5 Pandemic Cluster Event

November 30, 2020 by bobyurkovic

I started looking at COVID-19 as part of a big picture event and now I suggest that we are in the midst of a cluster pandemic event. We all see there are many things going on around us today. It is almost too much for us to understand and manage. It is rocking our world and lifestyle in a nasty way. This is more than COVID-19; it is a cluster of battles in a war for our livelihood.

If we are to win the battle of COVID-19, we need to fight 5 connected pandemics, a cluster pandemic, to survive. We are being crushed by adversity in amounts not witnessed before by our generation. If we beat all 5, we will be better for it individually, as a nation, and as a world.

Biological pandemic (SARS-COV-2 virus)
Info pandemic
Cyber pandemic
Science/Technology pandemic
Culture pandemic

COVID-19 is a Biological pandemic running rampant in the US as data shows. We need to beat this and there are many initiatives underway to manage it. However, we need to understand all of the connected influences to this Biological pandemic and how they are impacting COVID-19. For one, the Biological pandemic is getting fueled by the Info pandemic and Culture pandemic.

The Info-pandemic is about wide spread misuse of information used to mislead and cause harm to people. This pandemic is also out of control with growing amounts of misinformation and unregulated communications channels in TV news and social media. Anyone can say anything with minimal repercussions and cause harm to people. The average person is not sure who to trust regarding COVID-19 information resulting in unsafe practices that cause an increase in the spread of the virus. The Info pandemic also distracts us from focusing on resolving the biological pandemic through its divisive manner of attack.

The Cyber pandemic is about how hidden, focused attacks are disrupting our way of life. Secure living enables comfort and trust in how we work and play. The Cyber pandemic distracts our focus and impedes our progress on resolving COVID-19 by causing distrust, business disruption, and data integrity issues. Hackers and foreign entities are increasing their battles while becoming more sophisticated and successful in their attacks. Being hidden, it is another pandemic, like the Biological pandemic, that makes it difficult for the average person to understand since most of us can’t see it. We need to depend on, as well as trust, that science will help us find solutions.

The Science pandemic, or Technology pandemic, is about our lack of trust in science.

On the R&D front, the US lags on R&D spending compared to the EU and China. The US has many dependencies on external sources to fuel its innovation. Innovation is the key in finding new ways to defeat biologic threats and to advance our capabilities, An exception to this is Amazon, who reinvests its profits into innovation, new business models, and business growth. Another aspect is our inability to embrace what science tells us as we continue to vandalize the Earth, commit to unimaginable amounts of waste, and refute our impact to the environment while not acknowledging the consequences. R&D is essential to identify solutions to protect our existence,

As far as digital, I have seen many businesses, particularly in the healthcare sector, show their reluctance to fully embrace digital methods with speed, investment, and sponsorship. The Culture pandemic is partly due to a lack of digital adoption as well since a digital mindset is imperative for digital initiatives to flourish.

The Culture pandemic is about our mindset as individuals and as a people. It is about how we think and behave while guided by strong leadership and focused direction. For example, in the US, we live in a ME culture that focuses on personal desires while celebrating our individual successes while other countries live as a WE culture that work as one to the benefit of many. Our way of thinking limits our ability to act in unity to combat COVID-19 and all the other pandemics. The Culture pandemic impacts the Biological pandemic in many of us by our wanting not to be told what to do and not conforming to precautions recommended by medical experts. This is exacerbated with some leaders providing conflicting information on what to do – the Info pandemic.

What a formidable task that lies before us. No wonder we have been having so much trouble in the COVID-19 battle – it is a war and not just one battle. If we want to manage COVID-19, we need to manage all 5 pandemics together since they are connected and impact one another. We have the ability to win this and our humanity depends on it. History will see this time as us battling the granddaddy of all pandemics – a 5 pandemic cluster event – so it is a time to rethink this and attack with vigilance.

Disruptive Waves and COVID-19 Part 2 – 2020

July 30, 2020 by bobyurkovic

In Disruptive Waves Part 1, I discussed the concept of disruptive waves and the damage they cause to our environment, mental wellbeing, and disease recovery. Now, let us look at how to solve this dilemma.

Why is it getting worse? What can we do? We need to understand why we are in this situation and look at accountability and culture as possible causes.

So why are we here with new cases rising in some states? It is true that the disruptive waves have overwhelmed us. We see symptoms and aberrant behavior normally associated with PTSD. While PTSD usually comes from experiencing a severe traumatic event, COVID-19’s produces an ongoing barrage of smaller disruptive waves over a longer period of time. It is like a series of medium waves tearing away the beach over time. A few waves do not seem to cause much damage however, over time they can cause significant damage.

It is interesting how the US government is managing this slow, steady drip of disruptive waves from COVID-19. People get into arguments over insignificant issues in the streets as tempers flare showing their inability to cope with the situation. Some people call it COVID-19 fatigue. I believe it is more insidious and can have a lasting effect on society and our ability to manage the disease. We have not been able to adapt to our new abnormal in the US.

We see fragmented plans as states try to stop disease spread. The US is not working as one. What is interesting is there are different cultures in states that drive different behaviors and result in different approaches to manage the disease. We also see fragmented cultures in cities as they work separately on their own to combat the disease. The culture in the US is fragmented into many pieces and that results in difficulty in trying to manage programs to stop its spread. It is almost as though we are working against one another. Some states are closing their borders to people coming from high risk countries and states. This leads to more fragmentation.

It appears that the US has a culture of individuality and “ME” instead of a culture of “WE” that works together in unison. In the US, no one is accountable for the whole and we see state and local governments struggle to manage the disease in different ways. What if you were a patient in a hospital with a heart problem and every doctor and nurse wanted to treat you differently? You would not live long even though each medical provider thought they were right. Managing health issues and emergencies needs to be managed together as a team. Emergency departments have a very unique culture enabling them to work as one.

Is culture that important to in our recovery? Let us compare the US to another country with another culture.

