Presentation at Midwest HIMSS conference, Fall 2008

1. Setting Healthcare IT Strategy in a
Web 2.0 World
October 23, 2008
Presentation to Midwest HIMSS
David Oakley, Florida Hospital
Marc Danziger, The Revere Group
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

2. Actually, There IS a Web 3.0
• It’s about using “the semantic web” to
structure information
• You have to have Web 2.0 first
• So we’re going to talk about Web 2.0 today,
and that will open opportunities for learning
about and using Web 3.0
• See! It wasn’t a typo – it’s a future learning
opportunity!
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
2

3. Intro
• In late 2007 Florida Hospital hired The
Revere Group to assist in their portal strategy
and requirements
• This is what we both learned
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

4. Speakers
• David Oakley
• Marc Danziger
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

5. David Oakley Bio
• Manager or eHealth Strategies at Florida
Hospital
• Marketing with IT “in-the-blood”
• Launched several award winning websites for
Florida Hospital including
GlobalRoboticsInstitute.com and
DisneyChildrens.com
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

6. Marc Danziger Bio
• Revere’s National Competency Leader for Social Media
and Web 2.0
• Involved in online systems since 1993, when he
founded a BBS-based commercial real estate system
• Has worked and consulted for pioneering Internet firms
including CarsDirect.com and Physicians Online.
• Has cofounded four startups, two of which currently are
active and profitable – Pajamas Media and
ExposureManager.com
• Has advised clients including Fast Company and Inc.
magazines, Manpower, Florida Hospitals, NBC-
Universal, United Health, and Veterinary Pet Insurance
on social media strategy and implementation
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

7. Who is Florida Hospital?
๏ Faith/Mission Based
๏ Services
๏ 2,100 Beds
๏ 8 Orlando Campuses,18 Urgent Care
Centers, Health Plan, Home Health,
Ancillary Services
๏ 1,000,000 Patients Served
๏ 107,000 IP
๏ 350,000 ED
๏ Clinical Initiatives
๏ Global Robotics Institute
๏ Disney Children’s
๏ New Heart Tower
๏ Diabetes - With Biotech
๏ Advanced Surgical Launch
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
7
6

11. Where Are We Today?
Legacy Apps
Ormis USA
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
11

12. Patient Experience
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
12

13. Marketing
๏ Shift in Marketing
and Media
Communication
๏ Opportunity to be on
Leading Edge
๏ Affinity and Loyalty
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
13

15. The Magic Quadrant
Del.icio.us Links
Wellness
Ephemeral / Community
Public
Blogs
Data Type
Scheduling
PWR
Critical/
HIE
Cerner
Private
n
e
Op
/
Level of Control
d ow
se L
lo
/C
gh
i
H
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

16. What the heck do we mean “Web 2.0?”
• Web 2.0 is considered to be the second
strategic direction for the web
– Web 1.0 was about distributing content and
enabling transactions on the web
– Web 2.0 is about moving from using the web as a
megaphone toward using it as a telephone
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

17. How does that work?
• Traditional Media: “You pay, I talk, you
listen.”
• Interactive Media: “Let’s you and I talk.”
• Social Media: “You all talk to each other.”
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

18. Where can we go see it?
• Google
• Blogs
• Facebook
• Twitter
• YouTube
• Digg
• Del.icio.us
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

19. Why does it matter?
• Your customers and employees have been
talking back forever, but you could ignore
them – and you probably were
• Now they have almost as big a megaphone
as you do – and you can’t ignore them any
more
• Here’s a story...
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

20. June 2005
• Blogger Jeff Jarvis (disclosure: friend of mine) buys a
Dell computer, and has some problems
• Dell customer service is – unhelpful
• Jeff starts blogging about ‘Dell Hell’
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

21. November 2005:
• Jeff’s blog post has been cited by Business
Week, NY Times, PC World, the Guardian
UK, Adweek, and other mainstream media
• Dell’s reaction? It shuts down its message
boards and issues press releases
• The market’s reaction? Dell 29.24, HP 28.79
• Dell lost ~$36 Billion in market capitalization
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

