Acronym

The following is a guest post from Frank Fortin, CAE, chief digital strategist and communications director at the Massachusetts Medical Society.

Are you going to be in the kitchen or on the menu?

Time and again, that was the issue at the core of many conversations during the second day of ASAE's 2011 Healthcare Associations Conference in Baltimore, which ended Tuesday.

Whether our healthcare association represents doctors, nurses, hospitals, or something else, we are at an inflection point. The federal healthcare-reform law precipitated much of this, but if it was only about a law (which is only partially implemented), we wouldn't be feeling this way.

The first session I attended Tuesday was a terrific presentation by Shawn Scott from the North Carolina Medical Society, who walked us through how her staff and members are remaking their organization, even though her society is staunchly opposed to the federal reform law.

I next attended an offbeat session by economist Richard O'Sullivan on the five trends that are affecting healthcare associations. One might have judged his presentation too esoteric for the daily concerns of a healthcare association, but his five trends made it clear to me that we're dealing with environmental forces that will persist even if the Supreme Court or Congress eviscerates the Affordable Care Act.

Finally, Dr. Susan Nedza, an emergency physician who has worked at the Centers for Medicare and Medicaid Services, the American Medical Association, and other organizations, asked provocative questions about how we're going to lead our associations through these changes. She simply summarized the stark challenge: Provide better care, to more people, at a markedly lower cost.

Her most interesting concept was to embrace disruptive collaboration: working with non-traditional outsiders to address intractable problems. Conflict will inevitably result from such work, but innovation may also ensue, particularly when known approaches are getting us nowhere.

This was all brave talk about change, but I also heard lots of fear, loathing, and anxiety at the conference. Are we really that powerless to help our members face the future?

I got an insight from a book I picked up on my way home today. Jim Collins, the guy who wrote Good to Great, has just published Great by Choice, about companies that thrive in chaotic times. He starts by comparing the journeys of Roald Amundsen and Richard Fulton Scott, who famously and tragically raced to the South Pole in 1911. Amundsen got there first and returned safely to a hero's welcome. Scott got there 34 days later but froze to death trying to get back home.

What was the difference? According to Collins, Amundsen prepared for worst. He didn't wait for an unexpected storm to discover he needed more strength and endurance. His preparations were unorthodox, detailed in the extreme, but he was able to handle anything that came his way. Scott's preparations assumed one scenario, and he got another. He paid for the gamble with his life.

Our storm is here, and there's no predicting where it will take us. Just as the folks at the North Carolina Medical Society refused to let their personal views blind them to the adaption and change they needed, we have to prepare our members for the rough weather ahead, position our associations to serve them differently, and work with them to create a new future. To do anything else would be negligent.

The following is a guest post from Paula Eichenbrenner, vice president for advancement, American Society for Nutrition.

How does healthcare association management require a specialized skill set? The 200 attendees at ASAE's 2011 Healthcare Associations Conference could likely list 200 (or 2,000!) examples. Many of the unique challenges facing our community were apparent in today's presentations and conversations. The opening general session was delivered by Wired magazine Executive Editor Thomas Goetz (@tgoetz), who pointed to the revolutionary potential of personalized medicine and healthcare technology.

Learning labs (8 total) tackled topics relevant to executives, marketers, education developers, and fundraisers. Attendee Billye Potts said the most applicable point she'll bring back to the Association for Healthcare Foodservice (@ahfnetwork) is the importance of the "it question," discussed in "Your Healthcare Members Love You … But Do the Hospital Systems Know Who You Are?" In other words, AHF will strive to demonstrate the critical value of membership in their association and how AHF membership helps hospital professionals better serve their systems.

At the session "Online Education: Making Wise Business Choices," Society of Critical Care Medicine (@SCCM) staff shared their experience building the society's learning portal, LearnICU. "Real talk" about the SCCM LMS, related infrastructure, and program marketing highlighted several big issues for other healthcare associations to consider when delving into online learning. If this is a priority, remember: it's going to be impossible to satisfy everyone, particularly if you're addressing the needs of students and program directors. And looking to cover costs incurred in disseminating online education? Good luck with that! Audience members advised to consider price sensitivities (e.g., instructor-led courses may correlate with higher registration fees) and fundraising (bundle annual-meeting sponsorship with online content).

