Marketing Is More Than Promotion

The complaint is about tending to the details and thoughtfully expressing appreciation.  Put another way – demonstrating that you care – not letting things “fall through the cracks,” “get lost in the busyness of business” or just thinking it is too much effort to deal with so the detail is skipped.  This may not seem like a marketing issue, but really it is a significant one.  It is one of the elements that can un-do the best service delivery, the smartest pricing and the brainiest promotion strategy.

This marketing issue is about appreciation. Since many of our clients and readers are non-profits, they deal with lots of volunteers – on boards, doing fundraising, and helping move their organization forward.  The last thing you want to do is alienate someone who is helping your organization.  Woe to the organization that frustrates someone who gives of their time and of themselves to help you.

Two Unfortunate Marketing Un-doings

Two examples of poor thanking  execution and sorry to say these are true stories:

1)       For five years, a talented busy professional gave of his time to a small educational organization.  This individual created a novel mentoring program and worked hard to connect kids with families to further their academic success.  This individual went beyond the role of the basic board member and served the board well.  After five years, it was time to step off the board.  How did the organization thank him for his service?  They sent a dismissive email – “oh, yes, thank you “hard-working volunteer” for your help. We will take it from here.”  RESULT:  this volunteer was stunned, spent a weekend talking about it and now the story is circulated around town.  Fortunately, the volunteer does not utilize social networking otherwise his dis-content would be well spread beyond the community.

A well-crafted letter and/or a three minute preamble to a board meeting, celebrating the individual’s impact on the organization, would have moved the volunteer’s feelings in a very different and positive way.  This positive and more thoughtful action would also have celebrated the organization and volunteerism, setting a standard for others to volunteer.  Moving the conversation to the public arena would also gain publicity for the organization.  There is no down-side to a thoughtful thanking.

2)      A small group of business-owners took a half day from work to help another non-profit conduct a telethon fundraiser.  Part of the quid pro quo was that each volunteer would have their name announced and a public thank you over a popular radio station.  Not only did the radio announcer botch the names in his rapid reading, but proper credit was not given.  At one point during the telethon, the volunteers were shushed from being “too loud” while they were taking incoming gift calls.  The volunteers left the organization feeling they would not do any further volunteering for the organization but also somewhat offended and wondered if organizational leadership was slipping.

Whether old volunteers or new, people want to know that you appreciate what they are trying to do for their organization.  If part of the tacit agreement is a name shout-out, then make sure you do this well.  You always want your volunteers to speak well of your organization and to want to return for another volunteering effort.

Don’t let your good marketing efforts be undone through poor management of your employees or your volunteers.  The market will talk to these individuals first because of their presumed knowledge of the organization.  Whether it is your medical practice, your clinic or your hospital, make sure you do everything you can to have all of your emissaries singing your praises.

And like always — marketing is more effective because it is thoughtful and planned!

All of the data is courtesy of Ed Bennett and taken from his informative blog on February 14, 2010 and May 8, 2011.  Ed keeps a solid watch on hospital social media adoption.

http://ebennett.org/time-to-re-think-hospital-social-media-adoption/

U.S. Hospitals that use Social Networking tools – updated on May 8, 2011

965 Hospitals total

• 486 YouTube Channels
• 777 Facebook pages
• 714 Twitter Accounts
• 469 LinkedIn Accounts
• 723 Four Square
• 120 Blogs

3,289 Hospital Social Networking Sites

This is the February 2010 data:

• 254 YouTube Channels
• 336 Facebook pages
• 430 Twitter Accounts
• 70 Blogs

As organizations that want to reach out to people, the manner and approach is just as meaningful as the message. According to data on the web blog, SocialDoctor, there are 4.6 billion cell phone users in our world, 500 million Facebook users, 190 million Gmail accounts and 140 million people who Tweet. But what this data doesn’t reveal is who is doing what. In my last post, I briefly discussed the value of data in helping to target specific audiences. So, before, you viscerally decide to turn everything in your organization mobile because of all of the cell phone users, do a little more thinking a little more digging.

