Will Rome help build in-roads in the medical field?

Rome was not built in a day. In its development the Romans IMPLEMENTED many infrastructure changes that allowed for forward progress. They made roads to speed up transit and promote trade. They also created and used aqueducts to bring clean water to the people. The individual people of Rome could not have produced the same results given their individual devices. They took the summation of their resources and bettered the populace with infrastructure.

Today we apply the term infrastructure to many different applications that were not used in the time of Caesar. The last emerging world changing technology is the internet. Today a new world changing technology is coming into emergence. The new technology is “electronic medical records.”

This may seem a bit of a radical concept, but “electronic medical records” is a technology that will allow medicine to be reinforced with access to more information. Let’s step back to the Romans and their roads. Before Romans had roads, they walked and rode horses across the country side. With the advent of the road, traveling became more direct and efficient. Currently doctors are riding horses across the country side, and with EMR they should have a slightly more direct and efficient path.

Okay, we have heard the Obama administration talk about it since last year, but no one is telling us how. It starts with a very socialistic approach of national standardization. Before you fly off the handle at the concept of socialism, understand that all infrastructures have to have broad sweeping standards. An example would be road widths and speed limits. Another example would be internet data transmission with many of its boring details. I imagine the world of EMR will require many levels of boring standards to be effective.

In my very non-educated opinion, EMR will need a consortium of vendors to standardize the important information. Items like digitizing x-rays, ultra sounds and CT/PET scans are a given for needs. Text based information and standardizing “CODING” are also necessary, but someone has to make these decisions. Much like the Federal Banking system is for currency, the Center for Disease Control may be the best choice for heading up the EMR standardization, since they are the leading government agency with regards for health. This may be a good opportunity to create a consolidation agency that combines the CDC with the Food and Drug administration, much like the Department of Homeland Security combined all of the law enforcement agencies.

Once this standard is set, the medical community will become much more effective. However until the government setup a committee to take care of the standardization Health care will suffer in inefficiency.

Does your business have any business on the web?

While in business school we had many key items drilled into our heads. Some included economies of scale and scope to drive down cost. Others included maximization of operations through process adjustments and Bottleneck recognition. Well I don’t want bore you guys into managerial submission, but I do want to talk about Web sites.

First let’s look at websites as extensions of the business and realistically categorize them. Like anything in the business world, websites are optional, but they are also a point of judgment. A website is a virtual representation of your company, and in some cases the only representation of your company (think http://www.amazon.com/, http://www.google.com/, and http://www.facebook.com/). I also know of Multimillion dollar companies that do not have a webpage because it will only help them marginally.

Let’s focus on that last concept for a few moments. You always hear about the infinite vastness of the internet, but how effective is staking claim to a spot on it really worth to your business. In business school we had a couple of definitions for the styles of business that included products and services.

Obviously the easiest type of business to justify having a space on the internet is products based, because what is being paid for can be shipped to almost any location on the planet. I have personally seen catalog companies go online and jump 4 and 5 times in size just by having a good e-commerce site. That is the good news. The bad news is that without a good e-commerce site these companies take on thousands of dollars of overhead trying to setup their online store, and may never get recognized by search engines like google or yahoo.

Then there is the other type of business that cannot be easily shipped. It is safe to say that services are 99.9% regional and that has proven to be a problem with the World Wide Web in the past. There are 2 major service categories that are lost in the shuffle. One category is lawyers, and the other category is accountants. To circumvent this location ambiguity web sites are adding descriptive terms to their site to describe where they are performing these services.

For the lawyers, they are joining major law websites like lexus-nexus and martindale-hubble and setting up sites with them. Those two web site companies work by allowing law firms to setup mini-sites inside of their domain, which can have links to the practice's actual web site. Because these two sites generate so much traffic by “economies of scale” (thousands of law firms have mini sites with them) they rank higher on google and yahoo searches. Going back to the multimillion dollar company that does not have a site, they are a law firm that received almost 100% of their internet traffic from the mini site, and so they let the main web site go away when the hosting contracts came up for renewal. They figured it was a waste of money that was only being looked at 20-30 times a month.

As a business school graduate I must say that EVERY company should have a web presence, but I also have to advise that different style companies require different levels of web presence. In summary, if you are a turn based company it is probably a wise idea to setup a proper e-commerce site, but if you have a service business you should evaluate how much you can or want to divulge with rest of the world in intellectual property. Producing good information for free generates traffic, but you want to hold a little back to make money off of.

