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	<title>The Business Research Blog</title>
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	<link>http://www.brekiri.com/blog</link>
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		<title>What Does This Company Do Again?</title>
		<link>http://www.brekiri.com/blog/545/what-does-this-company-do-again/</link>
		<comments>http://www.brekiri.com/blog/545/what-does-this-company-do-again/#comments</comments>
		<pubDate>Thu, 14 Jul 2011 14:03:32 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Information Sources]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=545</guid>
		<description><![CDATA[<p>“We have more than 250 operating companies in 60 countries employing approximately 115,000 people.”  Statements like these illustrate how large companies, almost by definition, are highly confusing entities.  They encompass all sorts of legal entities for tax and other purposes that have little to do with running the business.  Even the actual lines of business [...]]]></description>
			<content:encoded><![CDATA[<p>“We have more than 250 operating companies in 60 countries employing approximately 115,000 people.”  Statements like these illustrate how large companies, almost by definition, are highly confusing entities.  They encompass all sorts of legal entities for tax and other purposes that have little to do with running the business.  Even the actual lines of business can be highly complex because of the sheer number of products and departments.  They acquire and divest businesses all the time, mash them up in a variety of confusing business units, and sometimes obfuscate their reporting to avoid giving away too much information to competitors.  Private companies are often even worse, of course, because they are not required to report as much information.</p>
<p>Brekiri is working on solving this problem by providing a clear, simple set of metadata to help you get your bearings on a company you’re researching, whether it’s a potential customer, competitor, or partner.  We show you the business unit structure, categorize those units into more specific industry segments than other sources, and give you a jumping off point for searching for financials, people, or other topics.<span id="more-545"></span></p>
<p>We’re still fine-tuning the application, but you can already take a look at a few examples of the company profiles we’re putting together:</p>
<ul>
<li><a href="http://dev.brekiri.com/landing/johnson_johnson/">Johnson &amp; Johnson</a></li>
<li><a href="http://dev.brekiri.com/landing/medtronic_inc_/">Medtronic</a></li>
<li><a href="http://dev.brekiri.com/landing/boston_scientific/">Boston Scientific</a></li>
<li><a href="http://dev.brekiri.com/landing/zimmer_holdings_inc_/">Zimmer</a></li>
<li><a href="http://dev.brekiri.com/landing/oracle_corporation/">Oracle</a></li>
<li><a href="http://dev.brekiri.com/landing/microsoft/">Microsoft</a></li>
<li><a href="http://dev.brekiri.com/landing/google/">Google</a></li>
<li><a href="http://dev.brekiri.com/landing/apple_inc_/">Apple</a></li>
</ul>
<p>As you can see, we’re focusing on the life sciences and information technology sectors initially.</p>
<p>The full Brekiri application combines this information with financial filings search, web search, and industry data to create an integrated starting point for all your company research projects.  We want you to be able to spend less time searching through Google, finance sources, and SEC filings, and more time getting your actual work done.</p>
<p>Check it out and let us know what you think.  What’s your biggest pain point when researching companies?</p>
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		<title>Open Source Business Analysis</title>
		<link>http://www.brekiri.com/blog/538/open-source-business-analysis/</link>
		<comments>http://www.brekiri.com/blog/538/open-source-business-analysis/#comments</comments>
		<pubDate>Fri, 24 Jun 2011 11:47:33 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Business Analysis]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=538</guid>
		<description><![CDATA[<p>I was talking with a private equity firm last week about how they did their research into software and hardware technology niches to understand potential investments, competitors, and market dynamics.  They estimate that 80% of the material they read is a waste of time, yet they consider their research process a proprietary advantage.  I think [...]]]></description>
			<content:encoded><![CDATA[<p>I was talking with a private equity firm last week about how they did their research into software and hardware technology niches to understand potential investments, competitors, and market dynamics.  They estimate that 80% of the material they read is a waste of time, yet they consider their research process a proprietary advantage.  I think that conversation reveals a basic business assumption that is about to change dramatically.</p>
<p>In every industry, you can picture thousands of unfortunate analysts across dozens of companies all doing essentially the same work.  They’re all forecasting market growth, analyzing competitors, trying to understand customers, and so on.  And they read the same news, the same financial reports, and the same market research, for the most part.  The results of this work are closely guarded proprietary analyses, yet they’re all very similar.  There’s a huge amount of duplicated effort that doesn’t add much value.<span id="more-538"></span></p>
<p><strong>Business Analysis as Software</strong></p>
<p>Does this remind you of anything?  It’s what software development used to be like when every company developed its own custom applications in-house.  Every company had its own system for everything from payroll to accounting, either done in-house or by expensive consultants.  Eventually, software development activity was consolidated through a number of mechanisms:</p>
<ul>
<li>Commercial off-the-shelf software</li>
<li>Process outsourcing (e.g., an external company handling your entire payroll process with their in-house software)</li>
<li>Higher-level software languages and components</li>
<li>Open source software</li>
</ul>
<p>As a result, software development these days results in much less duplicated effort.</p>
<p>This dynamic has not occurred to the same extent with business analysis, to say the least!  Most big companies still have departments that do things like economic forecasting and competitive analysis.  Certainly, a part of this thought process is unique to each company and thus valuable for informing business decisions, but most firms can’t pinpoint where the commodity information ends and the differentiation begins.  It reminds me of the old John Wanamaker quote, &#8220;Half the money I spend on advertising is wasted; the trouble is I don&#8217;t know which half.&#8221;  The same is true of business analysis.</p>
<p><strong>So Why Is This the Case?</strong></p>
<p>I see a few causes for this waste.  First, there’s a game theory problem.  The first company to “open source” its analysis benefits its peers but doesn’t receive any benefit in return.  So there’s no incentive for individual firms to go first.  The current equilibrium results in little or no information sharing.</p>