New Zealand has done a good job in managing the disease compared to the US. NZ manages COVID-19 across its entire country while the US is fragmented in its approach. NZ works as one while the US focuses on individuality. NZ has a hive mentality for the benefit of the whole as the US exhibits a lone wolf mentality for the benefit of the one. New Zealand leadership is direct in telling people what to do and the people follow. Disturbances are there but minimal as compared to the US.

In the US, many people express individuality as their freedom which works in many cases, but not during a pandemic assault on our country. The US culture is so different and direct approaches do not work. I have heard, “The government is not going to tell me what to do” and with an attitude. Why is this?

NZ is a culture of “WE”, acceptance, and forgiveness. Even the Maori are integrated into NZ culture.

US is a culture of “ME”, stubbornness, and blame. Factions of race, age, gender, etc. Native Americans are not integrated into the US culture further demonstrating a fragmented culture.

NZ and US are almost cultural opposites.

NZ’ers “embrace” cultural differences and absorb them living happily as one.

US’ers “celebrate” differences thinking one is better than the other and live in a constant fight trying to prove it or be better than the other. The US has taught us competitive behaviors since we were children further emphasizing it is about ME as being better and not WE living in harmony.

Our culture of “ME” and individuality is hindering our ability to recover from COVID-19. Many blame government leadership for this and it is true that culture starts and is supported by leadership in government and business. However, we are all accountable for the culture we create in the US. Each one of us is responsible. So, in reality, the government AND the people are really accountable for the current situation in the US. No pointing fingers since the culture we created belongs to each one of us.

A cultural shift is needed to combat this disease. When we learn to work together as individuals and leaders, we may be able to weave a culture of “WE”. As “WE”, we can fight this disease quicker.

A culture of learning and sharing is needed. We need to learn from those that have contained the disease better. If we knew how and why a state or city is containing the spread better, we should capture that knowledge and share it throughout the US. Centralized control is needed from federal government to manage knowledge instead of state managed control. We need a unified US program that reaches out locally and manages/guides centrally. Governors fighting with Mayors on what to do is ludicrous as is a President threatening Governors.

A culture of “WE” that works together is needed for the US to manage this disease and the next disease or catastrophe that hits us. All of us need to embrace that … government leaders and each one of us in the US. Cultural transformation is a difficult thing to do and requires our top leaders to recognize it and help us shift our thinking and behaviors during this troubling time. WE own it and WE can fix it if WE want to.

Culture is at the core of everything and WE create our culture.

How we react to disruptive waves and COVID-19 Part 1

May 4, 2020 by bobyurkovic

We are living in a world that is changing due to multiple, complex issues occurring at the same time. It can seem overwhelming to manage through this so I wanted to break it down. I began observing how people react to COVID-19 back in early March. I noticed aberrant behaviors as panic set. People began to hoard paper products. After toilet paper, cleaning products were in high demand. Every week or two, another product fell victim to this phenomenon and shelves were emptied in stores. I also noticed that news about COVID-19 hit us in waves. Each wave disrupted our lifestyles and our ability to function in a changing world. The disruptive waves are not just one wave but a series of waves constantly pounding us. COVID-19 gave us the primary wave.

SECONDARY WAVES

Every time a new story came out or social media offered its opinion, secondary disruptive waves pelted us along with the disease news and its set of disrupted waves. These secondary waves first hit us in our economy as fears drove stock prices down. Stay at home guidelines affected many of our jobs – another disruptive wave. Social relationships had new barriers with social distancing – another disruptive wave. A new type of secondary wave kept emerging over the months. Since we live in a connected world, one disruptive wave can trigger another disruptive wave. We see this now as supply chains get disrupted on different levels. We started with paper products and now we moved into food products. The recent exposure to COVID-19 at pork processing plants is causing a meat buying panic.

Secondary waves have these signatures:

Economic: personal

Investments, cash flow, expenses

Economic: company

Sales, production, delivery, channels, employees, business models

Job related

Do I have a job, can I perform my job, job models

Education related

Learning models

Social related

Relationships, entertainment, vacations, and activities

Supply chains

Food, goods, services, medical

Services

Grooming, cleaning, medical

Medical

Precautions, identification, treatment and care
- Assets: facilities, specialists, equipment

Disruptive waves are challenging our lifestyle and this alters our day-to-day reality. When our reality changes, it affects our behaviors as we try to cope and adapt with the changes. Our ability to adapt is based on how we react to the new norm and what behaviors drive our new thinking. Our inability to adjust and cope to the new norm can add stress and further impact our ability to function in the new environment.

TERTIARY WAVES

While we are being exposing to all of this chaos with secondary disrupted waves, we get pummeled by tertiary disruptive waves. These are due to the behavioral actions we take as our mental and emotional health is impacted from the continuing set of disruptive waves hitting us. We create these waves based on our actions. You see this in protests and some strange decision-making (hoarding and domestic violence). The tertiary waves can also amplify the secondary waves from the actions we take and transform them into a more destructive force.

Secondary waves can expose new behaviors in our being.

On the negative side, new behaviors can emerge out of frustration in coping and adjusting to disruption. These behaviors may look like:

Pessimistic
Defiance
Deceit
Anger
Withdrawn
Conflict
Passive
Societal breakdown
Hoard mentality (me)
Distrust
Grateful

On the positive side, new behaviors can emerge out of hope and the internal belief that change from disruption can open new paths. These behaviors may look like:

Optimistic
Responsive
Pro-social
Confidence
Investigative
Active
Creative
Cooperative mentality (we)
Trust
Ungrateful

Mental health support is vital to minimize the creation of tertiary waves and stabilize the fabric of society.

PRE_EXISTING WAVES

Yet, there are another set of disruptive waves that have been with us all along for the journey. These are pre-existing waves and include natural disasters, geopolitical problems, general hardships, and health other than COVID-19. Most of us can manage through these waves since they are part of our everyday life and if a new pre-existing wave hit us, we can deal with it on a 1 to 1 basis. However, add these waves to the new waves created by COVID-19 and our ability to juggle all of this becomes difficult.

DISRUPTIVE WAVES

A diagram of the disruptive waves would look like this.

