Such was the case yesterday when we were joined by former Beth Israel Deaconess Medical Center CEO Paul Levy. Paul was the inaugural speaker at our internal “All That and a Bag of Chips” speaker series sponsored by Eliza’s Product Management team.

The idea for the series was born from the theory that “a rising tide lifts all boats.” The goal of the initiative is to make available to the organization some incredible thought leaders and subject matter experts from both within Eliza and beyond to deliver short (45-60min) presentations about topics intrinsic to the business that we’re in.

This was certainly the case with Paul’s presentation focused on leadership; specifically how it applies to healthcare. Paul’s perspective centered around the topic of his new book “Goal-Play!” . For over the better part of an hour Paul captivated a diverse audience across the Eliza universe discussing such heady topics as:

• The number of PREVENTABLE deaths per year in US hospitals—100,000(!)
• The moral and ethical obligations of healthcare leaders to bring about positive change in the healthcare system
• How effective leadership is about the long view…always

More than these though, Paul talked about HOW you make this happen. This is not mere intellectual exercise. This is about mastering your own corner of the healthcare world and using your abilities to bring about effectual and positive change.

After the meeting the feedback from the attendees was almost unanimous in its context. (A) “Wow…that guys is inspiring!” and (B) “How do we translate this message here in what we do?”

We are all up for the challenge.

First, I want to thank you all for the well wishes on the marathon journey “from hell.” It’s not often in life that we are tested beyond what seems to be limits we didn’t realize existed. Sure, we may have a rough week at work, our kids may drive us to the point of slight insanity, our spouses may occasionally make us wish for our single days – but there are rare days in life that I’ve been faced with a challenge that I honestly did not know if I could conquer. Last Monday, the Boston Marathon, was that day for me.

As we made our way to the start at 10:40am, the temperature was already well into the high 80’s and there were no breezes to be found. I stood in my corral like a sardine packed in a hot oven, but had Tedi Bruschi right in front of me (and yes, I totally touched his shoulder for luck) and tried to ignore the weather and take in the absolute glory that starts the Boston Marathon.

Spectators were singing and cheering, my friends were screaming my name and I felt like an Olympian entering the arena with tears streaming down my face as I crossed the Start line. For about half a mile I was running on air. Then, everything quickly changed - as my body heated up, sweat started pouring down and my heart rate was much too high for just under a mile, I realized this wasn’t going to be an Olympic performance, this wasn’t even going to be an average bad running day, this was going to be really really HARD.

At about Mile 3, I slowed down to a quick walk to re-evaluate my plan. I realized that any time goals were going to be out the window so this day was about one thing – my children waiting for me at the finish on Boylston Street and making sure I got there for them. No matter how long it took me. Because mommy was running the Boston Marathon and being in a med tent or an ambulance or being carried down Boylston Street in front of them was not an option for me. Mommy needed to be a warrior.

So, taking the Boston Athletic Association’s recommendation to “think of it as an experience, not a race” words to heart – I moved forward. By Mile 5, 75% of the runners around me were already walking. By Mile 8, people were on the side of the road getting sick or just sitting with their heads in their hands. At Mile 10, three people in front of me completely collapsed to the ground mid-stride … and that happened more and more frequently as the miles went on. But I kept looking forward, kept trying to smile and high-five every child on the side of the road cheering – trying to ignore the complete and utter fear in my heart.

At the halfway point, my charity, Franklin Park Coalition had a tent set up. One of my teammates was already there and sobbing. But I was so happy to see people I knew I couldn’t stop smiling and joking – trying to ignore the chaos that surrounded us. They commented on how calm and happy I looked – this was funny, inside I was a disaster.

I took off and at Mile 15, took out my phone and called my coach, Mike Toomey. I told him that I was okay, but I was going really slowly and not to worry because finishing was more important to me now, and I was scared at what would happen if I went any faster.

The temperature was now over 90 degrees and at NO point in the course was there shade. The pavement seared as I walked on it…in fact, my only physical issue that day were huge blisters on the balls of both feet, and I know they were caused by the scorching streets, not from running.

At Mile 20 – all alone it seemed on the road at this point, I heard a small voice behind me say “Please tell me that’s Paula Renzi Gibbs.” Thinking I could indeed be hallucinating, I turned around and there was one of my good friends, Kennedy. Sad, cramped and alone, she was ready to throw in the towel.

