Is social media in hospitals easy?

Last week I wrote about what don’t hospitals  get  about social media. This week’s topic, is social media in a hospital or health system easy,  is about some ideas to re-energize and move forward with a social media program.

In hospitals and health systems, it really comes down to three questions to be answered. First, is there an organizational understanding  standing of the power of social media to engage the healthcare consumer and patients and its place in the annual marketing plan? Secondly, do you have the marketing  talent  to construct, execute  and evaluate the effort? Finally, can marketing resources - capital and human, be allocated to the social media program?

I am not going to debate whether or not a hospital or health system should or should not have a social media program.  That train left the station a long time ago and its catch up time for healthcare organizations.  But, if you can’t answer all three question positively, then you have some basic ground work to do before you move forward.

In the new world of healthcare where price, quality and a newly insured healthcare consumer paying more out-of-pocket costs for healthcare, social media represents an opportunity that can be used advantageously  to meet healthcare consumer’s and patient’s for that matter, demands for better direct engagement and experience.

Social media is an opportunity for establishing a one-on-one relationship with the patient, aka the healthcare consumer, directed by the healthcare organization that breaks from the pack, by creating an  experience that is memorable and can exceed an individual or families experience and expectations.

When you have constrained marketing resources, and you have to have a continuous presence in the market place to shift healthcare consumer’s attitudes, preferences and choices, a social media strategy that is fully integrated into the marketing plan and the healthcare organizations can achieve that end for you.

Follow these steps and you're on your way to developing and implementing  a strategically-focused, comprehensive and fully integrated, organizationally transparent social media strategy:

1. Strategy first, tactics second. Any old road will get you to where you want to go without a clear identifiable strategy. This is no different than a traditional marketing approach. Integrate the tools and techniques of social media  into your overall marketing efforts.

2.  Be clear about  your messages and what value using these tools will bring to your healthcare consumers.  The purpose is to engage in a dialogue not shout at them.  You have to understand what type of information and content your consumers want.  Without that knowledge you can say whatever you want, but chances are no one will be reading, responding or listening.

3. Take an integrated approach.  What goes on your web site is also on facebook and used in twitter to drive traffic to you.  Twitter is a great way to send out links for health related articles or news and information.   Have a video? Post it on YouTube. Writing a healthcare blog? You should be if you're not. Make sure twitter, facebook, YouTube, flicker etc follow you buttons are on your site. Running  Back-to- School, Sports or Camp physicals? Put it on twitter, facebook and even those coupon sites like Groupon. Holding a health and wellness event, ditto.

4. Use QR codes with your web site or specific page links or phone number embedded  in them to drive them to your site, call center or service line. Through the use of QR codes you can make your print and traditional activities social in nature.

5. Remember at all times your are building brand, perception and experience. This just isn't nice to have, people will remember what you say and do.  Be right the first time.

6.  Devote resources, budget, time and personnel for the task.  Your challenge is to keep in front of your audience with relevant information, all the time.  Attention spans are short.  If someone sees no changes on a pretty regular basis in your content or information, they will fall away.

7. Measure everything.  Evaluate.  Adjust based on your findings.

8. Be creative, don't limit yourself to the tried and true or what a competitor is doing. Be an innovator.

9. Use social media with your physicians and employees to communicate, build organizational support and loyalty.

10. Build excitement around what you are doing.

The budding  healthcare consumer and patient of today is social media savvy and networked to the nth degree.  They expect the same of you.

How is healthcare consumerism changing provider marketing?

Technological and care delivery innovations, specialty pharmaceuticals, social media influences, data releases on price and quality, the healthcare consumer sending more out-of-pocket and exhibiting consumeristic behaviors in insurance choices and provider section, have come together to create the perfect storm.

How has this affected healthcare provider marketing?

It's a tough balancing act when an organization has never really marketed in an evolving semi-retail healthcare market, or communicated with the healthcare consumer in meaningful price and quality terms. Terms that grow your brand, build stronger customer connections and answers the question, what's in it for them?

