The Ishikawa Diagram - also known as a “fishbone” or “root cause” diagram - can jump start your strategic planning with wonderful results.  Named after Kaoru Ishikawa, one of the early pioneers of Total Quality Management in the 60’s, it forces you to:

• Identify the drivers in your business ecosystem.  In the service industry these are often the 4 S’s: Surroundings, Suppliers, Systems, Skills.  If you are in manufacturing, you can start with the 6 M’s: Machine, Method, Materials, Maintenance, Man and Mother Nature
• Take a holistic approach. When you look for the relationships between different areas of your business you can’t help but form a big picture view.
• Think in a structured manner about ideas that were previously hard to pin down.

Sample Diagrams

Resources

• If you love Microsoft Excel, you might want to take a look at BPI Consulting’s SPC for Excel” will jump start your planning process.
• If you’re in more of a brainstorming mood, check out Mindjet’s Mindmanager 7, which runs on both PC’s and Macs.

Cloud computing refers to the shift of ownership and maintenance of servers from individual business units to a shared and secured environment on the internet. It means a lower total cost of ownership and the ability to scale rapidly to meet demand.

Think if it like this: if you’ve got an internet connection you’ve got access to storage space and software applications limited only by your budget. Nothing to install and nothing to maintain.

How It Will Affect Your Business

According to Merrill Lynch, it is estimated to be a $100 billion market within three years time.  If true, your business will:

• Own fewer servers
• License software on a monthly, per user basis rather than the more prevalent “per seat” basis
• Store data offsite rather than local harddrives

As Wiggly As Web 2.0

The term “cloud” comes from the term used to describe how various computers connect to one another over the internet. The lack of specificity in the illustration is helpful in understanding that “everything takes place on the internet.”  When it comes to understanding new and emerging business services, the vaguery is frustrating, just like that evil term “Web 2.0″

Examples For Managers In a Hurry

For business managers demanding great specificity, here are some examples to get you started:

• Amazon Web Services (AWS) - on demand servers and caching infrastructure favored by start ups. Need more storage, fill out a form and it’s online in minutes.
• Microsoft Live Mesh - which went live today for public beta (just use your hotmail or live.com address to log in) wants to compete with Apple and Google.  Click here for a nice screencam demo of Mesh.com.
• Google - Google and IBM are providing clusters of processors to universities for research programs. But this is just the tip of the iceberg.  Docs, Spreadsheets and Presentation while still “in beta” suggest a strategy broader and targeted towards business computing.

Lack of Uptime Guarantees Is A Problem

The problem with all this is the lack of reliability and uptime guarantees. When your critical data is out on the cloud and the cloud fails you’re just out of luck.  As I write this Apple’s “Mobile-Me” has failed to sync my calendar and contacts for 24 hours and Basecamp (a project management site built upon Amazon’s services) died for a critical two hour window when I needed it most.  In both instances I had local backup copies at the read.

Buzzword Status Score

• Hype: High
• Value: Real
• Time frame: Now, now, now!
• Caution: Control freaks will be frustrated

So I jumped the gun a little bit. Found the putative secret link to the iPhone 2.0 software update ahead of schedule.   Through some good luck happened to download the update just before Apple pulled the link.  The install was smooth enough, though doing a manual upgrade was a bit nerve wracking. To brick or not to brick that is the question.

Seeing absolutely no reason to buy the new 3G iPhone - AT&T already takes enough out of my wallet each month, so why pay more each month for nasty customer service  - I am content to enjoy the Apps.  Particularly impressed by Epocrates, which has been available as a Wi-Fi “application” for some time, but the whole offline experience is just great.  Highly recommend it for fellow healthcare folks.

Other top applications tonight have been:

• Remote - when you’re too lazy to get off the sofa to change iTunes yourself
• New York Times - now I can read on the subway while I ignore the Mariachi band next to me
• NetNewsWire - RSS Feeds that sync with my desktops and laptops
• Jott - now that I got the phone version working with Evernote, this should be interesting
• Facebook - now I can communicate with my twin 17-year old nieces who tell me “Uncle Mark, email is so 2006″

As for the rest of the applications, there’s really no way I’m going to pay $29.99 for the Pocket English to Portuguese Translation Dictionary.  I already know the international gesture for “sorry this seat is taken.”

Shire’s Vyvanse™ is the newest addition to the family of medications used to treat ADHD (Attention Deficit and Hyperactivity Disorder) in children and as of April 23 adults as well.  Given that ADHD is a disorder shrouded in confusion, shame and sometimes controversy, there is a demonstrated  need for premium patient education.

