Kaiser Permanente - Thrive

Disclaimer: As a reminder, the postings on this site are my own and do not represent Kaiser Permanente positions, strategies, or opinions.

I am happy to announce that early this fall (September), I accepted a role to help support Kaiser Permanente’s technology investment strategy.   This support will come mainly in the form of business and technology planning process development (but I may also sneak-in some of my technology management philosophies when appropriate).

Joining the health care industry, in many ways, is a departure from my technology industry experience.  I anticipate there will be many cultural differences.   While I have worked at large companies before, my support network (with some folks in the know) cation me that there are likely many  business style and etiquette differences between working at Kaiser Permanente and other large high-tech organizations (Sun or Cisco).

At the values level however, I have a found some refreshing similarities:

1. An organization wide commitment to a common vision: Providing the best health care to members at the most affordable price.
2. A value to leverage technology as competitive differentiators: KP HealthConnect; KP.org; Tele-Health; etc.
   
3. A passion for data and fact based decision making.
4. An entrepreneur’s instinct to rewrite old rules, listen to customers, and improve: Kaiser’s integrated Health Care model.
   

The health care crisis in America is profound.   It will take collaboration from many communities to reorganize the industry to meet our shared challenges.   I believe Kaiser’s successes (and failures) in leveraging technology within care delivery, patient engagement, and knowledge organization contexts, will be invaluable contributions towards building a next generation health care system in America.   I look forward to contributing to Kaiser’s ability to thrive as an organization.

Leveraging partner ecosystems is not new.  Social Media has not reinvented the space.   Regardless of how you are experimenting with social media and partnering to drive customer value, I would recommend to not stray too far from basics.  Here are 3 rules I recommend:

1. Never embarrass your partners in front of their customers
2. Maintain a [highly] visible profile in your Partner’s income statement
3. My Golden Rule:  Whether selling directly or through the channel, never let others define the value of your product.  Define a market disruptive “promise”, and then continually exceed expectations.

I grew up on a farm in the country, across the street from my grandparents.

The roots of my family’s involvement in farming began with their immigration to the United States at the turn of the 20th century.   My basque great grandparents settled in the Imperial Valley via Cuba (they moved on after 2 years because Cuba was poorer than the country they left!).   My Swiss grandparents (or great grandmother) settled in the Imperial Valley after losing her husband to Typhoid fever (year after the great SF Quake) and then remarrying (with 3 kids) via San Francisco.   The story of my family in farming continues today, but it is mostly written through our family friends (relationships forged through 3 farming generations) and my former classmates currently tending to their family farms.  This story may have lessons to teach to web entrepreneurs struggling to establish themselves amongst large corporate, venture capital, and governmental competitive interests.   Here are a few lessons that I have learned about how my [extended] family farm has adapted in the face of large and seemingly insurmountable challenges:

1. No Debt!: While easier said than done, there are many community strategies for bootstrapping your operation.  Debt is a four letter word to a farmer.  Those interests that have survived generation to generation never take on an obligation that isn’t readily serviceable if they can help it!
2. Own the means/ capacity to production: Those family farms that have survived through generations place high importance on owning their own capital equipment:  processing sheds; tractors; etc.   These capital outlays are incremental sources of revenue and reduce their operating costs.   Several family farms have also exited land farming completely to consolidate their interests behind being capital service providers to other farmers.  Most family farming operations run “cooperative” structures that leverage common capital services spread across several interests.   [Curious comparison to make here regarding cloud computing!  I wonder if Twitter would not be better served having a more immediate span of control over their service infrastructure.  The twitter model is very different from the Craiglist model. I believe the Craiglist's service "fidelity" is better served by their focus on owning their own means of production.]
3. Find your premium buyers – Be it Global or Local: Premium buyers exist for any product.  If traditional market servicing mechanisms are not delivering the price you need, go find your own buyer that will.  Great example:  Cattle Feed.  In my former home, a premium is paid  by Kobe beef ranchers to hay/grass growers because their very specific quality and nutrient requirements are met by Valley suppliers.  In response to servicing this outlet, farmers have created a cooperative that markets and sells their products into the Japanese market.  A “farmers market” / direct to consumer strategy can also be organized under this point.
4. Experiment with 10-15% of your capacity: Those family farms that have not only survived, but actually made money over the generations were DISCIPLINED experimenters!  Cash crops don’t just happen.  Lower operating costs don’t just happen.  These farmers MADE THEIR OWN LUCK, by diversifying their production across several crops and experimenting a % of their capacity with new types of crops.    Every business or activity has a learning curve and these successful family farmers know this point well.  I believe that Google’s 20% persona employee project edict is a fair mimic of this strategy.
5. Be involved in your local coffee shop: The coffee shop is a literal and figurative place where networking, knowledge sharing, and community happens.  Community can be ugly, protectionist, and exclusive, but that’s sort of the point isn’t it?   Community is personal and consistent.  It supports itself.  It fights like hell to maintain itself.  Its about status.  Its about influence.  But its mostly about “getting things done” and “having fun.”  This last point is the underpinning all others made here, so if you are trying to start a web business please note that the only thing more important than venture capital is social capital.