The actual destructive force to us is from the constant exposure to many disruptive waves that hit us one after the other. The destructive force to us is not just about getting the COVID-19 disease, the secondary waves occur from many other sources. As human beings, we realize we are now a punching bag from these hits and we need help.

I chose to call the “force of impact” a wave since it reminds me of being at a beach while watching waves constantly pound the beach and grind the shells into fine white sand. The waves always seem to win the battle of the beach. If you have ever stepping to the ocean during rough surf, it is an amazing experience of power as you get smacked by wave after wave. You cannot fight a wave especially if they come with a strong force and repeat one after the other.

The ability to adapt or collapse from the force of the waves seems to come from two things. One is our ability to embrace and manage change on a personal level. Each of us can help ourselves and one another with mental and emotional support thereby limiting the destructive impact of tertiary waves. The second is the need for leadership to guide us during troubling times on a community, business, or social level. Our ability to manage some of these waves is limited and high level leadership is required to help us through a coordinated effort.

COMPOSITION

To manage a wave, let’s look at its five properties and find solutions by understanding what the wave is and how they interact with one another.

Composition
Velocity
Volume
Periodicity
Additive nature of waves

This article is not meant to provide solutions. Its purpose is to provide an understanding of the destructive nature of the forces that are changing how we live, work, and play. Through an understanding, you can develop solutions to address the threat. COVID-19 is an example of a primary disruptive wave but there will be more and they will take shape in various forms.

You cannot stop a wave but you can learn to adapt to it through understanding that in turn may alter the impact and nature of the disruptive wave.

This is a perfect time to embrace digital transformation. Connected businesses can adapt faster to rapid change and find their new sweet spot in the market as well as drive optimum customer experiences. COVID-19 nudged our world into chaos so be flexible and adapt quickly if you want to survive.

4 Rules For Better Patient Health Engagement – 2018

November 5, 2018 by bobyurkovic

As a whole, healthcare organizations want to improve patient and member outcomes, and help those people achieve their desired outcomes. Whether it’s an older patient wanting to stay healthy enough to live independently, or a child needing a set of ear tubes to reduce the frequency of ear infections, each patient has unique needs that require attention to detail.

That said, there’s a wide gulf between how patients perceive themselves and their relationships with healthcare organizations. How can healthcare organizations engage collaboratively with their patients and members in order to achieve their goals and help them become more engaged in their own health journey? And how can healthcare organizations keep up with the digital trends in the healthcare sector to meet those goals?

Health Engagement is a Cycle

Health Affairs says patient engagement is a concept that combines a patient’s knowledge, skills, ability and willingness to manage his own health and care with interventions designed to increase activation and promote positive patient behavior. The problem some healthcare organizations find is, , some patients don’t really want to engage with providers around their health, unless there’s a critical condition that presents itself, such as a heart attack, stroke, or cancer diagnosis–many of which could have been less severe had preventative measures been taken prior to the diagnosis.

Patient engagement is a repeatable cycle with opportunities for engagement at multiple points to improve patient outcomes. Healthcare organizations can influence patients to achieve successful outcomes – if they can approach patients with their needs in mind.

We see three types of health interventions that each offer unique openings to the patient engagement conversation. For each type of opportunity, patients have different “jobs to be done” and will interact with the healthcare system in different ways:

Health monitoring – flu shots, vaccinations, screenings and check-ups. The patient’s “job to be done” is to complete the encounter successfully, one time.
Immediate/acute need – accidents, broken arms, lacerations, strokes. With these events, the patient’s “job to be done” is to restore health and functionality, with multiple encounters over a defined period of time.
Chronic need – treating chronic diseases like diabetes, hypertension or obesity, or recovery from surgery, heart attack or other event. With chronic needs, the patient’s “job to be done” may be defined more individually and over a longer time period. One patient might want to achieve a “cure”, or return to pre-event functioning. Another patient may seek to manage symptoms and have good quality of life.

Four Rules for Better Engagement

Before healthcare organizations engage with a patient and provide helpful ideas and activities, it’s useful to think through the rules of engagement from the patient’s view. Patients want to achieve their healthcare goals, and don’t always realize that engagement with their providers can help achieve this, thus, the need for easy engagement programs. By starting from the patient view and designing the experience she or he wants, healthcare organizations can initiate contact from a position of trust and empathy.

Rule #1 – Help Patients Match Quickly

Does your organization make it easy for patients to understand their benefits? Can they quickly find the right physicians to match their needs? Are appointments available soon enough? Technology such as Artificial Intelligence (AI) physician matching for provider directory, online scheduling, and web visits can help smooth the process.

Rule #2 – Work with the Whole Person

Once a patient engages in a clinical setting, the goal of treating the whole person and identifying issues to better health outcomes begins. This includes clinicians taking the time to understand root causes that may touch on social determinants of health, not just current symptoms, and seeing the whole picture of health. Their discovery process should be collaborative and multi-disciplinary, leveraging colleagues, experts and data sets. With this, an individualized plan for patient success can be developed, that continues after a patient leaves the exam room.

Working with not only the patient, but also their family, friends, and other support systems can help professionals with changing patient mindsets throughout the process, leading to profound and lasting impacts.

Rule #3 – Be Accessible

In healthcare, patient access typically refers to whether a person can schedule an appointment and get to a facility within a reasonable timeframe. For patients in a rural setting, this can mean a long drive to a healthcare facility that may keep them away–or for those unable to drive, just finding transportation to see a provider in person.

This calls into play the ability of telehealth to help foster patient engagement for those who can’t physically be in a physician’s office very easily.

This also calls attention to clinician activities in the office–was the clinician distracted? If the patient presented new concerns or different information, did the clinician reconnect in the moment? In a world of increasingly impersonal medical technology, patients seek the human inside the white coat to guide them through any anxiety and confusion.

Rule #4 – Review and Revise

Building feedback loops explicitly for patient engagement into the interdisciplinary practice will help reinforce the habit among clinicians. Such loops can provide opportunities to review how patient engagement strategies are working with patients and their families, as well as chances to revise strategies as a patient’s condition or support eco-system changes. The feedback loop can help patients internalize the clinical solutions provided by their physicians, and create a sense of empowerment and capability.