As a side note, and I also suggest this for all companies with web sites, I installed code for Google analytics on http://thinksmallgroup.com/ and the site has had visits from Canada, China, and New Jersey...Okay, maybe New Jersey is a state in the US, but sometimes I don’t understand a word they say...does that count?

You may be business casual, but your email is wearing shorts and a t-shirt

I am not going to sugar coat this message, if you have a small business no one is going to take you seriously until you have an email that reflects your business’s name. Me personally, I like to have domain names reflect the name of the business...Wait, I think I may be jumping the gun in the process, let me start at the beginning and ask, what type of email do you need? Yes, I like to ask questions to determine what is right for a particular client. This way seems to make the most sense to me because no one knows their communication needs like the owner of the business.

Step 1 – What level of email do you need? This one it kind of tricky because not many people understand how many types of emails there are. For this conversation we will stick with the 3 basic formats of web based, POP, and IMAP/MAPI. I promise to explain the technical jargon and acronyms to an understandable level, so let’s just work with the terms basic, standard, and enhanced.

Almost everyone has seen or even had a web based (basic) email address. This is the yahoo.com, hotmail.com, and gmail.com addresses of the world. You go to a web site, type in your email address and password, and get all of your emails from flower vendors and favorite clothing stores advertising sales. This is by far the most widely used format because of the sites ease of use, and generally very low price tag to register and get started. The general drawback to going with a web based email vendor is that you are CompanyA@gmail.com which does not scream “hey, I am a serious business over here!” These addresses also require that you log into them to get your email. Since these addresses do not get checked until you manually check them, emails can sit for long periods of time. Any small business that provides primary income for the owner should shy away from these types of emails because of the limitations.

POP (standard) email is taking a major charge up the market share ladder for businesses that want to take their communications a little more seriously. This email can be best associated with home service providers like AT&T and Comcast. Those companies offer 5 or so POP accounts for every DSL or Cable modem connection that they provide. These pop accounts are configured so that you can start using programs like Microsoft Outlook Express and Standard Outlook to go out to the servers and pull the messages down to your computer. POP email is exciting, because you can start to use registered domain names such as owner@CompanyA.com. This cost a little more than free, but it is well worth it in the long run when you have 5 to 10 employees, and they all have matching email addresses that reflect their association with your company. This technology is a “Pull” technology. The client goes out to the server periodically and “Pulls” the emails down, and the gaps can be set between these “Pulls”. By default Outlook is set to be 30 minutes and can go as low as 1 minute; however it can never truly be instantaneous.

IMAP/MAPI (enhanced) email is the stalwart of the email industry. This protocol (rules governing the transmittal of data) is the biggest and the best when it comes to features and response time. This is because it requires you to have access to a highly accessible server to perform. The biggest name in this industry is Microsoft Exchange which works well with Microsoft Outlook. The exchange server establishes a connection with the client (usually Outlook, others can work also) and as the new emails or updates hit the exchange server it “pushes” the data to the workstation. The only wait is in how long it takes to download the email. Another cool feature of Exchange is that since the data is stored on the server, you can share you data out with other people on the Exchange server. Say you have a secretary that needs to keep your calendar, you can share out just your calendar and she/he can update it without even bothering you. These updates are then automatically and instantly “pushed” down to your Outlook.

As you can tell, most of the email products out there can get the job done. The first question is to what level do you need your email to be? I guess a sub category of that question would be how much do you want to spend? This is where email is getting exciting! It is getting pretty cheap to have pretty good email. Obviously web email can range between free and $50 a year (you can upgrade most web email to work with outlook for a small fee). The big news is that POP email can be free also, as long as you pay for the domain, and have an email client to go out and get it (Outlook is about $85 per workstation). So really POP email is between $9 - $19 a year to register the domain and free to have up to 100 addresses on that domain. You can pay more for various services depending on the POP host including calendar sharing and file sharing. Exchange however is not so cheap. It starts out at around $36 for 3 mailboxes (you also have to buy the domain name like POP) and can go up at a decreasing rate depending on how many mailboxes you need. Just for simple math, let’s just say that 100 mailboxes is about $1000 a month.

To all the small business owners out there email is a serious tool. Finding the right level of email for a business is important. Changing email formats can be expensive and almost impossible. Before locking in on any solution you should consult a technician to verify that you are making a good decision for your business needs.

Tip of the day – As with your medical and financial needs, don’t trust your business’s computer systems to kids fresh out of high school. They may understand how things work, but they do not understand the value of downtime to a business.