, what real people are interested in spending time thinking about, and that we design our outreach efforts in a way that fully and unabashedly incorporates that very different perspective.

Bite me! I

How can we do that? By adding joy, soul, humor to our approach…by paying attention to the universal conversations that are happening at the water cooler, at the dinner table, at the bar…. by meeting people in the messy realities of their lives, speaking with them in a way they can understand, one that doesn’t feel condescending or academic, and working to help them solve the problems they care about, which may or may not be the ones on which we are focused.

We work hard to infuse our health messages with a true consumer approach, and we do all we can to avoid tactics like medical terrorism – a favorite go-to of many health organizations – even though the literature (and common sense) shows that terrifying someone into action may work once but has a very short half-life. Many of our favorite examples of what we love, and what we don’t, live at Seducehealth.org. Roll around in them for a bit and share what you think!

It’s not hard to do on paper – the tough part is being brave enough to roll out this kind of approach in the real world.  Luckily, we’ve been able to convince (coerce?) some of our customers into trying fresh approaches, and they work! For example, we reached out to women due for a mammogram with a flirty approach and found that women were 26% more likely to schedule a mammogram after hearing this message versus a straightforward reminder:  “Believe it or not, there’s a mammography machine out there that really misses you. You don’t call, you don’t write. Do you think you’ll visit soon?”

The one thing we know for sure is no one has figured out how to really nail this yet. But we think with time, with more experience, with more data, with more humility, and really with more bravery to try genuinely unorthodox and thrilling approaches to engagement – approaches that DON’T presume people are sitting around waiting to get lectured – we’re going to get there.

–Interviewed by Stacy Lu

Visionaries: Alexandra Drane on why women rock healthcare

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This installment of our Visionaries Series features Alexandra Drane, Founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation, a pioneer in health engagement management via a patented speech recognition technology, rich web and multi-modal delivery platform.

In Part One of our email interview, Drane talks about women in healthcare and how to make it as a startup.

Looking at yourself and other female entrepreneurs in healthcare, and at the growing number of women entering medical school, would you say that women are increasingly having more influence in health and medicine, both in the U.S. and worldwide? What kind of changes might that bring about, both in the business of healthcare and how it is delivered?

There is nothing that makes me happier than diversity of any kind in the healthcare space – why?  Because we humans are kind of a big ole’ mess. We are complicated…and a more collaborative and inclusive perspective on who we (as in the universal ‘We’) are, and how we make choices, is far more likely to succeed when what we’re trying to inspire are healthier behaviors in a day-to-day way, because that’s hard to do.

Alexandra Drane at TEDMED 2010

Also, as it relates to gender specifically, my favorite people in the world usually have a mix of masculine and feminine traits. And in my old age, I’m coming to believe that knowing how to apply traditionally gender-ascribed skill sets dynamically, regardless of your actual gender, is where real impact lives. It’s the balance that has the most value.

The unique relationship between women and the healthcare space is not new. I just think it’s evolving. A few fun stats on this:

  • Women make 80% of the healthcare decisions in their families, and are more likely to be the caregiver when a family member falls ill.
  • Women build stronger relationships and have greater brand affinity for their health plans. Eliza measures engagement using our Eliza Engagement Index, and we find that women are 30% more engaged than men with their health plans.
  • Women are savvy online searchers. 65% of women gather health information online versus 53% of men.
  • Women share what they know. 14% of all American moms are “mommy bloggers.”

So women are engaged – and they’re more ‘experienced,’ so to speak – and in a way I think that makes them more informed and more valuable to the overall process. It’s hard to comment when you have no context. Women historically have more context about what health is, and how it lives/manifests itself, so getting them more influence over the systems being built to impact that makes sense.

Finally – and this is going to get me in trouble – I just find women more willing to point to the blue elephant in the corner. And dagnabbit, there are a lot of blue elephants in the corner in healthcare! I have come to believe that most of us working in the healthcare space have two personalities: The personality we take with us to work where we feel comfortable preaching what people should do and proclaiming edicts to that end (I do this all the time), and then the personality we take home, where we have a third glass of wine and don’t schedule our mammogram and sleep for four hours and have chocolate for breakfast while blowing off the gym for the 7th day that week (story of my life).

Sometimes what we need to remember in our wood-paneled conference rooms is that getting people to live healthy is not as easy as just telling them to do that. Most people get that they are overweight, they get that they are not taking care of themselves. That’s not the problem. The problem is getting them to start, and keep, making different choices on a day-to-day basis; choices, by the way, that are not easy for any of us to make!

I find women are faster to both remember, and bring, this perspective to the work they do, so we can spend more time developing solutions that have a chance of working. Maybe this is because they’ve been more out of control for longer? So their context is more ‘real life’? Maybe it’s because they have tried and failed in their efforts to control the behaviors of their own families, so they carry those scars and that deep rooted respect for just what a challenge this is in all they do? Or, maybe it’s just because I’m a woman, so I’m inclined to think we are superior. :)

You’ve been mentoring companies that back health and medical startups, such as Rock Health and Blueprint Health. What are some of the major goals of startups these days? Are there new and/or recurring themes?

Well, the primary goal of a startup is and should be the same as it’s always been – to survive! It’s bloody hard to get one of these things started, and that’s only more true in healthcare where what we’re selling is just not necessarily what folks – the actual citizens of the U.S. and our end-users, so to speak – want to buy: Less of what they love like meat, cheese, sweets, alcohol, and laziness, and more of what they don’t such as exercise, discipline in food consumption, and taking their medicine, especially for asymptomatic conditions when the medicine has nasty side effects.

And, because of that, there is a universal and never-ending component to what all of us are (and have been) trying to do to make a difference, which is to get people engaged and enable them to make healthier choices. I have been in this space for twenty years now, and what we worked on when I was getting started is the same thing we are talking about now – even after 700 million interactions – getting the right message to the right person at the right time. What’s changed? We’ve added ‘in the right channel,’ to reflect the gorgeous proliferation of technologies that allow us to connect with individuals in real time wherever they are, and increasingly to do that in a way that leverages the far greater (and slowly but surely more relevant) amount of data we have on individuals, like the way they make decisions, for example.

The buzz you’ll hear about are things like mobile, gaming, incentives, provider-centric solutions…and these things are valid components of an overall successful approach. But they do not represent the missing and holy grail that will now ‘save us.’ We, as an industry, have a very ‘run to the light’ mentality: ‘Medical home will save us!’, ‘Texting will save us!’ The reality is no one thing is going to save us. Doctors matter, yes. Mobile phones are a great new channel, yes. Playing a game is better than being lectured, yes.

But living a healthy life is an exhausting and unrelenting day-to-day challenge (opportunity?). We will find success when we finally learn to not only coordinate all these efforts, but coordinate them in a singularly focused outside-in, person-centric way, when we come to realize that there is no one-size-fits-all solution, that there is no one-hit wonder, that we are going to have to try and fail a lot to get to more examples of what works. And we can’t keep throwing out approaches because they don’t deliver the immediate success we seek. Human behavior is messy, it’s complicated, it’s unpredictable – and anyone who questions that need only look at their own health behavior. Few of us are doing all the things we should be doing to be our best selves, and this is our job!

Read Part Two of our interview with Alexandra Drane on Monday, June 11th. To watch her TEDMED 2010 talk, click here.