Yes, I talked about this last week but I really want to drill home this concept. Start with determining your goals. What are you trying to achieve? If you are creating a marketing campaign to develop awareness of your practice and by that you mean increased inquiries leading to more patients, then you have to do a little, old-fashioned thinking first.

If you are promoting a sports medicine practice, then consider the most likely referral sources. Are these other physicians? Predominately primary care? What about sports teams and their trainers? Physical therapists? Personal trainers? Where are these referring sources likely to “hang-out” or get their information? Who are the top bloggers for sports information? Will they be listening to or watching certain programs? The point here is to think about your intended target and determine how you might best reach them. Then consider the message and the budget implications. You don’t necessarily have to do a knee-jerk reaction and develop a social media campaign because that is what everyone is talking about. Most likely, your plan should incorporate a variety of platforms to corral your targets. You might want to use a traditional media outlet (a radio spot on a popular sports program) as well as develop something more social. Perhaps begin a blog presence with one of the orthopedic surgeons to discuss sports injuries.

Start with your objectives, then consider your target audience and think about how you can reach them. Don’t leave it to one method but build a campaign and make sure, as always, that you track your outcomes so that you can refine and retool as necessary.

And like always — marketing is more effective because it is thoughtful and planned!

The guts of marketing still are about garnering attention and reaching out to segments of a market with a message and service that is relevant.  Marketing is about studying your market and knowing it well enough to employ a strategy that will foster targeted market share.  In a sense, the infrastructure of marketing remains the same;  it is the tools and techniques that have thankfully evolved.  And, just like before, measurement and methodology count for a lot but we give them more air time today because we struggle with this part of the marketing mix.

If you are a regular reader, you know that I have been absent from this blog for some time.  While there have been personal reasons (my father’s illness and subsequent demise), I have also taken some time to look around and think about what might be most helpful to write about.  What continues to hit me is the lack of marketing basics being employed by many organizations.  We are caught up in the nuances and the new tools but often there seems to be a significant lack of effort spent on addressing the basics.

What are the basics? Marketing basics begin with having a service or product worthy of notice and the understanding of what a particular “consumer” might need and value from a service.  The next steps evolve into determining how best to attract those interested consumers in that service/product and understanding how different features mean different things to specific segments of the market.  If we tweaked our admissions process, would that be more appealing to prospective patients/consumers?   Pricing, often overlooked in health care because of the complicated reimbursement structure, is also a basic element in the marketing mix.  The basic that seems to get the most attention, is how and in what manner do we communicate or attract that potential consumer?  And the basic, as I alluded to earlier, that gets short-changed is the measurement and analysis of our marketing endeavors in order to constantly push toward improvement.  Trial and error with a conscious, if you will.

So, for the next several weeks, I am going to dwell in the basics. But, I am going to try to make the basics more comprehensible by employing queries:

First up and brief because of my explanation above, is about choosing a forum for you message?  How do you do it?

Scenario:

You have been the marketing engine behind your hospital for some time.  Mostly you spend time on the website and print collateral.  More and more you are being pressed, and are curious yourself, about MySpace, FaceBook, LinkedIn and Twitter.  The only problem is that you have very little time to make a careful analysis and are not ready to re-do your marketing plan because that would take re-generating the planning committee…so let’s get some quick analysis done on  the fly and take an incremental step forward

1) A little testing is good.

Adopting new tools doesn’t have to be an “all or nothing” process.  Take incremental steps and investigate and sample the social media water.  Do some research on what other organizations are doing – this doesn’t have to be a deep dive, just spend some thoughtful time looking at organizations you care about

2) Think about what you want to test first – the renovated birthing center?

Start with something that is tried and true in your service mix.  Maybe this is the birthing center or your diabetes clinic.  But, work with something that you have a good understanding of in terms of service offerings and likely users.

3) Who is your target? What do you know about them?

Let’s look at the birthing center.  The target users will typically be women in child-bearing  age.  What zip codes?  What features might they value (focus group, survey analysis, etc.)

4) Determine your test plan – give it parameters and then legs.