Appian for Patient Engagement

Today, many healthcare customers are actively seeking ways to implement value-based care and move people from using healthcare as “sick care”, and helping people toward “well care,” using a spectrum of disciplines and tools to define health for each individual.

In a patient-centric world, when healthcare organizations think like consumer companies and relentlessly hack away obstacles, everyone benefits.

Appian’s automate more, code less, digital transformation platform makes it possible for a clinician to have their patients’ latest information before they even walk in the door. Our streamlined and automated processes also make follow up care, and creating a patient care plan easier

With unified data views, both clinicians and patients can be in touch virtually through real-time information sharing. This helps reduce readmittance, cutting down on costs, transportation hassles, or potential germ exposure that can happen during unnecessary in-person visits.

Want to learn more?

If you’re attending the MedCity Engage conference in San Diego this November, Appian’s Bob Yurkovic will be speaking on these topics, and more during his November 6 session.

Plus, hear now from Appian Vice President of Healthcare Provider practices Fritz Haimberger, as he sat down with experts from Nemours Children’s Health System and Northwell Health on this webcast as they discuss Leveraging Digital Tools to Treat Patients Along the Care Continuum. Hear how tools like Appian are helping patients take control of their health, and engage with their clinicians, even after discharge.

Influencing Decision-Making To Support Engagement

April 15, 2016 by bobyurkovic

By Robert Yurkovic

April 15, 2016

Many businesses are focusing on customer experience, user experience, education, and incentives to engage people in healthy living for a healthier population. People are motivated by different things and we find that decisions play an important role in how people engage in healthy behavior. By focusing on how people make decisions, we engage them in a sustainable and meaningful ways.

Real engagement in health care is about constantly making good decisions that affects our health. For sustainable good health, the key word is constantly. In the HealthScape of things, it is a war out there and we are the victims. Supermarkets are loaded with bombs disguised as processed food. Physicians hand out meds at the end of each session because we expect to get something for the visit. If we do not receive our adult version of a goody bag, we feel unrewarded. Marketing has us confused with inconsistent, irrelevant labeling so we are not sure what to buy even though the product is labeled natural and good for you. Our day is loaded with stress and is compressed with work deadlines, family issues, and too many things to do and focus on. How can we focus on our health and stay focused? We need to understand how we make decisions on a daily basis and understand that we live around a stream of decisions that shapes what we do. I call the constant processing in our minds a decision stream, which is made up of micro-decisions, mini-decisions, and macro-decisions. If a person wants to do something, they have to make a decision to do it and if it is not in our crowded decision stream, it does not get done.

Engaging people to lead healthy lives is not about thrusting an informative paper or web page in our faces on how to sleep, what to eat, how to manage stress, work life balance, and what exercises you must do every day. A push strategy has shown little success and so we need to look inside of ourselves to see what makes us tick or, more simply put, how we make decisions on what we do and how we live. If we can influence decisions and gain entry into a person’s decision stream, we have a chance to obtain sustained engagement.

As human beings, we make decisions based on fact, fiction, and hearsay. We are easily influenced from a variety of sources and internal mechanisms. It is my theory that constant decisions form the basis for sustainable consumer engagement in healthcare so if we wish to achieve sustainable engagement, we must influence decision-making. I always thought of the mind as a balance of analytic and emotion components with emotional components having the greatest decision-making power. But I have learned there is much more to it, such as the unconscious mind, which influences our behaviors in subtle, but powerful ways. This increases the complexity of decision-making and makes engagement more difficult to understand. So far, I have identified five key decision-making influencers and am surprised to find that the analytic component does not have a major effect on decision-making in normal everyday life until the moment we are thrust into making difficult decisions due to an adverse event or situation.

In my recent book, “Commercializing Consumer Engagement”, I created a quote to set the tone for the material. In 2014, I said, “Human are extraordinary beings that rise to face adversity but need adversity to be able to rise.” We are truly motivated to make good decisions and act accordingly when placed in a position of adversity. In other words, we tend to eat the right foods just after we had a heart attack or reduce our sugar intake after we learned we have diabetes type II. But when things are good, we tend to relax on our decision-making expertise which often lead to experiences that are less than optimal.

I understand the meaning of the following saying, “Live life like it is the last day of your life.” If we believe we would die tomorrow, our decisions are more analytic in nature and lead to better outcomes. Mortality has a way to motivate us in making good life decisions. The question is, why wait until something goes wrong to make healthy decisions? Why not influence our decision-making now and achieve and maintain a healthy lifestyle?

Three Parts of the Mind Molecule

Before we get into the five influencers, let’s look at the mind and the role it plays in more detail. The mind plays 3 roles in decision-making and controls much of what we do and believe.

I found there is a middle brain and not just a right and left brain in how we think. I updated my earlier view of the Mind Molecule to include a third part … the unconscious mind. I moved knowing from mental part and habit/focus from the emotion part to the unconscious part. The middle brain or mind is the intuitive part of the mind.

We witness how the mind works in an event with potential danger. We can’t put our finger on it through analyzing our situation and while the event may seem like a lot of fun, we decide not to do it due to our intuitive mind advising us not to do it. While this example may keep us out of danger, it also provides the hurdle of inertia preventing us to make a change in our lifestyle.

The tree parts of the Mind Molecule make up three of the five key influencers in decision-making. That also means that two of the three influencers of decision-making do not even get processed in the conscious mind but are somehow connected to the unconscious.

Five Decision Influencers

The five decision influencers, which are identified below, show how difficult it is to make a decision since we are inundated with stimulus from multiple sources. Later, I will explore the need for decision mapping so we may understand what influences our decision-making behaviors with the hope of guiding us to make good decisions through positive motivation rather than experiencing an adverse event.

ANALYTIC

The analytic mind likes facts, numbers, logic, and quantitative data. We can get lost in the data and analysis with the emotional side of the mind finding it boring. In health, we don’t see a forthcoming threat until we experience pain. Facts and figures should be compelling enough to persuade us to do the right thing but this part of the mind only accounts for one-fifth of the decision-making process.