So why should this be on leadership’s radar screen, as if there isn’t enough to worry about already?

I can give you five reasons why:

1. Retail medicine; 2. Price competition; 3. Newly Insured; 4.Consumer choice; 5. Social media.

These five market shifts are changing how healthcare organizations will do business. And if healthcare marketing is not changing, then what follows are the critical steps you need to take to leverage and move ahead to survive and thrive in an increasingly tough market.  

1. Market Research

Do the research on healthcare consumer behavior, what motivates them, how to communicate with them, how they make purchase decisions and price points they are willing to accept. Healthcare consumerism screams for market research. It's about the healthcare consumer, their needs, expectations, experience and engagement.  And thinking you know about them is not the same as having the quantitative date that knows them.

2. Business Savvy

Make the healthcare marketing department business savvy. Out with the marketing communications focus, and in with a data driven ROI marketing coupled with an understanding of finance, project management, and operations so that the marketing can be transformational. Going from saying "we care and provide world-class care" to building brand, engagement and experience as well as measuring that change in real terms requires a deep understanding  of the organization on many levels in order to be successful in the market.

3. Resource Commitment

Healthcare providers must resource marketing appropriately in capital and human terms in order to compete with retail medicine and pricing competition. Engage the healthcare consumer in a meaningful way and improve their experience. Build your brand and increase awareness. Presence builds preference. It cost money to accomplish market growth.

4. Agility

Be nimble. Be agile. Be quick.  Keep repeating that over and over again. Healthcare marketing needs to move from the tried and true to the exceptional, the innovative, the engaged and the motivational. One can't reach the healthcare consumer on an emotional level to make the right choices, treatment, lifestyle and purchase decisions in your favor unless you are sufficiently engaged.

5. Integration

Integrate your marketing plans deeply within the organization. The healthcare consumer is at the center of all that you do. Pay special attention to social media. Social media is not a billboard but an efficient and effective engagement strategy that enhances all the other marketing channels you use.

6. The multiplicity of markets and patient mechanisms

Not everyone will be in an ACO or a patient medical home. Not everyone will have employer sponsored insurance. Some won't have health insurance of any kind. Not everyone will be in expanded Medicaid programs.  Small business may decrease employee’s hours to not have provided health insurance.  Large employers are creating private HIXs and moving to defined contribution. Baby Boomers are demanding a healthcare experience the way they want. And retail medicine is here to stay and will expand.

That light at the end of the tunnel is healthcare consumerism and that Walgreens ACO has come to a location near you.

Can 2014 be the year of healthcare marketing ROI?

With the start of the Chinese New Year and it’s the Year of the Horse, why not make 2014 the year of healthcare marketing ROI? As we all face increasingly reduced marketing resources both human and capital in hospital, health systems and other providers, the only way I know to even begin to turn that around is by proving to the organization the Marketing Return on Investment or ROMI.

It’s not the impossible task. And it does involve a high degree of collaboration with the finance department.

Depending on the type of health care organization that one is employed by the measures will be different. For example, if the healthcare organization is sales drive, then measure the generation of Marketing Qualified Leads, Sales Accepted Leads, and based on that increases in the long and short term funnel compared to YOY. Any organization using email can measure click through rate, open rate, unsubscribed rates, open rate and downloads. For hospitals and health system if you have the right systems then you can pull integrated clinical and financial databases by campaign to calculate the ROMI.

Below is an example of an actual computation that I completed for a multi-hospital health system. Now that being said, I did have the good fortune to have an RN staffed call center which was used heavily in all campaigns.  And because the call center and finance systems were linked, once you have that name then you can track and determine the customer value, revenues generated and a return on investment ratio.

The method can be adapted to any campaign and provides you with the data fields and logical analysis you need.  This is not prohibited under HIPPA, so that is not a reason to say no can’t.

