The Integrative Stream

More Windows Vista

Yes, quite on the blog lately. We just finished up PCHRI 2007, which was a not inconsiderable part.

An update on Windows Vista - last weekend I gave up and reinstalled Windows XP on my new home machine. I installed Google Desktop and TaskSwitch XP, and am essentially back to the same feature set as under Windows - except that the computer runs faster and doesn’t crash. And I can print multiple copies of documents.

We’re Hiring!

Want to work on Personally Controlled Health Records? We’re hiring at CHIP for the IndivoHealth team. The first open position is for a top-notch Java QA Engineer, who will be responsible for building an automated testing infrastructure for the Indivo API. We’ll be opening a few more positions over the next couple of months.

Indivo Jobs

Great working environment, close proximity to me, etc.

There just has to be a pony in here somewhere…

A few months ago my mother’s computer died. She got a new one, with Windows Vista on it. Since she’d been running Windows 2000 before, any new machine was going to have a new interface, and I suggested that she just go all the way to the “state of the art” and get it over with. A few weeks later I decided I needed to replace my home workstation, and bought a new system myself, equipped with Vista Ultimate.

I’ve been using it for a few weeks now, and have developed opinions. My initial impression was positive - cautiously so, but positive. The new operating system was peppy enough, but my new workstation has a top-of-the-line, quad-core processor and four gigabytes of RAM, plus the graphics card that ate Manhattan. To put things in some kind of perspective, the graphics board in this system has more raw computing power than my first five computers combined, and that’s without springing for the really fancy ones that the games use. And I didn’t have any of the installation issues people have reported, but then again, I bought the thing entirely preconfigured. It’s a Systemax from Tiger Direct, incidentally, and I’m actually quite happy with it - nice machine, well integrated, quick shipping, and not loaded down with demoware. They even tossed in a one year subscription to CA Antivirus, rather than the 30 day trial you usually get, and the whole package was well under $2,000, including a terabyte of storage, dual DVD drives and sundry other extras.

No, the problem is Vista. The new user interface is fine, and didn’t take that long to figure out. And the new windows are very pretty. The periodic crashes are not as pretty. It doesn’t happen that often while I’m working, but I frequently come back to discover my computer has reset itself. Others report similar experiences. Configuring external devices was also a challenge - my home printer is attached to a Windows XP system, and while I was able to get it working with the new Vista machine, it took several arcane networking moves to do it, including some driver updates (easy) and NetBIOS reconfigurations (not entirely obviously).

Then mom tried to print multiple copies on her Vista machine. It didn’t work. One copy came out. She needed about 150. This was not good. She clicked a lot, and asked me why, again, I had burdened her with this loathsome operating system? Subsequent research showed that many drivers for Vista don’t implement the full feature set for some older printers - like the four year old HP Laserjet 2200D she had. “Full feature set” apparently includes printing multiple copies. No solution has yet presented itself. I just tried printing multiple copies on my trusty Samsung - and no success.

So what do I like about Windows Vista? Precious little. To be fair, the design of the Windows Explorer interface has improved somewhat, and having search implemented in the operating system (albeit just like what I used to get from Google Desktop) is a nice touch. But they had better get that service pack out soon.

In Memoriam

Dr. Daniel S. Bernstein passed away earlier this week, at 80. Dr. Bernstein was an early and vocal supporter of fluoridation initiatives, an vocal peace activist, and an incredibly influential educator in the local medical community. I knew almost none of this. Dr. Bernstein was also my primary care provider for the last six years, and an incredible example of the best kind of patient care - a model that younger doctors may aspire to but are often prevented from reaching in today’s medical environment. Dr. Bernstein would spend as much time with a patient as they needed. He never cut a corner. He reviewed your previous notes before your visit, and always followed up. When you didn’t need to worry about something, he told you why, and when you did need to worry, he told you what to do about it.

