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Connecting the Dots: How an Integrated Approach Can Help You Improve Your Health Systemís Marketing ROI and Results

By: Patrick U. Di Chiro, Chairman and CEO, THUNDER FACTORY

If you are still managing your health system’s marketing and communications programs in silos, then you are losing out on some powerful and profitable revenue-generating and reputation-enhancing opportunities. The fact is that in a technology networked world, it is no longer necessary – nor particularly smart – to reach out to and engage target customers (patients) and other key stakeholders in ways that are disconnected and un-strategic.

By “Connecting the Dots” of your branding, marketing and communications programs, you can maximize the results for your hospital and get the most Return on Investment (ROI) for every precious dollar spent in marketing. This white paper examines the needs, challenges and opportunities for health systems marketers and communicators to adopt a more holistic and integrated marketing approach that allows them to “Connect the Dots” for greater success with all of their marketing and communications programs.

Truly Engaging Your Consumers/Patients

Health systems are uniquely qualified to play a much bigger role in educating consumers and their communities about critical health and wellness concerns. No one knows better the myriad of issues involved, and what needs to be done to cure the chronic problems in the healthcare system. But, too often hospitals and their marketers have seemingly preferred to just sit on the sidelines when it comes to interacting with consumers.

This relative inaction is probably due to the tradition of healthcare organizations (especially hospitals) not really looking at their businesses in a market-driven way. In addition, regulatory mandates (and concerns about same) also tend to get in the way. Finally, there is a fair amount of inertia in a healthcare sector that never seemed to learn to communicate well with the people (consumers, customers, patients, whatever you want to call them) who actually benefit from its services.

The interactive power of the web and other digital media and marketing channels have opened up many new possibilities for health systems marketers to engage more deeply and relevantly with consumers. This means educating and informing consumers about critical health and wellness issues, but it also involves bringing consumers and patients into affinity groups and communities of interest that benefit everyone. Most importantly, the Internet is allowing hospitals and other primary care providers to listen much more to the real needs, interests, hopes and frankly fears of consumers (their patients). More and more healthcare companies are even starting to use these tools and channels to “co-create” products and services with their patients.

Ultimately, this patient-driven approach will only be a positive thing for consumers and the healthcare marketers alike. The first step toward effectively “Connecting the Dots” for great marketing success clearly is to get to know, and then better engage, your health system’s customers/patients.

Driving an Integrated Marketing Approach

Some call it “holistic” marketing, but the best way to look at this approach is to focus on the “integrated” nature of it. The first thing to understand is that integrated marketing fundamentally happens at the strategic level; it is not the process of combining a bunch of marketing and communications tactics, like many incorrectly believe it to be. Integrating your marketing activities, first and foremost, entails developing a strategy that is not driven or influenced by the media, channels or executional approaches you might choose to implement that strategy. This essential definition of integrated marketing is why many also call it “media neutral” or “media agnostic.”

As the old saying goes, “if you have a hammer, everything ends up looking like a nail.” Similarly in marketing, if you start off with a pre-conceived notion of what your media or executional choices should be (e.g., we want to do a new print ad campaign for our hospital group), then that ad campaign will totally drive your strategy. And that is the wrong order of things to optimize your marketing and communications impact and results. Letting tactics and media drive your strategy is the exact opposite path to take if you want to expand your marketing results by “Connecting the Dots” of your marketing and communications activities.

With integrated marketing, you build the strategy first, and then use it to guide the choice of channel, media, and the optimal tactics to accomplish your objectives. This may or may not include a PR program, a new website, search marketing, community events, a new sales outreach campaign, or even traditional brand advertising. Your integrated marketing strategy will be the super structure that holds these disparate elements together and ensures that you generate the maximum impact for your campaign. That really is “Connecting the Dots” in action.

Integration in the Healthcare Context

Health systems are embracing an integrated approach in more than just marketing. A recent New York Times article by a Silicon Valley-based science and technology writer Janet Rae-Dupree examined the growing phenomenon of integrated systems in the healthcare mix:

“Disruptive innovators in health care aim to shape a new system that provides a continuum of care focused on each individual patient’s needs, instead of focusing on crises. Some health care suppliers have set up fixed-fee integrated systems, and accept monthly payments from members in exchange for a promise of cradle-to-grave health care. Each usually also charges a small co-payment for treatment. Routine cases are handled through lower-cost facilities, leaving more complicated cases to higher-cost hospitals and specialists. Such systems include Kaiser Permanente, Intermountain Healthcare in Utah, the Mayo Clinic, the Geisinger Health System in Pennsylvania and the Veterans Health Administration.”

“By creating a continuum of care that follows patients wherever they go within an integrated system, says the Princeton University economist Uwe Reinhardt, care providers can stay on top of what preventive measures and therapies are most effective. Tests aren’t needlessly duplicated, competing medications aren’t prescribed by different doctors, and everyone knows what therapies a patient has received. As a result, integrated systems like Kaiser’s provide 22 percent greater cost efficiency than competing systems, according to a 2007 study by Hewitt Associates”.