Something inside of me charged up – I told her, there was NO WAY we were not going to finish this, we would walk the rest of the way together and somehow, someway, we were going to do this and cross that finish line together. I would have thrown her on my back if necessary. I believe some higher power led us to each other that day – because without each other, I’m not sure how or if those last 6.2 miles would have happened.

When we turned onto Hereford Street, a group of my local running friends came flying down the middle of the street cheering “RENZI!” in their flip flops. They told me to start running and before I knew it, I had taken the corner onto Boylston – somehow running again. Another group of my friends came running out into Boylston to hug me and I just kept saying “I can’t stop, I can’t stop.”

Then, I had the most beautiful sight of my life – my two children, Alec (9) and Lana (6), running onto Boylston street towards me, each grabbing a hand and saying “Mommy – we are going to run you across the finish!!” And there we ran - me, my children on either side, my friends next to them screaming my name, running down Boylston with cheers of “Renzi” from the crowd – and once again, I felt like an Olympian.

And before I knew it – we crossed the finish. With tears streaming, I’ve never hugged my children so tightly. Last Monday, I WAS a warrior.

Thank you so much to everyone for your thoughts, prayers and support – what doesn’t kill us, does indeed make us stronger.

We hope the below guest post by Nathan will inspire you to think about those tough conversations we should all be having with our loved ones about an uncomfortable but important topic – planning for when we die. And we hope you’ll pass it on.

Are you one of the 80% of Americans who haven’t completed an Advanced Directive yet? We’ve all struggled with how to get started on this topic – and there are plenty of reasons why we resist:

• Fear
• Uncertainty
• Not sure how to start
• Don’t know what’s legally binding
• Worried I’ll hurt someone’s feelings
• Just haven’t had the time to do it

That’s why we recognize April 16 as National Healthcare Decisions Day (NHDD) – a movement designed to inspire, educate, and empower the public and providers about the importance of advance care planning. Put another way, NHDD is a day for all adults to mark their calendars, have the talk, and document the talk with an advance directive.

Even if you’ve already had these conversations, you might find inspiration in this awesome three and a half minute video at http://www.nhdd.org/. It’s proof that it takes only a few minutes to start a conversation with your loved ones about advance care planning—a conversation that affects people for a lifetime.

After the goosebumps settle down from watching the video, here are some specific things you can do for NHDD:

• Lead by example. Schedule time with your loved ones to “Have the Talk” and complete your own advance directive. There are many tools, including free forms, you can use to walk you through the process and make your wishes known; access them through the NHDD Public Resources page.
• Encourage your loved ones and friends to learn more about advance directives and to complete their advance directives. You can forward this link: www.nhdd.org.
• Share your advance directive with your healthcare providers and make sure it is on file in the event it is needed.

Already had the conversation with your loved ones, but want to do more? Here a few suggestions to rally support for NHDD and encourage even more action:

• Like the NHDD Facebook fan page and share it with your Facebook friends
• On Twitter? Follow @NHDD and share the information with your followers, such as: It’s National Healthcare Decisions Day - when will you have the talk? @NHDD
• Share NHDD with your professional contacts on LinkedIn
• Send an email to your friends, staff, colleagues, lodge/social club members, and/or house of worship, telling them that you are participating in NHDD and encouraging them to do the same.

Advance care planning is something we ALL should do and encourage others to do, regardless of age or current health. Discussing your wishes can be one of the most important gifts you ever give your loved ones.

Please use and share the resources available through the NHDD website and encourage and empower us all to make our healthcare decisions now for whenever they will need to be known.

Nathan Kottkamp
Founder and Chair
National Healthcare Decisions Day

The content has been good so far, but one snippet really caught my attention. It was during Tawanda Holmes’ presentation titled Performance Audit: 2012 Process and Strategy. Tawanda is the Director, Division of Compliance Policy and Operations within the Center for Medicare, Program Compliance and Oversight Group.

She was explaining that CMS is actively looking at the correlation between 5 STAR performance and audit outcomes. They noted that plans that achieve 5 STAR ratings also tend to do very well during the audit process. During the presentation, Tawanda interjected an interesting observation (a.k.a “the snippet”) regarding a common thread that runs through all 5 STAR plans.