<p>Second, external information sources are opaque.  Market research reports only include conclusions and estimates, not how those conclusions were reached.  As a result, consumers of those reports end up double-checking the work to make sure it’s applicable to their situations, or redoing the entire analysis because they need a slightly different focus.  Black box information sources can’t be easily repurposed.  In order to tweak an analysis by 10%, I have to reverse engineer the whole thing.  This isn’t an accident, either.  Research vendors want their clients to remain dependent on them, and revealing any of the inputs to their analysis reduces that dependence.  It makes sense for vendors to maximize their profits, but it doesn’t exactly maximize value for customers!</p>
<p>Third, internal analytical departments are motivated to maintain their headcount and budgets.  Advances in efficiency are often resisted because those affected want to avoid creating a reduced need for their work.  In reality, the importance of business analysis and research services will just continue to grow.  The difference is that they will be doing more highly-skilled, value-added intellectual work and less rote data gathering and number crunching.  But like any such revolution, it’s easier for people to see the negative first-order effects than to see the positive (and overall more impactful) second-order effects.  Those attitudes will take time to change.</p>
<p><strong>Where Do We End Up?</strong></p>
<p>Eventually, we’ll end up in a world where business information is more readily accessible, cheaper, and easier to remix and customize to specific needs.  The opportunity to disrupt the current high-cost approach to business analysis is just too appealing for new entrants, and the potential cost and efficiency savings will be too attractive for customers.  But the barriers to change described above won’t go away overnight.  Time and effort will be needed to get people used to the new paradigm of open source business analysis.</p>
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		<title>The Many Faces of LinkedIn</title>
		<link>http://www.brekiri.com/blog/529/the-many-faces-of-linkedin/</link>
		<comments>http://www.brekiri.com/blog/529/the-many-faces-of-linkedin/#comments</comments>
		<pubDate>Wed, 18 May 2011 12:10:20 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Business Analysis]]></category>
		<category><![CDATA[Information Sources]]></category>
		<category><![CDATA[LinkedIn]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=529</guid>
		<description><![CDATA[<p>Having taken a look at LinkedIn’s financials, I also want to drill down a bit and look at the product from a user perspective.</p>
<p>LinkedIn is clearly going to have an extremely good IPO, whether they end up valued at $3 billion or $4 billion.  So it’s odd to say they’ve done a bad job of [...]]]></description>
			<content:encoded><![CDATA[<p>Having taken a look at <a href="http://www.brekiri.com/blog/521/is-the-linkedin-ipo-a-good-deal/">LinkedIn’s financials</a>, I also want to drill down a bit and look at the product from a user perspective.</p>
<p>LinkedIn is clearly going to have an extremely good IPO, whether they end up valued at $3 billion or $4 billion.  So it’s odd to say they’ve done a bad job of leveraging their assets, but it’s true.  The reason is that LinkedIn is really three or four very different products bundled into one.  The company has done a good job of developing and exploiting the recruiting product, but they’ve been pretty mediocre on the other ones, whether due to constrained resources or a lack of attention.<span id="more-529"></span></p>
<p><strong><span style="text-decoration: underline;">User Behavior</span></strong></p>
<p>LinkedIn isn’t a frequent activity for most people.  With around 100 million registered users, they get 75 million unique visitors per month.  So 25% or more of users don’t show up at all.  The site got about 5.5 billion page views in Q4 2010, which comes out to 61 million a day.  Most of those page views probably come from a few hardcore users.  Say 5% of the users look at 10 pages a day (probably not a stretch for recruiters and salespeople), and that’s already 50 million page views per day.  By implication, the rest of the users aren’t doing much.</p>
<p>Now the question is why those usage patterns look like they do.  In my mind, it boils down to how well LinkedIn addresses its various use cases.</p>
<p><strong><span style="text-decoration: underline;">Networking</span></strong></p>
<p>I believe the majority of users get little concrete value out of their LinkedIn networks.  They collect contacts because they feel like they should, but they just don’t know what to do with them.  LinkedIn needs to come up with better ways to activate users.  For example, if I want to change jobs in a year, what should I be doing right now on LinkedIn and elsewhere to prepare for that?  Most people, myself included, need more hand-holding to manage their professional networks, and LinkedIn would be the perfect company to provide that.  Think of it as personal CRM.</p>
<p>Apart from direct connections, LinkedIn’s primary networking feature is the “introduction.”  Almost no one I know uses it, and there are a couple of behavioral reasons why, in my opinion.  First, it seems that only people who can’t get “regular” introductions go for LinkedIn introductions, devaluing the entire concept.  Adverse selection.  Second, I think people see more convenient introductions as less meaningful, the same way a Facebook happy birthday wall post means less than a card or a phone call (see Andrew Mason in this <a href="http://www.justin.tv/startupschool/b/272180613">video</a> at 4:00 for more on that).  So by making the introduction easier, LinkedIn potentially makes it less valuable.  I think they can actually fix both of these problems by assigning some kind of notional cost to an introduction, along with an incentive for a meaningful one.  It’s time to gamify the introduction.</p>
<p>I could go on and on.  Could I get a networking workflow, please?  How about buying Plancast and integrating conference attendance with my professional network?</p>
<p><strong><span style="text-decoration: underline;">Advice and Information</span></strong></p>
<p>“Groups” are LinkedIn’s feature for facilitating interest networks, like pricing professionals or entrepreneurs.  I’ve always found those forums to be low in value because people primarily try to get airtime or promote their services rather than providing truly useful information.  It’s gotten worse recently since LinkedIn allowed group owners to open up groups.  I’m sure LinkedIn gets more page views and advertising revenue as a result, but the amount of literal spam has gone up significantly.  There may be functionality to help group owners limit spam, but in practice the owners aren’t necessarily doing enough.</p>
<p>It’s difficult to get both depth and breadth on any information source on the web.  As soon as you open up the community, you tend to get least-common-denominator information and spam.  StackExchange and Quora are doing a decent job.  Maybe LinkedIn should outsource their discussions to one of those companies?</p>
<p><strong><span style="text-decoration: underline;">Research</span></strong></p>