Optimize Every Patient Touch Point

You might be surprised to learn of the number of ways (and the frequency) that your hospital “touches” your customers/patients with some kind of marketing message and/or offer. These touch points include your doctors and nurses (who all represent your hospital brand every day), your reception process, your call center, your advertising, your media relations team, your pharmacists, your finance people, your website, your newsletter, and the list goes on.

The question is, is there any coordination at all to these numerous brand touch points? Indeed, is there any coherent or coordinated strategy for how all of these elements engage customers and stakeholders? Are there even any common objectives and metrics for measuring the success (or lack thereof) of these outreach efforts? By “Connecting the Dots” in your hospital’s marketing and communications efforts, you will start to more effectively and consistently coordinate all of these touch points in a much more strategic and integrated fashion. And, that will help you on the road to optimizing those touch points from a marketing, sales and overall business standpoint.

Case Study: Connecting the Dots at a Major City Health System

A friend of our firm is the head of marketing and strategy for a leading big city health system. He talks about the “bad old days” before he and his team realized that they had a huge unrealized opportunity to “Connect the Dots” in their marketing, sales and even business development efforts.

Based on this realization, he and his team developed an overarching integrated strategy to bring all of the disparate customer engagement efforts together. This included overall objectives and agreed-to success metrics. With this new integrated structure in place, the marketing team then examined holistically every marketing program being conducted by the health system (and those under consideration), as well as critical functions in media relations, sales, community relations and even internal training. Previously, all of these activities tended to be largely disconnected. But it was clear to all that none of these efforts took place in a vacuum.

If these customer facing activities were better integrated and coordinated with common messages, and then tracked and measured using established metrics, the health system would come a lot closer to optimizing its marketing and sales programs. That was the objective of what turned out to be a very successful integrated marketing program. Once all of the disparate marketing, communications and sales efforts were integrated around a common strategy, our friend’s marketing team was surprised and delighted at how much more bang for the buck (each one of those dollars being in increasingly short supply these days) they were able to generate for their health system. And all it really took was “Connecting the Dots” that were once strewn across multiple departments and functions of the health system.

Building a Marketing ROI Model for Your Health System

A critical component of our friend’s highly successful integrated marketing program is a detailed ROI model that enables his team to more clearly understand what they are “actually getting” for their combined marketing spend. Creating such an ROI model can be a relatively complicated undertaking, involving a lot of analytics and mathematics, an area not always at the top of marketers’ list of strong points! But, you can also develop a very basic ROI model that is comparatively easy to build and manage, and that still gives you a much better understanding of what is truly helping the bottom line (and what isn’t). One suggestion: From the beginning, enlist the support of a financial person to get intimately involved in this marketing analytics effort. She/he can play a vitally important role in not only setting up your marketing ROI system, but helping you operate it on an ongoing basis.

At the core of the ROI model are clear objectives and metrics that are agreed to by your key stakeholders. (Here again, the importance of building your program around a well considered integrated marketing strategy.) In addition, you’ll need to have a good understanding of crucial financial inputs, such as incremental investments, gross margins and net present value/NPV. (We told you it would be helpful to have a financial person on the team!)

As you move forward with your ROI measurement program, you will be monitoring and tracking exactly what you are spending for your marketing and communications activities, and then correlating those investments against the above mentioned objectives and metrics (believe me, gross margins and NPV do come into play here!). By computing the ROI of your marketing efforts, you will gain valuable insight and visibility into what is working and what needs work. And, armed with this data, you will then be much better prepared to ask for additional marketing resources from your CEO/CFO.

The following are two very informative books that will give you a detailed and practical “how-to” understanding of marketing ROI:

  • “Marketing ROI: The Path to Campaign, Customer, and Corporate Profitability,” by James D. Lenskold (American Marketing Association)
  • “Marketing Calculator: Measuring and Managing Return on Marketing Investment,” by Guy R. Powell (John Wiley & Sons)

Internal Branding: Don’t Forget Your Employees

Arguably, the main focus of your health system’s integrated marketing program should be inward – not outward, toward the usual hospital target audiences that include consumers/patients, the local community, physician partners, investors, etc. That probably sounds strange, but marketing “from the inside out” is easily some of the most powerful marketing you can do.

And, it’s typically the most ignored, too.

Virtually every company (and health systems are not very different in this regard) understands the importance of having a customer focused approach to business, especially in today’s turbulent and uncertain economic environment. So, why is it that so few organizations feel the need to focus on their most essential audience – employees?  Companies spend millions of dollars to communicate their brands to customers, but rarely do they make the same effort to build that same brand with their employees.

This critical concept of being “employee focused” is at the heart of Internal Branding.

