Reader Survey Results 2014

Right after the HIMSS conference every year, I survey HIStalk readers. The responses, which are always smart and insightful, help me plan the next year. That’s important since I rarely see readers in person – they don’t seem to stray often into the spare bedroom in which I write HIStalk alone, which is probably a good thing since I don’t have any extra chairs.

Some demographics of the 600 survey respondents:

• 38 percent of respondents have worked in the industry for more than 20 years, while another 31 percent have more than 11-20 years of experience.
• 45 percent of respondents work for vendors, 20 percent for consulting firms, and 27 percent for hospitals or practices.
• 6 percent of respondents are CEOs, 5 percent are CIOs, and 2 percent are CMIOs.
• The most-appreciated features of HIStalk are news, rumors, humor, and the morning headlines.
• 86 percent of respondents say they have a higher appreciation of companies I’ve mentioned on HIStalk.
• 37 percent of readers say they’ve recommended HIStalk to others in the past month, while people whose world revolves around social media might be surprised that only 11 percent of respondents saw even one of our tweets.
• My favorite stat: 92 percent of respondents say reading HIStalk helped them performed their job better in the past year. That’s the metric I watch most closely.

I’ve learned not to overreact to individual comments on the survey. Like everyone else, I think I’m representative of all readers and therefore can see obvious things that should be changed, but that’s not really the case. I don’t run HIStalk by committee because the result — as happens when software vendors let user groups dictate their entire R&D — would be a product that nobody hates but that nobody loves either.

Not everybody likes the same parts of HIStalk. Some people love interviews, some hate them. For every person who complains about music reviews, several say they love them and want more. Readers Write articles are often vendor fluff pieces even though I’m rejecting more of those, but some people don’t even like the really good ones because they just want to read news presented as tersely as possible. The bottom line on content is that I have to write and report what I think is relevant and interesting. I write something I would want to read. For those who don’t agree, other sites do it differently.

I’m also careful not to let my reach exceed my grasp. I get a lot of suggestions to cover more international news, to dig deeper into the payer market, or to cover more healthcare news in general and not just the healthcare IT side. I don’t have the time or interest to cover entire new subject areas well,  so I’ll stick with what I know. I’ll always try to make HIStalk better, but I don’t really want it to get bigger because then it wouldn’t be fun for me. It’s been 11 years since I started it and I would have quit long ago if I wasn’t having a good time.

I ask a couple of open-ended questions on the survey and will address some of the responses. I should add, though, that the most common comment was “don’t change anything.”

Get deeper into the implementation cycle. Do stories about how people get solid benefit realization.

I’m happy to do this. Providers are busy and don’t often have time to participate, but I almost always ask questions around benefit realization when I’m interviewing CIOs. Maybe that’s the opportunity – if you work for a health system in a non-CIO role but can speak authoritatively on implementation lessons learned, optimization, and benefits, I will interview you, anonymously or otherwise (since I know many hospitals don’t allow interviews without approval).

That answer applies to several suggestions. Readers want more information from providers just like I do, but it’s hard to bring those people into the conversation.

Create a moderated forum for further discussion.

I did that awhile back and participation was pathetic. Everybody loves the idea, including me, but a lesson I’ve learned is that while many people enjoy consuming content, few want to create it. It’s hard to solicit engaging comments and thoughtful guest articles except from people who are pitching something.

Express more opinion in your observations.

I agree. Sometimes I get so busy, especially for the Tuesday and Thursday night posts when I’m getting tired, that I focus on summarizing complex news items without adding as much personal commentary. That’s one takeaway from the survey – I will do more of that, although the folks who say “less commentary and just the facts” won’t be thrilled.

Add the patient experience of IT to the mix. It is a missing voice in HIStalk. Otherwise, it is off the charts incredible.

That would be great, but I don’t know to get them involved since they likely don’t read HIStalk. I just thought of something that I might be able to do along those lines, so let me think it through and I’ll report back.

I would add some basic educational materials targeted at folks who are new to healthcare IT.

I keep thinking about how to do this, but it’s a big job for me to take on alone.

The webinars still feel a bit too vendor sales focused.

We’ve tried to make the ones we’ve produced more educational, but the bar was set low and we haven’t been able to raise it as quickly or as far as I’d hoped yet. We’ve had vendors come to our rehearsals without the presenter even having seen the slide deck. We have drawn the line in some ways – I review the slides and rehearsal ahead of time and if I think it’s irrelevant except as a sales pitch to prospects, I make them say so in the abstract’s target audience. The one thing I’ll say is that the webinar you see will always be better than it would have been without our guidance. Whether it could have been better still is the issue we’re addressing.

Let’s hear more from front-line nurses, like a Dr. Jayne column.

I agree. I would need someone insightful with the time and ability to write well and regularly. I’ve solicited that kind of talent before and have struck out. I would be happy to hear from a nurse in an actual caregiving role who is IT savvy, opinionated, and an engaging writer.

Add tags for discussion, links to specific story items, or improve the search function.

