If you are interested in innovation, or are concerned about the condition of our healthcare system, then you will enjoy reading The Innovator’s Prescription by Clayton Christensen, Jerome H. Grossman M.D., and Jason Hwang M.D.  If you are interested in innovation and healthcare, you need to click over to Amazon, drive down to your neighborhood bookstore, or log on to your library’s web site to get this book right now!

The other day I picked up The Innovator’s Prescription to read while I waited for an appointment.  I first read the book back in January when it first came out.  Rereading the Disrupting the Business Model of the Physician’s Practice chapter got me all pumped up again.  This is one great book.

This timely volume combines Christensen’s proven theories on innovation with 10 years of research on all levels of health care.  The book covers providers, hospitals, pharma, patients, and everything in between.  Rather than propose new spending programs or seeking to protect current interests, Christensen, et al provide a clear, rational assessment of healthcare as it exists today in the United States; along with well reasoned suggestions of how it could, and should, evolve into something much better.  Though many of the ideas presented are “disruptive” of the status quo, these are ideas that make sense, not some cooked up, forced plan to “save” healthcare.

Although more than four hundred pages, this book is riveting, enlightening, and liberating.  If you have concerns about healthcare, do yourself a favor and read this book.  As a bonus you will find many engaging case studies, anecdotes, and real-world illustrations of innovation at work.

The Innovator’s Prescription is a must read!

I got a “one time offer” in the mail today to renew a magazine subscription.  I threw it right into the recycle bin.  I never respond to the first renewal offer I get for a magazine.  If you have ever subscribed to a magazine you know why.  Regardless of what the offer says (one-time deal, last chance, etc.) there is always another offer coming, usually at the same price — or better.

You’d think that in this world of “voice of the customer,” viral marketing, extreme customer service, etc.  that magazine publishers would figure out that they would get more subscriptions, with fewing mailings, if they would stop lying to us.

Instead of numerous renewal offers that start cluttering our mail box just weeks after we complete the prior renewal, just send an e-mail with a link to their web site.  On the site give us three or four options (1 year, 2 year, gift subscription, etc.) with pricing that we can trust.  And, offer to not bill the credit card until the current expiration date. I’d go for that.

But, forget the “one time offer” that involves my payment 9 months before my current subscription runs out, when I know I’m going to get at least six more offers.  Just be honest with me, and leave the “buy now, or else” scare tactics to the sleazy used car salesmen.

Is that too much to ask?

Don’t you just hate interactive voice response systems?  You know, the automated voice that asks you for all kinds of information so it can “better serve you.”

One of my least favorite aspects of these systems is that they pretend to be an effort to better serve me, when in reality they are first, and foremost, a way to cut costs.  I called to request a detailed bill for a recent visit to the emergency room of a local hospital.  The automated voice said that to better serve me, and to route my call to the correct area it would need to get some information.  This was expected, and I complied fully… yes, I was the patient; account number; date of birth, last four of my social security number…  You know the drill, I’m sure.

When I had given the system all the information it needed, another voice informed me that to ensure quality customer service my call may be recorded.  After a brief pause a new voice came on the line.  Another automated attendant!  And guess what?  It asked me the same questions again!  After complying fully, and confirming my account, date of birth, last four digits of my social security number, and answering a few more questions I finally got an option to request a detailed bill.

I understand how these systems save money for the companies that utilize them.  The computer that answers the phones isn’t on salary, and doesn’t need breaks.  I just don’t understand how they can claim (with a straight face) that these systems are implemented to improve the customer experience.

I’ve often marveled at the naivete of designers that are so excited about their cool new web interface, or developers who are so proud of their shiny new service or method when, in reality, their creations are only novelties because they don’t solve a real need.  Cool for cool’s sake is not good design (or good code).  Good design meets a need, helps the user/customer accomplish a goal.  So, to have good design, you first must know your customer.

Along the same line is this great quote about innovation from The Game-Changer by A. G. Lafley and Ram Charan:

To understand innovation, you first have to see the differences between an invention and an innovation.  An invention is a new idea that is often turned into a tangible outcome, such as a product or a system.  An innovation is the conversion of a new idea into revenues and profits.  An idea that looks great in the lab and fails in the market is not an innovation; it is, at best, a curiosity.  As Jeff Immelt once put it, “Innovation without a customer is nonsense; it’s not even innovation.”

I would add that a design that doesn’t meet a customer’s need is not a design.  It is, at best, a curiosity.  Great designs have purpose, they achieve a goal.  And if they are cool in the process, all the better.  But, if they are “cool” without getting the job done, they are, at best, curiosities.

A couple of weeks ago I arrived at the Gaylord Palms Resort and Convention Center in Orlando for a conference. I, along with the others in my group, was immediately impressed with the grandeur of the resort.