But wait! Don't revise your sponsorship prospectus until you check in on the latest regulations impacting industry funding, ably outlined this afternoon by Susan Cantrell and Tom Sullivan (@policymed). Parsing updates on political, media, legal, and popular pressure on medical societies, the experts also made predictive suggestions on the regulatory landscape for 2012 and beyond. Implications are numerous; for example, various state-level regulations could influence your site selection for future conference. If you're trying to keep up with this facet of healthcare association management, check out Susan and Tom's presentation slides for the five scenarios presented for audience interaction. Additional resources include the "Ask ACCME" feature online.

And whatever you do, build interorganizational conversations! The afternoon lab "Competition and Collaboration: The Good, the Bad, and the Ugly" emphasized the value in partnering. Speakers coined the term "coopetition," a cross between cooperation and competition. With the conclusion of Day 1's learning labs, we wrapped up with a healthcare reform panel in the style of The View. Five presenters bandied about the implications of the federal elections on the future of healthcare legislation, as well as legal challenges to the ACA and more. See you tomorrow!

ASAE's Healthcare Community Committee (#asaehlth) addresses the educational, networking and knowledge needs of association professionals working in healthcare organizations. Let us know what you'd value as a HC professional in the comments, and join the Healthcare Community Cafe on ASAE's Collaborate site.

The following is a guest post from Frank Fortin, CAE, chief digital strategist and communications director, Massachusetts Medical Society.

What is ASAE's emerging value for healthcare associations?

Though 20 to 25 percent of ASAE's members are from healthcare associations, I've wondered whether the extraordinary diversity of ASAE's healthcare membership would frustrate efforts to create value inside ASAE's structures.

After attending three high energy healthcare sessions this week, my answer is: Yes!

Like healthcare itself, ASAE's healthcare members are all over the map. You have your doctors and nurses, for sure. But there are also allied health professionals, medical device groups, long-term care providers, collaborative care organizations, consultants, and even a healthcare economist. (Oddly, I didn't see anyone from health insurers for the drug industry. Maybe we can work on that.)

What we all share in common is the urgency to respond quickly to the incredible change that is already engulfing our members and our industry.

Federal healthcare reform only scratches the surface of what lies before us. It terrifies many of our members, because there are few well-tested solutions, and healthcare professionals find extreme comfort in well-tested solutions!

At the Annual Meeting, our esteemed facilitators from the Healthcare Community Committee started the dialogue by collecting lists of the things that keep us up at night. And then we all talked about what we're all doing to address these issues, one at a time.

Without exception — and I mean that without exaggeration — the things that people shared could help every one of us in the room, regardless of the type of profession we work in.

For me, the gnarliest issue that threatens the very value proposition of our medical society. Not too long ago, most physicians were independent and self-employed. Think: Marcus Welby. Today, most doctors work for somebody else. In a few years, almost everyone will be employed. Think: House.

That irrevocably changes our value proposition, because so much of what we have offered is for the doctor who doubles as a small business owner. That era is almost over. So if associations don't change, we die.

Honestly, I didn't get the golden answer this week that will let me sleep soundly at night. But I did see that others are tossing and turning over the same thing. And there are issues we will have lots of trouble agreeing on.

Almost anyone who goes to the movies has probably seen the Oscar-nominated The King's Speech. The remarkable film captures the lifelong battle of the future King George against the serious stuttering that threatens to weaken his leadership at a time when he is ascending the throne and speaking out against the rise of Hitler.

It also shone an unprecedented spotlight on a personal and professional challenge faced by millions of adults and children worldwide.

"We've waited a lifetime to get this kind of interest in stuttering, so it's thrilling for us," said Jane Fraser, president of The Stuttering Foundation and vice president of the Association for Research into Stammering in Childhood, Michael Palin Centre, in London, when I gave her a call today for a pre-Oscars chat about the impact of the film on her organization.

