[Healthcare Success Industry Leadership Podcast] Our distinguished guests today are Rob Klein, founder and CEO of Klein & Partners, and Toni Klein, co-founder and Digital Practice Lead at the respected healthcare marketing research firm. They are talking with Stewart Gandolf, CEO of Healthcare Success about the State of Digital Healthcare Marketing study by Klein & Partners and Greystone.net.
This podcast discussion provides a revealing insight into the study and rapidly changing state of digital healthcare marketing. In particular, Stewart, Rob and Toni talk about fixing the major pain points and discuss:
STEWART GANDOLF: I love sharing the stats of your new study at our seminars and with our clients. It is a terrific resource. In our conversation today, I’d like to focus on context from the study. For example, what are the things that were the most surprising, the most important, most foreboding, or other significant observations for the future? Rob, do you want to start the round robin?
ROB KLEIN: Thanks again for having us on, Stewart. As background, listeners should know that this is the third annual wave of our research. This is an online survey where we talked with 240 healthcare marketers and digital marketers across the country that work at hospitals and health systems of all shapes and sizes. For the past three years, we’ve asked these professionals a series of 70 or 80 questions about what they are doing, what they are not doing, what they are planning, what are their budgets…all of those wonderful questions that tell us what our peers are doing.
From all of this, perhaps the biggest “ah-ha” insight that came from this is there seems to be a loss of confidence in CRM. [Simply defined, CRM is a Customer Relationship Management system that provides a business with the means to manage continuing relationships, data and information.]
We’re seeing that people are not confident that they are able to present CRM to their executives. And what we’re noticing in that is, when we ask people to rate their own knowledge of CRM, the vast majority of responses were “intermediate” or “beginner.” So, what we think is happening is that over the past four or five years, people have gotten excited about the positive CRM stories from healthcare organizations.
These people decided that they want a CRM system (and expected similar results), without realizing there is a steep learning curve. This is not a plug-and-play system. CRM is not a tool that you buy and plug it in and the ROI starts to flow. CRM is a strategy that has many tools to achieve a more intimate, targeted relationship with your customers, patients or prospects. Typically, it takes three to five years to recognize a solid Return-on-Investment.
But what is happening with the C-suite is, they are asking “what did you do this quarter?” So marketers are not armed with enough knowledge and confidence with their C-suite to explain, “this is going to take a while. This is a chess match, not a checkers match.”
STEWART: Some of our listeners are very sophisticated, and others are not. So please take a minute to explain CRM. This is a vast new area of opportunity for marketing, explain how it can be used and its potential if it’s done right.
ROB: Stewart, that’s the million-dollar question that is at the crux of the problem. One challenge is that the definition of CRM depends on whom you’re talking to, and that’s one of the biggest challenges. I was at a CRM conference recently, and there was not one single definition that these marketers could agree on. These are the CRM users.
What’s more, I’ve talked with CRM vendors who admit that they tweak the definition to highlight what they do the best. That’s not good or bad. CRM is so new in healthcare that we are all trying to figure out what it can do for the business.
STEWART: Yesterday we were listening to speakers about HIPPA restrictions and marketing automation and we find there is a lot of confusion about how these things integrate and how do they work together. These things appear to be easy in concept. We love, for example, marketing automation and that’s a monster. It’s not about making things easier, it’s about getting more complex and how to get things to be more effective in the marketing. You need the sophistication to pull this off correctly and efficiently.
So are people disappointed in the amount of money that they’ve spent? Do people talk to you privately as you do your survey? Do they not understand the situation? Where do you think the problem is in the real world with hospitals that you’re working with?
ROB: It’s a multi-faceted problem. It is: “We’ve just spent a lot of money, and they want ROI now!” So some of it is properly setting expectations. CRM was the new shiny object and everyone wanted to jump on the bandwagon. This happens often in many industries…we all want to follow the leader. But this is an expensive follow-the-leader, and it has a multi-year payoff. Not a six month or nine-month payoff.
Having to recalibrate expectations with senior leadership is challenging when our survey shows the two biggest pain points were: “We don’t have enough budget,” and “We don’t have enough FTE,” especially in the digital area. They tell us: We don’t have all the people we need to make the digital strategy…be it CRM, or our website, or marketing automation, or the email campaign. We don’t have enough bodies to do it justice. We’re struggling to show ROI, not because of the tool – there’s nothing wrong with the software – but it requires enough staff and funding. CRM is data hungry and it’s a laborious process to feed it—before it can give you the output that produces ROI.
STEWART: CRM feels like “the flavor of the month.” Today we were talking about SEO, and the person next to me said, “that seems like an amazing amount of work.” And that’s what you pay SEO firms like ours to do. There are a million moving parts, and CRM is even more complex. First, you have to understand the strategy of what you want to do, and then you have to create the resources for it, and then you have to execute properly—so there’s a lot to it.
