Saturday, September 22, 2007

To Hype Or Not To Hype

There are astonishing differences in the way people market their services to potential clients. One type of sales person takes an extremely aggressive approach, using whatever steps necessary to get a client to sign a contract. The challenge is to clinch the sale. To win. To conquer. To score. From that sales person’s perspective, once the contract is signed, it’s a done deal. End of story. Whether or not the business can and will deliver on promises that have been made often remains to be seen.

By contrast, those who offer a more clearly-defined set of business services tend to approach new clients with a softer sell (sometimes they simply let new clients come to them). Often, these people display a better understanding of the actual costs of doing business over the long term. They are not interested in overselling their skills. Nor are they are focused on “sticking it to the client” so they can take the money and run. Their goal is to build and nurture business relationships as a way of developing referrals and maintaining client loyalty.

Recent studies reveal definite distinctions in how men and women respond to stress. Men seem to react in more linear and combative ways whereas women tend to think globally and nurture. Many men become competitive or aggressive, thriving on a testosterone or adrenaline-induced high whereas women often invoke problem-solving and peace-making strategies. These are, of course, highly stereotypical concepts. Until one looks at the demographics of the medical transcription industry.

It’s no secret that 99% of the people in the United States who actively perform medical transcription are women. Some have built successful local services which, in the past few years, have been acquired by larger corporations. And yet, when one looks at the money and power behind the venture capital that has funded many corporate takeovers (as well as funding some of the new megaservices entering the transcription market), there is a distinctly male energy at work. There is no doubt that plenty of aggressive new businesswomen are graduating from business schools armed with MBA degrees. But within the medical transcription industry, the new regime of “suits” is mostly comprised of men.

A peculiar kind of male energy also permeates much of the hype we’ve been hearing with regard to new products and services for the MT industry. Last year I listened to a male sales rep from a speech recognition vendor wax euphoric about how his product was going to change the face of the medical transcription industry forever. I thought his sales pitch was full of holes and told him so in no uncertain terms. Dressed for success and quite full of himself, he replied “You’re really going to want to get on the band wagon with this because it’s going to take over the whole industry. And if you’re not using this technology, you’re just going to feel so stupid for not having gotten there in the beginning.”

That remark remained buried in the nether regions of my mind until early May, when I was driving across the Oakland Bay Bridge with a computer programmer who is much too smart for his own good. As we headed home from a pot luck dinner, Jeff and I were discussing some of the observations my business partner (who has a background as a computer programmer) had sent to me while attending the MTIA conference in Toronto. “All you keep hearing about these new software products is what they will be able to do at some point in the future. In other words, they’re trying to sell people vaporware,”wrote Tom. “At a panel on emerging technology, one speaker said that 70% of the medical transcription market would embrace the use of an ASP(application service provider) within a year. A few minutes later, another speaker warned that 70% of the ASP products coming to market would fail. That sure didn’t make me want to go down the ASP path!”

As we passed the toll plaza, Jeff started to chuckle. He explained that, having worked for several Silicon Valley startups over the years, predictions of triumphant product roll-outs are often met with raised eyebrows. “Here’s a piece of advice you should keep in mind,” he cautioned. “Whenever you hear someone use the phrase ‘You really want to get in on this in the early stages or else you’re going to feel really stupid,’ it usually means that their product will fail.”

How, then, does a medical transcriptionist, an MTSO, or even a hospital cut through all the hype to get at the truth? For starters, why not take a cue from how diabetics are taught to read food labels. If you go to a supermarket or drugstore and start examining products which are marketed with terms like “Sugar Free” or “No Added Sugar,” you soon discover that the product contains sugar alcohols which, once ingested, are quickly converted to carbohydrates. Is the manufacturer being honest when claiming that the product is “Sugar Free” or has “No Added Sugar”? From a legal and technical standpoint, yes. But hidden sugars are like hidden costs. They show up later and, if you’re not careful, can be very expensive.

If checking for hidden sugars doesn’t excite you, think about those nifty labels that state “Assemble At Home” or “So Easy, Even A Child Can Assemble This.” Yeah, right.

Hype is hype. And there is a big difference between the sizzle (which marketers use to sell a product) and the reality of what happens once you tryto use the product. In terms of analyzing software hype, what better place to start than with the debut of Windows 95! Remember how it was only supposed to cost $99 to upgrade your operating system from Windows 3.1? Consumers soon discovered the extra costs of adding RAM memory, larger hard drives, and all the important related program upgrades that were required to effectively work with Windows 95. Has anyone forgotten about subsequent product upgrades that were rushed to market although they were still based on a 16-bit architecture instead of a true 32-bit architecture? Or any of the “Year 2000" products that were rushed to market as being Y2K compliant (even though the software might have contained other programming bugs)?