She noted that in every case the top performing plans used proactive communication to engage with their members. She mentioned an outreach to members whose prior authorization ran out as one of many possible examples.

Clearly the implication here is that proactive outreach has a positive impact on the operational aspects of running an Medicare Advantage plan (hence the reference during an audit presentation), but can you imagine the positive member experience that is created too.

Think about the size of the potential impact if these proactive communications are delivered in a way that is supportive of the brand with an eye toward building satisfaction and loyalty! Not only do you reap the rewards of operational performance gains, you also ring the bell on “member satisfaction with the plan” and a whole host of other CAHPS measures.

If you’re not already doing it, it might be time to look at these types of member touch points… and if you’re reading this, you’ve come to the right place. 

Ask us how we can help.

It’s been a wild two years as the entire healthcare system has scrambled to adapt to the new requirements that were immediately enforced, while preparing for the monumental shift on the horizon in 2014.

Of course there have been challenges along the way.  In fact, the Supreme Court began hearing arguments this week for a legal challenge to the constitutionality of the core aspects of the law.  Much of the “teeth” associated with ACA will be dependent on the outcome of the Supreme Court ruling, but the impact of ACA has already changed the way our whole country thinks about healthcare.

Case in point: I’m sitting at a restaurant in the Chicago O’Hare airport listening to a friendly debate between the bartender and several patrons about healthcare and, as one patron put it, the “un-funded mandate of healthcare reform.”  I don’t think I ever would have imagined a scene like this… especially in the middle of March Madness when everyone in their right mind should be talking about basketball when sitting in an airport bar.  To think that healthcare reform trumps NCAA basketball is a testament to the far reaching impact healthcare reform has on our lives.

Whether you’re for it or against it, healthcare reform is giving us – and our clients – the chance to address consumers in fresh ways.  The expanding rolls of Medicaid plans and the monumental shift to a consumer-centric approach is changing the way millions of people will interact with the healthcare system.

It may not be a slam dunk, but it’s a game that will be well worth the hustle.

Melodramatic perhaps, but now more than ever healthcare organizations are working to inspire the kind of loyalty that people have for their favorite consumer products, if not quite their household pets.

The fruits of these efforts come to bear in the things like SatMetrix’s recently-released 2012 Net Promoter scores for health insurance plans.   Net Promoter is a well known industry measure that captures a customer’s willingness to recommend a product or service to others.  Sure it’s got its critics, but you could argue that it’s a decent proxy for loyalty and customer retention – since most of us wouldn’t recommend a product or service we didn’t like ourselves, and if we like it, we probably aren’t around the market to find something better.

As you can see, while folks like Kaiser Permanente lead the industry, the health insurance industry in general lags behind other markets – there’s plenty of work to be done to change how people feel about their health plans.

While there’s no silver bullet for that specific challenge, we do believe that plans that operate with an eye towards improved Health Engagement Management can help boost satisfaction ratings like this Net Promoter score, with retention as the enviable by-product. In fact, our analysis has shown a strong correlation between the engagement indices that we capture and third-party measures like Net Promoter.

Health plans may never be as beloved as the latest Apple product, but the way the healthcare market is moving, they’ll need to find some way to inspire that same kind of loyalty.

Woof!

It’s a strategy that’s worked wonders for certain web-based companies that have made themselves household  names for anyone looking to follow their friends’ activities or buy a book (check out this article for more on this point).

And just as Silicon Valley style companies will become experts at designing user habits, so are we trying to do the same with health habits, through our own brand of health engagement management.

For our clients, that means things like using fresh, relevant approaches (for example, a recent outreach that reflected what we know about what really makes a person tick when it comes to behavior saw that these segmented approaches far outperform general messages when it comes to driving behavior).  It means using well-timed outreach to enforce better habits… such as a text message that offers a healthy snacking tip just when that 3:00 slump rolls around. And it means having a systematic way to gauge the impact of these messages, and apply these insights to create even more meaningful outreach that builds even stronger habits.

For personal selves, it means things like being more mindful of our eating (check out this article for more on that). It means not leaving the office until all the pens on our desk are stowed and piles of paper are filed (even if the jury is still out on whether a clean desk is a sign of a focused mind). And it means learning that simply getting into the habit of making the kids’ lunches the night before makes it 100% easier to get out of the house and to the gym early the next morning.

