What’s next for higher ed?  Mt Holyoke gave us a hint.  In the 1980s.

What’s next for higher ed? Mt Holyoke gave us a hint. In the 1980s.

D-Day is less than 2 weeks away. On June 1, high school seniors and recent graduates will decide which, if any college to attend in the Fall. But, for most, they still won’t know where they’ll be living first semester.

Higher education, like so many other industries, has been rocked by the Coronavirus pandemic – classes are taught entirely on-line, students moved out of dorms and back home months before they planned, campuses are closed, and thousands of employees have been laid off or furloughed.

Like most other industries, colleges and universities have scrambled to respond and to prepare for what’s next.  Most pushed Decision Day back a month, from May 1 to June 1, to give prospective students more time to learn about schools offering admission and to assess their own ability to pay for and attend schools when classes resume.

But colleges and universities are facing a challenge that most industries are not.

Their customers are rebelling.  They are filing lawsuits.  They are asking a fundamental question, “What does my tuition actually buy?”

Before the pandemic, people though they knew.

It was only 30 years ago that most high school graduates opted to go to college.  According to research from the Georgetown Center on Education and the Workforce, in 1970, only 26% of middle-class workers had any post-high school education.  By 1992, it had jumped to 56% and 62% in 2018.

Today, prospective students, and their families believe that a college education is the cost of entry to a middle-class life.  You hear it in the Jobs to be Done (problems to be solved, goals to be achieved) they express when you ask why they want to go to college:

  • “I want to get a good job when I graduate” – functional Job to be Done
  • “I want to make a good living” – functional Job to be Done
  • “I want to have more independence” – Emotional Job to be Done (i.e. how I want to feel)
  • “I want to be part of something bigger than myself” – Social Job to be Done (i.e. how I want others to see me).

In response, colleges invested huge sums of money to convince students and their families that they offer the best solution to all of these Jobs to be Done.

  • Functional Jobs to be Done:. “I want to get a good job when I graduate” and “I want to make a good living”
    • Elements of the “College Solution”
      • Strong reputation
      • World-class education
      • Renowned faculty
      • Access to alumni network
      • Active Career services department
      • Relationships with employers
  • Emotional Job to be Done: “I want to have more independence”
    • Elements of the “College Solution”
      • Location near a major metro area or a fun college town
      • Access to student housing
      • Access to food
  • Social Job to be Done: “I want to be part of something bigger than myself”
    • Elements of the “College Solution”
      • Student clubs
      • Social clubs
      • Diverse student population
      • Championship athletics
      • Great living facilities

These elements and more are marketed in beautiful glossy brochures, recruiting roadshows, and campus tours.

The message is clear, “All of this and more could be yours if you are accepted and willing to pay.” And pay the students and their families did.

But here’s the rub.

When America went on lock-down in mid-March, colleges and universities were forced to close their campuses and send home students.  Classes were moved to virtual settings with little to no training to help faculty adjust to the new format. Overnight, almost all the elements of the “College solution” disappeared or were compromised, leaving a list that looks like this:

  • Functional Jobs to be Done:. “I want to get a good job when I graduate” and “I want to make a good living”
    • Elements of the “College Solution”
      • Strong reputation
      • World-class education*
      • Renowned faculty
      • Access to alumni network*
      • Active Career services department*
      • Relationships with employers*
  • Emotional Job to be Done: “I want to have more independence”
    • Elements of the “College Solution” – n/a
  • Social Job to be Done: “I want to be part of something bigger than myself”
    • Elements of the “College Solution” – n/a

(* = significantly compromised due to moving to a virtual setting or to economic conditions)

Yet the price of the “College solution” did not change. What happens when the customer thinks they’re paying for one thing (long list of elements) and the seller gives them something less (short list of elements) and refuses to refund a portion of their money? Lawsuits. As Mark Schaffer, the parent of a George Washington University student, explained in his Washington Post Oped:

“When my daughter was deciding where to go to college, we were persuaded by George Washington University’s promises of an extraordinary on-campus experience. The school’s recruiting materials tout a dazzling array of opportunities — to engage one-on-one with renowned faculty, join more than 450 clubs and organizations, or explore passions in high-tech labs, vast libraries, and state-of-the-art study spaces.