<p>I always do a LinkedIn search on people before I meet them. However, for real research on companies or industries, LinkedIn isn’t that great.  Company pages are a nice step, but LinkedIn has to tread the line between providing useful information and exposing so much data that companies protect themselves by putting less information on the site.  It’s a bit odd, but research may be a use case better left untouched.</p>
<p><strong><span style="text-decoration: underline;">Inbound Leads</span></strong></p>
<p>I hesitate to even bring this one up because it’s been a non-event for me.  Once in a blue moon, someone contacts me for work or expertise through my LinkedIn profile.  The LinkedIn profile could be a hub for marketing yourself professionally.  As it is, that honor appears to have been taken by a combination of Twitter and the personal blog.  Of course, you can’t be all things to all people, but I think LinkedIn needs to take a second look at serving as a personal marketing engine, generating inbound leads for work or other opportunities.  (Or maybe I’m just revealing that I’m not in demand.  Software developers may have a very different experience with this one.)</p>
<p><strong><span style="text-decoration: underline;">Lead Generation</span></strong><span style="text-decoration: underline;"> </span></p>
<p>Clearly, LinkedIn is nailing this use case for recruiters.  In my past life as a consultant and my current one as an entrepreneur, I’ve found the site to be less than optimal.  One big problem is that there’s no differentiation among connections.  If I’m trying to get an introduction to someone, how do I choose between all of our mutual contacts?  Third-degree connections are even worse:  I’m connected to 29 people who know <strong><em>someone </em></strong>who knows <a href="http://uk.linkedin.com/in/niklaszennstrom">Niklas Zennstrom</a>.  After a while, I feel like I’m playing <a href="http://en.wikipedia.org/wiki/Six_Degrees_of_Kevin_Bacon">six degrees of Kevin Bacon</a>.  It’s just not useful.</p>
<p>To make it useful, LinkedIn should invest in refining its browsing and search functionality.  Something like Gmail’s priority inbox, but for connections, would also be extremely useful.  I want to know which connections I should actually contact to get an introduction, as opposed to the “I met them once five years ago, and they don’t remember who I am” connections that make up a large portion of the LinkedIn graph.</p>
<p><strong><span style="text-decoration: underline;">The Many Faces of LinkedIn</span></strong></p>
<p>The more I think about LinkedIn, the more I’m convinced that it’s really 3-4 different products.  The company has done a pretty good job with the recruiting product, but most of the others are sub-optimal.  If I were Reid Hoffman, I would create a product team entirely compensated and promoted based on helping the “average” user.  Otherwise, another company will eventually come along and offer a better pure networking product (Hashable?), and LinkedIn’s biggest asset, its user base, will start to be undermined.  I hope the upcoming IPO enables LinkedIn to truly blow out its product development roadmap and address these various needs more fully.</p>
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		<title>Is the LinkedIn IPO a Good Deal?</title>
		<link>http://www.brekiri.com/blog/521/is-the-linkedin-ipo-a-good-deal/</link>
		<comments>http://www.brekiri.com/blog/521/is-the-linkedin-ipo-a-good-deal/#comments</comments>
		<pubDate>Mon, 16 May 2011 08:17:18 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Business Analysis]]></category>
		<category><![CDATA[Facebook]]></category>
		<category><![CDATA[LinkedIn]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=521</guid>
		<description><![CDATA[<p>Among social networks, LinkedIn is a fascinating outlier.  It’s by far the largest professional network, and as such it personifies the debate over whether people want different networks for different purposes.  I think the answer is yes.  Both Facebook and LinkedIn are based on webs of relationships, but no degree of privacy controls or slapped-on [...]]]></description>
			<content:encoded><![CDATA[<p>Among social networks, LinkedIn is a fascinating outlier.  It’s by far the largest professional network, and as such it personifies the debate over whether people want different networks for different purposes.  I think the answer is yes.  Both Facebook and LinkedIn are based on webs of relationships, but no degree of privacy controls or slapped-on features can turn Facebook into an effective business networking tool.  Perhaps I’m biased.  For me, Facebook is a place to socialize, while LinkedIn is a place to promote myself professionally.  Just because two products look similar, it doesn’t mean they do the <a title="How Customers View Products" href="http://hbswk.hbs.edu/item/6496.html" target="_blank">same job</a>.</p>
<p>Let’s take a closer look at LinkedIn now that the company is moving towards an IPO.<span id="more-521"></span></p>
<p><strong><span style="text-decoration: underline;">LinkedIn’s Economics</span></strong></p>
<p>LinkedIn users should be much more profitable than general social networking users because both those users and people who want to reach them are more willing to pay for features.  According to comScore, LinkedIn had 26 million unique visitors in December 2010, which works out to revenue per user of over $9.  According to <a title="Revenue Per User for Google, Facebook, Etc." href="http://www.businessinsider.com/chart-of-the-day-revenue-per-unique-visitor-2011-1" target="_blank">recent reports</a>, that’s more than twice the per-user performance of Facebook.</p>
<p>So then why is LinkedIn, at $3 billion, worth so much less than Facebook at $70 billion or so?  It really boils down to size and profitability.  Facebook apparently made about $500 million in profits in 2010 off of $2 billion in revenue, while LinkedIn only managed $15.4 million on $243 million in revenue.  That’s a 25% profit margin versus a 6% profit margin.  As it turns out, a rough PEG (price/earnings/growth) ratio for the two companies shows that LinkedIn is valued over twice as highly as Facebook based on 2010 profits and growth!  That Facebook valuation is starting to look better.</p>
<p>What’s unclear is how much LinkedIn is investing in future growth and to what extent it’s simply in a lower-margin business than Facebook.  While individual Facebook users are not necessarily that valuable, the business as a whole appears to be an incredible profit machine.</p>
<p><strong><span style="text-decoration: underline;">Sales and Marketing Costs</span></strong></p>
<p>What’s even more intriguing is LinkedIn’s Q1 2011 numbers.  Sales and marketing expenses went from 23% of revenue to 31%, and net income dropped from 6.3% in 2010 to just 1.4% in Q1 2011.  At first I was surprised at the big jump in expenses, but on further reflection, I don’t think this is necessarily a bad sign.  LinkedIn is in a large and relatively open market.  In fact, I can’t believe no serious competitors have cropped up.  That’s a story in itself.  Anyway, the firm is in land-grab mode.  Spending heavily on sales and marketing now to build greater barriers to entry (in the form of more registered users, data, and corporate customers for recruiting and marketing) makes sense.</p>