I’ve been relatively fortunate with my health, but there have been a few incidents over the years, and that’s one reason I’ve always tried have regular checkups and good doctors. I was lucky to get into Dr. Bernstein’s practice at all - I only found him on the recommendation of one of my own mentors, who had been a student of Dr. Bernstein’s years earlier, and Dr. Bernstein took me into his practice (which, given his age at the time, he had closed to new patients) as a favor. Apparently that was fairly common - he always wanted to help, and, as his obituary in the Boston Globe points out, was still inquiring after his patients from his own hospital bed.

I’m not looking forward to finding a new doctor, because I doubt that I’ll be so fortunate in the future. Primary Care is in crisis; there isn’t a single open slot in any of the hospital affiliated primary care practices at the major teaching hospitals in Harvard Medical Center. Younger doctors don’t seem to have the opportunity to practice the kind of medicine that Dr. Bernstein did. Of course, Dr. Bernstein’s personality was a bit exceptional - he was clearly more than a product of his era! - but I can’t help but see an important policy question here. How can we create a system that will make more doctors like him?

Cost and Quality

I’ve been thinking a bit about what I want to continue writing about here (I’ve also been largely on the road for the past six weeks, including my move back to Boston from Washington). Still undecided. Here’s a link about the challenge of incorporating cost into decisions about healthcare coverage.

HealthAffairs: The Difficult but Critical Step of Adding Cost

Transparency in Senior Leadership

More on the role of blogging in business.

I’ve been thinking a lot over the last few weeks about the evolving transformation of consumer mentalities. Tools are changing. Will younger consumers expect a more transparent business environment?

Smokers Denied Surgery

Jason Shafrin looks at the story.

Links

• West on the Verge of a Medical Crisis - Daily Telegraph

The Content Concentration Process

I have a roughly half-hour interview for this article:

InformationWeek: Doctors Debate Giving Patients’ Online Access To Health Data

It got sliced down to one quote. There was some really good stuff there, too. The whole feature is a nice layman’s overview of current progress in health information exchange and electronic health record adoption.

Technology Review on Next-Gen Sequencing

A disruptive technology.

The Carnival of the Capitalists

As part of my return to full time blogging (after my stint in the Federal government), it is my distinct pleasure to host this week’s edition of The Carnival of the Capitalists. For those who aren’t familiar, the Carnival is a roaming weekly roundup of some of the week’s best blog entries on the subject of business. Good CoTC posts focus on the economy, business strategy, and the practice of management. The carnival generally does not focus on personal finance or job hunting, and posts must be substantial and original - not just a link and comment on someone else, or even on the latest New York Times story. In recent weeks, the organizers have tightened up the inclusion criteria, and I’ve done my best to maintain the high standards that the previous hosts have set.

This week ten entries made the cut, about a third of the total submissions. The last time I did this, I marked a few posts as Editor’s Choice. Under the new, stricter editing rules, I have a few favorites, but they’re all worth reading, and unlike last time you won’t need to spend all morning doing it. Without further ado:

Hiring and Firing

Wally Bock at Three Star Leadership explores how A “War for Talent” mindset can be hazardous to your company. Just because some consultants wrote a book about something doesn’t mean that it’s a good idea. Culture matters, a lot.

Communications & Branding

Aloys Hosman debunks “brand value” in Google most valuable brand. So what?. For what it’s worth, I think he’s right about Google’s brand - but I’m not ready to write off the idea of independent brand value just yet. But brand equity is way too easy to overstate. Almost as easy as it is to destroy.

I enjoyed Josh Dorkin’s description of his logo design process at Time For Blogging. Logos are not the most important part of a business, and we’d all prefer to be judged by the content of our offerings rather than the color of our web sites (with deep apologies to Dr. Martin Luther King). But customers, floating in a sea of options, need all the help they can get.

If I hadn’t been hosting this week, I’d have submitted Good Healthcare CEO Blogs, Bad Healthcare CEO Blogs, in which I compared the blogs of three healthcare industry executives, all of whom have recently adopted blogging. I liked two of the blogs; the third blogger left a comment which triggered Healthcare CEO Blogs, Revisited. So please enjoy my take on what makes a CEO blog, and also an example of a healthy, effective response to criticism.

