When it comes to transparency in health care, it doesn’t get more open than the chief executive of a hospital sharing unfiltered opinions online. It’s a risk, sure, but it’s one that has made F. Nicholas Jacobs, president and CEO of Windber (Pa.) Medical Center, a minor celebrity and turned WMC, a small community hospital, into a survivor.

Jacobs is the voice behind Nick’s Blog, launched in May 2005 as a means of promoting the 52-bed hospital in rural Western Pennsylvania.

“By using traditional media, we could never, ever make the ‘buy’ that we needed that would get the word across,” Jacobs says. Larger, regional hospitals would simply spend more and crowd Windber out of the marketplace. The Internet enables Windber to “pursue growth and to make us an internationally recognized center.”

Jacobs was perhaps the first hospital CEO in the U.S. to start publicly blogging, and still is among just a handful who do so, including Paul Levy of Beth Israel Deaconess Medical Center in Boston. Others shy away from blogging, he says, in part because of the time commitment required, but mostly because so many are loath to talk about issues that might not play well with the hospital’s board or that might give competitors some strategic insight into the organization.

Jacobs, however, calls himself a risk taker as demonstrated by his willingness to accept the top job a small hospital in the difficult climate that existed a decade ago. “When I took this position in 1997, we were going out of business,” Jacobs recalls. One consulting firm said that small-town hospitals would be a thing of the past by 2002.

“Our obituary had been written,” Jacobs says. “At least if we go out, we go out in a Viking funeral.”

Some of the risk-taking involved a research agreement with Walter Reed Army Medical Center (Washington, D.C.) that required Windber to build a huge IT infrastructure to share information. In the early part of this decade, Windber garnered plenty of coverage in the national press — particularly because it’s located near where United Flight 93 went down on Sept. 11, 2001 — but local media didn’t show much interest.

The Internet helped change that behavior. “It is a tool that makes the world flat,” Jacobs says.

“I wrote my first blog without permission because I’ve always believed it’s better to ask for forgiveness than permission,” Jacobs says.

“The media began to read my blog and they began to quote my blog,” he recalls. “It became an offensive instead of a defensive mechanism.”

Jacobs notes that the local newspaper ignored a major award that Windber Medical Center won, but on the same day wrote about improvements in food service at a competing hospital. A critical blog post resulted in a big story on Windber a week later.

Jacobs also has used the blog to pre-empt negative coverage about the hospital and to address internal operational problems.

“We can do employee recognition through it. We can also do employee embarrassment through it,” Jacobs only half-jokingly says. “Without naming them, I’ve mentioned the fact that I’ve been disturbed with their attitude relative to certain things, and it’s certainly gotten to them right away, and they fixed it for us. It’s been very effective that way.”

Welcome to the world of new media.

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