When Windows 98 made its long-heralded and oft-delayed debut, consumers who had already been burned by the upgrade process did not line up outside computer stores with quite the same fervor as they had for the release of Windows 95. When Windows 2000 finally appeared in stores, it was greeted with a very suspicious yawn. Translation: Let someone else’s computers crash first.

One of the enigmas confronting American transcriptionists for the past two years has been how offshore transcription firms in India could claim “98 to 99.5% accuracy” in their sales pitches when the transcribed documents they returned to American clients needed such extensive editing. It wasn’t until one of the industry experts on a technology panel at this year’s MTIA conference advised MTSOs that, if they are using speech recognition, they should be selling their product as “verbatim transcription,” that I was finally able to connect the dots. I’m now willing to bet that many offshore firms are regurgitating the product hype for speech recognition right off the box and using those claims in their marketing pitches to American hospitals and MTSOs.

My suspicions are bolstered by a quote from the annual report to shareholders of E-docs: “In May 1998, we began development of a software product that provides healthcare professionals with a tool for Internet-based transcription and dictation services. The product, VoiceCOMMANDER 99, provided a mobile dictation solution designed to improve the quality and reduce the costs of healthcare information needs. In February 1999, we introduced VoiceCOMMANDER 99 as an integrated Internet-based speech recognition product designed specifically for the healthcare transcription market. After ten months of usage by physicians, we recognized that the voice recognition component of VoiceCOMMANDER was not generating the cost and labor savings previously believed possible. However, the market clearly indicated a preference for a browser-oriented tool for Internet-based transcription and medical records storage services. We never derived significant revenues from VoiceCOMMANDER 99; and have ceased the development and use of it as part of our business plan.”


What about the case of Dr. Barry J. Lobovits (a Pittsfield, Massachusetts physician who tried an electronic template charting system in 1997 and 1998 before abandoning the software)? According to media reports, inaccurate information may have been recorded in his patients’ charts by a template system which could generate certain “normals” (boilerplate paragraphs of text). “I was trying to reduce the time spent with record-keeping and to increase the time I spent with patients,” Lobovits explained to a reporter from the Berkshire Eagle.

In a classic case of being penny wise and pound foolish, the physician was ordered by the local Board of Registration in Medicine to set things right. The letter he sent to his patients (which had been drafted by the board), stated: “The board has instructed me to offer you a full medical examination at no cost to you or your insurer. In addition, my office will take all necessary steps to correct any inaccurate information about your health that has been sent to any third parties, such as employers or insurers. All records will be reviewed by an outside physician approved by the board.”

If you’re starting to feel nervous about all the hype you’re hearing -- and the hidden costs of succumbing to an overhyped product -- then you’re in good company. Considering all the risks, few people want to be the guinea pig. That’s why fewer and fewer people are rushing out to buy new upgrades until they’ve heard some reliable reports about the product’s market acceptance.

A stunning demonstration of this phenomenon took place during the recent MTIA conference when one of the industry’s most popular techno wizards queried the audience in an attempt to find out how many were currently using speech recognition. “How many plan to be using it within a year? How many are currently using an ASP? How many plan to be using an ASP within a year?” he asked.

As my business partner glanced around the room, Tom was unable to find more than 10 hands raised in response to such questions. And in a room filled with 300 people, that kind of poor showing does not bode well for industry-wide acceptance. If anything, such a tepid response signals a dangerously wide disconnect between the marketers and their marketplace.

When it comes to computer issues, my sister (who is a middle school librarian) has a fail-safe method for deflating a sales representative’s product claims. She looks the person right in the face and asks if the product offers LRF support. The quacks assure her that it does. Those who know their product ask for an opportunity to check with the folks in tech support to get a solid answer.

One day, after seeing Alice completely baffle a sales person with this question, a friend asked her what LRF stands for. “It’s simple,” replied my sister. “If you lift up your computer and look underneath, you’ll notice it has Little Rubber Feet!”

So here’s a friendly warning: Over the next two years many software products will be aggressively marketed to the healthcare industry as being “fully HIPAA compliant.” Be sure to ask prospective vendors for specific documentation to back up such claims. If the vendor can’t -- or won’t-- deliver the details, don’t buy the product.

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