Entrepreneurship

Silicon Valley Blogger presents 6 Ways We’re Managing Our Finances and Our Emotions While Starting A Business at The Digerati Life. Starting a company is stressful, risky and time consuming, and it’s important to make sure the whole family understands what it means, and is ready to sign on.

Wayne Hurlbert talks about The value of mistakes at Blog Business World. This isn’t new advice, but it’s worth repeating, and Wayne does a nice job presenting the message. If you aren’t willing to make mistakes, you’re unlikely to get everywhere. The plan never survives contact with the enemy, and the business plan (almost) never survives contact with the customers.

You have to love a blog about laundromats, and you have to respect somebody who spends his vacation time touring other people’s laundromats. And some pricing lessons are universal. The Laundry Capitalist contributes Price Wise - Is your Laundromat Keeping Up with the Times? Hint for readers: it doesn’t have to be a laundromat.

Politics and Economics

Jack Yoest sat down with the Administrator of the US Government’s General Services Administration, and the result is a great post entitled How To Cut The Federal Budget at a Government Agency by Lurita Alexis Doan at Reasoned Audacity. A warning: the preamble is a little political, and I include the post without endorsement either way. The meat of the post is insightful and - speaking as a former employee of the Federal Government - spot on. I’ll likely comment on this post further later this week.

For Earth Day, Sean Hackbarth presents The Environment’s Best Friend: Economic Growth at The American Mind.

And the rest…

Tongue firmly in cheek, Ironman presents The Coming Global Trade Superstorm at Political Calculations. Those pesky polynomial expansion models. Actually, you can read this one two ways.

David Aron submitted Gliese 581c and Interstellar Capitalism at The Capitalist League. I had to include this one because of the line “alien societies may be genetically predisposed to socialism.”

That’s it for this week; thanks for visiting, and remember to tip your server. Next week’s edition will be at Race in the Workplace, and you can sign up for email announcements at The CoTC Home Page.

Healthcare CEO Blogs, Revisited

A few days ago I wrote a post on Healthcare CEO Blogs, in which I expressed my disappointment in Steve Case’s Revolution Manifesto blog at Revolution Health. My main complaint was that it simply wasn’t all that interesting, particularly compared to two of the other (arguably) most prominent CEO blogs in the healthcare area.

In this case, disappointment was a function of expectations. I heard Hillary Clinton speak at Yale shortly after she was elected to the Senate. I know she has interesting things to say - on the dynamics of Washington, if nothing else - but she was playing things safe and her speech was boring. My reaction to Case’s blog was similar. Here’s a very smart guy, who built one of the iconic late 20th century companies and is now taking on a very complex healthcare industry. That’s a recipe for interesting discussions, provided one has the time and inclination to go ahead with actually producing the content.

I was up in Boston for meetings much of this week, and when I finally got back to Washington yesterday morning I was somewhat surprised to see a comment from Steve Case. Even more surprising was that he concurred that the blog had been a little dull of late. He also confirmed that he did, in fact, write it himself, and fair’s fair, so I apologize for the insinuation that he didn’t. Reading my RSS feed this morning, I saw not one but two new entries in the blog–and they’re increasingly interesting. I’m not so hubristic as to actually take any credit for this, since with the launch of the Revolution Health web site I suspect he has some more time on his hands.

So what’s the wrap-up here? I’m not entirely sure. The response to my post was spot on, if not necessarily economically efficient given that I’m the definition of micro market media. I’m looking forward to reading Case’s blog over the next few months, and hopefully learning something. And my advice is to follow Levy and Baker’s examples: write about whatever is interesting, wherever you have a unique insight, and without obvious spin - better to admit you can’t write about something than to write about it disingenuously (not that I’ve observed such in this case). The combination builds traffic, but it also builds trust, and trust is a vital corporate asset, especially in healthcare.