While you could move into all social media sites at once, if you are time-strapped, focus one at a time.  So which one for the birthing center?  New stats tell us that Twitter might be utilized by only 10% of the American population.  You know LinkedIn is more about professional connections, so what about FaceBook and MySpace?  Facebook has the following demographics (Advertising Age data):

                                                          FaceBook                            MySpace

Women  ages 21 – 24                     16.6%                                    14.8%

Ages 25 – 29                                  11.7%                                    12.5%

Ages 30 – 34                                   9.7%                                     7.1%

Ages 35 – 44                                  15.4%                                    7.5%

There are many ways to do this and certainly, the more detailed your data and your objectives, the more careful the analysis.  But, I would choose FaceBook over MySpace based on this data alone.  What you don’t have here are economic or educational factors which will impact choices, but going on age alone, you will reach a greater portion of the female market with FaceBook.

Once you have decided to work on FaceBook, you have to go back to what features are women of this age most interested in and start developing a campaign highlighting those features.  Building your FaceBook page and building your community are other crucial considerations, but we won’t tackle those items for now.

And remember – marketing is more effective because it is thoughtful and planned!

He had a series of complications toward the end.  He had a colostomy as well as two nephrostomy tubes.  Most of the work for the colostomy could be done at home but the nephrostomy tubes had to be surgically re-inserted periodically.  On his last visit for the procedure, two weeks before he died, my dad looked at the nurse as she was preparing him and said, “You won’t keep me here, will you?”  Even though it took three of us to get him out of his bed at home and into the car via a wheelchair, my dad did not want to be in the hospital and preferred the physical strain it cost him to return home.

Knowing what I know now about dying — and dying from cancer, I can still say that dying at home, without the fuss of hospital policies/standards/protocols etc. provided a more comfortable and private place for my dad and my family.  For us, the ultimate patient experience was a quiet and private passing.  Hospice nurses and aides took great care to make sure my father was comfortable, clean, with limited pain and in good care.  They took extra steps to help my mother and me know what to expect and what we could do to help my father.  They stepped out when our questioning was done but stood ready to help, steward and comfort us.

According to the Journal of Clinical Oncology as reported by Reuters (September 13, 2010), at-home hospice care saves money, reduces emotional distress for caregivers and leads to a more peaceful end-of-life passing. While most cancer patients indicate they would prefer to die at home, more than 36% will die in an acute care setting.  Over 25% of Medicare expenditures are spent in the final month of life, most often in intensive care even though there is limited evidence of benefit for the patient.

Physicians and healthcare organizations can help patients and their families in this final quest for a positive patient experience by providing more conversation around the planning for the end of life.

Research conducted by the Agency for Healthcare Research and Quality (AHRQ) indicates the following:

• Less than 50 percent of the severely or terminally ill patients surveyed had an advance directive in their medical record.
• Only 12 percent of patients with an advance directive had received input from their physician in its development
• At least 2/3 of physicians surveyed whose patients had an advance directive were not aware that it existed.
• Care at the end of life sometimes appears to be inconsistent with patient preferences of forgoing life-sustaining treatment.

As health care professionals and as family members, let’s not leave out the important conversation about end-of-life issues.  Talk it over, ask questions, review with each other and make sure that when the time comes, you AND your loved ones understand what is important.  Knowing that my dad died in the manner he hoped makes his absence more tolerable.

Too often, the business plan gets moved to the “back burner” because of time constraints and never receives its fair share of reflection and planning. And even worse, the service may get implemented without a solid planning process and that is where the trouble begins.

Rationale for Developing a Business Plan for your Hospital Service Line

A good business plan is never really done.  It is constantly being revamped.  The goal is not getting it done but rather having a repository of information in an acceptable format that compels testing and implementation. The plan is the guide and by creating a plan, you will discover what is necessary for success.  You will alter the plan for different audiences once you have the basic template but consider having two basic formats: one for internal use and one for external conversations.

The actual posture of writing your business plan will push you to serious contemplation and that is where the benefits are derived.  You are creating a roadmap for your service line and considering the key elements stretches your thinking. Knowing what resources are required  (space to personnel), what your payer mix might be and forecasting utilization will help you estimate how long it will take before the service contributes to the operating margin.