<p>Of course, that position assumes that there is no permanent shift towards a much higher cost to acquire and retain customers.  That is a potential concern.  LinkedIn’s channel mix is slowly shifting from online to field sales (up from 47% to 56% in the last two years), which according to the company’s disclosure is associated with a longer sales cycles and higher sales costs.  It does also result in higher average selling prices, so it doesn’t appear to be a significant concern yet.</p>
<p>However, it does illustrate the limits of LinkedIn’s virality.  Facebook has built a huge viral engine on photo tagging, newsfeeds, and social games, and the draw of professional connections is certainly weaker for the average person.  As an aside, there are of course limits to Facebook’s growth curve as well, with some claiming that <a title="Facebook Growth Rates by Country" href="http://www.insidefacebook.com/2011/05/15/countries-that-adopted-facebook-early-see-lower-traffic-growth-rates-occasionally-negative/" target="_blank">Facebook penetration</a> tops out at around 50% of the population in most countries.</p>
<p><strong><span style="text-decoration: underline;">Revenue Breakdown</span></strong></p>
<p>The revenue breakdown by product also reveals a lot about LinkedIn’s future direction.  There are three product categories, hiring solutions, marketing solutions, and premium subscriptions.  Hiring solutions revenue grew 182% from 2009 to 2010 and now makes up 42% of the company’s revenue.  In contrast, premium subscriptions grew 35% on 64% growth in registered users.  Advertising growth fell in the middle at 107%.  Clearly, the average user doesn’t see much need for a premium subscription, while recruiters can’t get enough of LinkedIn’s services.  Companies tend to follow their most profitable customers, so I expect LinkedIn to start offering much more sophisticated recruiting solutions over time.  I’m curious to see how they fare against other up-and-coming recruiting companies like TheLadders, Indeed, and Simply Hired.</p>
<p><strong><span style="text-decoration: underline;">So Is It a Good Deal?</span></strong></p>
<p>If LinkedIn didn’t exist, someone would have to create it.  The online resume and professional network are basic features of modern life, and LinkedIn has hitched itself to a new consumer behavior that will only continue to grow.  As an individual, I wish LinkedIn would provide more <a title="The Many Faces of LinkedIn" href="http://www.brekiri.com/blog/529/the-many-faces-of-linkedin/" target="_blank">useful features</a>, but as a hypothetical investor, I see an ongoing growth story in this company.  The question, as always, is how much one is willing to pay for that growth, and that’s one I have a hard time answering.  LinkedIn’s venture capital investors, Sequoia Capital, Greylock Partners, and Bessemer Ventures, made up of infinitely better investors than me, are sitting on their shares and not participating in the IPO.  That suggests they expect the value of the company to continue climbing sharply.</p>
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		<title>Who Will Survive Hospital Consolidation?</title>
		<link>http://www.brekiri.com/blog/516/who-will-survive-hospital-consolidation/</link>
		<comments>http://www.brekiri.com/blog/516/who-will-survive-hospital-consolidation/#comments</comments>
		<pubDate>Mon, 09 May 2011 14:08:58 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Business Analysis]]></category>
		<category><![CDATA[HCA]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=516</guid>
		<description><![CDATA[<p>Healthcare providers are under pressure on a variety of fronts.  Patients demand extensive care regardless of cost.  Payers both public and private are struggling to reduce costs, and the resulting billing struggles result in high administrative overhead.  Staffing is in short supply, resulting in high overtime and temporary staffing costs.  New technology and equipment require [...]]]></description>
			<content:encoded><![CDATA[<p>Healthcare providers are under pressure on a variety of fronts.  Patients demand extensive care regardless of cost.  Payers both public and private are struggling to reduce costs, and the resulting billing struggles result in high administrative overhead.  Staffing is in short supply, resulting in high overtime and temporary staffing costs.  New technology and equipment require large capital expenditures that many facilities cannot afford.  Pharma and medical device manufacturers get a much bigger share of the healthcare profit pie.</p>
<p>The situation is even worse for hospitals in particular.  They’re overwhelmingly complex organizations, and as a result they’re difficult to manage.  They also have high fixed costs, and there is often over-capacity in specific geographical markets, leading to intense competition.  From a Porter’s Five Forces perspective, most of the puzzle pieces look pretty bad.<span id="more-516"></span></p>
<p>Most importantly, overall healthcare costs cannot continue climbing at their current rate indefinitely.  And like the old quote says, if something can’t continue indefinitely, it won’t.  Much more significant waves of reimbursement cuts are inevitably on the way, although no one knows when they will hit.</p>
<p>Considering all of these factors, it seems probable that the industry will undergo painful change and consolidation over the next couple of decades.</p>
<p>So what kinds of providers will survive ongoing changes in the field?  Here are the likely candidates:</p>
<ul>
<li>Unique, mission-driven organizations like the Mayo Clinic</li>
<li><a href="http://www.brekiri.com/blog/379/disruptive-innovation-in-healthcare/">Disruptive</a> providers like specialty hospitals that can offer more standardized care with a lower cost structure</li>
<li>Large organizations that can develop superior processes and leverage high-quality management talent to outperform smaller competitors (i.e., the big hospital chains)</li>
</ul>
<p>Unfortunately, the last of the three is probably the least likely.  I assume many hospital chains will attempt to go down this road but will fail nevertheless.  Why?</p>
<ul>
<li><strong>Organizational chaos</strong> – Mergers bring scale but also dysfunction.  Many hospital chains will be unable to deal with the disruption and clashing priorities that mergers introduce.</li>
<li><strong>Apathy</strong> – Big, impersonal organizations exacerbate the tendency among the rank and file to say, “That’s not my job.”  Large hospitals have a much harder time holding people accountable.  Processes have to substitute for individual initiative, but they often can’t fill the gap completely.</li>
<li><strong>Complexity</strong> – Economies of scale are only good if you can really achieve them.  Because hospitals are individually so complex, just having more locations within the same company doesn’t necessarily achieve a lot of efficiencies.  Administrative tasks like billing likely become somewhat more efficient, but I doubt large hospital chains manage their physical resources any better.</li>
</ul>
<p>As the largest hospital chain in the country, <a href="http://www.brekiri.com/blog/451/what-can-hca-tell-us-about-the-healthcare-sector/">HCA</a> would seem to be the flag bearer for the scale strategy in the hospital industry.  The recent IPO was successful, but I’m less convinced that they will actually be able to generate the operating advantages they’re looking for.  Operating margins look like they’re in the general ballpark of public healthcare providers at about 7% – not exactly a ringing endorsement of the strategy.</p>