An analysis was undertaken to look at the ROMI of the Physician Referral Call Center. The analysis matched a database of call center name records for the period to financial records which had already been downloaded.  The analysis produced the following results:

      9,102 call records were matched with utilization and financial data.

      9,102 calls resulted in a total of 9,121 encounters in the ER, Inpatient and Outpatient categories of service.

      751 encounters were ER

o   177 returning encounters

o   573 first time encounters

      1,105 encounters were Inpatient

o    530 returning encounters

o    699 first time encounters

      7,267 were Outpatient

o   2,014 returning encounters

o   5,253 first time encounters

      Total charges for all encounters equaled $22,522,649

      Charges for new encounters all services totaled $16,085,198 or 71 percent of the total charges

      Average charge per ER encounter  $1,304

      Average charge per  Inpatient encounter $13,581

      Average charge per Outpatient encounter  $903

      Gallup measures loyalty at 68 percent (would return for service) which means that for every 100 patients 32 would not return for care- therefore:

o   ED- 57 returning encounters captured that would not have returned

o   Inpatient – 170 returning encounters captured that would not have returned

o   Outpatient- 645 returning encounters captured that would not have returned

      Incremental charges counted returning encounters not loyal

o   ER - $74,337

o   Inpatient- $2,308,851

o   Outpatient-  $582,505

o   Subtotal charges counted:  $2,965,693

      Overall market share in primary and secondary service area is 14.53 percent. The number of first time encounters have utilized us above market presence is therefore:

o   ER 573 first time encounters,  83 not countered, 490 counted –

o   Inpatient – 699 first time encounters, 101 not counted,  598 counted

o   Outpatient – 5,253 first time encounters, 763 encounters not counted, 4,490 counted

      Based on an overall market share of  14.5  percent the  incremental charges counted for new  encounters not because of market presence:

o   ER - $638,960

o   Inpatient – $8,121,438

o   Outpatient –  $4,054,470

      Total Charges counted: $12,814,868

      Discount from gross charges for Medicare, Medicaid, Managed Care, Bad Debt and Charity Care @ 65% is $8,326,644

      Net Revenue:  $4,488,224

      PRCC program costs:  $233,410

      Net contribution:  $4,254,814

      ROI 18.22:1

Let’s make 2104 the year of return on marketing investment in healthcare.

Have you made your healthcare marketing resolutions for 2014?

New Year's Resolutions, for the most part, play an important role in most everyone's life.  To lose weight. Live life more fully. Be a better husband, wife, or significant other etc.  Value more what we have in our family and friends.  And many more that I have missed. But have you ever considered New Year' Resolutions as a part of your business and managerial life? 

So my last Healthcare Marketing Matters blog for 2013 is about New Year Marketing Resolutions.  My own Top 10 list to get things started.  What are yours?

10.  Focus on meeting the needs of the healthcare consumer aka the newly insured.

9.  Learn from the healthcare retail giants like Walgreens, CVS Caremark and others. Healthcare continues to evolve into a semi-retail market and what has worked in the past won’t work anymore.

8.  Marry price to outcomes and be transparent to the healthcare consumer. Prove value.

7.  Integrate traditional, online and social marketing strategies. All are complementary to one another and drive multiple successes.

6.  Innovate- again and again and again;

5.  Foster a spirit of and demand marketing excellence in the marketing department.  Good enough is not good enough.

4.  Focus on the data and show ROI. If it doesn’t work then stop doing it.

3. Stop using the words "unique", "state-of-the-art", and anything that is considered “buzz word" terminology in my marketing communications.  Unique can be duplicated easily. State-of-the-art refers to yesterday's systems as things change so fast. Buzz words quickly fall out of favor.

2.  Bridge the divide between sales and marketing.

1.  Serve and be humble, for working in healthcare is a privilege, not a right.

It’s been a most interesting year, HMM went over 5,000 page views a month and is now read in 52 countries around the world.  There was a lot of spirited discussion in LinkedIn groups about several of the posts. I fielded calls on various topics from Bloomberg Weekly, Reuters, Associated Press, Crain’s and Strategic Health Care Marketing (published December 2013).  It was all appreciated and fun.  But most of all thank you for reading, for that is what really makes doing this worthwhile. I am taking a couple of weeks off. See you in 2104.