The university promises that living at the school opens the door to “world-class” internships, lifelong friendships with neighbors and roommates, and the chance to “become a part of the nation’s capital and make a difference in it every day.” In exchange, GWU expects around $30,000 per semester.   As college campuses across the country have shut down to slow the spread of the novel coronavirus, most schools, including GWU, have offered only online classes since mid-March. The reason for the shift is not the schools’ fault. But this remote education is nowhere near the caliber of the on-campus experience students were promised. For this reason, I and other GWU parents have requested a partial refund of this semester’s tuition and fees.   Unfortunately — and offensively — the university has refused these requests. This is why I am suing GWU for damages to compensate my family for losses suffered because of the school’s breach of contract, and why I am seeking to represent all families similarly harmed by the school through a class action.”

What happens in the Fall is unclear

As lawsuits against GWU, Northwestern, University of Chicago, NYU, Columbia, and other schools wind their ways through the legal system, everyone is scrambling to figure out what happens in the Fall. Most schools haven’t made decisions and the few schools that have seem to be falling into 3 buckets:

  • Return to pre-pandemic normal by resuming all on-campus classes, activities, and operations: Brown University (as advocated by their president in a NYT Oped), Purdue University
  • Proceed cautiously with a phased approach to resuming on-campus operations, classes, and living: UC Berkeley
  • Stayed closed and continue virtual classes: California State University (the largest university system in the US)

Students are also struggling with their decisions.  Without clarity as to what the Fall semester looks like and certainty as to their families’ financial means due to the economic downturn and rising unemployment, many students are considering taking a gap year or enrolling in a lower-cost option, such as a community college or public university.

What happens in 2021 and beyond is much easier to predict.

Certainly, the impact of decisions made about the Fall semester will reverberate for years to come as colleges cope with lost revenue from enrollment and a fairly high fixed costs base.

But the greater impact will come from students’ and families’ sudden awareness of the Mt. Holyoke Phenomenon and the role it’s played in their decision making.

First witnessed in the 1980s, the “Mt. Holyoke Phenomenon” reveals that  “charging higher tuition leads to a greater number of applicants, as well as academically higher quality applicants.”

The impact of this phenomenon is simple – higher tuition attracts better students, better students demand better education and experiences, better education and experiences improve the school’s brand, a better brand means schools can raise tuition and make more money.

Given that college tuition has increased 260% since 1980, compared to the 120% increase in all consumer items, it’s reasonable to assume that, more and more, tuition is buying access to the college’s reputation.

And, as the lawsuits and declining enrollments suggest, people thought skyrocketing tuition paid for a lot more and, suddenly aware that it doesn’t, may no longer be willing to pay the premium.

The result will re-shape higher education as we know it.

Instead of getting into the most prestigious school possible and relying on financial aid and loans to pay for it, high school seniors will consider a wider variety of post-high school options, including:

  • Trade schools which lead to high-paying and highly in demand skilled work
  • Community colleges that grant Associate’s degrees and/or a path to transfer to a 4-year college
  • Co-op programs that allow them to gain work experience at the same time as a college degree

Colleges, too, will step away from their all (on-campus) or nothing solution to offer a wider portfolio of options.  In fact, some schools already have:

  • Miami University has several campuses, one in Oxford offering a traditional, residential 4-year experience, and two other campuses nearby that offer part-time associates and bachelor’s degrees
  • Harvard University offers a traditional 4-year college education, and undergraduate and graduate degrees through the nonresidential Harvard Extension School, and online certificates through Harvard X
  • SNHU famously offers online and campus degree programs and a special “Military Experience” that offers generous tuition discounts, credit transfers, and support programs to active duty military and their spouses

 It will take years for demand (what students want and are willing to pay for) and supply (what colleges and universities can offer) to reach equilibrium.  But that equilibrium will look very different than it does today.  Mt Holyoke taught us that in the 1980s.  The coronavirus reminded us.