Even though data suggests a proper direction to be taken or a decision to be made, we often ignore it due to an emotion or “gut feel” that another viewpoint is more compelling. Sometimes, the first stage of the decision process is to perform an analysis so we can tell ourselves we did our due diligence to make an informed decision. Check mark! Then we move on to convince ourselves that this could be wrong. Why? Emotions and influencers are more powerful that logic and facts. Sometimes, rules are not to be followed and better judgement comes from other sources and sometimes, the data leads us in the wrong direction.

EMOTION

Most of us understand that many decisions we make are based on emotion, such as buying a car or clothes. Many companies use the coolness factor to influence our decision to buy and use. Advertising plays off of this premise so we buy products based on emotional impact instead of actual product content.

With regard to health, not many of us actually read the contents of food products we buy at the supermarket so packaging and brand influences most of our purchase decisions. Consumerism plays a huge role in decision making so we look for products that are convenient and easy to prepare. These products satisfy an emotional need for comfort and simplicity even if the decision is … I made my life easier. Health, on the other hand, is not easily attained and requires focus and work.

Emotions may not lead to rational decision-making and in the case of consumerism, convenience over powers a healthy lifestyle. Emotion can trick us into thinking that ‘easy’ provides a good lifestyle and we deserve it since we work so hard. Our mind is confused by good lifestyle and healthy lifestyle. The analytic mind is needed to focus our decisions so that good now means healthy and we are now emotionally satisfied with being healthy.

With emotions playing such as large role in decision-making, one would think that the emotional satisfaction of looking good in a bathing suit in the summer would be enough to persuade us to be healthy and lose our winter weight. But, no, the unconscious mind has a strong influence over our emotions and the habit of eating more during the winter is so strong, its inertia carries us through the summer months.

UNCONSCIOUS

The unconscious mind is an important part of the decision-making process and, like snowflakes; our unconscious minds are unique to each of us. Influences come from our habits, rewards, personal associations, ethics, and social proof. These are things that make us feel comfortable. We make decisions in this area before they even get to the conscious mind for emotional or analytic review. We tend to do what is expected by others and conform to an acceptable, comfortable norm. Yes, we are creatures that do not like change.

With many variables embedded in our unconscious mind, it may be challenging to understand what key influencers are impacting health related decisions. The unconscious mind is a very personal view of ourselves since the mix of variables makes us quite unique. It is important to understand how the unconscious mind affects out decision-making process by searching for hidden root causes. This is an another reason why hypnosis can work on treating chronic diseases since it has so much power of the analytic and emotion side of the mind.

BODY

Another major influence on decision-making is our physical bodies. Our bodies seemed to know what we need to eat when we need essential minerals or compounds. We get a craving that fires off an action to consume spinach for its iron or bananas for their potassium. I believe craving stimulates an automatic part of the mind that makes a rapid-fire decision that may not be rational, habitual, or emotional. The physical body bypasses the analytic, unconscious, and emotional decision part of our brain and we go from physical body right to action without conscious or unconscious thought … we immediately decide to eat something to satisfy a physical need.

The physical body is a real time trigger for decision-making. The body tells us to stop eating when we are full. This may be overridden by the desire to eat more ice cream or drink too much beer because we receive emotional value from it.

What if we use connected devices to monitor the body and inform us to take action for a specific need. We now combine body and the fifth influencer … digital.

DIGITAL

When we add connected devices (IoT) to the mix, we will probably see more decisions made through devices that bypass our mind for authority. Yes, these decisions are made for us as we enter a new wave of digital evolution called Controlled Living. The connected devices feed off of our body’s data and these semi-intelligent devices trigger a response or decision to do something. This can simplify a saturated, internal decision-stream by routing micro-data to devices for making micro-decisions so we don’t have to think about it. This concept makes our world more convenient but also removes the human element of health care. This certainly fits into the key tenets of consumerism – convenience and easy to use.

The implications cause some concern. While I like the idea of reducing errors through rules-based connected devices, I want important health or personal decisions to be made by my emotional, unconscious, rational, crazy mind. Maybe it is better to have devices make micro-decisions since I am not shedding 10 pounds by my present method of decision-making. I may need a kick in the butt by a digital conscience or motivator. Digital therapy can be useful if properly integrated into the other four influencers in decision-making.

In the years to come, IoT will play a larger role in decision-making so my question is, what will drop out of the decision stream to accommodate it or will the decision-stream become less cluttered to allow for more significant decisions?

Balance

There needs to be a balance of power between the analytic, emotion, and unconscious mind. We can also use the emotion side and unconscious side of the mind to influence healthy decisions instead of providing rational logic and information to people. Combine the mind with the body and digital devices and we can create influencers for a decision experience supporting decisions around healthy choices.

Since we may not be able to balance a person’s decision-making process, it is important to understand how they make decisions and which of their decision influencers are in control so we can focus on the key influencers from that part of the mind-body. I am not suggesting we manipulate the person’s mind, but instead work within their own framework to trigger decisions based on a healthy lifestyle.

The Mechanics of Decision-Making

DECISION STREAM

We process information at an alarming rate and I see people making multiple decisions every second. I call the small ones micro-decisions and the 5 plus decisions made every second makes up a decision stream. Micro-decisions may be thought of as seeing a color and deciding on whether you like it, seeing something and deciding to view it more closely, or seeing a person and deciding whether to talk to them and then another decision fires immediately about the topic to talk about. The decision stream is a crowded place filled with micro-decisions and big decisions. We prioritize what goes into the decision stream based on the influencers and their importance. I could say that micro-decisions add clutter and impedes our ability to focus on what is important so focusing on the ‘now’ and prioritizing health decisions as important is critical for our mind to process them.

As discussed earlier, decision influencers are the mind (conscious analytic, conscious emotional, unconscious), physical body, and digital. There is only so much bandwidth available in the mind-body to accommodate decisions so if we are to engage someone in a healthy behavior; we need influencers to be inserted into the decision stream as our thought processes occur. While decisions flow into the decision stream, they go through a four step process for action or for a person to engage.

