Did the stimulous reduce EHR adoption?

Shahid Shah thinks that the "bill probably has frozen more customers into waiting than encouraging them to buy." Software Advice is conducting a survey on the subject.

Which vendor not to choose for your EHR system

The Washington Post: Electronic medical records draw frequent criticisms:

Legal experts say it is impossible to know how often health IT mishaps occur. Electronic medical records are not classified as medical devices, so hospitals are not required to report problems. Many health IT contracts do not allow hospitals to discuss computer flaws, say Koppel and Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University in Cleveland.

Anytime a vendor wants you to sign an agreement that you will not discuss flaws in their system, that should set off a warning bell not to go near that vendor.

A more citizen centric FCC web site

Arts Technica reviews the new improved FCC web site:

The Federal Communications Commission (FCC) took a big step towards becoming more accessible on Friday, with an impressive upgrade of its Electronic Comment Filing System. The new EFCS offers far more searching capability, formatting flexibility, and bookmarking power than ever before. The system offers text searching and RSS conversion, and it makes it easier to comment on proceedings. EFCS 2.0 still doesn't go quite as far as we recommended last year, but it's another example of how the Commission is turning fcc.gov into a true public resource.

If the other agencies follow suit the collective impact will have an enormous effect upon a citizen's relationship with their government. I wonder if pubic affairs PR practitioners understand that.

How to publicize your Firefox extension

Today was spent listening to Steve Auerbach’s interesting presentation on Firefox extensions, and I got to thinking, how would a developer publicize their Firefox extensions?

Firefox lists extensions in order of number of downloads, and it shows the average ratings and links to reviews. Clearly you need to get your Firefox extension reviewed before users will try it.

The only thing I can think of is to send the link to any discussion list you participate in, and to members of any relevant user group you are a member of.

From customers to community

I am reading Chris Anderson’s insightful book, Free, and am stuck by the repeated references to community. Those of us who spend a significant amount of time online are conscious of the importance of building community, whether it is as simple as comments on blogs or as complicated as building an international network of user groups. Communities build and sustain markets in a way that nothing else can.

It is not a new phenomenon; there have always been hobbyist groups. It is simply that the Internet has given communities an opportunity to thrive as never before. Success in marketing communications will more and more be defined by the ability to cultivate communities.

Mark Warner’s address to the Grow Smart Business Conference

Senator Warner began by saying “It is OK to leave your cell phones on, to me it sounds like money,” to appreciative laughter. Warner said his work at Nextel and Columbia Capital gave him some perspective on financial and business matters.

He began to describe where he thought the economy was at. Warner said we needed some financial re-regulation. He described himself as a new senator who “just got hired,” and that it had been a wild nine months. He characterized the recent actions of the federal government as extraordinary, and that few appreciated how close we came to a complete financial meltdown. Ugly and blunt instruments had halted a world wide recession. Warner said that never again should Americans hear too big to fail. While the stimulus was necessary, Warner said that it had been “mis-marketed.” On third of the stimulus is tax cuts, one third relief for the states and the remaining third is spending that offers a lot of opportunities, especially for small business.

Warner pointed out that while Virginia is one of the few remaining states with AAA bond rating; without the relief from the recent stimulus package Virginia’s finances would look like California. The economy is that bad.

Warner explained that the spending part of the stimulus consisted of grants and other incentives for smart grid, build out of broadband, high speed rail, and health care IT. He said that he was “disturbed” that the administration has not been faster in getting those dollars out.

Continuing to speak about the economy, Warner said that we had avoided complete disaster; but that we were not out of the woods. He repeated his earlier assertion that we need financial re-regulation; he did not appreciate how much excess and abuse there had been in the financial sector until the recent hearings before senate banking committee. While a fan of free market capitalism, Warner said that we need rules.

He said that small business faces tough times to get financing and that he would welcome ideas as to how to rebuild small business financing. He said that 89% job growth will come from small businesses if they can get financing.

Here, Warner began to talk about health care and said that both from a moral and economic view, “we have to get it done.” He predicted that without reform our health care system will collapse.

He jokingly described a town meeting in Fredericksburg, Virginia with “1800 of my closest friends.” He said that he had told the town meeting attendees, “You know Medicare if a government problem,” only to hear “NO it is not!” The senator lamented that you “can’t make progress with people like that.”

He said that we have to decrease out federal deficit; and that, “I hope that we can find a private market solution” to our health care problem. He expressed hope for a bipartisan solution but that he was a “little disappointed with colleagues on the other side” and that even in the absence of bipartisan support, “We still have to act.” .

The senator began to talk about health care IT, observing that technology has revolutionized every industry except health care. He said that the federal government needs to establish standards, going on the observe that federal standards had made the cell phone industry possible and that we needed federal standards for health care IT.