So which new habits have you picked up lately?

“Once in four years, just once, perhaps we could:

Forgive, forget, relax, care, stand out, speak up, contribute, embrace, create, make a ruckus, give credit, skip, smile, speak truth and refuse to compromise–more than we usually do. Pick just one or two and start there.

Hey, it’s just one day.

Careful, though, it might become a habit.”

It’s a smell that inspires excitement, and it’s in the air as Eliza prepares to move into our new home this weekend.  So update your records – as of February 21 our new address is:

75 Sylvan Street, Danvers MA 01923.

Our phone numbers and email addresses haven’t changed.

We’ll fondly remember a lot of “firsts” that have happened over the past 11 years we’ve spent at 100 Cummings Center… such as installing our first data center, whose call volume essentially made us into a decent-sized phone company; the first (and second, and third, and 12th) time we were able to smash through the walls to take over additional office space as we grew; the first time we got a set of matching chairs. And of course – and most importantly – every time we won over a new client or developed a brand new program aimed at improving people’s health.

Our new office will support the hijinx that makes us who we are, while giving us room to grow. But it will also keep sacred the things we love about our old space… to collaborate freely, to celebrate what works, to learn from what doesn’t, and to always remember the greater vision – to help people be happier, healthier, and more productive – and have a dang good time along the way.

And we just know it will suit us well as we continue to support increased Health Engagement Management for you and the people you serve.

Watch this space for pictures!

5. Hearing how we make a difference in people’s lives

Just about every day we hear people telling us – in their own words – about the impact that Eliza outreach has on their lives. Here are a few randomly chosen examples from today (and yes, we realize that we are blessed to be able to be able to just randomly choose a few comments of the day that are as goosebump-inducing as these):

“Thank you very much for this message. I wrote down everything that she said and I do know I’m overdue for both of those so…this is the little kick I needed to take this to heart and follow-up with this stuff so I will go make my appointment. Thank you and have a good day. Bye-bye.”

“Thank you very much for providing this helpful information in Spanish which is my first language. Thank you very much. Goodbye.”

“Ma’am I think the reminder is great and I am really satisfied with [Health Plan name]. I am very thankful to God and I hope you continue doing this.”

4. A magical playground for analytics geeks

So. Much. Data.

3. You never know when your work will be interrupted by something fun

Your fearless leaders sumo wrestling? A company-wide email that gets everyone brainstorming ideas for the perfect analogy to use as part of a big presentation? Beer Friday? In some ways it’s a wonder we get anything accomplished – but as it turns out, these are exactly the kinds of distractions that keep us running strong and working as a team. Because really, you can’t help but share an inside joke once you’ve collectively experienced the singing clown.

2. Amazing, innovative, creative, unstoppable, even brave colleagues

Most of the time those adjectives describe how we approach our work, but once in a while we can’t help but be amazed at some of the creative ways that our colleagues address life challenges – as illustrated by this lightly censored email exchange by members of our senior management team:

1.Good karma

There’s just got to be some positive payback in working so hard to positively impact how people view and manage their health. So to all our clients and partners and supporters, we thank you for joining us on this wild ride.

Here’s to happy, healthy, and prosperous new year!

It may not come as a surprise to many, but it is worth thinking about, especially for those of us in the business of trying to engage people in conversation about topics beyond field trip permission slips – such as how we care for our health.

At Eliza we do a lot of looking at different population segments and developing messaging that will resonate based on key characteristics – from traditional socio-demographic things like lifestage, gender, region, and clinical conditions as well as more unorthodox markers that get at people’s motivation, behaviors, and attitudes around their health.

Beyond this, there are these ‘lifestyle’ categories – like the bleary-eyed new mother trying to keep it all together – that also inform the way we approach and engage. We know that talking about whether or not you’ll get that recommended mammogram, or why you’re not refilling your prescription, or your satisfaction level with your doctor might be last on your list of things to do.

But it’s important to acknowledge these realities that exist in the lives of the people we’re reaching out to. So we design our interactions accordingly. And if we can get through to you before the pasta boils over on the stove, and get you to really think about why you can’t put off that preventive screening any longer, and if we can actually help you cross one thing OFF your to-do list by transferring you in real time to schedule an appointment, then we will have helped.