22. What did Dell do then?
• Dell got smart
• Reopened message boards
• Started a corporate blog, took its licks and
converted a number of its critics to allies
• Decided to start listening to its customers,
and with Salesforce.com, launched
‘Ideastorm’ a Digg-like rating tool that let
customers suggest ideas and vote on the
ideas suggested
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

23. The most popular idea?
• Linux notebooks
• Today, you can buy Ubuntu (Linux)
notebooks from Dell
• Takeaway? Dell is talking to, and listening to,
its customers
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

24. Why did Dell get in trouble?
• Because they didn’t know what their
customers thought of them
• They talked ‘at’ their customers, they didn’t
converse ‘with’ them
• So when the customers tried to tell them they
were unhappy, they had no way of knowing
• Until…
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

25. Conversation is the Heart of Web 2.0
• Technology and organization that facilitates:
–Business conversing with customers
–Bosses conversing with employee
–Leaders conversing with followers
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

26. 3 ‘legs’ of Web 2.0
• Technology
• Communication
• Organization
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

27. Web 2.0 Technology
• Systems ‘accrete’ – grow organically
• No system is an island – value through
sharing
• Data as value, not data manipulation – own
the data
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

28. Web 2.0 Communication
• Peer 2 Peer
• Personal – not corporate
• Immediate – not polished
• Persistent, searchable, indexable
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

29. Web 2.0 Organization Model
“The A Team”
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

30. Operaticonal Detachment Alpha –
a Special Forces ‘A team’
• Non hierarchical
– High levels of trust and conversation within the team – anticipation,
improvisation, responsive to changing conditions
– High levels of trust of the team by leadership – directed by goals, not tasks
– Short OODA (Observe-Orient-Decide-Act) loops
• Works in the context of a traditional
organization
– …but pushes power to the edges – to the people facing problems
– …but releases team members from tight levels of top-down control
“In command and out of control”
– Col. Paul Van Riper
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

31. Health 2.0
• The hyperinformed patient
• Extending care past the office/ hospital room
walls by connecting patients to caregivers
and caregiving information
• Improving patient care by improving
transparency
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

32. How Could Web 2.0 Concepts, Features &
Tools Be Applied to you?
• Strategic direction – lightweight business models and rapid evolution
in response to patient and stakeholder preferences
• Strategic direction – opening content to patients and stakeholders,
rather than tightly controlling it
• Technical direction – lightweight tools and services as the primary
deliverables
• Challenge – maintaining brand identity and regulatory compliance in
an environment where tight control is not possible. Institutional limits
on how far healthcare companies can go
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

33. Web 2.0 as a Methodology and
Software and as Business Design
Philosophy
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
33

34. 3 Common Fatal Missteps
• Don’t make it someone’s job
• Assume you can just buy tools and it will
happen
• Don’t align the 2.0 implementation strategy –
in branding, technology, marketing – with
corporate strategy
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

35. The Magic Quadrant Reprise
Del.icio.us Links
Wellness
Ephemeral / Community
Public
Blogs
Data Type
Scheduling
PWR
Critical/
HIE
Cerner
Private
n
e
Op
/
Level of Control
d ow
se L
lo
/C
gh
i
H
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

36. Interactive:
What is your institution looking to do in
social media?
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
36

37. The challenges of setting a strategic
direction in Healthcare IT with Web 2.0
• Healthcare is highly regulated
Healthcare is highly regulated
• Healthcare management is multipolar
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

38. Healthcare Web Technology and Web 2.0
• Most major healthcare system providers are
providing some web access to their systems,
and some (Epic, McKesson) are moving
toward creating patient portals
• This offers one direction to providing outside
web access to patients
• What are the pros and cons of this?
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
38

39. Managing the interfaces between legacy
systems and Web 2.0 systems
• Healthcare is deeply enmeshed in legacy
technology
• And facing the need to change dramatically
• Can Web 2.0 help?
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