He reminded the audience of the obvious, that we need more transparency in health care. List prices have no real relation to what people are paying. Warner said that we need wellness and prevention programs. Some very large employers have wellness programs. The senator said that we should take the best practice models and make them more available. He suggested that large businesses should be able to open up their plans to their suppliers.

Warner said that tort reform should be part of the health care reform mix.

He reminded the audience of his work for the Virginia Health Care Foundation. It is devoted to helping those who cannot afford insurance, but whose incomes are too high to qualify for any public assistance.

Warner said that it was “important to make system work”,
observing that too grand a package could be too expensive. He said that we needed to change financial incentives. Our present systems rewards hospitals with high readmission rate. He said that instead of fee for service we need to move to a health care system that rewards value.

Video of Warner’s remarks.

Chris Anderson's address to the Grow Smart Business Conference

Chris Anderson gave the keynote address, characterizing our time as the golden age of small business. He considers that the Internet has so changed the distribution system, that niche markets have a chance to develop in a way that was not previously possible. By way of example he talked about watching Gilligan’s Island as a youngster. The show was such a huge hit that it was difficult not to believe that this is what Americans really wanted to watch. But as Anderson pointed out, this was the twentieth century’s confusion with supply and demand. Broadcast TV’s distribution system limits choice. The Internet shows that we are more diverse.

Anderson pointed out that the Internet has infinite shelf pace. Everything is out there and small businesses have the opportunity to appeal to long tail niche audiences. Consumers are not satisfied with what is on the shelf at Walmart, they want more choices. Markets are global and your customer can be anywhere.

He said that most of us live in both the head and the tail. Appealing to niche audiences can make you more profitable. Anderson observed that the Italian economy has excelled in producing small boutique companies with global impact.

He said that companies exist to minimize transaction costs; they aggregate people, supplies, and distribution. He called the twentieth century the era of big companies. The Internet has lowered transaction costs.

Here, Anderson began to talk about his experience as an entrepreneur. He pointed out that the Internet offers us the opportunity to find the smartest people in the world. He offered his opinion that the passionate amateur was more valuable than the bored professional.

While working on his robotics company Anderson searched the Internet to discoverer everyone who was writing about robotics. He discovered that the ideal candidate for his company turned out to be a nineteen year old high school drop out, describing the young man’s expertise as a Google Ph.D.. He said this illustrated the “meritocracy of the Internet.”

Anderson allowed that big companies do some things magnificently. He said that small companies can move quickly; but have trouble scaling up.
The moment you go on the Internet, you are a global company. With Paypal you can accept business from anywhere, you can, as it were, box above your weight.

He said that the Web is a good place to do business with suppliers. Three guys with laptops can be a hardware company. He offered the sad tale of the man who invented intermittent windshield wipers as an example. He was in the middle of building his factory when he discovered that the Auto companies had stolen his idea from him. Nowadays you would simply use the Internet to locate a manufacturer and get your order for wipers before risking your capital.

At this point Anderson began to discuss the evolution of the free economy. He told the story of Jello, how the manufacturer had given away free cook books filled with recipes based on Jello and then took product to the local store and persuaded the local store owner to stock some Jello, based on the demand the cook books were sure to generate.

Anderson said that the “power of free” allows consumers to experience products for free. The minority pays for majority. Google takes profits from one product (advertising) to subsidize its free products.

He said that freemium is the inversion of old free sample give away. The freemium model gives out 90% of the product and charges for 10%. Freemium sells itself; the consumer experiences the product before they pay and is sure they want it. The challenge is to properly define the free/paid divide.

Microsoft enterprise software is free to small business and paid to big business. Clearly, the idea is that as the small business grows to a large business it will pay for Microsoft because it likes the product.

Microsoft got the idea from Chinese pirates. Microsoft realized that in a developing country like China, if software pirates were going to steal software, it is better that they steal your software. The music industry failed to understand this, and lost the opportunity to control their industry. The video game industry is moving to the freemium model, and here Anderson described his son's fascination with the Club Penguin. Anderson suggested that the freemium model could work well for health care IT. We could have information driven health care, only going to doctors for the big things.

Free: The Past and Future of a Radical Price by Chris Anderson

Network Solutions Grow Smart Business Conference

Congratulations to the entire Network Solutions team for putting on one of the best conferences ever. The conference was devoted to small business and it was full of practical tips. As befits an Internet company, much of the discussion surrounded the ways small businesses can use the Internet.

Clearly designed as a product launch, the conference introduced Network Solutions products and services for small business. Wisely, Network Solutions commissioned a survey of small businesses to discover their problems, and how successful companies were solving those problems. Network Solutions took that data and built a product based on their research. Having built their product, they designed a spectacular conference as a launch vehicle (this is the sort of thing big business can do well if they so choose).

Network Solutions’ small business package will be available at end of October. It will provide professional looking websites for a very competitive price. I predict they will do extremely well with it.

Roy Dunbar opens the conference.