Within the past week, I was asked to take on a more active executive role in Dossia, the combination of the for-profit service corporation and the not-for-profit foundation which has a mission of deploying and managing a patient-controlled, private, portable, personal health record system.  Dossia has been in place for four years, and I began serving as the Chairman of the Board in February, 2007.

In early 2009, the Obama Administration included significant funding in the ARRA stimulus legislation for the upgrading of medical records in physician offices, and directed the U.S. Department of Health and Human Services and the Federal Trade Commission to issue regulations, which would implement a transition process over a multi-year period.  Those regulations are largely in place and the legislation and regulations have enabled Dossia and the other players in the market, including Microsoft and Google, to get anchored in a relatively stable, coherent regulatory environment.

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Reporter David Segal of The New York Times wrote a piece in the Sunday, September 19, issue entitled Just Manic Enough: Seeking Perfect Entrepreneurs – The New York Times which really resonated with me.

I am producing a feature film, and many have said to me, in one form or another, what one investor said in the article about starting a new company:  “You need to suspend disbelief to start a company, because so many people will tell you that what you’re doing can’t be done, and if it could be done, someone would have done it already.”  Segal describes entrepreneurs and people like me who are engaged in entrepreneur-like activity as having to be “just crazy enough.”

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I am a big fan of Thomas Friedman, so I avidly read everything he publishes.  In the April 4, 2010, Sunday’s New York Times, he published an op-ed piece entitled “Start-Ups, Not Bailouts.” His main argument:

“Good-paying jobs don’t come from bailouts.  They come from start-ups.”  Will start-ups address our structural unemployment problem?

Yes and no.  They will be a great solution for well-educated, enthusiastic young people who are currently unemployed and perhaps discouraged about prospects for jobs and careers.  Without some additional interventions, they are not a good short-term or even medium-term solution for older workers who have lost their jobs at big companies or government agencies.  As the former CEO of a big company and the current chairman of one start-up business, Dossia, and a board member or investor in several other start-ups, big company or government and start-up jobs and work situations are radically different.

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In the Friday, March 26, 2010, issue of The Wall Street Journal, there was a very thought provoking article entitled “Reynolds Faces Very Tough Test with Smokeless Tobacco Lineup.” The article specifically details the strategic intent of the tobacco companies to address the public’s concern with the harm created by smoking by moving their customers toward forms of tobacco ingredient ingestion that do not require the inhalation or the creation of smoke.  The article identified lozenges and other forms of orally ingested nicotine products.  In effect, the product becomes nicotine and the other addictive ingredients of tobacco, not the cigarette, cigar, or other delivery system for that nicotine.

The theory behind this strategy is that smoking, not ingestion of harmful ingredients, is the health risk both to the user and to bystanders.  Clearly, when someone orally ingests nicotine, there is no second-hand smoke problem for others, and, for the user, there is no problem with small particulate matter in the lungs.  The remaining hazard is the chemical alteration of the body from the ingestion of nicotine and other substances.  Smokeless ingestion systems are less harmful than traditional cigarettes, but some degree of harm remains.

Even more interesting, Altria recently acquired a company that markets smoking cessation products, which positions it to offset the decline of sales of cigarettes.

This article poses two big strategic questions in the battle to improve health:

• Can we enlist those who have produced unhealthy products and services to transition to healthy or, at a minimum, less unhealthy offerings?
• Should we support the marketing of transitional products that retain addictive behaviors which are still harmful, but are less harmful than what they replace?

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During the course of determining whether I should invest in a documentary film about dogs, I gained some quite interesting insights into the potentially new role dogs can play in our health care system.  Because dogs have a sense of smell that is 40 times as acute and discriminating as that residing in humans, some researchers have explored whether dogs can detect diseases as accurately and reliability as much more expensive technologies, with no need for invasive and time-consuming diagnostic processes.

Two organizations, the Pine Street Foundation in California and the Sensory Research Institute at Florida State University, have each done reported studies which have concluded that dogs can reliably detect various kinds of cancers, such as prostate, breast and skin cancers, because tumor cells give off different odors from regular cells.  It will be quite interesting to determine whether their reliable detection is such that they can detect the presence of these diseases even earlier than more high-tech alternatives like 64-slice CT scans or MRI’s or nuclear magnetic resonance systems.  Dogs apparently have demonstrated as well that they can detect the imminence of an epileptic seizure minutes before the individual subject to the seizure has any symptoms.

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As I have thought about how to change human behavior to get people to do healthier things, I remember the 1984 movie The Karate Kid. In that movie, the lead character, Daniel LaRusso, played by Ralph Macchio, finds a master teacher, Mr. Miyagi, played by Pat Morita.  He believes that he is going to receive conventional instruction on how to be a karate black belt.  Instead, he gets assigned one chore after another, such as painting fences and waxing cars.  It is only after he is doing these chores for a while that he realizes that each task is also serving to strengthen him for karate.  He develops his capabilities while doing something else.

I believe that the only way we will change societal behaviors and get people to do things which make them healthier is to make healthy activity unconscious and fun.  For example, on the web site Thefuntheory.com, there is a video which shows the building, installation, and use of a stairway adjacent to an escalator in what appears to be a Swedish train station.  Because each step in the stairway looks like a big piano key and each one sounds a note as someone steps on it, the result is that stairway usage increases by 66%.

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One television show I enjoy watching is Mad Men, which takes viewers back to the world of the early 1960’s advertising agency.  Through the series, we get reminded how far we have come on reducing gender discrimination and sexual harassment and smoking.

We also realize that life was a great deal slower then and that there was an element of unreality and unsustainability in how people lived then.  There was no hint of global competition or even of the brutal competition that would characterize the American business world even two decades later. (more…)

On April 6, I had an opportunity to speak on The CEO Show with Robert Reiss. I shared some ideas for how small to medium-sized businesses can improve their customer communications and take advantage of valuable marketing opportunities. I also reflected on some strategies I used as CEO, and discussed how Pitney Bowes is working to evolve, adapt to change, and enhance the “customer experience” through innovation.

I enjoyed this interview very much. Please click below to listen to the recording.

At Pitney Bowes, we have done a lot of thinking about how to innovate successfully. As a result, we have challenged conventional wisdom about how innovation actually occurs. There are two traditional views about innovation with which I am familiar:

• One is the idea that institutions have large research and development budgets, begin a number of projects, have many failures, and funnel down to a handful of successes. The “funnel” metaphor is used to describe this idea.
• The second is the idea that organizations either invest in entrepreneurial companies, or create entrepreneurial “skunkworks” which operate outside the company’s annual budgeting processes and produce innovation. This was a popular theory, supported by the IBM PC launch in the early 1980’s.

Both views are flawed, because they oversimplify how innovation really happens. I got the best insight on innovation from my 15-year-old daughter, who is not only a serious musician, playing the harp, flute, and piano, but an avid student of popular music history. She read and gave me a copy of Bill Wyman’s Rolling with the Stones. Wyman was one of the founding members of the Rolling Stones. (more…)