We reviewed the “Vyvanse™ : Child’s Starter Kit” (made available to parents by physicians) and found it to be one of the best DTC-Patient Ed pieces we’ve seen in a long while.  The kit consists of:

• 16 page, full color booklet with basic information about the disease state
• An interactive CD-ROM that plays on both Windows and Macs (the latter representing a smart marketing decision. In the US, Apple represents two thirds of all new computer sales)
• An ATM-like card to be used at local pharmacies for a free 30-day trial of the product
• Standard P.I. insert

The process of converting the “concerned and curious” to new customers begins immediately. The right front page prominently displays a serialized card used for enrollment in the 30-Day trial. Parents must call a toll-free number to activate the card prior to filling the prescription.

A patient who went through the enrollment process described it as “quick and easy” but was somewhat distraught over the perceived lack of privacy (we received a firewall warning that the CD was attempting to connect to the Internet without our permission).

For a parent to receive the free 30-day trial they must agree to automatic enrollment in market research, direct mail, and other activities that may seem invasive. A second phone number to “opt-out” was provided, but this emotional response may have been exacerbated by the automated fulfillment process - no humans just I.V.R. - suggesting that there might be a role for stronger messaging around privacy assurance. Parents are a skittish lot.

The multimedia presentation itself was well paced, well structured, and followed best practices including:

• “Closed Captioning” of the opening slide show narration
• Easy to use, persistent navigation providing a “you are here” feel
• Supportive rather than gratuitous graphics

These small touches are important as they lower the barriers to navigating new information.  Beyond what you might expect to find in an introductory overview of ADHD were some real jewels:

• “Success Tracker” to chart and reinforce a child’s improvement in tasks that had previous proven difficult
• Recognition Certificate for the child - we’re assuming it works on the principle of “accomplish so many things and your reward will be..”
• Household Organizer Chart - for both child and parent, bringing a little structure back into home life

The net result was a solid introduction to the science of ADHD, useful tools for parents already under a great deal of stress, a 30-day free trial that - perceived privacy concerns notwithstanding - that was easy to activate and readily accepted at the pharmacy, and an overall positive user experience.  Looks like Vyvanse™ got it right and with one million scripts in ten months of launch, they’re off to a great start.

That’s not a typo, that’s Soocial, a web service that syncs your contacts amongst all your connected devices and web applications.  It promises a “one address book solution to contact management” syncing data from mobile phone to Google address book to all your home and work computers. All quietly in the background.

If this sounds a lot like Plaxo or (gag) Mobile-Me, you’re right.  But Plaxo can’t decide what it wants to be since they’ve been acquired by Comcast. Soocial on the other hand just wants to sync. It supports an impressive 400 phones, contacts in Gmail and 37Signals’ Highrise CRM app (which we rolled out to replace top-heavy Salesforce.com).

So far the beta looks good and the first day’s experience has been positive.  I’ve got one beta invitation left, available to whoever writes me first.  In the meantime, you might enjoy this short 3 minute video about “Hassle Free Sync” featuring David Hasselhoff, a great visual pun if ever there was one.

iPhones and Tom-Tom’s oh my!  As more and more hand held devices begin sharing data with each other and with the net, the ability to predict behavior becomes the next big thing for marketers, social networks and of course governments curious about citizens’ behaviors.

All of this falls under the rubric of “Reality Mining,” a term used to describe the marriage of GPS (global positioning systems) and large scale data mining. Pioneered by Sandy Pentland, a researcher at MIT whose work received funding from Nokia (the mobile phone handset manufacturer), the field shows great promise for those interested in predictive behavior.

By tracking physical location of the handset and hence its owner, proximity to contacts in the device address book which is a new feature in the forthcoming iPhone 2.0, and activity information such as motion or rest, a great deal of information can be gleaned.  Here are some examples all ready under way:

• “Will shoppers go out of their way to visit Starbucks? Or do they visit the closest coffee shop?”
  Product: Path Intelligence
• “I am downtown and it’s lunch time.  What good restaurants are nearby?
  “Product: Yelp Location Aware
• “I’ve got some free time.  I wonder where my friends are?”
  Product: BrightKite Social Networking

All of this begs the question of privacy, an area in which the United States seems to be trailing Europe.  Will users “opt-in” or will we rely upon the good intentions of the telco’s to scrub data clean of identifying information?  Or is privacy just a mirage, long since destroyed by the marriage of barcodes, traditional data-mining and putative “customer loyalty programs”?

We all know that Google reads our email.  Those contextual ads in Gmail are the quid pro quo for free Internet email.  With the launch of “Google Health” the question becomes “but will they read my healthcare records?”

John Halamka, M.D., CIO of the CareGroup Health System, CIO and Dean of Technology for Harvard Medical,  author of the highly regarded Geek Doctor Blog and an unpaid advisor to Google (hat’s off to Dr. Halamka) says no.