Good Healthcare CEO Blogs, Bad Healthcare CEO Blogs

CEO blogs are arriving in the healthcare space. One of the best is by Paul Levy, at Running a Hospital. Levy is the CEO of the Beth Israel-Deaconess Medical Center here in Boston. The blog is informative, candid, well written, almost obsesively frequently updated, and has caused quite a stir in the Boston healthcare community. Another local CEO healthcare blogger is Charlie Baker of Harvard Pilgrim, one of the major Massachusetts health plans. He’s posted some interesting points about healthcare costs, and the discussions in the comments have been both high minded informative. I’ve met Baker in person, and he’s an engaging speaker on issues of healthcare cost; the blog is just as interesting.

Are Levy and Baker using their blogs to drive business to their respective organizations? Not really. Levy seems to be using his as much to drive change within his own hospital (and, perhaps incidentally, the wider Boston healthcare environment). I suspect the staff members appreciate his candor. Baker’s blog is newer, but people don’t make health insurance decisions based on the CEO of the health plan; it seems that what he’s trying to do is engage constructively with the larger healthcare policy debate.

I’ve learned a lot from reading those two blogs. I’ve learned nothing from Steve Case, who is trying to lead a “Revolution” at Revolution Health. He has a blog called “The Revolution Manifesto”, which contains the occasional announcement of new features and expressions of his pride in the team that’s built the web site. I’ve learned nothing from it in the several months that I’ve subscribed to the RSS feed. I’m by no means convinced that he’s actually writing it, and I certainly haven’t come away with any new insight into the healthcare industry or his company itself. If that’s your CEO blog - let alone your Manifesto - perhaps it’s better not to bother.

And I’m back!

Friday was my final day as an employee of the Federal Government. I never did hear back from the ethics department about what I could blog on - and not blog on - without approval, so I played it conservative over the last ten months and ended up blogging very little. While there are still a few areas I feel obligated to avoid (and you’ll have to wait for the autobiography to hear the tell-all bits), as of this week I’m going to start getting back to the blog on a regular basis.

To start with, on Monday I’ll be hosting The Carnival of the Capitalists. For a sneak peak, check out this week’s CoTC at The Geek Practioners Blog, then come back Monday for the finest in business blogging, as selected by me. And there’s more to come.

Cultural Context

Research indicates that cultural context is the key to reading facial expressions. Anybody who has tried to do business abroad has encountered this. What I didn’t realize is the extent to which this tendency extends to the Internet. Specifically, emoticons. The American “Happy” emoticon is (extra space to keep the blog from turning it into a pretty picture):


: )


Wherease in Japan:

^_^

Business Networking

It’s a few months old, but I just came across a neat post from Businesspundit: How To Network: For Introverts.

I like Rob’s insights, particularly since we share a similar background. Some people reach out automatically. I think the magic trick, for them, is that they’re utterly unafraid that somebody will say no. I’d say it’s equally important to respect the other guy’s (or girl’s) judgment - if they don’t have time for lunch, they’ll tell you. Invitations are not impositions, or at least they shouldn’t be.

Here’s another thought - connections exist to be used, and there’s nothing wrong with using them on someone else’s behalf.

Control What Can Be Controlled

Case study of the day: sometimes it all works out. Airlines, hotels and travel web sites are not always known for stellar customer service, but sometimes a company just gets it right.

For example, hotels in London. I’ve had a checkered history with my London hotel reservations. I used PriceLine once for a two day stay, and ended up with a nice rate at a nice hotel in Kensington. The hotel seemed to have regretted giving me that rate, since they decided I was only there for one night and, while I was at dinner, cleaned out my room and rented it to somebody else. I discovered this at about 2:00 in the morning. If I hadn’t printed the receipt I might not have gotten into the one remaining room.

My cousin is getting married in London in May, so my entire extended family is converging on the city. My mother took on the task of coordinating hotel reservations, and booked a nice hotel through LondonTown, a London tourism web site that has a better selection of hotels available than Expedia and its ilk. However, through a (family) miscommunication, my reservation ended up a day short. I noticed this today, and emailed the hotel, who told me I had to go through the web site.