"Our website hits have doubled," she added, noting that speech therapists across the country report a big jump in the number of inquiries from people who stutter and their families since the movie's Christmas Day 2010 release. "One of the therapists we refer to in Chicago said she had a 70-year-old man come in this week.... Across the board, that movie is so meaningful that anyone who has seen it will never laugh at stuttering again."

Maybe that's why one of the foundation's videos, Stuttering: For Kids, By Kids, has been viewed more than 50,000 times in the past week. The charity, which educates and refers stutters and specially trains speech therapists, also "whipped out a poster three weeks ago," Fraser laughs. "We designed ["Stuttering Gets the Royal Treatment] Friday morning, and on Monday at 5, it came off the press. The printer had never done that before. Everyone at the print house was excited." She had no problem securing permission from the independent film company, The Weinstein Company, to use photos from the film in the poster, which also directs viewers to the foundation website.

What have been the biggest impacts of the film on her group? "The exciting thing about The King's Speech is that people realize they can become fluent," Fraser enthuses. "... It's obvious in the movie that speaking is a lot of work, but ... some of the methods you see in the movie [such as learning to speak in phrases rather than entire sentences] are techniques that have been used over the years."

It also focuses on the "beautiful therapist-patient alliance. The king got to the point where the therapist was his close friend. Like all therapeutic situations, there are ups and down, but the beautiful way this relationship unwound is important.... You must have that total trust between the professional and the patient." She thinks film viewers will better understand how that deep relationship works.

You can join Fraser and her staff in rooting for the foundation and The King's Speech Sunday night during the 83th Annual Oscars Ceremony. Watch a trailer and learn more about this Best Picture Nominee here.

The 2010 Healthcare Association Conference kicked off this morning with Lance Secretan, Ph.D.'s session "The Spark, the Flame, and the Torch: Restoring Inspiration in American Healthcare." Secretan, author of The Spark, The Flame, and the Torch, says that inspirational leadership has three main components: serving others, helping people grow, and making the world a better place. But before you can create an inspirational organization, you need to start with yourself. Why are you here? Create a mission statement and assess your own purpose and meaning in life as a step toward being an inspiring leader.

Secretan says 65 percent of the current workforce says they would leave their current jobs if they could. With eight percent of uninspiring leaders, it's not surprising that employees have one foot outside the door. Secretan says uninspiring leaders are:

• Cowardly;
• Inauthentic;
• Self-serving;
• Dishonest;
• Unfeeling
• Ineffective.

And it seems simple enough, but inspirational leaders do the opposite of the six attributes above. To be inspirational, consider what he calls the CASTLE Principle:

• Courage;
• Authenticity;
• Service;
• Truthfulness;
• Love;
• Effectiveness.

As you lead today, ask yourself these questions:

• Can you make breakthroughs quickly to exhibit courage?
• Will you be authentic about your work and will you admit when you make a mistake?
• Are you willing to serve others, even if it seems inconvenient?
• Will you make an effort to tell the truth more often?
• Will you love between the hours of 9:00 a.m. and 5:00 p.m.?

When you put those pieces together you become more effective, and maybe a little more inspiring.

Did anyone else happen to enjoy two articles in this week's Bloomberg Businessweek about associations? The first one is a three-page piece that uses the Romance Writers of America conference as entry into discussion of the rise of the entire "bodice rippers" book industry. I especially liked learning about how rapidly this section of the bookselling industry was being fractured into micro niches that change in a heartbeat to mimic social changes.

Uniting those splinters, though, is a larger theme noted by one of the profession's leading authors, Marie Bostwick: "There is a tremendous desire for community. Somehow in this world, where everyone is constantly communicating, people have lost real friendships."

Maybe that is why the Romance Writers of America and its conferences continue to grow as well--that desire to get together over endless cups of coffee and a common passion for, well, passion. How might the rest of us better identify and leverage the rising and falling (dare I write, heaving) of membership micro-niches that fulfill emotionally driven needs and interests of our members, rather than more reserved connections related to professional function or title?