Once you are done (with the first version!), you will have your objectives articulated and the process outlined that will help you reach those objectives.  You will be taking the guesswork out of the mix and applying solid, useful planning that will enable you to carefully guide your service toward success and then check back in when assumptions or the environment changes.  The plan will serve as your playbook and kept up-to-date, it provides you with a key management tool serves as fodder for crafting management reports.

Business Plan Elements

• Business plan elements typically include the following:
• Executive Summary
• The Organization
• The Management Team/Personnel
• The Service
• Operation Plan
• Market Overview (include competition)
• Market Plan
• Implementation Plan
• Financials

Building infrastructure around the communication process will improve engagement and most likely compliance.  Adding to your communication pipeline might be good medicine as well as good marketing.

Kaiser Permanente has 3.3 million online PHR (personal health record) users.  Recent research has been done by Kaiser to find data to support the theory that greater access leads to greater engagement.  Some of that research will be shared this week at HIMSS but a preview by Valerie Sue at Kaiser, indicates that patients who can use email with clinicians, can check lab test results, schedule appointments, refill prescriptions and review visit information are simply more engaged.  They have an alternative route to communication about their health that goes beyond the fast moving office visit.

PHRs can be a significant tool to empower patients, communicate more meaningfully and help patients take more control of their own health status. Jan Oldberg, practice leader for internet services group at Kaiser, states that there is clear evidence that PHR use in positively correlated to increased patient motivation.  Oldberg also indicates that PHRs have also led to a drop in calls and visits.

Going back to the communication issue in a busy practice.…a PHR can serve as a communication device and help physicians provide their patients with the ability to access accurate and timely information and help their patients keep track of their health issues.  Patients don’t have to rely on remembering everything the physicians said during the office visit.

A Step Toward Coordination

A recent survey conducted by the Markel organization indicates that physicians would also prefer a computerized method of sharing information with each other. In the 2010 survey, only 17% of the physicians queried use a computer-based method for communicating with referring physicians and yet 74% indicated they would prefer a computer-based method when sharing patient information with each other.

The 2011 Markle Survey on Health in a Networked Life also compares physician and patient preference on information dissemination.  Summary findings as reported by the Markle organization indicate:

• Nearly all physicians indicate that their patients sometimes or most times forget potentially important things they are told.
• Both physicians and patients indicate important information is sometimes forgotten or lost in their interactions.
• Nearly half of the public perceives that their ‘main doctor’ is the one who should keep the patient’s most accurate, complete health and medical records.
• And yet 2 out of 5 physician groups say it is the patient and not the physician who should perform such a role.
• 15% of the general public believes that no one is performing this role.
• Both physicians and patients alike believe that patients should be able to obtain and keep a copy of their own personal health information.
• 93% of the public rarely or never request copies of their health information in an electronic format

The Markle Survey of Health in a Networked Life also has interesting findings on preferences:

• For physicians, 74% would prefer computer-based means of sharing patient information with each other.
• 47% of the physicians surveyed also indicate they would prefer to have a computer-based means of sharing records with their patients while only 5% do so today.
• 70% of the general public favor patients receiving a written or online summary after each medical while only 4% of physician indicate they currently provide patient summaries.

Providing access to a PHR takes the pressure off the office visit communication and provides  tools that can help your patient become more engaged and informed about their own health concerns.  Seems like a no-brainer method to improve upon the patient experience.

If you think I am stretching the content of this blog, and wondering how food can be related to healthcare marketing, think about cooking classes as an added offering for your community outreach as one simple tactic to engage your patients and help them focus on prevention.  Okay…Mr. Bittman’s column is well worth reading in its entirety but I have included some key points below:

The typical American diet is unhealthful and unsafe.