40. One Concept of How it Might
Public Internet
Portals
(Loosely Coupled)
Scheduling API Demographic API Clinical API
Data Translation Layer
(Tightly Coupled) Custom Connectors
Legacy Transactional Applications
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

41. What was the Project that FHS and
Revere Did Together
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
41

42. Florida Hospital Ask
• Define & align
requirements for
an Enterprise
Portal solution
– Understand
future state
operating model
– Identify functions
that can be
enabled with
information
technology,
including the
Web 2.0
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

43. Project Methodology
 What are the uniquely important business functions across Florida Hospital?
Requirement
 How might those functions be enabled with information technology, including the
s
web? And with what benefit?
Definition
Key Activities Key Outcomes
 Conduct interviews and observe current state operations (2-4 hrs  Working Inventory of Key
Requirements
each x 16)
 Facilitate a series of up to 6-7 focus groups (up to 1/2 day each)
 Preliminary mapping of
among clusters of the constituent groups. Goal is to understand requirements to technology &
current operations at a high level, planned changes and market available components
opportunities for improvement in related areas
 Synthesize major processes drivers of each business unit and
identify technology enablers including portal functionality
 Facilitate a work session (Clarity 1) with the senior leadership and
Duration
the Portal Steering Committee to summarize and validate the
6-7 weeks, beginning November 1
uniquely important enterprise portal requirements (common needs
and those unique to business units)
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

44. PROLOGUE: Ann’s private home page… Ann’s homepage allows her to keep track of her
DISCUSSION
personal information and communicate with
FORUMS
members with similar conditions. It also gives
Ann can schedule
her access to useful programs the hospital may
appointments and pre-register
be offering for her condition. She is able to make
through her home page. When TARGETTED
all of her donationa online as she pleases.
she registers, she is emailed a FOUNDATION
map of how to get there and any COMMUNICATION
pre-appointment directions. There
is an estimate of the cost of this
appointment to her after taking
into consideration how her health
plan with reimburse. EXERCISE
PROGRAM PERSONAL
HEALTH RECORD
Ann can access her secure
TARGETED TARGETTED
medical information as well as
ADVERTISING MARKETING
the information about her family
COMMUNICATION
that she is authorized to view.
She also gets refill and
appointment reminders.
Ann’s caregivers have access to her Personal
Health Record and can check on the status of
her exercise program to ensure she is on the
right track. They also have the ability to
communicate with her via secure messaging.
Ann’s Health Provider team has
access to her medical information
and also gets alerted if any
appointments are overdue or
when test results come in.
Diagrams modified from Microsoft Health Vault
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This 2008—The Revere Group, anconfidential information and is being reserved.solely for client evaluation purposes.
© proposal contains proprietary and NTT Data Company. All rights submitted

45. How Florida Hospital Is Applying
the Project
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

46. Florida Hospital Vision
Singular Vision - Executive Leadership
• Combine Consumer Generated, Editorial, and Clinical
Content
• Foster Ownership / Motivate Engagement / Nurture
Loyalty
• Web 2.0 and beyond
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

47. myFloridaHospital
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

49. Integration into Current Sites
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

50. Personal Page Development
No Integration Integration
Support Groups Bi-Directional Messaging
Recommend Content Realtime Scheduling
Content Bookmarks Bill Notification
Share your Story Personal Health Record
Community Calendar Physician Directory
Creation Health Devotional ER Wait Times
Bookmark Content Physician Pages
Forum Posts Recommend a Physician
Games Pharmacy eCommerce
One-Way Messaging DME eCommerce
eCommerce
Site Stickiness
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

51. Joint Team
• Tear Down Silos
• Talk - Establish Your Vision
• It Ain’t Easy
– Cultural Differences
– Language Barriers
– Trust Building
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
51

52. Interactive Game
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.

53. Platform
Social Networking
“Right Now” Projects
Management
Culture
Strategy
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
53

54. Platform
Social Networking
“Right Now” Projects
Management
Culture
Strategy
© 2008—The Revere Group, an NTT Data Company. All rights reserved.
This proposal contains proprietary and confidential information and is being submitted solely for client evaluation purposes.
54