So, Toni, Rob just talked about disappointments with CRMs. What is your recommendation?
TONI KLEIN: CRM is a long-term play, and we need to set expectations correctly with the C-suite. Also, there’s the need to work with your CRM partners to understand how long it’s going to take and look to them for their expertise. And ask them to help you position this with your C-suite—that it isn’t a “one-and-done” scenario.
STEWART: Looking at the research, another thing that surprised me was the number of hospitals that said they were actively doing digital marketing—whether it was AdWords, Facebook or paid social. Maybe they are all taking little bites of the apple. You talk with these people all the time…what do you think is happening there?
ROB: There’s a lot of investigation and “trying.” I’ll use a funny term, there’s a lot of “dating” going on. They say: “let’s try this, or let’s try Google AdWords, or whatever.” They are trying different things to see what sticks. But I do think that I see the beginnings of consolidation where “we’ve tried 10 different things, and these eight things aren’t working that well, so let’s consolidate around what we know is working.”
To illustrate…there are all these new things that came out after Facebook. But what we’re seeing is they are running back to Facebook as their go-to platform. It was the first toy in the toy box and then new things came out…people started going away from Facebook. And now they are realizing that Facebook was kind of the solid or first BFF…let’s go back to it.
Consolidation is going to start. Consider that, you don’t have the budget and the staffing to manage campaigns across eight or nine different tools—it’s unmanageable in today’s world. So if you find two or three that work well, you are going to consolidate around them.
STEWART: People who know me understand that I have a lot of analogies. From Finding Nemo, for example: When they’re going down into the abyss…it’s as if they are seeing “shiny lights…shiny lights.” And for us, the shiny lights were all these things that were out there and which are all possible. But even the largest staff only has so much bandwidth and so much time. We always come back to the same idea of what’s working. It’s the 80-20 Rule.
What is the 20 percent of effort that yields 80 percent of the results? What’s working without trying to do every possible social media? In your study, Periscope was big last year, but not so much this year, and I can see why.
You can only do so much, and that’s a good insight. Perhaps people are becoming more mature. If you look at it from the social media professional’s perspective, “we have to do everything.” But if you look at it from the CMO perspective, “I only want to do the stuff that really matters.” What’s more, there’s the potential for blowback and problems with things that don’t matter.
Going forward, you also spent a lot of time with user testing, web design and those kinds of things. What do you see now as the trends in usability, UI/UX.
ROB: That was the subject today at our conference roundtable…”What are the user experience pain points at the website? And what we have found to be the two biggest pain points that users have are paying bills and setting an appointment. Those issues are creating major challenges. Our study reveals disconcerting verbatim comments, such as: “You force me to come online to pay my bill, but you make it so difficult that it can’t be done. Do you want my money or not?”
It’s very frustrating. People will say, “Why can I go on OpenTable and make a restaurant reservation, but I have to argue with the doctor’s office because I can’t figure out how to schedule an appointment with your online system?” They say, “It doesn’t work or my doctor isn’t listed or there are no times listed. You want me on your website, but you make it very difficult for me, the patient.” It’s important that we recognize that today’s healthcare website is the digital front door. It is a brand-building or a brand-hurting relationship.
One of the questions that we asked in our study is: Did this website experience reaffirm existing positive or negative feelings that you had about the brand? Or, did it create new positive or negative feelings toward the brand?
We have about 25,000 interviews in our new study tool, and across the country, 11 percent of visitors to a hospital or health system are saying that this [website] experience created new, negative feelings about that brand. So, multiply 11 percent times the number of unique annual visitors—and that’s a scary number.
We are able to profile what those people look like. What they look like, and what’s bothering them. There is so much detail on healthcare websites that, in focus groups, people say they feel like Alice in Wonderland and have gone down the rabbit hole. They feel that if they get lost, they can’t backup. In our survey, people are losing their patience, saying, “three clicks and I’m out.”
What people are telling us in focus groups is that they are comparing their website visits to retail. They say is: Why can’t you be more like Amazon, or more like Zappos, or more like a favorite hotel, or a favorite retail site? They are not making a comparison with another healthcare website, people are drawing a comparison with the best of the retail websites.
In our previous podcast, we said: Retail is learning healthcare faster than healthcare is learning retail. So we have a big challenge ahead with our medical websites. And if we don’t realize that we are the digital front door, we’re going to treat them like online, digital Yellow Pages. It is not a one-way conversation. It is a two-way dialog that can either enhance your brand equity or erode it.
TONI: What we’ve learned from Google is that the expected load time on the site is now reduced to three seconds. Versus only a few months ago, it was seven or eight seconds.
ROB: Exactly. How do we keep up with quickly changing demand?