As for mountain of dirty laundry piling up, it can wait another day. And believe us, we empathize.

*percent of US population that’s female according to 2010 US Census data

A trite expression, often a figure of speech whose effectiveness has been worn out through overuse and excessive familiarity.

Cliché #1 - When it rains it pours
Saturday starts with a trip to the ER because I can’t stop coughing, was diagnosed with a viral infection, got to the 24hour Walgreens, but the technician on duty went home sick and they can’t fill prescriptions until later. It’s literally pouring rain outside and I look out and the sprinklers on the front lawn are running, while the neighbor is writing the infraction down in her notebook. All I want to do is lie down, but when I get into the bed the dogs have brought in their favorite toys from the backyard, which are wet and covered with mud and they are playing with them under my sheets.

Cliché #2 - People in Glass Houses Shouldn’t Throw Stones or That’s the Kettle calling the Pot Black
My job entails dispensing advice and guidance to people on a regular basis. Sometimes the lines between personal and work life blur and people seek out my help on a number of issues. I am well known for telling people to take care of themselves, how important their health and welfare is above all else, etc. My yearly check-up this week included the news that everything was too high - weight, blood pressure, cholesterol - and even though my life resembles an HBO sitcom, I’m advised that I have to take care of myself.
Hypocrisy is extremely enlightening and powerful. Time to get back on the treadmill and get rid of the Coke.

Cliché #3 - It’s Just a Midlife Crisis
Nope - the divorce papers came in the mail today and it isn’t just a new car or new girlfriend that my ex-husband is looking for. It’s a new life. I guess that’s why my ipod is filled with break-up songs that I sing at the top of my lungs. Not to recite another cliché but what doesn’t kill you makes you stronger. I was also reminded by a very smart woman (known around here as Alex) that I will look back and be grateful and realize that everything that has happened has made me into the person I am today. Not quite there yet, but am feeling like I am on that path.

Cliché #4 - The Acorn Doesn’t Fall Far from the Tree
Today I listened to my 13-year old daughter explain to me that she wants to live with her father full-time because I am mean and rude and send her to her room and he doesn’t. Hmmm, am I the only adult here? The look on her face is one that I know well, and I know where she got it from. It took every ounce of strength I had to not get angry and understand that she is hurting as well. I need to think of her well-being right now, and if that means not trashing her father, and letting her spend more time with him, that’s what I will do. It’s not easy being an adult.

Cliché #5 - When the Going gets Tough, the Tough Get Going
For the first time in my life I finally, truly understand this and have made it my new mantra. For every crappy thing that happened this week, there were at least if not more positive things that happened as well. Why do I focus on only the negative? Why does anyone? Because it is easier - it actually takes more effort to be positive. Now don’t get me wrong - I spent hours crying (and singing break-up songs), but once I did that, I began to really think things through and started to formulate a plan.

Just doing that, coming up with actionable items that would start me working on my clichéd life, to improve it, made a huge difference. Inaction is debilitating in so many ways. What else did I do? I donated money to the local pet shelter, took my dogs for a walk, and signed up to be a Big Sister. On my way out now to buy gifts for my godchildren that I will surprise them with tomorrow.

I think I have turned that frown upside down!!!!

We recently had the pleasure of learning from someone who’s been there, done that, so to speak – Rosemarie Day of Day Health Strategies.

As the founding Deputy Director & Chief Operating Officer of Massachusetts’ health insurance exchange (the Commonwealth Health Insurance Connector Authority), Day played a significant role in launching the first state-run health insurance exchange in the United States.

Given this experience, she knows what’s needed to compete and win in the exchange marketplace. In fact, she is currently consulting to over half a dozen states and numerous private companies on health insurance exchange implementation.

She sat down with our own Marc Jeffreys to talk about discussing the state of the exchanges today, learnings so far, and how consumer engagement and satisfaction can drive a competitive conversion strategy.

To listen in, just register here to gain access to the recording.

Seems almost more fitting than usual this year – the year of making change happen. 2011 gave us the Arab Spring – people on the ground using social media to organize a real political revolution. And now – love it or hate it – it’s the Occupy Wall Street movement that’s got people talking.

Smart people (like our good friend Susannah Fox) have made the point that unlike those political and economic movements, our mission isn’t an issue we need to raise our fists about…it’s an issue we have the luxury of being able to hold hands about.