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		<title>I Love Equity Analysts</title>
		<link>http://www.brekiri.com/blog/508/i-love-equity-analysts/</link>
		<comments>http://www.brekiri.com/blog/508/i-love-equity-analysts/#comments</comments>
		<pubDate>Tue, 03 May 2011 12:55:36 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Information Sources]]></category>
		<category><![CDATA[business research]]></category>
		<category><![CDATA[company report]]></category>
		<category><![CDATA[industry research]]></category>
		<category><![CDATA[market research]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=508</guid>
		<description><![CDATA[<p>Research reports by investment banking are by far my favorite source of background research on companies and industries.  Thomson Research (formerly Investext) is the standard-bearer in this area, and I’ve made voracious use of it when I’ve had (highly expensive) access.  Finding a good “initiating coverage” report makes my day, for better or worse.</p>
<p>What makes [...]]]></description>
			<content:encoded><![CDATA[<p>Research reports by investment banking are by far my favorite source of background research on companies and industries.  Thomson Research (formerly Investext) is the standard-bearer in this area, and I’ve made voracious use of it when I’ve had (highly expensive) access.  Finding a good “initiating coverage” report makes my day, for better or worse.</p>
<p><strong>What makes them so good?</strong></p>
<p>First, they’re much more in-depth than typical market research reports (DataMonitor, I’m looking at you).  When reading market research reports, I get the impression the analysts are filling out a template as quickly as possible.  The inevitable SWOT section tends to be extremely generic, to the point of uselessness.  Equity analysts, in contrast, do their homework.  They do channel and customer checks, even with difficult to reach constituencies like medical specialists.  They attend (and even organize) industry conferences.  They typically cover multiple leading companies in an industry segment and draw relevant comparisons between them.<span id="more-508"></span></p>
<p>More generally, market research report writers are trying to minimize their costs, while equity analysts are extremely well paid and are trying to show off how clever they are in order to get more underwriting and M&amp;A business.  The latter leads to better results!</p>
<p>Second, equity analysts are forced to draw conclusions because they have to come up with a price target.  As a result, they have to come up with some kind of impact for all the factors they analyze.  That need to synthesize data and make a conclusion forces them to be much sharper in their thinking.</p>
<p>As an aside, compared to Forrester and similar IT analysts, I have to say that equity analysts tend to be less fluffy and full of platitudes.  I don’t have anything against the IT research firms, but when reading their reports I tend to find myself mentally arguing with their conclusions.  That happens less with equity analysts, perhaps because they are so focused on business fundamentals rather than more ambiguous concepts like mindshare and who’s the most innovative.</p>
<p><strong>Where they still fall short of the ideal</strong></p>
<p>Despite all my gushing praise, equity analyst reports do still have a few shortcomings for business research (I’m thinking of management consultants and managers internal to companies in the industry here).  First, reports focus on the overall company rather than business units or product lines.  That makes perfect sense for stock picks and price targets, but it’s not as useful for managing a product line or business unit, where you need more granular information and analysis.</p>
<p>Second, there’s limited functional focus.  The typical report barely scratches the surface on issues like customer lifecycle management, supply chain management, sales force strategy, and so on.</p>
<p>The best stock analyst reports transcend these limitations to some degree.  The worst devote the entire report to minuscule tweaks to earnings projections.  Nevertheless, equity reports are usually one of my first stops on a project.  They’re good stuff!  Now if only they weren’t so expensive.</p>
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		<title>The New Paradigm of Investor Relations</title>
		<link>http://www.brekiri.com/blog/477/the-new-paradigm-of-investor-relations/</link>
		<comments>http://www.brekiri.com/blog/477/the-new-paradigm-of-investor-relations/#comments</comments>
		<pubDate>Fri, 04 Mar 2011 11:29:05 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Company Strategy]]></category>
		<category><![CDATA[Information Sources]]></category>
		<category><![CDATA[differentiation]]></category>
		<category><![CDATA[investor relations]]></category>
		<category><![CDATA[strategy]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=477</guid>
		<description><![CDATA[<p>If you&#8217;re like me, you think of investor relations as a fairly staid field. As far as I can tell from the outside, IR is usually responsible for getting the annual reports and SEC filings written (with a healthy dose of accounting and legal input), managing earnings conference calls, and perhaps helping deal with the [...]]]></description>
			<content:encoded><![CDATA[<p>If you&#8217;re like me, you think of investor relations as a fairly staid field. As far as I can tell from the outside, IR is usually responsible for getting the annual reports and <a title="What's in a 10-K?" href="http://www.brekiri.com/blog/37/whats-in-a-10-k/" target="_blank">SEC filings</a> written (with a healthy dose of accounting and legal input), managing <a title="Investor Conference Calls and Presentations" href="http://www.brekiri.com/blog/43/using-investor-conference-calls-and-presentations/" target="_blank">earnings conference calls</a>, and perhaps helping deal with the occasional company crisis. But of course it doesn&#8217;t have to be that way. In theory, investor relations should be educating investors on their company and industry, protecting the company&#8217;s access to capital. The communication channel should also flow the other way, keeping management apprised of potential risks to the company.</p>
<p style="text-align: left;"><strong>The wrong way</strong></p>
<p style="text-align: left;">Probably 95% of investor relations departments don&#8217;t have this kind of mandate. To pick on a recent example, let&#8217;s consider Strabag, one of Europe&#8217;s leading construction companies. The firm recently <a title="Firm stops investor relations tweeting, blames poor engagement" href="http://communitelligence.posterous.com/fortune-firm-stops-investor-relations-tweetin" target="_blank">shut down</a> its communications Twitter account because no one was tweeting them. Of course, the company didn&#8217;t use the account for anything except for relaying analyst ratings and the status of its order backlog &#8211; not exactly captivating.</p>
<p style="text-align: center;"><a href="http://twitter.com/#!/STRABAG_SE" target="_blank"><img src="http://www.brekiri.com/imgs/Strabag-Twitter.jpg" alt="Strabag Twitter account" /></a></p>