I haven’t found an easy technical way to do any of these things. The “one post, many items” format is perfect for reading, but doesn’t lend itself to breaking out discrete data elements for searching or filtering. I would contract out doing some manual indexing if I could figure out what the result would even look like. Someone suggesting reaching out to an informatics professor to have their students devise a solution, which would be fun.

Stop being so pro-Epic.

I report about Epic the same as any other vendor. They are successful and a driving force in the industry, but they also aren’t perfect and I report that too (questionable non-competes, hospital bond ratings that suffer because of Epic rollouts, and weaknesses in specific product lines). Epic will get mentioned more than some vendors because they are big and many readers, especially the big-hospital ones, are involved with their products and have more to say about them. Everybody either loves or hates Epic  (often breaking down into Epic users vs. Epic competitors), but I think I’m as much in the middle as anyone. Of course everyone thinks they are unbiased and I’m no different.

Do more interviews with non-sponsoring companies.

I will interview almost anyone who sounds interesting and who volunteers or who agrees when I reach out, although for companies I only interview at the CEO level. I don’t guarantee sponsors that I will interview their executives, but their PR people often make the CEO available and I’ll usually accept under my rules (no blatant promotion, no advance screening of the questions, no approval editing of the transcript, I’ll talk about what I want to talk about and that probably won’t be the usual PR fluff.) I love interviewing providers, but they rarely volunteer. Typically the only interviews I decline are non-CEOs and CEOs of companies that aren’t doing anything interesting or important enough for most readers to care.

Avoid the whining sour tone that creeps into HIStalk.

This is another area where opinions vary. Some people claim I’m an industry cheerleader oblivious to the facts, while others see me as a negative naysayer. I can only say that I’m being myself when I write and you either like it or you don’t. I’m not changing.

Have you considered charging people to write "Readers Write" articles? They have become self-promotional advertisements for consultants or software vendors.

I agree that they had become tedious until a couple of months ago. My policy was to accept anything that wasn’t promotional. Lately, I’ve started rejecting articles that don’t present useful information appropriate to a knowledgeable audience and I’ve alerted the PR people who were ghost-writing them that I can’t use those articles. I will also say that anyone who interviews or submits guest articles is promoting something, even themselves, or they wouldn’t bother, so it will never be perfect unless I stop accepting guest content altogether.

HIStalk seems to be getting rather smug and self-congratulatory, especially in the case of HIMSS coverage and the HISsie awards and the HIStalk party. It seems you are beginning to think that what HIStalk does IS the news rather than you report the news.

We do cover ourselves at HIMSS since everything we’re doing there involves readers, but not to the exclusion of anything else. It’s tongue in cheek – it’s not news, just acknowledgment that HIMSS brings a lot of readers and us together. I barely mentioned the HISsies awards and only enough about HIStalkapalooza to allow people to sign up and to read the recaps afterward. It isn’t news, but then again neither is most of what happens that week.

I would like to see more B2B opportunities for sponsors and other companies to connect with each other for partnerships, staffing, or even acquisitions.

I’ve always liked the idea, although I’m not sure I have any particular expertise to make it happen. I’m open to ideas.

I believe there’s an opportunity with HIStalk for readers to share with the entrepreneur community what are the real world problems that still exist and still remain unsolved. 

Readers would have to step up and contribute and that doesn’t usually happen. I could ask for volunteers to serve as an ongoing provider panel, contacting them every six months or so.

Morning headlines don’t seem very useful. The information is usually covered in more detail during the following news post.

That’s the point. Some people just want a quick glance at the most important news. It stands to reason that stories important enough to be included in the headlines would also be covered in the regular HIStalk post, with the assumption that someone short on time might not get to the latter right away.

The email updates don’t offer anything helpful. They just say something new was posted to the website.

That’s all they are intended to do. I’m not writing a newsletter, I’m just letting people who signed up for the updates know there’s a new post. The majority of readers come to the site by clicking the email link. I am willing to put Lt. Dan’s morning headline posts into their own full email if people want that, and a few respondents do.

Include more regular content from healthcare M&A investors.

I would be happy to do that, but those folks are busy enough that nobody has volunteered. People like the idea of writing regularly for HIStalk, but then realize that it’s a fair amount of work on a fixed schedule. I’ve tried several people as regular writers and they dropped out not long after they started.

More information about cutting edge technologies.

I’m willing. It’s hard to tell which startups are BS or doomed to a mercifully quick death (and quite a few are both), but I will interview CEOs (or even better, their customers, if they have any) since that’s the best way to find out what they’re doing.

Filter comments more to get the non-productive ones out.

That’s a slippery slope. I generally approve all comments except those that are potentially libelous or are of a suspicious nature (like someone making unsubstantiated claims about a publicly traded company.) I would love having more thoughtful and balanced comments, but I can’t make people submit them. I have started deleting the incessantly anti-EMR whining ones from the many fake names of the reader known as Not Tired of Suzy, RN because they all say the same thing.