Merry Christmas, Happy Holidays and Happy New Year! Have a healthy, safe and prosperous year.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger read in over 52 countries worldwide.. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Does your patient experience fail the test?

True story.  "Well, you can always bring her back to the hospital if she still has trouble breathing", said the home health care nurse sent from the hospital less than 2 hours after a patient had been discharged.  Oh, and did I tell you that her eye was infected, almost fell going to the bathroom in the hospital and informed the nurse, had slurred speech and could barley ambulate?  That patient had been cleared by all to be discharged from the hospital.

And then the family hears or sees an ad about all the wonderful quality care awards from third parties that they receive, and how many lives would be saved if everyone was as good as them.

What do you think the now healthcare consumer, formally the patient thought?

Countless times every day, the patient experience goes fails the test.  Big things and small things alike that take place in the healthcare encounter all add up to one patient experience, good or bad. 

When healthcare executives are surveyed, the majority say that customer/patient experience management is a critical business success factor along with patient safety and cost reduction.  But at the same time, the majority of healthcare CEOs admit that they really don't know where to start on successfully managing the experience.

Experience management is about changing the way you interact with the individual or family from start to finish.  Not just managing the experience at isolated points along the care continuum. It's not about just focusing on service recovery like something was wrong with a hotel stay.  Managing the experience requires a complete understanding of what the patients expectations are, not yours. Experience management is culturally and organizationally uncomfortable. And that is because it's not about you anymore.

So when the patient experience fails, your reputation, your brand and your future in a risk or value-based payment environment fails as well. And then there are those readmissions penalties you face when a patient like this comes back in less than 30 days.

You should see what's being said on facebook and in social media circles from others that chime about how bad their experience was at that particular hospital. Do you still think social media is nothing more than a billboard?

Yep, the chuckle factor is really high when those quality award ads are heard and seen.  Pay attention to the patient experience, and pay attention to the marketing. They are not separated, but closely related.

The newly insured healthcare consumer is paying close attention now. It costing them money, they have too.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Are you using social media marketing for an exceptional healthcare experience?

In the new world of healthcare where price, quality and a newly insured healthcare consumer is paying more out-of-pocket costs for healthcare, social media marketing represents an opportunity that can be used advantageously to meet healthcare consumers demands for a better experience.

Social media represents a great opportunity for establishing a one-on-one relationship with the patient, aka the healthcare consumer, directed by the healthcare organization that breaks from the pack, by creating a social media healthcare experience that is memorable, exceeding an individual or families experience and expectations.

Most healthcare organizations are still stumbling with using social media and the online experience to drive differentiation, meaningful information and experience. Think of this in terms of a channel of communications and engagement that meets the healthcare consumer on their terms but with your messaging.

In any case, when you look at your social media strategy and presence, does your social media experience:

Ø  Delight your customer?

Ø  Create sustainable differentiation?

Ø  Is adaptable to new opportunities?

Ø  Leverages your investment?

Ø  Deliver in every situation?

Ø  Connect with the newly insured?

Ø  Does it engage the healthcare consumer?

Ø  Provide answers or guidance looking for solutions to medical challenges?

Ø  Define experience, outcomes, price and value?

Or, is it just pushing out information that is that you have deemed valuable to you, but carries no relevant meaning for the healthcare consumer?  

This is the lens of criticality needed to objectively evaluate efforts.  If it's not doing these things, then chances are nil in delivering an exceptional social media experience. But for that matter, neither are your competitors. 

Make your social media presence not just "good enough" but exceptional.