5 DECISION-MAKING STEPS

There are 5 key steps toward making a decision that leads to engagement.

If a person has a chronic health condition, they need to be aware of it and recognize it is a problem. At this point, the issue is now in the decision stream in which it can flourish or die.
Next, they have to understand its effect on them and internalize it thereby making it personal. At this step, the issue takes root in the mind as a priority in the decision stream.
The next step is about how a solution can help me as I seek to validate a solution before making a decision to proceed.
The fourth step is about authorizing myself to do something. This is where many people get lost. They agree to do something with a ‘check mark mentality’ and enter a holding pattern of inaction. For fitness, they may buy a connected device to track activity, but fail to integrate it into their lifestyle.
The final step in the decision-making process is to make a final commitment and prioritize a place in the decision stream so we constantly decide to do it over and over again.

DECISION EXPERIENCE AND MAPPING

As people, it is our habit to focus more on our health after something goes terribly wrong. The emotional aspect of a health event forces the analytic part of the mind to play a larger role in decision-making. We start to eat more healthy foods after a heart attack or stop eating so much sugar and carbs after being diagnosed with diabetes. Our decision-making priorities have shifted decision control to reason. It seems adversity is a key motivator for making smart health decisions. The trick to engagement is to force a decision to the analytic mind before we experience adversity in our health. We can capture our attention in the decision stream through feelings in the emotional mind and through influencing in the unconscious mind. We need influencers and raised awareness in the early stages of potential adverse health conditions to shift decision-making focus on them to avoid a drastic health event. If we want to influence decisions and engage people in better health habits, we need to understand their decision streams and what influences their decisions to engage people in healthy behaviors. We must get past the emotional and unconscious aspects before we tap into the analytic mind to educate people in making informed decisions. Customer experience and user experience does not cover this. I believe Decision Experience (DX) is required to account for this. Decision mapping may be the next thing in understanding how to engage consumers in better health.

When performing a decision map exercise, use personas as you would with a customer experience journey map. There are so many variables in the unconscious mind, the personas will allow you to focus on key influencers and group them.

Select a persona and a chronic disease, such as class 1 obesity, before proceeding. Develop an approach to engaging them with that chronic disease. The approach includes influencers and tasks for each decision step. Ask the people if that influencer resulted in a positive decision for each step and apply a diamond to the appropriate layer. At the end, you should expose influencers that worked the most for that persona with a specific chronic disease. This will also allow you to focus on correcting influencers to provide a correct decision. The more positives in the Correct Decision band should result in sustained engagement.

Decision mapping identifies triggers and influencers along the path of engagement for people. Instead of identifying our emotional satisfaction or experience at interaction / touch points as we map Customer Experience journeys, we identify influencers and triggers at decision points along the person’s thought process. Understanding the DX for a person enables us to shape an experience in their decision stream and guide them along the 4 steps of decision-making to achieve sustainable engagement. The objective is a healthier population by engineering an environment to facilitate proper decision-making before adversity occurs.

USA Today – Employee Well-Being Supplement – 2015

September 26, 2015 by bobyurkovic

How to assist employers in employee well-being using the CCR principles of engagement. Published in the Employer Well-Being supplement of USA Today on September 26, 2015. The article is located on page 14.

Cogent Communications Leads to Consumer Engagement

August 27, 2015 by bobyurkovic

August 27, 2015

By Robert Yurkovic

When interacting with consumers, there are many channels for the delivery of communications. Multi-channel and Omni-channel are buzz words many of us use and they enable organizations to deliver communications to consumers through various methods and technologies. The issue I have is it is not a consumer-facing point of view and in some ways companies are abusing the technology that enabled them. With so many channels aimed at a consumer, the consumer feels like a bullseye resulting in an experience that is frustrating and chaotic. This often results in communications that are ignored and discarded, which decreases the opportunity to engage them.

To engage consumers, communications must be cogent … clear, strong and convincing as well as being able to influence the mind and behaviors. The goal should be meaningful communications and not worthless junk mail.

Why does this occur in healthcare and other industries? In healthcare, silo’ed organizations are common place. Each organization wants to reach out to the consumer with their message. Multi-channel platforms and applications provide access to the consumer and if each organization sends their unique communications, the consumer is bombarded with confusing, conflicting, and irrelevant content. No consumer wants pieces of an encyclopedia thrown at them requiring them to fish out relevant information. Consumers have short attention spans and scan material for relevancy in 2-3 seconds.

Coordinated

Organizations are not coordinating their communications across the business so a communication over mobile may be different than a communication over email or a web site. The outcome is a confused consumer, which may result in a phone call to the contact center or discarding the messages altogether as unimportant. If a consumer receives 2, 3, or 4 different communications from various company representatives, they will likely be discarded as the consumer’s perception is all communications are incorrect. Consumers will not spend time validating which communication is correct … this is a formula for a bad game show. The opportunity for engagement suffers and the customer experience deteriorates.

Consistent

Organizations tend to delivery different communications to one consumer even on the same channel. For example, I reached out to a healthcare payer’s contact center for a fairly simple question and received 3 different answers as I stumbled through their IVR system and multiple organizational representatives. 40 minutes of my time was wasted and my goal was not achieved so I was frustrated. The damage doesn’t end there since I communicated my experience with neighbors and friends. Now I am influencing a community and the company’s brand suffers. The lack of consistency of communications results in hours of wasted time and causes a degraded customer experience. The company disengaged me.

Clear

A communication is no good if you cannot understand it. Useful communications that have impact are simple and clear and refine the message to its essential core. No long, endless diatribe and no spouting paragraphs of information. Your audience must be able to understand the message quickly and without confusion.