From the grand entrance and the ornate lobby to huge atrium with a mini everglades including live alligators, beautiful pools, and tasteful restaurants, to the personal greeting on the screen of the in-room computer system, this was a fabulous resort (as they repeatedly called it).

The “Big Things” were all very nice, very grand. Obviously a lot of money spent. This was no average hotel and convention center. In a very short time my expectations for the experience I would have there were set very high.

Those high expectations were short lived, however. As I spent time in and around the resort I was continuously bombarded by little things overlooked or done poorly.

The first night I was there I came back to my room (after having been in and out of the room several times) and my key card would not work. I went down to the front desk and got a new one and I went back up to my room. I was still locked out. I went down to the desk again. They called security. I went back up and waited in the hall. Security got finally got there and I thought my wait was over. Wrong. He tried a few tricks, but couldn’t get in either. He radioed for engineering. So, I paced the hall and waited — again. The guy from engineering didn’t have any better luck getting the lock to work. Fortunately, he had a metal rod with a string that he could put under the door, hook the handle and break into my room. Yes, break in. That made me feel secure. An hour after I first tried to get into my room, I was finally successful. The guy from engineering said he had to rush off to help someone else who was locked out of their room, but he could come back after and replace the lock, or someone could come the next day. Well, I didn’t want to go into the next day not being able to get into my room, so I told him I’d wait up for him. Forty-five minutes later my door worked. I made it to bed about 1:30 am.

The next morning the fun continued. Although I could get into my room fine, I found that I could not get out of the guest parking. Fortunately, the card reader had a button you could push for help. “They will let me out” I thought. Wrong. I had to get the 2 cars behind me to back up and drive to the exit that had an attendant — who insisted on swiping my card herself and looking up my room number before she would believe that it didn’t work (but should have).

I had been eager to forgive after getting locked out. Mechanical failures happen. Now, however, I was beginning to get a bit frustrated. And, the frustrations continued. I won’t bore you with the details, but little things continued to go wrong throughout the week. Not just for me, but for most in my group. Of the 8 in my group, only one didn’t have several irritating problems, from in-room air conditioning and phone not working to being checked into rooms that had not been cleaned (including a used shaving kit in the bathroom).

Sadly, instead of coming away with great memories of a great experience, we all came away with a bad taste in our mouths due to “Little Things” that were overlooked and mishandled. A lot of money was spent on big things to make a big impression. But that money was wasted due to the little things gone awry. That’s too bad for everyone involved.

I was in Minneapolis recently for some meetings at a customer’s offices in a suburban area. While there I stayed at the Hyatt Place. It was my first trip to the area, but those I was traveling with had been there before and said that they wanted to stay at the Hyatt Place. I was not familiar with Hyatt Place, but went along with their recommendation. From the outside it looked pretty much like the myriad of other small hotels that locate around offices in suburban areas.

Walking into the lobby, however, was a unique experience.

Just inside the front door we were greeted by the friendly staff wearing coordinating sweaters instead of formal uniforms. There was no large registration desk that separated us from the staff, just a small counter. As we came in a couple of staffers stepped to the counter and checked us in. The computer monitor was build into the counter top, which was waist high. The whole experience was open, inviting, friendly. Not formal, stuffy, or separating.

Stepping into my room was likewise a pleasant surprise. Instead of a narrow passage between a closet and a bathroom, I was greeted by the view of a large room with a sectional couch! My first impression of the room wasn’t small and cramped, but open and spacious. As I stepped into the room I then saw the 42 inch flat screen HDTV that swiveled so it could be viewed either from the couch or the bed. The things that were visible from the main areas of the room (desk, couch, bed) were all very nice. The sinks were set in a granite counter that was next to the closet, across from the bed. The bathroom was in the far corner of the room and was nice, but fairly plain. The attention to detail was in those area that would be seen, and used, the most. Very nice.

I highly recommend Hyatt Place, especially if you are going to be there more than one night. It was a great experience.

Note: I started this post back in October, but never got it posted. Dave Brubeck turned 87 on December 6, 2007.

I had the good fortune to see the Dave Brubeck Quartet in concert last month. For those of you who may not know, Dave Brubeck is one of the legends of Jazz. He is a classically trained pianist, who has been delighting audiences with his jazz renditions (usually with his quartet) for more than 60 years. Yes, that makes him quite old. Eighty-six years old, to be precise. But, he still has “it.”

“It” in this case refers to the ability to captivate an audience, to deliver an amazing concert experience.

Certainly, the quartet contributed to the whole experience, but the key focus was Dave Brubeck and the piano. He didn’t need to jump around, or bob his head, or wear flashy clothes to keep the attention of the audience. He simply played the piano with amazing finesse and style, and talked genuinely with the audience between sets. No big light show, no theatrics, just amazing music from an amazing artist. That was the experience we came for, that was the experience we got. And we weren’t disappointed.