A bit less content. It’s a lot to read 

It is quite a bit of reading, maybe 10 minutes per day, but it’s everything important going on the industry. I reject 95 percent of the “news” that’s out there because it’s irrelevant and what’s left is what I think is important. Certainly you could skip some sections that you know in advance won’t interest you as being hard news (probably the reader comments, sponsor updates, upcoming webinars, etc.) but I’m writing for people with a lot of backgrounds, some of whom find information on sales, business news, and people changes to be the most useful parts of HIStalk. In other words, everyone would like to see content tailored to their specific interests, but those interests vary.

Create a cleaner front page design.

I have to be honest that I’m more of a content guy. Everybody likes the idea of a different page design, but when I looked at it awhile back with reader input, nobody had any great ideas given the nature of the content. However, I will take this chance to remind that you can click the “View/Print Text Only” link at the bottom of the post to get a simpler layout that some find easier to read. It also makes it easier to copy/paste if you want to send a snippet to someone. Try it right now.

Interviews with users and not just C level.

I’m willing to interview anyone who is interesting, but I can’t make them volunteer. I don’t have any good way to get in touch with floor nurses or hospitalists from hospitals all over the country.

How about a column from someone at ONC or a member of the HIT Policy Committee? Also, The Investor’s Chair has tapered off and it would be good to see more of him.

I’m certainly willing on the former. On the latter, I love running Ben’s stuff but I guess he’s been busy, same as Dr. Rick Weinhaus’s “EHR Design Talk.” Volunteer contributors  have jobs and lives that come first. Writing isn’t their primary activity.

I would love a section for analytics.

I probably need to dig a little deeper into that, but there’s an awful lot of frothiness out there (or maybe that’s a reason do to it instead of a reason not to.) I will figure out how to get more education on the topic since I’m a casual follower for now. 

Create an HIStalk podcast or audio format of HIStalk for the morning commute.

I could do that, but I don’t know if enough people would care to make it worthwhile. I’m biased because I’d much rather read words than listen to audio or watch video where I can’t skim, but it might be fun for commuters.

Bigger venue for HIStalkapalooza.

HIStalkapalooza has turned into a headache as it keeps getting bigger and expectations are raised, but I’ll try to make it better where I have enough influence with the company that’s paying. I dread it every year because I get into emotional arguments about how many people I can invite, where it will be held, and how we’ll handle things like guest requests or special diets. Then I get into a Vietnam of requests from righteously indignant people who didn’t sign up or who I couldn’t invite because of capacity. I said after this year’s event that I was done with it, but I’ll probably change my mind over the summer.

Don’t dilute your brand with things outside your core of news and comments.

I’m keeping close to the core, I think. The only new offering involves webinars and I let Lorre manage those so I don’t get distracted. I received probably 30 or more ideas of things I should get more involved with, but I will likely pass on most or all of them and stick to my knitting. I have enough challenges already.

I would make the "Anonymous CIO" interviews a regular feature.

I would love to. I asked for volunteers and got the one you saw. That’s it.

Bring back the old logo. Don’t give in to the PC police!

I didn’t drop the smoking doc logo because of political correctness. It’s still at the bottom of every post, in fact. The problem was that it wasn’t designed as a logo. It was cool, but the size, shape, and detail didn’t work as a logo. I still get occasional hysterical emails from people who don’t get the intentional irony of a 1950s, reflector-wearing, pipe-smoking doctor, who think that they are the first to have noticed that a healthcare IT site features smoking.

Most of your content is regurgitated news from other sources.

News almost always comes from other sources no matter what you’re reading, although I will take exception in that some of the reader comments, rumors, and interviews provide news that nobody else has. None of the big-budget publications have people out there on the street doing investigative journalism or first-person reporting – we’re all somewhat reliant on announcements, journal articles, vendor propaganda, and lame survey results (and in the case of many sites, using what they find on HIStalk and pretending they didn’t get it there.) The HIStalk difference, I hope, is that I won’t run space-filling stories that don’t interest me, I summarize the stories and put them into perspective, and I’ll add my own commentary when I think I can add value. I’ve been on the provider side for a lot of years, so I would hope I can do a better job than a reporter fresh off a fashion magazine. 

Separate out the content areas into separate sections in their own posts.

I don’t want to do that. People want one quick glance to see everything, not to go clicking on several separate posts just to see what’s new. I know other sites do it that way, but I think they are wrong.

Take a break and get some R&R more often so you don’t flame out prematurely.

I’ve been writing HIStalk for almost 11 years and I still look forward to it every day. Sometimes the administrative parts take more energy than I’d like, but that’s why I got smart and brought Lorre and some other folks on board to help out so I can do the parts I care most about.  

A couple of readers have asked about my succession plan. There isn’t one. If I flame out prematurely or otherwise, HIStalk flames out with me. That leaves Inga or Lt. Dan to post my obituary, which I hope in honor of my tiny legacy will be crisply concise and snarky.