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Today, I attended a talk by Alicia Ledlie, Senior Director, Health Business Development of Wal-Mart Stores, about the future of retail clinic care within the largest retailer on the planet.

Wal-Mart has already changed healthcare for low-income, underinsured Americans by lowering the cost of generic prescriptions to $4 — and, by extension, a larger population than their customer base thanks to Target and competitors joining in. The low-cost, “pass the savings on” mentality extends to their philosophy of clinic care — walk-in costs are $40-60 a pop, and include some basic testing services.

Here’s what Wal-Mart is doing right with healthcare:

1. Extended hours: they are open 8am to 8pm M-F and also on weekends from 9 to 5. That’s about twice the hours of an average doctor’s office.

2. Access to care: 55% of their population served by these clinics have no insurance. (Compared to about 40% for the average walk-in clinic.) This should be a measurable community benefit as it removes a strain on the ER, where visits run $1,000 or more and are often written off by hospitals anyway.

3. Fixed costs: by posting fees upfront, they reduce the likelihood that a potential patient won’t just walk away. As Ms. Ledlie says, “If you have $50 in your pocket and it costs $60, you won’t go.” A greater proportion of the community can afford to receive care and therefore elects for care.

Now none of these are unique to Wal-Mart, except for maybe the incredible access of retail space. But with their scale, Wal-Mart can offer a few more things. Through an innovative partnership model, Wal-Mart becomes a landlord to a hospital-sponsored tenant — either a direct offshoot of your hospital or a third-party relationship that refers into the hospital system.

Also, they’re proving eClinicalWorks as an EMR for the patients. (I guess that makes it a PHR, but go with me here.) Without the baggage of a system from the 70’s, they can roll-over a real, hard-ROI EMR platform… for those 130 million customers that pass through their doors.

What are you doing to make life easier for your patients that Wal-Mart can’t do better, cheaper, or faster nation-wide?

One of my favorite things about being a CEO is that I believe it is forwarding my life’s dream of becoming a pundit.

Pundits, you will note, only discuss the future and, the future being a distant and murky place, by the time one can prove you wrong, you’ve already moved on to the next, future subject.

I attend many, many conferences and I’ve learned a few tricks from some excellent keynotes which may be helpful to you establish yourself as a pundit within your organization.

First, show a lot of irrelevant but very cool technology. If, for example, you are asked to explain how to do service line marketing on the web to your internal team, show them a few screen shots of Second Life and explain, that in 10 years, we’ll all be avatars anyway, so what’s the point of actually trying to talk to consumers now? Your audience will soon lose you as you outline the future growth of massively multiplayer online games and begin thinking about more mundane tasks such as their checkbook balances and if they should get a new haircut.

Perfect. They are now putty in your hands.

Flash a few meaningless statistics you lifted off another presentation that lifted slides from a Forrester or Jupiter Research report. Show a few screen shots of the coolest things you’d like to do and end by showing a multi-million dollar website as a good example of what to do, even though you have a budget 98% smaller.

If anyone dares ask what the return on investment might be, explain that healthcare is complicated, that we can’t really assess the true cost of doing such things but that the future is now.

It’s important to maintain an air of righteous indignation to ensure you have the moral high ground: how can anyone question your conclusions? How can anyone point out errors in your data? To be a pundit, one must have an attitude of utter security about one’s opinions and then ensure one leaves before the future promised results.

So, a quick recap:

• Project at least 2 more years into the future as you plan to be at your organization
• Show kewl, unnecessarily expensive examples of what your organization can never achieve
• Back up your findings with a double-shot of opinion and imply anyone who doesn’t believe you is a dinosaur

I wish you the best of luck in your rise to the top. May we meet each other as fellow keynote presenters someday soon.

I’ve been working on a talk and have seen the wisdom of chucking out the traditional bulleted Powerpoint list in favor of a completely visual (read: all pictures) presentation. For the last decade, Edward Tufte has complained PowerPoint’s density of information is so low, its only media analog is Soviet propaganda. Me? I just want the audience to fall asleep less. And since we gave a webinar on how to write a good presentation, I’m taking some of my own advice. After all, if this blog were a PowerPoint entry, it would read as follows:

• Working on a talk; how best to write?
• PowerPoint tradition = bulleted lists
• But… low density of information
• Tufte says, “Soviet Propaganda!”
• Want people to stay awake
• Taking own advice

So from here on out: PowerPoint Perestroika!

Rensselaer Polytechnic Institute is hosting a new conference on The Future of the American Hospital

As I grew up in the rust-belt of Upstate New York, I am well aware of the level of quality of RPI’s educational programs and I’m sure this foray into healthcare has been well thought out. (Except, perhaps, for not inviting us to speak…)

It’s going to occur on both coasts, which means you’re at most 1,500 miles away. If you’re tired of the usual suspects of speakers at conferences, RPI is working hard to bring some different voices to the table.

Below is the info, should you be interested.

• Marriott, Newport, Rhode Island
  Tuesday-Wednesday, May 13-14, 2008
• Hyatt Fisherman’s Wharf, San Francisco, California
  Thursday-Friday, May 22-23, 2008

Healthcare is facing crises on a number of fronts, from changing demographics to payers’ cuts and a shift toward “Retailization.”

Rensselaer Polytechnic Institute, one of America’s foremost technology universities brings its thought leadership to this critical topic.