Relevant

It is a B2C world and everyone wants to touch a consumer within a company and across different companies resulting in an increase of information sent through every possible channel. But is “more” better than “less”? Or is it a question of the right information to the right consumer? Relevant communications has the best chance of capturing a consumer’s attention and engaging them. For example, I receive newsletters from my primary physician’s office, the local regional medical center, urgent care, and several other health-related sources. The print matter ends up in the trash and the emails end up in junk mail. Why? The content does not pertain to me. Why do I want to hear about asthma or diabetes in a generic newsletter since I and my family do not have or are at risk for those conditions? There may be something relevant on page 4, however I did not get that far since I dismissed the communication at page one. The result is the communications deemed useless and failed to engage me. I also associate that company with other companies that send me junk mail, which damages their brand image. I am now conditioned to discard future communications swiftly and they have a very little chance of engaging me in the future.

Why Channel Unity?

Channel Unity means all channels communicate to the consumer with one cogent voice. To the consumer, it doesn’t matter what channel they use, they want to experience useful communications from the company. Companies need to shift their thinking to a B2C Model and embrace Consistent, Coordinated, Clear, and Relevant (CCCR) interactions and communications. Consumers don’t care about all the channels that reach them. They care about a connection to the company and expect it to act with a cogent voice.

I have never seen a company transform and eliminate their deeply embedded silo’s quickly so the solution to Channel Unity must enable data, content, and processes to overlay a company’s business in a way that offers consistent, coordinated, and relevant communications to consumers. Autonomy is protected in the silo’s and a company does not need to wait 5 years for a major cultural shift to occur.

In my recent book, Commercializing Consumer Engagement, I describe best practices and approaches to achieve Channel Unity and consumer engagement without disrupting what is currently working within company. Engagement is all about consumer behaviors and connecting with them in a way that supports their lifestyle.

We Need More Cultural Disruption

April 8, 2015 by bobyurkovic

We tend to focus on disruption in technology, but we should notice a disruption in culture as well. This may sound strange coming from a person educated in engineering but I found that healthcare requires cultural disruption in order to fix healthcare as we know it … broken pieces to a consumer’s eyes.

Technology

Everyone loves technology and it surrounds us cradle to grave. Why not? Technology disruption creates opportunities, instability (catalyst for change), and perspective shifts in our thinking. The issue is that we tend to focus on technology disruption while ignoring the potential for cultural disruption. Technology disruption enables things to change using technology as a tool. Technology enablers include such things as mobility, devices (IoT), cloud, and analytics. They are very important and have led to great discoveries and cool tools such as smartphones and innovative medical devices. We design them based on usability standards and consumer needs. But, is that enough?

Wearables are gaining in popularity and also end up in your dresser draw in a few weeks or months once the novelty wears off. The reason we stop using them could be due to several reasons.

Lack of usefulness – there is no health program attached to them so their value is limited to monitoring data – that can get boring quickly
The coolness factor dissipated
There is no consideration for cultural disruption and conversion

It is fine to offer cool technologies that have the potential to add value to our lifestyles, but if you want true sustainable engagement, cultural disruption must also occur.

Cultural Disruption

Cultural disruption focuses on our and the larger communities behaviors. Behavioral change can lead to sustainable shifts in what we do and how we act. Cultural enablers include social, community, personal behaviors, customer experience, and organizational behaviors. Cultural disruption can lead to sustainable change because it focuses on us, the consumers and our surrounding community. Our inner core being must be touched in order to make and keep a change in our behavior. We look to other people as influencers to help us with decision-making and on what we adopt. Localization has a strong impact on health programs. Health care is personal and local programs tend to work better than pushed remote, corporate programs because they deal with the cultural aspect of our lives that reside in our homes and community. Cultural disruption can help consumers manage chronic diseases by altering their perspective on their health and in decision-making behaviors.

Cultural disruption causes a shift in our thinking and expectations. It also sets up new internal rules for us to follow. From this disruption, we may decide to integrate something into our lifestyle, decide what we focus on, or behave in a different way. If we want to make a change in how we manage our health, a wearable device by itself is not enough. We need cultural disruption to occur.

Apple did it

Steve Jobs performed cultural disruption very well with his innovative mobile products and those products were more about cultural change than they were about technology. That technology had been around a while, but Jobs focused on how it would impact our lifestyle, particularly around entertainment.

Disruption in Healthcare

Health care needs to focus on cultural disruption and continue to make advances in the areas of technology. Technology alone will not make a sustainable difference. Businesses allocate large budgets on IT and they should think about allocating resources around culture as it impacts their organization and products. Technology disruption must be aligned with a cultural disruption to make a difference in consumer engagement or any engagement for that matter. We need more cultural disruption in all industries.

Engagement Happens When We Work Together

March 27, 2015 by bobyurkovic

What would it be like to attend a customer engagement conference where the presenters, panelists, and audience were truly engaged and shared what they know? I chaired the Customer Analytics and Engagement in healthcare conference in Chicago this week and I found out. It was not like an ordinary conference with fancy slides and polished speakers. It was about real professionals working in the healthcare trenches with a desire to make significant changes and learn from others. I witnessed the walls of silos disintegrate.

Experts shared their points of view on issues facing healthcare. Topics for discussion included predictive modeling, readmissions, B2C market shifts, behavioral trends, social media, customer experience, engagement strategies, ACOs, provider strategies and more. We had presentations, interviews, and panel discussions on the hottest topics facing the healthcare industry. The audience was truly engaged as tough questions were given to experts on our panels.

This conference was extremely useful as influential companies in healthcare worked together. Payers, providers, ACOs, and health services companies attended. Humana, Cigna, Aetna, and Anthem represented from the top 5 payers with many Blues attending as well. Dr. Furno represented CMS and talked about the work CMS is doing around readmissions. Stuart Hanson at Citi attended to share what they have learned about B2C in banking and if their experiences could translate to healthcare. Thomas Sondergeld, from Walgreens, shared his insights on engaging the employee workforce with corporate wellness programs. Vijay Murugappan, VP from HCSC, delivered a keynote and shared his thoughts on analytics and technology. Kimberly Higgins-Mays, VP from Aetna, shared her views on Accountable Care Solutions and how Aetna is changing their thinking to adapt to the market shifts in healthcare. Bryan Bennett, predictive analytics adjunct professor, from Northwestern University lit up the panel with insights on predictive analytics. Jim Tincher, customer experience expert, provided insights and an education around persona development and journey maps on Thursdays morning session showing us that a just creating a journey map with bubbles is not enough. These are professionals with diverse perspectives but with one common goal .. to help healthcare get better.