Security and privacy are foundational to Google Health. The privacy policy, with oversight from the Google Health Advisory Council, stipulates that data will never be transferred, sold, mined or released without specific consent of the patient. Patients completely control the content and may remove it any time.

But I’m not so sure.  Remember the Google Reader debacle? When business acquaintances with whom you chatted perhaps once suddenly had access to your RSS feeds?  This prompted a public outcry of protest, with journalists like Garett Rogers of ZDNET to demand “Close all Google accounts: Google doesn’t care about privacy!”.

Privacy International - an internet privacy watchdog - placed Google at the bottom of the list of Internet service companies. And David Harlow’s Health Care Law Blog says Google Health privacy policy can be changed at any time in the future.

Now some might argue that opting in to online healthcare records represents an informed choice between convenience and privacy. But when companies like BIDMC, Cleveland Clinic, Longs, MEDCO, Minute Clinic/CVS, Quest Laboratories, RxAmerica, Wallgreens and now BlueCross BlueShield (see Boston Globe article) want to link up with you the stakes get significantly higher.  Most Americans have strong sentiments about the  trustworthiness of medical insurance companies.

I am much more intrigued by Microsoft’s Health Vault, particularly in light of the announced relationship with Kaiser Permanente.  Here patient data is not only centralized but enhanced by value-added services like interpretation and explanation.

Consumers can not only see a record of a test that they had, but also the result of that test and in some cases, direct feedback from their doctors about the result.

Not only is Microsoft’s privacy record thus far superior to Google’s  but they are offering data portability. Leave Kaiser and take your data with you.

There are no easy answers in the wild west of medical privacy. But given the gray market of pre-employment screening of  job applicants for adverse health conditions and the rampant fears of genetic discrimination the best answer to: “should I put my records online?” is

“Caveat emptor. Don’t do it if you don’t have to.”

According to a recent article in Drugs.com Novartis, Pfizer and Merck have taken the lead in “strong relationships” with physicians as measured along several axes including:

• personal and professional conduct
• knowledge and expertise
• sales visit quality and value

The original research published by TNS Healthcare Research notes that what separated the top performers from the pack was performance across the full range of other service experiences. This is interesting because it has often been difficult to quantify the ROI of investing in the myriad of ecosystem components such as:

• patient and physician education
• practice and staff support
• total brand experience
• corporate reputation

We’ve all known that these are must-have’s, but when faced with pressure to grow top-line sales they may often seem like distractions.  Yet in the complex business ecosystem of pharmaceutical sales so-called soft services do correlate to improved results.

What This Means To Marketers - Education Matters

Of particular interest was the finding that while rep interactions are important, “…two-thirds of physicians give high importance to both doctor and patient education programs.” In the new click-economy, the ability to deliver information, whether in-office or on the web will continue to be valued and remembered.

EyeForPharma just interviewed Baba Awopetu, Manager of Brand Strategy, EMEA at Stryker that highlighted the challenges that big pharma faces in a period of decreasing profit margins. “The future of pharma marketing” offers an interesting perspective of strategic shifts to come:

• Pharma will be looking for people to help solve its problems which new kinds of marketing skills. Think less hiring from within the industry and a more open-minded look at “pure marketing” that taps other industries
• Greater reliance on multi channel approaches in the ways brands are built and products marketed
• Emphasis on “innovating value” that places greater value on “out of the box” approaches that emphasize ROI and profit.

And in a shot across the bow of status quo, he suggests:

Less of what we have at the moment, which is agencies driving strategies in conjunction with brand managers. In the future, he says, marketers will be held more accountable for driving and developing brand building strategies.

All of which to say is the end of big budgets, big spends, and carpet-bombing sales tactics may be at an end. The layoffs in sales forces, disappointing pipelines and the prospect of significant healthcare reforms come post election would tend to back up his admonition that “the secret to success is paranoia.”

Raf Cammarano is an Enterprise Architect based in Australia whose blog covers the nexus of I.T. strategy and design. While I’ll grant it may be a tough read for non-geeks, he’s written a wonderful series on Business Ecosystems which outlines how old, linear supply chains are being supplanted by more complex ecosystems of interdependent and inter-related resources.

A linear supply chain is relatively easy to manage… Business ecosystems, on the other hand, have a complex array of relationships and each relationship has to be managed. This can’t be done without the help of technology.

What strikes me as interesting is that marketers hoping to tap new consumer demands will increasingly need to rely upon a new way of thinking. One that emphasizes relationships over process flow. And none of this will be possible without advisors able to translate complex technology into every day terms.