It’s a mission that’s driven by all the personal stories we’ve heard of people who’ve seen their loved ones suffer unnecessarily at the end of their lives.

It’s driven by that ripping-off-the-band-aid feeling of relief you get when you’ve finally broached the subject of end of life wishes with your family, free from the burden of just not knowing what they’d want for themselves, and knowing you could advocate for these wishes if your loved one weren’t able to speak up for themselves.

And it’s driven by knowing that this is a conversation that needs to happen early, and often. One of the greatest gifts you can give the ones you love is making sure you’re all on the same page. In the words of the amazing Atul Gawande – you only die once! Die the way you want. Make sure your loved ones get that same gift. And there is a way to engage in this topic with grace…

Here are the five questions – read them, consider them, answer them (you can securely save your answers on the Engage with Grace site), share your answers with your loved ones. It doesn’t matter what your answers are, it just matters that you know them for yourself, and for your loved ones. And they for you.

We all know the power of a group that decides to assemble. In fact, we recently spent an amazing couple of days with the members of the Coalition to Transform Advanced Care – or C-TAC – working together to channel so much of the extraordinary work that organizations are already doing to improve the quality of care for our country’s sickest and most vulnerable.

Noted journalist Eleanor Clift gave an amazing talk – finding a way to weave humor and joy into her telling of the story she shared in this Health Affairs article. She elegantly sums up (as only she can) the reason that we have this blog rally every year:

“For too many physicians, that conversation is hard to have, and families, too, are reluctant to initiate a discussion about what Mom or Dad might want until they’re in a crisis, which isn’t the best time to make these kinds of decisions. Ideally, that conversation should begin at the kitchen table with family members, rather than in a doctor’s office.”

It’s a conversation you need to have wherever and whenever you can – and the more people you can rope into it, the better! Make this conversation a part of your Thanksgiving weekend – there will be a right moment – you just might not realize how right it was until you begin the conversation.

This is a time to be inspired, informed…to tackle our challenges in real, substantive, and scalable ways. Participating in this blog rally is just one small – yet huge – way that we can each keep that fire burning in our bellies, long after the turkey dinner is gone.

Wishing you and yours a happy and healthy holiday season. Let’s Engage with Grace together.

To learn more please go to www.engagewithgrace.org. This post was developed by Alexandra Drane and the Engage With Grace team.

My parents spent time every morning and night doing hip exercises with my chubby little legs to try and groove out the sockets that so that I would have a chance of walking correctly.

As I learned to walk, the brace and treatment seemed to have done their magic. In fact, starting at age 6, I took dance for almost 20 years.

But running was never something I was able to do without pain or just frustration at how slow I was. My legs just did not move in any way that they should to make me an effective runner and no matter how much I tried, I couldn’t get past a mile without stopping.

I wanted to be a runner so badly - one of my biggest goals was to run a marathon…so much so that I would watch the start of the Boston marathon on TV each year with tears running down my face.

Last year, just to see, I joined a beginners running clinic in Salem, MA with the hopes that maybe one day I could learn to run 5 miles without stopping and without pain. The first clinic, I was doubled over gasping for air after running the first 100 meters.

But slowly, I learned how to run a 200 meter sprint. And then a 400 meter sprint. And then a mile. And then last Thanksgiving, I ran my first 5 mile race and didn’t stop once.

And something in my head clicked that if I could learn to run 200 meters and I could learn to run 5 miles, I could, maybe, just maybe, actually learn to run a marathon.

In January of this year, I was offered the opportunity to run the NYC Marathon and raise money for the local autism non-profit, For Jake’s Sake. Armed with who I personally feel is one of the most gifted and amazing running coaches around, Michael Toomey, along with a fabulous running Club in Salem (Wicked Running Club) and the support of my family – I set out with 100% determination.

On November 6, 2011, I finished the NYC Marathon with not an ounce of pain, in a full on sprint for the last mile and my heart glowing out of my chest.

I don’t share this to brag but to tell anyone who doubts or believes they have what it takes to reach a physical goal that I am proof positive it goes far beyond physical ability.

It’s that sometimes - reaching your goals is 99.9% all about the strength of your heart.

I thank everyone at Eliza who showed such great support during this journey with me. Next up, I’m taking on the Boston Marathon on April 16!