A lot of things can contribute to an experience. If no one thing really stands out, and drives the experience, sometimes other things can be added, or enhanced to make the experience more powerful. But, when the experience people want comes through simply, powerfully, “adding” other things to the experience ends up detracting and taking away from the experience.

Dave Brubeck is the real deal, a genuine artist with true star power. Seeing him in concert, in all his simplicity, was a fabulous experience. Anything else would have been a cheap substitute.

Good design requires understanding. And true understanding (of customer/user and business needs, constraints, opportunities, etc.) doesn’t just happen. It requires probing, studying, and questioning.

So, when one stops asking questions, for whatever reason, good design becomes much more difficult. Through the years I have repeatedly seen one key reason that people stop asking questions: Smart Guy Syndrome (or SGS). (Not to be sexist, but my experience is that men have a much bigger problem with SGS than women — although it does afflict women on occasion.)

It usually happens like this. A guy is given a job/ project/ team/ whatever to run — because he is a “smart guy.” Now, he needs to support the premise that he is indeed a smart guy. He is a smart guy because he has the answers. Asking questions would just undermine his position as a smart guy, therefore he quits asking questions. It doesn’t happen all at once, but gradually the questions and the probing lessen, and more and more trust is placed in what is already “known.” After all, he is a smart guy. As this happens, the design becomes more ego-centric, and based less on true needs and opportunities.

If you stop and think for a minute (and you are honest with yourself), I’m sure you can recall several cases of SGS. You may have even been afflicted at one time yourself (most of us have). The challenge for each of us is to stay alert, to recognize the early signs of SGS, and take preventive measures (seek true understanding through probing, studying, and questioning). Avoiding SGS is one of the best ways to improve designs. Trust me, I know…

Last month I was at MIT for the Campus Preview Weekend for next year’s freshmen. It was a fun weekend packed with seminars, tours, classes, presentations and parties. Of course the focus was on my daughter, not me. But, there still were plenty of things for the parents to do. At a reception for the parents Phillip Clay, the chancellor of MIT, spoke of the many projects undertaken by MIT and MIT students that are making a difference for the poor and less fortunate around the world. It was an interesting, and impressive, presentation. Truly the skills, talents, and intellect of these exceptional people is making a difference.

At another presentation, Susan Hockfield, the president of MIT, also spoke of MIT initiatives that are targeted at helping in third-world countries. She described these efforts as “helping those who can’t help themselves.” I was both encouraged and frightened by her comments. I was encouraged for the obvious reasons — that those who have been given much would go out of their way to help those less fortunate. I was frightened because of the potential dangers of “helping” too much. Not social engineering, exactly, but assuming we know what is best for others when we see only our perspective, and don’t understand theirs.

What does this have to do with design? All too often we rush in to design and/or build some great new thing that the users will love. After all, we have skills and talents, and we can help them. Except, skill, talent, and desire to help aren’t enough if we don’t really understand what the real users want or need.

Before you “rush in” on your next design or project stop and consider — honestly — who your audience really is. What drives them? What are their goals and objectives? What are their fears and frustrations? Now, design to satisfy their needs, goals and desires, not just what you assume would work for them. The best way to help is to first truly understand the need, and design to that need, and not just impose our ideas on others. As Uncle Ben said to Peter Parker, “with great power comes great responsibility.” [More to come on this subject.]

While testing the beta of the new Interaction Design Association web site (ixda.org) I came across an entry that I had posted in a thread about the commercialization of art/design back in December 2005. A slightly modified version follows.

Design is not a random, spontaneous act. It has purpose — a goal that is trying to be achieved. Good design achieves the intended goal or purpose (or, at least gets close). If I design a chair that is visually appealing, but terribly uncomfortable, my design has not succeeded (as a chair, although, it may succeed as sculpture, or art.)

It is true that some designs may be overly constrained due to business issues. But, this is nothing new. Many great artists through the years were constrained by the desires, or willingness to pay, of their benefactors. What they painted, composed, sculpted, etc. was greatly influenced by their employer. That doesn’t mean their work wasn’t worthwhile, or successful. The reality is that most designs have constraints of time and money. Tradeoffs must be made. Good designs focus on achieving the objectives of the sponsor, and of the user even if some *art* gets sacrificed in the process.

I don’t see this as pandering to profits. It is not a bad thing to be avoided, rather it is what makes design design. Does that mean that a comfortable chair cannot be visually appealing? Absolutely not! If the visual aesthetics add to the overall experience, they add to the success of the design.

Great designs go beyond the business (sponsor) needs. Really great designs have as one of their key objectives to meet the needs/wants of their users (in an elegant way). Great designs provide great user experiences, not just a creative outlet for the designer. And, bad designs (that don’t consider the user experience), generally are limited in their benefit to the business paying for the design. The process is self regulating. Bad designs have limited commercial success. Good/Great designs often have the best commercial success. (Think of iPod, IKEA, Google, or your favorite products/services/software.)