The conference actually turned into more of a workshop since collaboration, interest, and expertise within the group was so strong. It is what made this gathering unique and a blueprint of how a conference for change should look like. I am convinced that collaboration such as this is the best way to bring together Payers, Medical Providers, and Pharma together to define what healthcare should be in the future … and with the consumer in mind.

Well done to those that attended and contributed. You are the movers and shakers that are changing healthcare for the better. Everyone showed passion for making healthcare relevant and useful for consumers. It is time to remove what is complex and listen to our consumers … not an easy task.

Hats off the FC Business Intelligence for putting the conference together.

Consumerism and Trust in Healthcare

February 1, 2015 by bobyurkovic

Brian Solis talks about Connected Consumerism and Generation C in his book “What’s The Future of Business”. I believe connected consumerism in healthcare is an investment in product relevance and meaningful relationships to improve the state of a consumer’s health throughout their life cycle. In order to engage your consumers, trust is a required element before consumers will engage with you. The concept of providing health care is about being connected and remaining connected with your consumers and offer services that integrates with their lifestyle. However, a relationship needs to be developed in order to build trust. Why? Health is personal. The best examples of engagement in health are personalized services. Services should be local and embedded in the community since the community is a natural support group for people reaching for health goals or trying to change a behavior to fight a chronic disease.

Health is Special

Remember that health is very personal unlike many consumer product goods so the connection should be real and meaningful. Decades ago, doctors had genuine relationships with their consumers. They knew the consumer as they followed them along their life cycle. With increasing medical costs, doctors built larger practices and focused on cost efficiency and service speed. Consumers don’t visit the same doctor every time due to availability and scheduling in larger practices. As doctors lost the personal connection with their consumers over the past few decades, trust eroded and consumers left those doctors and chose their doctors from a list of provided by healthcare insurers. Consumers also began to obtain health advice on the Internet instead of from doctors since they were difficult to get a hold of and expensive if an office visit was required. In the consumer’s mind, doctors could be replaced easily as long as they could get a doctor covered under their medical plan. Keeping costs down instead of a continued relationship with a doctor was now a higher value to consumers. Most consumers with plans have to pay more to go out of network.

Commoditization

Commoditization for primary care was taking hold as consumers were sacrificing quality over cost and convenience. This was exacerbated as many employers switch health plans during renewal periods and with that; a consumer received a list of different in-network doctors. Now doctors are fighting to regain the trust once earned and grow their customer base. For a doctor, it is like pushing mud uphill as regional health practices form to manage operational costs and drive consumers to large practices. To lower costs, some doctors practice defensive medicine to avoid malpractice issues and push more consumers in a tight schedule. This is not an environment that nurtures and grows trust. Doctors are no longer connected to their consumers as consumers are now connected through social channels. Searching for health information is a top search category on Google and consumers also reach out to others seeking advice on a procedure or condition, or references about a doctor.

New Entrants

Some companies are trying to earn the consumer‘s trust so doctors have much more competition now. New entrants such as Google and Apple have entered the market and while they are not providing diagnostic services, they are providing information and acquiring health data from devices that support healthy lifestyles. These companies understand consumerism and how to deliver a great experience; qualities that are little used in established medical businesses. Other companies, such as Walmart and CVS are offering local, affordable basic health care services once provided by primary care physicians. Local urgent care centers are providing care services without the wait and cost issues associated with emergency departments. Doctors and hospitals are left with specialized health services as general health services move to other businesses.

Path to Trust

For a consumer, who do you trust? Trust is a key component to retention and consumer engagement so we know it is of upmost importance. What are the connections between trust, relationships, engagement, and behaviors?

Behaviors drive consumer engagement
In order to influence a behavior, you need to build trust
In order to have trust, you need a meaningful relationship … a connection worthy of the consumer’s attention
In order to build a valued connection, you need to interact where the consumer lives while combining a great experience with useful services and information that supports the consumer’s lifestyle and goals

For consumers trying to manage their health, they need tools and information to make informed decisions. Communications plays an important role in making this occur as a conduit for exchanges between the consumer and the business.

Payer Situation

Healthcare Payers operate in a transaction mode such as when a health transaction, such as a claim, occurs for the consumer. At that point, an interaction is started with the consumer. An example of this is an Explanation of Benefits (EOB). A claim is placed and an EOB is sent to the consumer explaining the transaction that occurred. Better communications during the claim processing phase with create a better experience such as sending an email to a consumer saying, “Your claim was received on January 3, and is being processed.” Interactions and communications could include additional suggestions for improving the consumer’s health around an existing condition or personal objective for health. Extending the interaction with useful and relevant content helps the consumer manage their health issue and learn more about their health. A relationship starts to develop as content is exchange with the consumer. Relevant, trusted content is essential to a dialog between a Payer and consumer.

Coordinated, Consistent, Relevant

Coordinated, consistent communications that are relevant supports a valuable dialog and the relationship begins to form. This is much the way a doctor communicated with their patients many decades ago. The desired goal is to be embedded in a relationship that impacts the consumer’s lifestyle and daily living. The consumer is able to better manage their health and make proper decisions when equipped with relevant information and tools. The triad of healthcare, Payers, Providers, and Pharma, must work together and share consumer information and speak to the consumer in a coordinated manner; speak in a singular health voice. This approach offers the consumer a superior experience and the value of the combined effort would be multiplied as opposed to speaking as 3 separate voices. Relationships can grow as Payers, Providers, and Pharma jointly build relevant interactions around consumer’s lifestyle. What could the next C level position be? Perhaps it could be a Chief Alliance Officer responsible for making the connections between businesses, leading joint initiatives, and readying technology systems and processes to be able to exchange information readily and support a singular voice.

More about consumer behaviors, trust and building relationships, and consumer engagement in my new book titled, “Commercializing Consumer Engagement” at http://www.commercializing-consumer-engagement.com/