STEWART: Cleveland Clinic did user studies about its website. And, for example, those of us in the trade refer to the mobile menu button as “the hamburger.” Insiders have often assumed that the audience knows about “the hamburger.” But in the many Cleveland Clinic studies, not one usability study person actually knew that the hamburger was the menu button. So they have replaced that with the word MENU.
Fortunately, we have been doing that with our sites anyway, but it illustrates how it’s easy for the tech guys to be excited about things and assume that everyone on the planet is as sophisticated as they are.
When I do our seminars, I’ll ask the audience, “How many of you knew that the home page is clickable from the logo?” Usually, about half the hands go up. These are doctors, executives and marketers…and about half the audience doesn’t know. It shows that people tend to really overestimate the tenacity, the motivation and the sophistication of their users, and there’s danger in that view.
So, as we begin to wrap up, perhaps each of you has a final bit of wisdom or recommendation based on your research for the listening audience.
As a starter, let me offer the idea that, as you’re going forward and thinking about your healthcare marketing, consider the 80-20 Rule and the things that really matter. In the past, we would come out with marketing plans that included dozens of ideas. And now, what we have found is that things that are passive, things that we can do for them, are things that really matter.
So when it comes to your own marketing, ask: What thigs are:
You can get lost in a sea of activity…but is it effective? As an example, for some of our clients, organic social media is not as important as it once was. Facebook has cut their algorithm back and it’s not showing up as much. So we are supplementing the plan with paid social media. It’s fast and it’s easy. I’m not saying don’t do organic. I don’t want you to misunderstand, we love organic social media, but we really have to prioritize. Toni? Comments?
TONI: This is really a long-term play. It’s a strategic decision, and more of a chess match. Our advice is to stay the course and work with your partners to better understand the specific Key Performance Indicators (KPI) that you’re measuring for your marketing activities. And don’t expect a one-and-done; it’s going to be an ongoing effort. But it’s certainly worth the wait, so be patient.
ROB: I wanted to add something from our discussions with a conference speaker from Google. And that is the data reflecting the explosion of online videos. And I get that because we are visual as a human race we like to see and hear things. But what’s interesting is, something I read recently, that Proctor and Gamble pulled all their ads from YouTube and the other video content producers. They had concerns about their ads showing adjacent to questionable videos, and they didn’t want the association.
They pulled everything in the second quarter and they actually saw a two percent organic growth rate in their sales. So, they decided to remain on the sidelines because we did not get hurt by not spending $170 million in that quarter. And that’s got the likes of YouTube and others shaking in their boots. They are not sure what to do, and that could have very big implications about the efficacy of banner ads and videos. Are people actually looking at them?
Articles in AdAge present a big discussion in the industry that asks, how do we actually identify a genuine “watch” of a video ad? Is it that you click on it and you watch it for one second, for two seconds, watch halfway through, or all the way through? People are arguing that tooth and nail, and it’s not been settled. How much it is watched determines how much advertisers are going to pay. It’s a discussion of how much is that worth—what is a "quality view" versus an accidental click? Or, you watched one second…do you pay full price for that?
It’s an ongoing challenge. As healthcare marketers, as you put videos together and you put ads on a video site like YouTube, are you really getting the bang for your buck? I don’t have an answer for that yet.
STEWART: This just illustrates how our industry changes almost daily. For example, I received an email today from Google. For full disclosure, we are a big Google partner and friends, and we do a lot with them. The email was regarding the issue of the brand being next to good content or bad content, and providing specific recommendations.
At the same time, I was writing an email to my team today about an upcoming seminar in New York regarding marketing automation. At the end of the first day, we’ll provide opt-in videos about how else our firm can help them. It’s not intrusive and it’s not a big sales pitch. I would say that about one-third of the attendees come to our seminar to check us out before they hire us. About one-third come in with their arms crossed and thinking “don’t sell us a thing.” And it never occurred to a third.
There certainly is an audience that wants to know more about us. So we chose video as the way to do this. It’s opt-in video, so they can come and get a peek behind the scenes. We also have one describing some of our marketing planning programs. So we know that video is a powerful tool.
Rob and Toni, it’s been fun interviewing you guys as colleagues in arms who understand each other. Please give us your contact information again.
STEWART: And thanks also to our listeners who make this possible by supporting our company, Healthcare Success, as well. We appreciate it, and thanks again.
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FOR RELATED LISTENING: Click here for our previous podcast, The State of Healthcare Marketing Research: Reaching and Winning New Patients.
ROB KLEIN, CEO, KLEIN & PARTNERS – For more than 30 years, Rob Klein has provided research and brand consulting to many leading hospitals, systems, and health plan brands. A frequent speaker at national healthcare conferences, Rob has served on the boards of the Detroit AMA (president), Chicago AMA (VP research), AHSM, and on the national board of SHSMD.
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