5 Unexpected Uses of Telemedicine and How They May Help You

5 Unexpected Uses of Telemedicine and How They May Help You

There is more to telemedicine – the exchange of medical information from one site to another through electronic communication to improve a patient’s health – than virtual visits with physicians.

Specialists like dentists, orthodontists, ophthalmologists, psychologists, and even veterinarians are using telemedicine solutions during the pandemic.

Like their physician counterparts, many resisted virtual visits until it became the only way to continue to care for patients and stay in business, as stay-at-home orders expanded from weeks to months.

Here’s a quick run-down of telemedicine’s use in other specialties and what the road ahead could look like for each.


Where we are now

According to the American Dental Association, since early March, 79% of dentistry practices closed except for emergency procedures, and another 18% closed completely.

This isn’t surprising given how COVID-19 is transmitted but, for patients in pain, it can be hard to know what constitutes a true emergency and what can be managed at home.  Helping patients figure out what needs immediate attention and what can wait seems to be tele-dentistry’s sweet spot.

“Research indicates that 80% of acute dental concerns can be addressed at home without an in-person visit,” explains Chelsea Acosta Patel, Head of Wally Experience at Wally Health, a dental care start-up based in Boston.  “Using technology, dentists can triage issues and care for patients while keeping them out of the chair.”

Where we go from here

The bigger, long-term opportunity, according to Patel, may be in preventative care by creating and monitoring at-home preventive care solutions across the patient dental journey.

“Most dentists don’t have the tools to keep an ongoing pulse with patients.  They just assume that if a patient has an issue or a question, they’ll call the office.  Teledentistry solutions enable dentists to develop customized, ongoing touchpoints to help patients remain healthy and catch potential issues early. This improves the patient’s experience, drives loyalty and word of mouth (pun intended) for the dentist, creating a virtuous oral health cycle.”


Where we are now

While Dentists need a way to answer questions, triage issues, and provide follow-up care, Orthodontists have a more pressing need – to make sure their patients’ jaws continue to develop and their teeth continue to move in the right way.

“We serve a vulnerable pediatric population whose jaws are developing.  The adjustments we make as part of their treatment affect that growth and development,” explains Dr. Adam Welmerink of Welmerink Orthodontics in Reno Nevada.  “When we realized this would be more than a 2-week shutdown, we needed a way to keep our patients safe, make sure their appliances weren’t doing any harm, and ensure their treatment was progressing as planned,”

Through services like Orthodontic Screening Kit (OSK), patients receive instructions on how to take photos and upload them to the OSK site for review by their orthodontists.  Of course, the orthodontist’s ability to assess the patient’s need is determined by the quality of the photos, but, at a minimum, the service creates an opportunity for orthodontists to reconnect with their patients and give them guidance on signs that could trigger an in-office visit.

Where we go from here

Telemedicine in orthodontics, like many other specialties, will likely continue to be used to triage issues or to serve patients in remote rural areas.

“Many of our patients live in rural areas, with some driving 2 hours for a 10-minute appointment.  We’ll probably continue to use (OSK) to see if they need to come in.  And I could see using it in a limited capacity to triage patients who call with an emergency to assess if they can treat the issue at home or if they need to come in.” Dr. Welmerink mused.  “Honestly, time-wise, it’s quicker to see a patient in the office. But this is great for right now.”


Where we are now

Telemedicine’s use as a way to calm patients and triage concerns, deciding whether or not an in-office visit is required, continues with eye care.

“It is certainly a way to reassure patients that we are there for them, which is most important in these scary times,” NYC optometrist Dr. Susan Resnick told All About Vision.

While reassurance is important, most eye care professionals agree that telemedicine’s use is extremely limited.  Proper eye care requires pupil dilation and specialized tools to accurately identify problems like glaucoma or assess the health of optic nerves and retinas.

Where we go from here

Despite its limitations, Dr. Resnick sees value in continuing to use telemedicine, “We will continue to utilize this platform whenever necessary.  We do not view it as a disruptor or threat, but rather as a way to bolster our practice.”