For a hospital, being patient focused and employee focused are not mutually exclusive. In fact, they are closely connected.  For any organization to live up to that core value of putting their clients/patients first, they must first realize that their primary focus actually needs to be on their own people. The question is: “How are those employees/colleagues building and consistently delivering upon the brand promise internally? If one can get that internal brand promise and process right, then delivering for clients is pretty well assured.

This Internal Branding approach is in many ways the greatest untapped marketing and communications opportunity for health systems and their brands. In order to build a strong Internal Branding Program as part of your integrated marketing approach, it is important to consider the following seven key principles:

  • Co-Creation – It is always preferable to “co-create “ your branding programs with the employees themselves, rather than just directing the strategy from the top down. Co-creation is a powerful business and organizational strategy that has particular resonance in internal marketing and communications.
  • Larger Purpose – Hospitals, by their very nature and mission, are focused on the health and well being of patients. That, in and of itself, represents a “purpose” that is larger than just making more money or driving success metrics ever higher. By getting internal audiences to rally around a shared “larger purpose,” you have a much better chance of achieving true branding results for your organization (internally and externally).
  • Empowerment – It may be the most overused business and organizational concept, but empowerment really is critical in the internal branding area. You need to empower your people to advocate for your hospital’s brand and mission. Give them the tools to extend and communicate your hospital’s brand message, and then get them excited about going out there and delivering on it.
  • Education – Of course, you cannot just expect all of your people to understand immediately what your brand is about, and how you want it perceived by key stakeholders. Getting to that point requires focused and ongoing brand education programs. Don’t skimp on this. Education really does pay big dividends.
  • Accountability – Everyone in your organization has a stake in the health of your organization’s brand. And, all should be accountable in some way to the successful growth, nurturing and maintenance of that brand.
  • Shared Incentives – As with accountability, everyone should share the incentives for keeping your health system brand strong and positive. It’s not just a matter of one group shouldering this responsibility. All departments should share in the incentives, and be accountable to the results, of your branding efforts.
  • Measurement – If you can measure it, you can improve it. Just as you need to measure other key areas of hospital performance (medication safety, performance, financial, etc.), you need to set clear goals and metrics to measure the health and impact of your health system brand.

There is significant potential for you and your health system to improve performance, strengthen your corporate culture, and increase results, through Internal Branding. This is an untapped and under-leveraged process that bridges multiple organizational functions. Internal Branding really should be the starting point in your integrated marketing program.

Connecting the Dots to Marketing Success

If this white paper leaves you with one lasting thought it would be to start planning your marketing and communications efforts more holistically. Forget the old media- and tactic-driven approach to marketing. The silos are just getting in the way of your health system’s marketing success.

Your various marketing, communications and sales activities are ultimately connected, whether or not they appear to be. Like with any other product, service or brand, your consumers/patients/customers form a perception of your hospital from multiple sources and interactions. Each of those “touch points” has the potential of enhancing your standing in their minds, or diminishing it.

And that is precisely why you should be thinking and acting in a more integrated way in terms of how you reach out to and engage all your key stakeholders. For example, if you create a very positive impression of your hospital through an effective advertising campaign or a first class website, that good feeling could be tarnished or blown up entirely by one negative experience with a call center agent (and, as we all know, a negative experience has a much bigger viral effect than a positive one ever does). If you agree that the definition of a brand is a “promise made and a promise kept…consistently over time,” then you need to make sure that your marketing and communications efforts are delivering on that promise every step of the way.

“Connecting the Dots” in your marketing, sales, customer/patient services and communications activities will help you send a consistent message to your hospital’s community of stakeholders. This holistic, integrated approach will also enable you to maximize your resources in an historically challenging economic environment, where every dollar needs to work as hard as it can to ensure the continuing success of your healthcare enterprise.

About the Author

Patrick Di Chiro has more than 30 years of international experience in marketing, branding and communications. Patrick has had significant experience in marketing for major healthcare organizations, and has worked for some of the world’s leading brands and marketing-communications agencies. Before launching THUNDER FACTORY in 2000, Patrick was Chief Communications Officer for E*TRADE Group, the pioneering web-based brokerage and banking company. Prior to that, Patrick was head of global technology and e-commerce marketing for Visa International, and a Partner with Ketchum, the world’s fifth largest public relations and marketing firm. Earlier in his career, Patrick was director of international marketing and communications for American Express Company.


Since its founding in 2000, THUNDER FACTORY has built a national reputation for delivering integrated, Big Idea-driven marketing services and solutions that help clients build their businesses. The firm provides a comprehensive range of services in five key areas: integrated marketing strategy/brand development; communications (including online/offline advertising, public relations, social media, collateral development and event marketing); digital/Interactive marketing (including web development, online/email marketing, mobile marketing, search marketing and online promotions); direct response marketing; and partnership marketing/sales promotions. THUNDER FACTORY's clients range from Fortune 50 corporations to leading mid-sized companies and start-ups, including McKesson Corporation, TD AMERITRADE, RSM McGladrey, The Camden Group and Omni-ID.

Eric Granof
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