The other Businessweek article looks not at an association so much as its leader, the new and increasingly influential association executive director, Rose Ann DeMoro. DeMoro rose to power from a supermarket cashier position in Missouri to lead the rapidly growing California Nurses Association (CNA) and--since December 2009--its evolution and merger into a 155,000-member nursing organization. This new player--called the National Nurses United--is composed of CAN CNA, United American Nurses, and the Massachusetts Nurses Association, and the dynamic DeMoro is fully in charge at the top.

Whether you agree or not with DeMoro's rather flamboyant style, you can't deny the heart of the article: passion. One woman's focused, determined battle to ensure that "nurses should win every battle."

That a publication dedicated to business coverage should devote six pages in its feature well to address (however indirectly) the influence of passion and community-building on the workplace was as refreshing as a dewy rose. No? Okay, strike that last phrase. I'll keep it simple: The articles are good reading for folks in every field in our sector.

With the contining spread of the swine flu, we’re all hearing one directive drilled into us like never before—wash your hands! Often! In the right way! Sounds pretty straightforward, but even before the swine flu hit, the Soap and Detergent Association and the American Society for Microbiology were responding to data showing poor hand hygiene in many adults (a rather disturbing 25% of adults, for instance, don’t wash their hands in public restrooms).

Now, with 149 swine flu deaths on record and almost 1,700 people sickened, what seemed a small project last fall--creation of an online and print-version brochure (www.cleaning101.com/handhygiene) about proper hand washing--takes on new and greater importance. Available in English and Spanish, “'Don’t Get Caught Dirty Handed' reminds adults that many cases of colds, flu, and food-borne illness are spread by unclean hands, and these diseases are responsible for billions of dollars each year in health care expenditures and productivity losses in the United States,” says the association.

No soap around? Reach for a hand sanitizer (keep one in your desk, purse, laptop pocket and car glove compartment) or hand wipes.

With a slight blush of embarassment, I suggest sharing this information with staff as a gentle but direct reminder that we’re all in this together when it comes to germ sharing and avoidance. For more info, visit www.washup.org.

With reports breaking all Friday regarding hundreds of both Mexican and American citizens sickened or even killed by a new form of swine flu, associations in the health care and agricultural communities have been busy confirming information, alerting and surveying members about any potential swine flu-related patients, and calming an anxious public even while acknowledging that much—including the original source of the illness--remains unknown.

"At this point, it appears to be human-to-human transmission only," said Dr. Ron DeHaven, CEO, American Veterinary Medical Association (AVMA), in a press statement Friday. "We've been in contact with the American Association of Swine Veterinarians (AASV), and there have been no reports of outbreaks among animals, although their members are certainly aware of what's happening and are stepping up surveillance for the virus with federal and state animal health officials."

According to officials, “there is little or no risk of catching swine flu from eating pork or pork products, but as always, proper food handling and hand washing should be practiced.”

The AASV is regularly updating its Web site at http://www.aasv.org with news for its veterinarian members and the general public.

The American Lung Association in California quickly blogged about the six documented cases of this new strain of swine flu in the San Diego area and Imperial County, as well as two cases in San Antonio. It noted that rapid flu tests cannot tell this type of flu from seasonal flu, “and the current vaccine may not be protective. Tamiflu works, as does Relenza.” The post, found at http://alacsd.blogspot.com/2009/04/swine-flu-outbreak-in-mexico-touches.html, also notes that “while there are likely more cases in the U.S., there are no large-scale outbreaks.”

As of this Friday night post, however, CNN is reporting that 75 high school students in New York City are being tested for suspected swine flu.

The National Pork Board also has issued a helpful 4-page information sheet about swine flu at http://www.aasv.org/aasv/documents/InfluenzaFactSheet.pdf.

In addition, the Centers for Disease Control has information on the human swine flu investigation at http://www.cdc.gov/flu/swine/investigation.htm.