Not everyone agrees.

“I’m not terribly enthusiastic (about remote eye exams),” Illinois ophthalmologist Dr. Benjamin Ticho told All About Vision.  “There’s going to be too many mistakes.  Plus, it diminishes the warmth and personality of the interaction.  For many patients, a good doctor visit is a pleasant social occasion, and for many doctors, that’s part of why we went into medicine.”


Where we are now

The data is staggering.

Before the crisis, 20% of US adults lived with mental illness but less than half received treatment according to federal statistics.

In the last two weeks of March, 45% of US adults felt that worry and stress related to COVID-19 were harming their mental health.  It’s likely that number has increased as stay-at-home orders extend, and job losses and furloughs increase.

Yet the adoption of telemedicine to address mental health concerns has been slow.  A phenomenon that is far from new.  Case in point – over a decade ago, Congress excluded mental health providers from a $30M investment in digitizing patient health records.  Even now, as CMS, private insurers, and state regulators are easing restrictions and increasing reimbursement for telemedicine to treat physical concerns, similar attention and flexibility have not been shown to mental health concerns.

As a result, “(providers) are kind of trying everything right now and seeing what can work,” John Torous, director of the digital psychiatry division at Beth Israel Deaconess Medical Center told Politico.

Where we go from here

More than other specialties, the jury is out on what happens next with regards to telemedicine for mental health.

On one hand, “so much of counseling has to do with body language, being physically present in the room, intonation,” Lynn Linde for the American Counseling Association told Politco.  “Sometimes, that’s lost when you don’t have a good internet connection, or one of your starts getting garbled.”

On the other, this could be a “tipping point for the way we practice,” said Peter Yellowlees, a professor of clinical psychiatry at the University of California, Davis and former president of the American Telemedicine Association.

Optum, a division of UnitedHealth, seems to be betting on the latter.  Last week it announced that it was in talks to acquire AbleTo, a New York-based virtual therapy provider for $470M, or 10x forward revenue.


Where we are now

If telemedicine is good enough for humans, it’s good enough for our animal companions.

A relatively new addition to the specialties offering telemedicine solutions, only a handful of companies are currently playing in this field.  TeleVet, a “Texas-based, digitally optimized company focused on veterinary care,” is one.

Before the outbreak, TeleVet was in use in 1000 clinics across the US and even closed a $2M seed round in January.

“We can check for infections such as ear infections or drainage from either a still picture or a video, or even a live video conference with the owner,” Dr. Amy Garrou as Houston-area vet explained to Innovation Map. “The platform has been useful because we can do any of those consultations and get the information we need to manage the case without the pet owner having to come into the clinic.”

Where we go from here

Like dentistry, orthodontics, and eye care, telemedicine’s use in the Veterinary space is a boon for providers and patients at a time when it’s not safe to be in a crowded office.  But as restrictions lift, like the other health care fields, it’s likely to be used primarily to answer questions, triage concerns, and perform post-surgery check-ups.



Yes, telemedicine is an incredible tool to have in our collective healthcare toolkit.  Its use across medical specialties is evidence that it fills a need for clinicians (provide care for my patients) and patients (address my concerns).

In “normal” times, those needs are well addressed by in-office visits, retail clinics, and urgent care.  It is only in very specific circumstances, like when medical professionals cannot easily or safely see patients in-person, that existing solutions fall short and telemedicine becomes the most attractive option.

However, telemedicine only became an available option when regulators relaxed rules, insurers increased reimbursement, and patients accepted emails and video-chats as treatment.

It took a pandemic to create the confluence of circumstances required for physicians, dentists, orthodontists, eye care professionals, mental health caregivers, veterinarians, and other clinicians to begin or expand the use of telemedicine.  It’s their experience, and the experiences and decisions of other players in the healthcare ecosystem, that will lead them back to the office and the hands-on care that is both desired and required.

10 Moments of Innovation Zen: Travel

10 Moments of Innovation Zen: Travel

Sunday was Read a Roadmap Day which is, naturally, one of MileZero’s favorite days.