<p style="text-align: left;">Strabag made a variety of mistakes. All marketing, but especially social marketing, is a content-driven activity. If you don&#8217;t have interesting things to say, no one will listen. You don&#8217;t have to be in a sexy business to come up with meaningful content (look at <a title="Zappo's Twitter" href="http://twitter.com/#!/Zappos_Service" target="_blank">Zappo&#8217;s</a> in shoe retailing), but you do have to think about what your audience wants to hear. Strabag could have engaged in a dialog with analysts, better understanding their information needs and perceptions of the company. A primer for investors unfamiliar with the construction market would have been even better. I won&#8217;t belabor all the usual social media points beyond that.</p>
<p style="text-align: left;">Tactically, Twitter is an awful channel for arbitrary data points (output is up 6%!) lacking context. Even order backlog is probably interesting to investors and equity analysts, but it should at least link back to a chart and spreadsheet showing the trend over time, comparisons with competitors, and implications. There&#8217;s no reason for online communications to mimic the dry facts of a stock ticker. Help people draw conclusions!</p>
<p style="text-align: left;"><strong>The right way</strong></p>
<p style="text-align: left;">In contrast, I was blown away by the exchange between <a title="Netflix CEO Reed Hastings Responds to Whitney Tilson: Cover Your Short Position. Now." href="http://seekingalpha.com/article/242653-netflix-ceo-reed-hastings-responds-to-whitney-tilson-cover-your-short-position-now" target="_blank">Reed Hastings</a> from Netflix and a hedge fund <a title="Whitney Tilson: Why We Covered Our Netflix Short" href="http://seekingalpha.com/article/252316-whitney-tilson-why-we-covered-our-netflix-short" target="_blank">short seller</a> on Seeking Alpha (brilliant site, by the way). The hedge fund manager lays out his concerns about Netflix&#8217;s valuation, new competition, the costs and quality of licensed streaming content, and a few other reasons for his short position. Hastings addresses them all openly and dismantles most of them. Finally, the short seller posts again to say that he&#8217;s covered his position and why. For a business geek like me, their dueling analyses are such fun to read, and they do an excellent job of illuminating the company&#8217;s strategy, the industry landscape, and possible risks and upsides. I probably could have read Netflix&#8217;s entire 10-K filing and come away with much less understanding of their business than after reading those posts. It&#8217;s also brilliant <a title="IR Web Report" href="http://irwebreport.com/20110212/after-ceos-blog-post-netflix-short-seller-changes-his-mind" target="_blank">investor relations</a>, and Hastings and his team eliminated a potential stock performance issue, thus allowing them to stay focused on the core business. Now, this kind of response requires that your company actually have a very well thought-out strategy and evidence to back it up. Most firms probably couldn&#8217;t hack it, but it is something to aspire to.</p>
<p style="text-align: left;"><strong>Expand your mandate</strong></p>
<p style="text-align: left;">Various corporate functions have been transformed from rote work to strategic assets over the last few decades. Human resources used to be about job postings and benefits management. Now, ideally, it&#8217;s about selecting, recruiting, and retaining the best possible talent. Traditionally, purchasing was probably one of the dullest jobs imaginable (no offense). However, in the context of strategic sourcing, the job is more about partnering with suppliers, understanding their impact on product quality and strategy, and forecasting the evolution of your industry value chain than just about issuing purchase orders.</p>
<p style="text-align: left;">The same thing needs to happen with investor relations. Investors are critical stakeholders in public companies, and we&#8217;ve seen various examples of firms crippled by short sellers over the last few years. Investor relations should be a strategic communication channel to cultivate a supportive investor base and to funnel market information back to management. It&#8217;s time to go beyond conference calls and financial filings.</p>
<p style="text-align: left;">
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		<title>Why Is Good Business Information So Scarce?</title>
		<link>http://www.brekiri.com/blog/461/why-is-good-business-information-so-scarce/</link>
		<comments>http://www.brekiri.com/blog/461/why-is-good-business-information-so-scarce/#comments</comments>
		<pubDate>Wed, 02 Mar 2011 14:35:16 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Information Sources]]></category>
		<category><![CDATA[Technology Trends]]></category>
		<category><![CDATA[business intelligence]]></category>
		<category><![CDATA[business research]]></category>
		<category><![CDATA[industry research]]></category>
		<category><![CDATA[market research]]></category>
		<category><![CDATA[research]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=461</guid>
		<description><![CDATA[
<p>I recently came across this O&#8217;Reilly post about CrunchBase, the open database of information on startup companies, asking whether CrunchBase will remain free in the long term.  While the post itself is interesting, the part that puzzles me is why there is so little business-oriented information freely available out there.  Data as a service has been [...]]]></description>
			<content:encoded><![CDATA[<div>
<p>I recently came across this <a title="Will data be too cheap to meter?" href="http://radar.oreilly.com/2011/02/crunchbase-cheap-data.html" target="_blank">O&#8217;Reilly post</a> about CrunchBase, the open database of information on startup companies, asking whether CrunchBase will remain free in the long term.  While the post itself is interesting, the part that puzzles me is why there is so little business-oriented information freely available out there.  <a title="Data Is the Next Major Layer of the Cloud" href="http://www.bothsidesofthetable.com/2010/12/09/data-is-the-next-major-layer-of-the-cloud-a-major-victory-for-startups/" target="_blank">Data as a service</a> has been generating a lot of excitement recently, and I think it&#8217;s well warranted.  However, the only prominent sources of open <strong>business</strong> information are the SEC&#8217;s <a title="SEC Edgar database" href="http://www.sec.gov/edgar/searchedgar/companysearch.html" target="_blank">Edgar</a> database, LinkedIn, and CrunchBase.  After that, the field gets very thin.  Considering how much effort companies put into business intelligence and competitive intelligence, it seems like there should be a great profit motive for someone to provide a deeper business information layer.  So I don&#8217;t really understand why we&#8217;re in this situation, but it does seem like a big opportunity.<span id="more-461"></span></p>
<p>These days, most companies are still creating expensive in-house data sets for purposes like market analysis and competitive intelligence. Data providers like Thomson Reuters and CapitalIQ do the same thing and charge through the nose for it.  As a result, big companies end up paying a lot for often not very impressive information. Meanwhile, the rest of the market makes do with sources like Google that just aren&#8217;t intended for business research.</p>