On another note, my apologies for missing a post last week. I was out of town with my wife and daughter last weekend. Alex is a left-handed pitcher on a 16U a fastpitch softball college exposure team and we were in Des Moines, Iowa for the ASA 16U A Heartland Showcase Series College Exposure Tournament.   Saturday was playing for college coaches and scouts. Sunday was a single elimination tournament.  There were  27,16U A teams playing. We made it to the final four and a three way tie for 1^st place because the final games were canceled due to rain. It was a good time.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

How do you market to the newly insured?

Here comes the newly insured. They are not in ACOs.  Some will have chosen high deductible plans.  Some have even chosen narrow networks to limit their premium cost.  Some of the newly insured will be in the expanded Medicaid program.  What we do know is that it will be a potpourri of ages, sex, income, health status, relationship status and education.  We know that there will be a lot of people who never had access to health insurance.

So how do you market to the newly insured, knowing that the probably haven’t seen a doctor in a few years? They most likely don’t have a primary care physician. And when they needed care as the uninsured, they most likely used Emergency Rooms as their primary source for medical care considering themselves to be ER frequent flyers.  They will be less healthy and in need of navigation though your healthcare system.   They can be a financial godsend to your hospital or a drain depending on their medical condition and source of payment.   

Because you waited until now to start marketing, the chance to establish a relationship with the newly insured prior to the opening of the HIX and that insurance purchase has been lost.  Now you have to compete. And telling the newly insured you have the best doctors and most caring staff is right out of the nineties and meaningless.

The healthcare market is changing and these people are paying out of pocket and they will be paying attention to price, quality and experience. So it is really along these three dimensions that you need to focus your integrated strategic marketing efforts.

Push the newly insured to the primary care doctor.  Pull the primary care doctor to the hospital.

Push the newly insured from the emergency room to free standing clinics and other less costly settings.

Engage the newly insured in meaningful ways along price, experience and quality.

Look out for Walgreens and CVS Caremark, Rite Aid and others whose retail clinic strategy is perfect for the newly insured, and will limit their out of pocket expenses better than you can.  Look out for the hospital or health system that will be the first in your market to engage the newly insured in meaningful ways along price, experience and quality.

The age of semi-retail healthcare is now beginning.  That means the healthcare consumer, aka the newly insured, have some leverage and bargaining power.  Meet their needs and establish a meaningful relationship on their terms, or keep doing what you have always done in marketing and watch them walk away.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Can patient experience and satisfaction drive healthcare marketing?

Patient experience and satisfaction is no longer a nice too have, but a got to have in the evolving consumer-centric healthcare market place.  Consumers are paying more out of pocket and when consumers pay more they expect more.  A better healthcare consumer and patient experience in the end means a more compliant patient pre and post treatment.  Higher level of service and medical process satisfaction brings the healthcare consumer back in a sea of providers who all offer the sameness. 

It is one of the primary drivers for a reason to return. And when all things are equal and undifferentiated, experience and satisfaction become a major determination of return and for their recommendations of you.

Difficult to achieve and tough to competitively beat once you have it, experience and satisfaction with your medical products, clinical services and processes regardless of the vertical, be it specialty pharmacy, medical device,  pharma, hospitals, doctors etc., will drive revenue.  Revenue from the standpoint of Pay-for-Performance (P4P) programs and volume from healthcare consumers aka patients, selecting you in a very commoditized and provider undifferentiated healthcare market place is at stake.

Not everyone will be in an ACO or risk-sharing agreements.  Some will choose narrow networks to save a buck on premium. Fee-for-service will still be around for awhile.  The opening of public insurance exchanges in October, 2013, Medicaid expansion in some states and the now becoming ever more popular the private insurance exchange where companies are moving to defined contribution (see Walgreens, Sears and others in recent times), means that you have a direct to consumer opportunity along very different dimensions then in the past.

The healthcare consumer of today will view your services as: value= f(cost, quality, satisfaction) as compared to the near past where value= f(cost, quality). Value as described by the healthcare consumer here is the result of the function of cost, quality and satisfaction with you.