For hundreds of years, maps were works of art. Available to only the rich and powerful, they described the full sum of our understanding of the land and sea, and told stories of the fantastical creatures that lived beyond our shores.

Even as maps became more accessible, reading a roadmap still felt like reading a treasure map. As a kid, I loved to study the different types and colors of lines signaled different types of roads. Dozens of symbols each translated to some wondrous place or service. And don’t get me started on the wonder and magic of AAA’s TripTiks!

As time goes on, fewer and fewer people know how to read road maps, which is understandable given that technology puts real-time custom location information at our fingertips. But there’s still magic in maps and in the discoveries that only occur through travel.

So, for this week’s 10 Moments of Innovation Zen, and in honor of Read a Roadmap Day, here i are 10 innovations in travel that you can enjoy from your own home (which is really your only option at the moment)

Savage Beauty by Kari Kola in Connemara, Galway County, Ireland

Savage Beauty, the largest site-specific light artwork ever created because art need not be constrained to pencil, paint, and canvas

Nordlandsbanen Bodo — Trodheim

Slow TV in which there is no story line, no script, no drama, no climax, just 9+ hours of Norwegian landscape as viewed from a train

Easter Island

Heritage on the Edge by Google showing how World Heritage Sites are affected by global climate change

Animal Cams so you can virtually visit the pandas at the Smithsonian National Zoo or the penguins, fish, seals, and other inhabitants of the New England Aquarium

Dotonbori area in Osaka Japan

Virtual Walking Tours of NYC, South Korea, Japan, the Philippines, LA, San Diego, and a few US college campuses

Staircase at The Vatican Museum

Virtual Museum Tours of the LouvreMadrid’s Museo Nacional Thyssen-Bornemisza, and The Vatican Museum

Berlin Philharmonic Hall

Virtual Concerts performed by the Melbourne Symphony Orchestra or the Berlin Philharmonic

Madama Butterfly, Royal Swedish Opera

Virtual Operas from all over the world, including the Royal Swedish Opera’s Madama Butterfly and the Polish National Opera’s Tosca

Arches National Park

Google Earth lets you visit anywhere on, well, earth and, with this link, you can visit any of the US National Parks

Royal Portuguese Reading Rooms, Rio de Janeiro, by Getty Images

Listicles of the best of anything, including the world’s most beautiful libraries (sorry, I just love books too much)

Creative or Reactive: Which One Are You Right Now?

Creative or Reactive: Which One Are You Right Now?

Creative and Reactive

Same letters.

Different order.

Very different results.

These are strange times.

A relentless stream of news and updates are coming at us, warning us about COVID-19, a declining stock market, rising unemployment, and the financial crunch facing millions and millions of individuals and families.

On the other hand, we’re also getting daily notifications from companies about what they’re doing in the face of all of this news, tips for working from home and maintaining our mental health, and encouragement to support our friends, families, neighbors, and strangers in new ways.

Should we be scared or stoic? Isolated or connected? Hoarding or sharing?

Whatever you choose (and it is your choice), I encourage you to also be creative.

I’m not talking about being creative in the capital C way and take up painting, sculpting, composing, or any of the other activities we typically associate with the fine arts.

I’m talking about calmly assessing your situation, clearly acknowledging the constraints that are requiring change, and then exploring the “new normal” you can create.

This is what innovators do and you, yes YOU, are an innovator.

Innovators know that creativity thrives within constraints. If anything is possible and everything is permissible, you can do whatever you want! But that’s not how the world is. Not now and not before COVID-19.

We, people and businesses, have always faced constraints because we’ve never had infinite resources, money, or time. But we acknowledged the constraints and created within them. That’s what we have to do now.

Here’s some inspiration:


Devil’s Food Catering: From event caterer to consortium offering takeout meals

Caterers have to order food well before events take place so when events are cancelled, caterers are left with a lot of food that they’ve already paid for and without the event income that was going to cover their costs.