<p><strong>The open source analogy</strong></p>
<p>The current landscape reminds me of the days when every big company did custom development for its own IT applications, even though each company&#8217;s payroll or data processing system did basically the same thing. That&#8217;s good for consultants and developers, but it makes process improvement very expensive for corporations. Similar walled gardens still dominate the business information market.  We need to move to a mindset closer to the open source world. In the last ten years, open source software has become a very competitive option compared to commercial software.  While the core movement is still based on developers writing code based on their personal interests, an important catalyst for the movement has been the rise of companies that add a layer of support and commercialization on top of the core technology. Open source is now a lively market, not just a movement. What&#8217;s interesting is that users of open source, from Google and Facebook to NASA, probably contribute more to it now than the companies that sprung up to commercialize it, like Red Hat.  The crowd is contributing to tools that would often be prohibitively time-consuming to build internally or too expensive to license from a vendor.  All the users benefit as a result.</p>
<p><strong>The Wikipedia of business?</strong></p>
<p>Wikipedia and other crowdsourced sites like Wikinvest (a wiki for public company information for investors) are a bit analogous to the open source movement. People make contributions for fun or or to burnish their reputations, not for monetary incentives. The results have been amazing &#8211; the English language Wikipedia alone has over 3 million articles. But there are also limits to the phenomenon. Growth in articles is estimated to have peaked in 2006, and you can tell that sometimes articles of marginal interest to the community languish or are even deleted. And as the base of articles becomes more static, it will be interesting to see whether the relatively mundane task of updating all those articles still motivates people.</p>
<p>Wikinvest is another amazing tool, but also one with limits. Interesting companies are updated frequently, but articles on, say, pulp and paper companies tend to be out of date. (As an aside, I get the impression that contributors to Wikinvest are overwhelmingly undergraduate business majors. I wonder what the incentive is. Do corporate recruiters look at the site?)</p>
<p>So there are limits to the open source model for data, particularly commercial data like company information. Somehow writing up a stock analysis doesn&#8217;t have the same craft appeal as working on a piece of software.</p>
<p><strong>The commercial data layer</strong></p>
<p>But I do think there&#8217;s potential for a real commercial data layer, crowdsourced but with profit and cost savings motives as a driver. There are myriads of players who need information on topics like companies and industries (or who want to sell it), and right now they&#8217;re all creating expensive, in-house data sets.  Moreover, much of the data is inaccurate or rapidly goes out of date because maintaining that volume of information requires massive scale. It&#8217;s a lot like the software world before first off the shelf and then open source became prevalent.  There are huge economies of scale to be realized with a more consolidated data layer.</p>
<p>Facebook owns the social graph. FourSquare or Yelp will likely do the same with local business information (although Groupon could be well positioned to horn in on it). Right now, no one has claimed pole position in creating this data layer for commercial purposes. There are also lots of aspirants to that position: Thomson Reuters, Capital IQ, Bloomberg, and on and on. I just don&#8217;t think any of them are taking the right approach. We need a platform, not a silo.</p>
<p>Once commodity information on companies becomes more widely available, it will be interesting to see what kinds of applications people can build on that information.  Tools like Google Finance, which is quite amazing for a free service, are just the tip of the iceberg. Imagine if you never had to do another bubble chart yourself again! Freeing people from basic research will make it much easier to do deep, thoughtful business analysis instead of spending your time trolling for information online. Basic business information needs to become an open commodity.</p>
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		<title>What Can HCA Tell Us About the Healthcare Sector?</title>
		<link>http://www.brekiri.com/blog/451/what-can-hca-tell-us-about-the-healthcare-sector/</link>
		<comments>http://www.brekiri.com/blog/451/what-can-hca-tell-us-about-the-healthcare-sector/#comments</comments>
		<pubDate>Tue, 01 Mar 2011 16:04:39 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Business Analysis]]></category>
		<category><![CDATA[HCA]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[IPO]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=451</guid>
		<description><![CDATA[<p>When HCA Inc. was acquired in 2006 by a private equity consortium including Bain Capital, KKR, and Merrill Lynch (now of course Bank of America), it was the biggest leveraged buyout in history.  For that reason, the announcement a couple of weeks ago that HCA was pricing its IPO at around $3.7 billion piqued my [...]]]></description>
			<content:encoded><![CDATA[<p>When HCA Inc. was acquired in 2006 by a private equity consortium including Bain Capital, KKR, and Merrill Lynch (now of course Bank of America), it was the biggest leveraged buyout in history.  For that reason, the announcement a couple of weeks ago that HCA was pricing its IPO at around $3.7 billion piqued my interest.  The company is the largest private healthcare provider in the US, providing 4-5% of all hospital services with 156 hospitals, not to mention 97 freestanding surgical centers.  Just because of HCA’s sheer size and influence on management practices, it is an interesting company to analyze a bit more closely to understand trends in the US healthcare sector.<span id="more-451"></span></p>
<p>As is usual with private equity deals, HCA has been fairly heavily loaded with debt.  The IPO won’t give it too much additional financial flexibility since proceeds are expected to go primarily to the current private equity owners.  So pursuing large-scale consolidation, which was Columbia/HCA’s original claim to fame, seems unlikely.  Instead, HCA plans to selectively extend its services in major markets.  The company also just reorganized to offer its shared services, like revenue cycle management and supply chain management, to other healthcare providers.</p>
<p>It’s not clear yet how interested investors are in the IPO, but HCA reduced the fundraising target for its IPO from $4.6 billion initially to the current price.  This suggests less than unbridled demand for shares.  One area of concern may be the impact that <a href="http://www.reuters.com/article/2011/02/26/markets-stocks-ipos-idUSN2528075320110226">healthcare reform</a> will have on HCA’s business.  The government has been making more efforts to contain the growth of Medicare and Medicaid spending, which makes up about 40% of HCA’s revenue.  Overall, it seems unlikely that shaving part of a percentage point off government healthcare reimbursements will make a big difference to HCA, but maybe investors are easily spooked these days.</p>