Why is it important:

• High levels of experience and satisfaction are a powerful differentiator in your market.
• Done correctly, your experience improvement and satisfaction program becomes the ongoing Voice of the Customer (VoC) program to drive real organizational change.
•  It is a strategic and tactical edge for your brand and your marketing communication efforts. 
• Think customer evangelization.
• Think of the power of a high-quality experience and exemplary satisfaction and what that can do for your organization. Think of what it can do in your effort to differentiate.

The choice is yours.  Make it before others make it for you.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on  facebook at the michael J group, and connect with me on LinkedIn and  Twitter.

The media is calling; how do you respond to PR crisis?

Sometimes, another organizations PR missteps are an opportunity to learn how not to handle a PR crisis.  Just ask the any of the hospitals and health systems that have been in the media the past few weeks with HIPAA violations for data beaches. And what I have seen from the healthcare consumer side in the coverage and their responses have been arrogance, apathy and really stupid responses by senior management.

I mean really, “We had a panic button and security camera.”  Does it matter in your response that the theft happened after hours?  Or the, “We had 60 days under the law before we had to report it.”  How do you think the public reads that answer of hiding behind regulations when their personal data is at stake?

In an age of healthcare model evolution from provider-dominated models of decision making to consumer-directed models, those bygone days of being able to mismanage a PR crisis and response and get away with it are gone.

Is your response to dive for under the desk? Do you send out poorly prepared underlings, to face reporters and the public? Does leadership, make proud pronouncements at the outset, that could come back to haunt you because at this point, you just don't know?   Do you react as an arrogant organization with the, "How dare you question us response"?   Do you think that it can never happen to you? Do you have a crisis communications plan in place?

Every healthcare organization will face a PR crisis. How you handle the communications, will determine the amount of brand damage and length of time people remember, the good and the bad.  In this age of social media and the Internet, there are no, "We just need to wait 3 days to weather the storm", anymore.

Many times organizations respond with:

·         Lack of organizational understanding of the need to handle a situation as crisis communications;

·         Different, conflicting senior management messages;

·         Testy responses to questions;

·         Lack of preparation by speakers in understanding the seriousness of the communication;

·         Poor speaker body language;

·         No overriding organizational message;

·         Organizational arrogance;

·         Lost messaging opportunity;

·         Appearance of blaming others;

·         The organization appearing not accountable;

·         The organization furthering to anger the media;

·         No response at all with the "it's just a three day story and will go away";

·         Sending out unprepared underlings to face the media;

Is it not true that any press is good press!  Every day, someone somewhere faces a crisis communications issue which is poorly handled.

By following these planning guides, you can weather any storm, limit reputation, revenue and ultimately brand image damage:

·         Understand the nature of the situation;

·         Be transparent;

·         Be proactive in how you intend to address the situation;.

·         Limit the amount of time senior leaders i.e. the CEO or president speak;

·         Make sure everyone has the same message and is on board;

·         Develop strong organizational messaging of care and concern;

·         Don’t scapegoat, blame others or give the appearance of blaming others;

·         Don’t tell people things will change when things are not changing;

·         Practice, practice, practice;

·         Bring in an outside PR firm for another viewpoint;

·         Understand that your reputation is built up over a long time and can be destroyed in a few short minutes;

·         Remember that it is not just a three day story;

·         Watch your body language;

·         Know your facts about past performance, reporters will be prepared;

·         Learn from others;

·         Each year engage in a day of media training for executives. Dealing with the media is a learned skill that the majority of executives do not have.  It is not as easy as it looks.

Most importantly, engage the media all the time all year round not just when you have a problem.  By establishing positive media relations with the good you do, you won't necessarily be cut any slack in a bad situation, but you will get the opportunity to tell your side.  You won't if you don't have good media relations already in place.

Plan now for that crisis communications event, and you will better off as a prepared healthcare organization.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on  facebook at the michael J group, and connect with me on LinkedIn and  Twitter.