The second part of yesterday's session was equally, if not more, interesting than the first. Each of the panelists talked about the specific tools they were using and what they accomplished. Here are some of the details:

- Mayo Clinic started with a Facebook site - in fact, they were one of the first institutional sites on Facebook. They launched a YouTube channel (Lee Aase, the panelist suggested this is an absolute no-brainer for any association) and one of the benefits is that they don't need a server dedicated to video streaming for their blog. He also mentioned that if you are going to get into video, get a Flip video camera - they're inexpensive and have their own USB port to quickly import the video you've captured. (I've used them - it really can't get much easier!)

- The chief marketing officer from Sermo, Gina Ashe, shared more about their product that has created a secure, exclusive community for physicians. Their business model was interesting - there is no fee for physicians to join and no advertising. It sounds like they earn revenue from companies and organizations who obtain access to the site as observers. The most interesting tidbit from her presentation was about a partnership they had developed with Bloomberg. They are using the physicians on their site to make sense of medical information for the financial markets. It was obvious that there was a lot of interest in this in the room.

- Frank Fortin from the Massachusetts Medical Society discussed their endeavors in developing community online, including a past failure as well as their plans for the future. One interesting tidbit I picked up - he had read Groundswell, written by Forrester researchers, and was interested in developing a social technographics profile of his membership to help MMS get a handle on why their communities were not thriving. You might think that would be expensive - Forrester is a pretty big name. Frank says it was actually quite inexpensive for a one-time use. Lesson? It's never a bad idea to ask!

The session closed with each panelist providing their one parting thought... here's what was said:

- Web 2.0 is about listening

- Encourage the empowerment of your membership. They are allowed to have opinions. Allow them to build upon their best assets.

- Mayo has sharing guidelines (for social sites) for their staff.

- Want to know more about social media? Lee Aase started Social Media University Global. Check it out. There's even a picture from the first session.

- The decision to participate in social media is not about shiny new tools. It should be a decision to communicate better with your stakeholders. Don't overthink it. Members will tell you what they need.

Bravo Jeff and panelists! Excellent session!

Kristi has already covered some great content.

I want to flag the session from Shaun Flynn of NYSNA on triaging advocacy issues as one that was particularly great for me. I'm in a cultural tug-of-war with a colleague about process vs. output. I appreciated Shaun's discussion of creating a volunteer-owned process for setting issue priorities, articulating them, and understanding and communicating multi-year strategies for specific goals. He suggested offering tools for members to get them involved on issues that need attention but aren't highest priority. Most important, to me, was the notion that failures need to be discussed with members as much as successes. Finding smaller wins to build momentum and ease issue fatigue among your membership can help sustain you through multi-year fights on bigger issues.

Also amazing (and risky!) the suggestion to identify long-sacred fights to walk away from. For them, they let go of chasing every single scope-of-practice issue, which in turn opened them up for collaboration on other issues with groups who might not have talked to them before. A great example of how figuring out what's on your "stop-doing" list is almost more important than creating a "to-do" list.

As for the social media sessions - a two-part piece that I thought was just great, it was so nice to hear a reasoned discussion of the pros/cons, caveats, all that - with a much clearer sense of how to make sense of all that when I land in Oregon on Wednesday.

Great job, ASAE staff and healthcare community committee, for assembling this program. It was worth absolutely every penny to me.

[edited twice because, apparently, I can't remember how to do anything I do less than quarterly. Sorry, readers.]

I just attended the session that paid for the conference. Jeff De Cagna faciliated a panel discussion between individuals representing Mayo, Sermo, Permanente and the Massachusetts Medical Society. It was a fascinating discussion, but with not much time, I'll focus on a few bullet points:

- Physicians who were seeking community online for collaborative problem solving are moving from anonymity to full disclosure of their identity to establish their following and gain recognition for their contributions.

- GenX is not interest in the peer-review journal process. It's too time consuming. We have to find ways to engage them differently. Avoid the filter then publish process and move to the publish then filter process.

- Some are comparing the advent of social media to the way the printing press, railways, telephone and TV changed society - it's that powerful.