Here’s where it got interesting. I looked back at the confirmation email, and it had the name of a real person, rather than “reservations” or some other generic name. So I sent her a note, attaching the original confirmation and asking if they could extend it a day. They are in London, I am in Washington. Regardless, within five minutes my cell phone rang, showing a +44 country code in caller ID, and a very polite fellow named Paul, who had all of the information about my reservation available, was on the line from the web site. He gave me my options (including realizing that, due to rate changes, I could now add breakfast to my reservation for about two dollars), and even called the hotel back to see if they could extend my reservation at the original rate. It ended up being a few dollars more expensive, but I got the impression he’d tried to save me as much as possible, and since the original reservation was in January a rise of a few dollars is acceptable. Within a few minutes everything was resolved.

I found the whole interaction fascinating. They called me from England! That’s service, particularly compared with my prior experience of getting kicked out of my hotel room. I may not end up liking the hotel, but I like the booking process, and I’ll use them next time I need a London hotel room. As a bonus for LondonTown, I’m writing it up here.

There are a couple of generalizable thoughts here:

Control what you can. Booking web sites don’t have any control over the hotel. I haven’t used PriceLine since the Kensington Incident, and not because of anything they did - the hotel miskeyed the fax. This has happened to me before, with an Expedia booking, but since it was detected at checkin and the hotel made good on it, I wasn’t put to any trouble and it didn’t stop me from using Expedia in the future. In that case, the Holiday Inn saved Expedia’s reputation. In the PriceLine case, I never did get my razor back.

Even if they can’t control the hotel, the web sites can control the reservation experience, and that’s what LondonTown did well. They were proactive; I’ve never, in my life, gotten a call from an Internet based company to resolve an issue. The closest was a call to confirm my credit card number. I’ve been told to call (and to wait on hold), but I have never been called until now.

Personalize the experience. LondonTown gave me a name to connect with. It wasn’t the person who actually called me back, but if made me feel like I was interacting with a person who could help me, rather than a faceless call center. Given how quickly the callback occurred, I wouldn’t be in the least surprised if everything that goes to that address is automatically parsed out, and there isnt’ anybody with that name at the company at all. It doesn’t matter; mission accomplished anyway.

Use technology to change the offering. I’m old enough (barely) that I remember when calling internationally was a pretty big deal. That’s not true anymore, and it’s just as inexpensive for the call center in the UK to call me in the US as it is to call a fellow Briton, give or take a few pence. Most of it is probably routed over the Internet. The low costs mean that the authority to pick up and call someone in the US can sit at the lowest level of the organization. And getting that call, for an American trying to book a room in London, is a real time saver.

Think about the whole package. If I hadn’t needed to rebook, I wouldn’t have any particular memory of this company. I didn’t even make the original reservation myself. The “high touch” rebooking was a chance to make a sale (after all, I was adding an additional night, and London hotels aren’t cheap), but it was also a chance to cement future sales. I’ll use them again. This kind of thing is even pretty easy to measure - just look at the repeat customer rates among people who have interacted with the call center and those who haven’t. If they’re not collecting these metrics, they should be.

TaskSwitchXP

Download of the Day: TaskSwitchXP (Windows)

Via LifeHacker.

This is a great utility; I installed it about fifteen minutes ago and already don’t know what I did without it. One of the great things about Mac OS X (and, apparently, Windows Vista) is toolset that allows you to easily deal with multiple windows. This tiny little utility gets you most of the way there without shelling out for the Windows upgrade (and the new computer that goes with it). When you hit Alt-Tab on keyboard rather than the unhelpful array of Windows icons you get little thumbnails and full window titles. If you have a lot of windows open, you can use the mouse to quickly select from the list. It seems to do some other things too, which I haven’t played with yet.

Drop out, Start Up, or Live Your Life