Devil’s Food Catering in Portland OR faced exactly this situation. Instead of letting the food go to waste or trying to become a take-out shop on their own, they created Handbasket by teaming with other with other Portland area restaurants, breweries, distilleries, bakeries, and other providers to create “handmade menus for quality in-home dining experiences during this of social distancing.”

Gyms, Fitness Studios, and Personal Trainers: From in-person to on-line communities

Some people are gifted with the motivation to workout and some of us, well…aren’t.

In-person classes and personal training are often the solutions we rely on because we feel a sense of connection with our instructors, trainers, and classmates. As gyms close and social distancing becomes a way of life, the loss of live workouts can deepen our sense of isolation.

Recognizing this, local gyms, studios, and personal trainers in cities across the country are offering livestream classes so that we can continue to feel connected AND healthy AND active from the comfort of our own homes.

p.s. the link above is for the Boston area but I found similar articles for Philly, Washington, Houston, and even Wyoming

Speakers Who Dare: From Broadway event to Livestream to Movie

Spears Who Dare bills itself as TED meets Broadway, “a groundbreaking speaker series produced like a Broadway show, featuring speakers from around the world who want to ignite change and inspire new ways of thinking.”

Scheduled to take place on March 24, the organizers recognized that, like many other live events, their original plans for a live Broadway event needed to change. Last week, they shifted from live to livestream, planning a 6-camera shoot of each speaker and performer sharing their messages and art in an empty theater.

Then NYC closed the theaters. Within hours the organizers shifted again and asked each speaker to record a “mini-movie” that could be edited together to create “a full-blown Speakers Who Dare Film” to be shared with a global audience, viewing together on the original event date.


Seeing your coworkers when you can’t (or don’t want to) videoconference

Homemade games for when you’ve already played all the games you bought

More homemade games for when you really need to interact with people outside your own home

How and what will YOU create today?

Just in case you need a nudge…find the perfect gif starring the perfect celebrity expressing the perfect emotion and send it to someone who needs it

h/t to Kate Dixon and Megan Shea for sending their suggestions

10 Moments of Innovation Zen

10 Moments of Innovation Zen

I don’t know about you, but I’m rather tired of the non-stop hysteria that seems to be occurring these days. Between COVID-19, politics, the economy, and the state of Tom Brady’s contract (sorry, I live in Boston), it seems that the world is having a panic attack.

Namaste, people. Namaste.

In an effort to not contribute to the panic, instead of writing something topical and relating it to innovation, I’m simply going to share images of something that makes me extremely happy and peaceful and relate them to innovation.


I love books. I love reading them, looking at them, talking about them, and just being amongst them. In the days before Amazon, I would go to bookstores and simply sit in the aisle because it was the most calming and energizing thing I could think of. Don’t even get me started on the sheer joy of going into The Stacks in a library.

But as Amazon grew and the big chain bookstores shrank or went out of business, my opportunities for moments of book-filled zen became fewer and far between.

That’s why I love what independent bookstores are doing. They are innovating too, by changing the business they’re in. They’re no longer in the book-selling business (Amazon won that battle), they’re in the book experience business.

The Book Experience business is everything that Amazon.com can’t offer — discovery, community, an environment that stimulates all your 5 senses. Don’t believe me? Why do you think Amazon is opening physical book stores?

Yes, it takes time, money, risk, and resources to re-define the business you’re in but it’s worth it because it not only keeps you in business, it creates a competitive advantage that lasts.

And may even create moments of zen.

An interior view of the Zhongshuge bookstore in Chongqing, Oct. 22, 2019. VCG

People browse for books at a new store with wraparound shelving units in Hohhot, Inner Mongolia Autonomous Region, April 21, 2019. IC

An interior view of the Sanlian Taofen bookstore in Ningbo, Zhejiang province. From @设计美学志 on Weibo

An interior view of the Zhongshuge bookstore in Beijing, June 26, 2019. VCG

Libreria Acqua Alta, Venice

Livraria Lello, Porto

Shakespeare & Co, Paris

The Last Bookstore, Los Angeles, United States

Cook & Book, Brussels Belgium

Saraiva, Rio de Janeiro