<p>HCA’s results for the fourth quarter of 2010 included a 31% jump in net income, although most of that appears due to miscellaneous accounting adjustments.  Surely just a coincidence with an upcoming IPO, right?  From a top-line revenue perspective, growth slowed down considerably in 2010.  The reason is unlikely to be the economy considering that revenue did grow well in 2008 and 2009.</p>
<p>In many ways, HCA is a pretty straightforward company.  I’m going to spend some time digging into HCA’s latest 10-K and their IPO prospectus and see if I can find out anything interesting about the company, or perhaps even about the healthcare industry these days.</p>
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		<title>Can Better Analysis Improve Healthcare?</title>
		<link>http://www.brekiri.com/blog/423/can-better-analysis-improve-healthcare/</link>
		<comments>http://www.brekiri.com/blog/423/can-better-analysis-improve-healthcare/#comments</comments>
		<pubDate>Thu, 17 Feb 2011 14:10:00 +0000</pubDate>
		<dc:creator>Greg</dc:creator>
				<category><![CDATA[Technology Trends]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://www.brekiri.com/blog/?p=423</guid>
		<description><![CDATA[<p>For decades, our understanding of the relationship between healthcare spending, pricing, and health outcomes has been limited to the crude level of epidemiological studies.  Most of those results suggested that offering better healthcare didn&#8217;t improve outcomes, a depressing conclusion.  However, everyone seems to be talking about how we&#8217;re now in the era of &#8220;big data.&#8221; [...]]]></description>
			<content:encoded><![CDATA[<p>For decades, our understanding of the relationship between healthcare spending, pricing, and health outcomes has been limited to the crude level of epidemiological studies.  Most of those results suggested that offering better healthcare didn&#8217;t improve outcomes, a depressing conclusion.  However, everyone seems to be talking about how we&#8217;re now in the era of &#8220;big data.&#8221;  Interest in deeper analysis of healthcare data, and more sophisticated responses to the results of that analysis, seems to be spiking.  Here are a few examples of budding healthcare innovation that have received attention in just in the last few weeks:</p>
<ul>
<li><a title="U.S. tries open-source model for health data systems" href="http://bits.blogs.nytimes.com/2011/02/02/u-s-tries-open-source-model-for-health-data-systems/" target="_blank">U.S. tries open-source model for health data systems</a>
<ul>
<li>The government and a variety of big companies are working to quickly develop a standard for sharing healthcare information among different providers.  The early version basically appears to be encrypted email.  It sounds ridiculously simple, but maybe getting a basic standard in place and seeing what healthcare users need to help them do their jobs is a better approach than spending years in standard-setting only to realize the specification doesn&#8217;t really meet people&#8217;s needs.</li>
</ul>
</li>
</ul>
<p><span id="more-423"></span></p>
<ul>
<li><a title="A new challenge looks for a smarter algorithm to improve healthcare" href="http://radar.oreilly.com/2011/02/algorithm-healthcare-challenge.html" target="_blank">A new challenge looks for a smarter algorithm to improve healthcare</a>
<ul>
<li>The Heritage Provider Network, a big primary care network in Southern California, is offering a <a title="Netflix Prize" href="http://www.netflixprize.com/" target="_blank">Netflix-style</a> prize of $3 million to whoever can best predict which patients will end up in the hospital based on anonymous medical data.  The idea is that statistical analysis might catch risk trends that physicians miss, allowing riskier patients to receive better care and thus mitigating the chance of costly hospitalization.</li>
</ul>
</li>
<li><a title="Lower costs and better care for neediest patients" href="http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande" target="_blank">Can we lower medical costs by giving the neediest patients better care?</a>
<ul>
<li>In New Jersey, Boston, and Atlantic City, a few doctors are taking a much more intensive approach to the sickest patients, trying to minimize extremely expensive chronic hospitalizations.  Even more interestingly, the article mentions companies like Verisk that are attempting to use data analysis to minimize healthcare costs in much more sophisticated ways than usual.</li>
</ul>
</li>
<li><a title="Massive Health uses big data, mobile phones to fight chronic disease" href="http://gigaom.com/2011/02/02/massive-health-uses-big-data-mobile-phones-to-fight-chronic-disease/" target="_blank">Massive Health uses big data, mobile phones to fight chronic disease</a>
<ul>
<li>Details are a bit slim, but Massive Health recently got a couple of million in funding from top-tier venture investors like Andreessen Horowitz to help patients manage their chronic diseases with the help of mobile phone data.  The idea is that real-time feedback on their behavior will encourage them to change it, the same way real-time mileage information changes driving patterns.</li>
</ul>
</li>
</ul>
<p>Of course, these initiatives are all different.  And there are very legitimate reasons to be <a title="Responses to healthcare hot-spotting" href="http://www.newyorker.com/online/blogs/newsdesk/2011/01/seeing-spots.html" target="_blank">skeptical</a> of whether they can all be successful, or more importantly whether initial, localized success can be extended to the overall healthcare landscape.</p>
<p>But these initiatives already seem more likely to have an impact than efforts like <a title="Google Health" href="http://www.google.com/intl/en-US/health/about/" target="_blank">Google Health</a> and <a title="Microsoft Health Vault" href="http://www.healthvault.com/personal/index.aspx" target="_blank">Microsoft Health Vault</a>, both of which seem like platforms looking for a problem to solve.  Most patients simply aren&#8217;t that interested in the abstract idea of online health records.  To make inroads with health data, companies need to either focus on helping healthcare providers or create consumer applications that focus on <a title="FitBit" href="http://www.fitbit.com/" target="_blank">self-improvement</a> rather than healthcare per se.   The paradox, as always, is that the patients who need to be the most vigilant about health issues are usually the hardest to motivate.  That challenge won&#8217;t simply wash away in a wave of new technology.  Innovation in medical business models and practices will also be necessary, and progress will probably be slow.</p>
<p>From a technology perspective, we can only hope that the insoluble problems of healthcare decision-making become more tractable over time.  Speech recognition, computer vision, and the <a title="Tricorder" href="http://en.wikipedia.org/wiki/Tricorder" target="_blank">tricorder</a> all once seemed like pie in the sky but are now either a reality or just around the corner.  Now that healthcare information is finally becoming digital, perhaps similar advances will finally be possible with the treatment of chronic disease.</p>
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