- When offering something online, consider whether it creates harmony or puts community members at war. What you offer has to make life easier.

- Mayo Clinic has a internal group called Mayo 2020 that examines the ongoing relationships patients and their providers have with Mayo and how that may change if they don't need to come to the campus in the future.

Sites worth visiting:
www.sermo.com
www.medgle.com
www.patientslikeme.com

I was talking to a colleague tonight who was really jazzed about the sessions she went to. I had told her that I was on the fence about how necessary a separate conference is for healthcare assns, and for me the jury is still out. She replied, "No, I think it's great. In fact, we were having one discussion in a session where someone asked a question, and it was nice to actually know that what others had to say would be relevant to my issues - that there wasn't just a 25% chance that it would be relevant." I'm paraphrasing, but hopefully, it makes sense.

On another note, I'm back from dinner with some colleagues, and once again reminded of the value of networking and being engaged. I get so much value out of the ASAE conferences I've been to. I have already made a few contacts that will hopefully be good resources in my next job, and rekindled relationships with acquaintances I haven't seen in years at other ASAE meetings. It shouldn't surprise me, but it still amazes me how small the world is. If the conference was already over, it was worth the investment. And I still have another day to go!

The term "evidence-based" gets used a lot in healthcare. And I can appreciate it, certainly, as a patient. I like to think that the interventions that might be applied to me in the course of my own healthcare are rooted in practice and evaluated by experienced practitioners.

But, I wonder, are the terms "evidence-based" and "innovative" mutually exclusive? How do you get from innovative to evidence-based? I can see it from a knowledge management perspective - cycling from ideas in practice to refinement to publishing to evaluation - but I think sometimes the term "evidence-based" gets applied incorrectly in the association setting. Do healthcare associations, not healthcare practitioners, get sucked into the need to make sure their efforts are evidence-based, because that is what their members do?

Carson did provide one interesting analogy… he talked about how the existence of a government agency made it possible for homeowners to afford homeowners insurance. That organization is FEMA. Without FEMA, insurance companies would have to charge premiums that cover a much greater variety of unlikely catastrophes. One of the challenges, he says, that health insurers face is that they must charge enough to cover the event of a catastrophic illness. He says that the government should take responsibility for covering individuals who suffer from catastrophic injuries or illness, relieving insurers from having to factor that into their policies, and therefore, premiums.

I’m attending the first ASAE Healthcare Association Conference today and tomorrow in Baltimore. I have to admit that, at first, while intrigued by the idea, I wondered why such a meeting was necessary… other than the continuing education issues that we face, is much else really different from other associations in other industries? Then I heard today that 25% of ASAE members are employed in healthcare associations – that is a large membership segment. And, it is a segment with, I think, a very general common goal – the sustained, improved health of the general public – a BHAG when you have such a diverse and varied group of interests with very strong opinions.

Having worked for a variety of health-related associations, and even some providers, I think that the commonality extends beyond issues of CME to the structure of the healthcare system and healthcare reform. After just one education session, it is painfully obvious what a tangled web we face in terms of healthcare reform. Those of us here already “get it”; the question is now, what can we do about it? How are we going to fix it? There is something very interesting about having this conference right now in the midst of what could be the biggest reform agenda ever.

I sat in a discussion group this morning of people who represented nurses, physical therapists, hospitals and physicians. Even there, a colleague looked at me and suggested that one of the problems we were discussing wouldn’t be such a problem if the hospital administrators weren’t pushing their members to do more with less. Which I understood, but I can also hear administrators complaining about reduced insurance payments. It is really a sick cycle.

This morning’s keynote came from Dr. Ben Carson, a pediatric neurologist at Johns Hopkins (more on him later). On one hand, this problem of healthcare reform seems so big, so unwieldy that I simply can’t comprehend a fix that is going to meet every associations’ constituents’ needs. On the other hand, Dr. Carson reminded us that our brains are capable of handling and processing an infinite amount of knowledge.

Reform is going to happen. We can do this.