Here are some ideas — frequently discussed, but sadly not yet implemented — that would make the growing, preparation and consumption of food healthier, saner, more productive, less damaging and more enduring:

• • End government subsidies to processed food. We grow more corn for livestock and cars than for humans, and it’s subsidized by more than $3 billion annually; most of it is processed beyond recognition.
  • Begin subsidies to those who produce and sell actual food for direct consumption. (Think farmers’ markets.)
  • Break up the U.S. Department of Agriculture and empower the Food and Drug Administration. Currently, the U.S.D.A. counts among its missions both expanding markets for agricultural products (like corn and soy!) and providing nutrition education. These goals are at odds with each other…
  • Outlaw concentrated animal feeding operations and encourage the development of sustainable animal husbandry. The concentrated system degrades the environment… and produces tainted meat, poultry, eggs, and, more recently, fish. Sustainable methods of producing meat for consumption exist.
  • At the same time, we must educate and encourage Americans to eat differently.
  • It’s difficult to find a principled nutrition and health expert who doesn’t believe that a largely plant-based diet is the way to promote health and attack chronic diseases.
  • Encourage and subsidize home cooking.  People make better choices when they cook their own food.
  • Tax the marketing and sale of unhealthful foods. Another budget booster. This isn’t nanny-state paternalism but an accepted role of government: public health. If you support seat-belt, tobacco and alcohol laws, sewer systems and traffic lights, you should support legislation curbing the relentless marketing of soda and other foods that are hazardous to our health…

Partially because of my father’s circumstances (prostate cancer that has metastasized into his bones) and partially because this is how life works, I have spent a considerable amount of time as a family member in several different emergency departments in the last few months.  No amount of marketing, brand promotion or social media forays can make up for those face to face moments with the admissions representative, the triage nurse, the nurse or the physician.  At times like this (and stated before in this blog), the service is the marketing.  And because a visit to the ED or the hospital is a particularly vulnerable time for the patient and his/her family, every extra step makes a difference.

I have mentioned Berkshire Medical Center in Pittsfield, MA before for its amazing balance of high tech with high touch.  Most hospitals strive for this balance but it takes significant work to get the balance past the word-smith and actually identifiable in the exam rooms.  It starts with making the right hiring decisions and then it continues with the nurturing of a caring culture and modeling that culture for employees.

• Imagine the impression your hospital would make on the arriving emergency patient if a member of the admissions team came out to the car and helped you get your family member into a wheel chair and then shepherded you in and first made the patient comfortable before tending to the business of the admission.
• What would the patient think if the triage nurse knew that the patient would have to have a CT prep cocktail and also knew the wait to see a physician, even with a suspected bowel obstruction, was two hours, and that nurse sought out a physician so they could start the CT prep cocktail while the patient was still in the waiting room so that the actual time in the exam room could be expedited?
• Or imagine that in a busy clinic, the nurse comes out, between patients, to explain why there is a slight delay and makes sure that patient is comfortable and understands the process in front of him.
• Or imagine the surgical resident who comes to the ER because she sees the patient’s name and remembers him from a prior visit and just wants to check on how that patient is doing.
• Or imagine the charge nurse helping out with a discharge because the patient is agitated and so ready to go home.  Not only does the charge nurse defuse the patient’s anxiety, but she uses charm and warmth, to disarm the entire family while carefully explaining the tedious discharge instructions.  By the time the patient leaves, he feels like he has a new best friend!

None of the above examples can be written in an employment manual. They all actually took place at Berkshire Medical.  It took an extra step for each of these employees to reach out and they did it and probably continue to do it because they care and they feel enabled in their work environment to demonstrate their care and concern.

Each employee in the above examples could have easily made other choices.  This is the moment of truth for any organization.  When the patient comes face to face with an employee, what will be the result?  Inputs cannot be controlled (grumpy and sick patients) but employee responses can be nurtured with the aspiration of positive outcomes.

We know the importance of measuring our outreach efforts.  Tracking helps us plan better, aim more carefully and get closer to the results we want. We gain better health care marketing results, i.e. return on our marketing investment. Websites and especially medical practice websites are no different in benefiting from measurement.  We need to develop a set of metrics to help us understand who is visiting and what they are doing/looking at.

Setting up a solid tracking system on your website is a worthy endeavor.  I found the following blog post that does a great job of explaining the basics to you.  Don’t be fooled by the non-health care orientation.  This is good stuff on tracking for your website.

Thanks to SearchEngineWatch and Rob Chant.