1. Is my cloud computing strategy full of hot air? Bubble talk abounded at the conference, but I was amazed when I walked the expo floor.  There were many “infrastructure” service providers offering computing scaling services, build in IT Ops services, On demand storage and CPUs, Ad networks for hire, etc  which got me to thinking:  Can this even be real?   “Computing as a service” isn’t easy.  For every “on demand” provider, there were probably .5 providers offering services to monitoring these venders’ service performance and uptime.   This is a space that definitely carries a “buyer beware” flag and may be the first to get impacted by any Web2.0 bubble pop.  These providers represent significant capital outlays in terms of infrastructure and people (or a least they should if they are any good).
2. Facebook vs. Wordpress – Like comparing a MTV teen show to a cellur network!  One the speakers mentioned that the difference between the recent Facebook valuation as compared to WordPress is argument in favor of social media platform consolidation! (It may have been Tim O’Riely).   What!   Bias disclosure:  this blog is written with wordpress. I completely disagree with this comment.   Wordpress is a true “social” platform that is open, easy to use, extend-able, and built to last in the future because of its commitment to supporting and integrating evolving technical standards for social media.  It has true ” hig personalization fidelity”, as in the user really has the flexibility to change anything and everything about their digital “broadcast.”   Facebook on the other hand is a VHI pop video channel version of classmates.com.  The company treats its plebes, I mean, members, as “ad units” and it shows.   Windows dominated the PC market because of the relative value contained within its application ecosystem, value add partner base, and extendability.   Apple only became SOMEWHAT relevant recently when they decided to borrow the opensource value ecosystem of Linux and OpenBSD. My money might not be on Wordpress to evolve into the only Social Media “operating system” of choice, but it is certainly against Facebook taking this title.  I am almost embarrassed to say I even started a facebook account last fall. As data portability and other “broadcast” technologies become more standardized, people will choose their social media platform based on personalization and overall extendability  motives as opposed to the “critical mass and lock in” reasons that dominate the market today.  Skeptical?  Want Proof?  Then go try Twitter (also integrated in my current wordpress set up).   While “Fascism” may be good for business, in a social context, its boring.  If Warren Buffet actually bet on technology, I think he would bet on Wordpress now and into the future.  This is not to suggest that Wordpress does not have strategic holes to fill, but systems that are open, standardized, and get out of the way from their community’s creativity tend to win over time (just look at the Internet, right?).
3. Ambient computing is the future!  Web 3.0 will not exist because a new term will be coined for describing the inclusion of our digital heartbeat (representing physical space, time, and social context) into our connected lives!!!!   Welcome to the Interweb!  – I didn’t really hear this at the conference, but it is an idea that I have captivated with for some time.   It was started by Time’s person of the year article.  When given a choice, people, or at least Americans, tend to be very lazy.   Social Media is now work to many of us and its tangible ROE (return of effort) is unclear to many participants.   A digital connected pulse view of the world combines both the passive (lazy) and voyeuristic instincts of man.  It would be a future that represents the most natural progression from our current state (Assuming a Malthusian conspiracy is not unleashed to keep the masses in check).

One of the best facilitation tools in my toolbox relates to the anti-brainstorming. Here’s how it works:

1. Get your group to focus on what your product / process / thing would look like if it were completely broken.
2. Do this exercise out loud and be stunned at the high energy of the participants.
3. Control the energy by time bounding the exercise. Real the group back in by translating the “broken statements” into their inverse statements.

I want to the thank the company Rockwell for allowing me and my future groups to skip this tool for all future sales, communication, training video brainstroms. From now on, I will just show the following video ! I can’t tell if this is a sales video or “dirty talk” for electricians!

Rockwell Retro Encabulator