Marketing & Digital Trends for Healthcare

What's in store for 2017? This webinar looks at trends directly impacting healthcare marketing.

Last year’s predictions included consumerism and transparency. What’s in store for 2017? Get ready with a high-level look at the trends that will directly impact healthcare marketing in the coming year.

You’ll learn:

  • The important “macro” trends and how they relate to healthcare marketing
  • Where the latest marketing technology intersects
  • How to weave these trends into your plan for 2017 and beyond


Welcome again to Geonetric’s January webinar. Marketing and Digital Trends for 2017. As the new year comes around it’s always a great time for us to take a step back, look at what’s going on, both, in industry and out of industry, what’s going on in the digital marketing world, and seeing how these things come together in ways that we might want to utilize or take advantage of here in the coming year or years. Sometimes these things are…things we’re looking at even maybe a little further on the future. But it’s good to have an idea where we’re going in the short-term. We’ve got about eight trends and we’re gonna jump right in.

So our first trend for today is, you know, healthcare is gonna see more uncertainty in the coming year. You know, I think this is no surprise. We’ve been in really an unprecedented amount of change in healthcare here over the last couple of years, at least more change than we’ve seen in a generation, new to most of us who are working in the space now. And so, that’s led to a lot of different stresses and strains within our organizations. A lot of pressures to deliver and oftentimes with less resources. And frankly, a lot of uncertainty which has sometimes prevented organizations from being as aggressive as they might be in other scenarios. And 2017 promises to be no different in terms of that trend moving forward. So certainly, we’ve got a new president coming into office, and new administration here this week. We’ve got a new congress in place. And a very different set of priorities around healthcare as we go forward. And certainly, I think anyone who’s been listening to news of any sort over the last couple of weeks knows that the repeal of Obamacare really has been a top priority for the incoming administration. And that you know, there is a lot of pressure for a repeal and replace. And the administration, the new administration is really hoping that can be done very quickly. I think it’s not something that can be done with a repeal and a replace very quickly. And so, we’re seeing a lot of those tensions and a lot of those pressures right now as there’s discussions about, you know, do we pull things away right now and then figure out what we’re gonna do after that? Do we try to do it on one coordinated maneuver? And if so, how long is it gonna take us to figure those things out? The reality on the ground right now appears to be that there is a great amount of consensus around repeal. And again, we can go back, the model here is really based off what you know, Governor Romney did in Massachusetts once upon a time. It is a model that I think, in many ways appeals to a lot of Republican ideals. However, there’s a real desire to take away the accomplishment of this sort of signature law by the Obama administration. And so, that part is I think a lot of consensuses, the piece that isn’t is, you know, that repeal is really a stepping stone to what’s next and I think there is very little in terms of consensus on the what’s next piece of this.

So obviously, it’s not something that most of us are gonna have a lot of opportunities to influence in a meaningful way. But I think as we look at this in context and we understand that we’re gonna be in organizations that are going to have a lot of uncertainty are gonna be planning in an environment where they really don’t know what the next couple of years are gonna look like are probably not for a while. You know, I think there’s a few things that are probably good practice just given that environment. The first is, if you’re not already feeling external pressure to make sure that the things you’re doing from marketing perspective are things for which you can deliver real tangible results, and the kinds of results that frankly are meaningful to the folks in the C-Suite, then I think you should be putting that pressure on yourselves. At some point, someone’s probably gonna walk in and say, “Hey, demonstrate to me why we shouldn’t cut your budget.” And if that’s something that you’re not already doing in a concrete way where you’re really connecting it to this is the number of patients that we brought in for the services, is the amount of revenue that we’re bringing in, given the marketing investment that we’re making, I think, I wouldn’t encourage you to really focus your efforts in those ways here in the coming year.

The other thing I think is, we’re seeing you know, sort of, what some of this stuff might mean going forward. We’re seeing a lot of discussions of really the idea that you know, the incoming administration believes in markets and market forces. They want consumers to be more engaged in decision-making. They want insurance companies to be able to operate across state lines and things like that. It’s a little unclear how you accomplish some of those things. But there seems to be a real interest in creating a market that works which means consumers are acting like consumers in the healthcare space and that there’s greater competition in many, many different ways. And the idea being that with those things in place that you know, prices will improve, the quality will improve, the experiences will improve. And frankly, you know, other things that are required for that, things like transparency initiatives are likely gonna be pieces of what that is that’s coming. But as we look at the market, as we look at healthcare being more market driven, more consumer driven, we are likely to need to do more consumer-focused marketing. We’re gonna need to influence more patient decisions than we have in the past. And we’ve been on that path already. There’s a possibility the changes that come here in the next year or two may really ramp that up in a very significant way. And that’s something that we should be prepared for.

Now, along with all this, you know, they need to engage consumers and influence them, they need to get measurable results. I think for most organizations is gonna mean less dollars spent on general awareness and brand building kinds of activities. Those can be important in many ways, in many situations. However, they are very difficult to capture solid ROI around. And so, you know, I think we’re seeing a general preference towards measurable results and things like that, which often means that we’re more focused on filling schedules, we’re more focused on promoting specific services and service lines, and having calls to action within that. They can very directly connect our marketing and outreach activities to the dollars that we bring into the organization. So I think we’re gonna see more organizations opting for that side of the coin.

Now the other thing that we’ve been seeing in this time of uncertainty and with the changes that have been going on, and something that all indications of we’re gonna continue to see is that our healthcare provider organizations are gonna continue to get bigger and bigger and bigger. And Becker’s Healthcare published a research piece at the end of the year that looked specifically at this issue, like, how are you going to grow? In what ways…in what channels do you see as your way to get there? What are the things driving that growth? And so, 31% of respondents indicated that they’re launching new segments and new business lines in 2017. That’s a significant step up from what we saw in 2016 where there was only 17% of respondents to their annual survey. So we’re gonna see a lot more organic growth push across the board. They’re seeing a pretty similar level of merger and acquisition activity going on in 2017 as we’ve been seeing. And again, I think we’ve seen historically high levels of acquisition, [inaudible 00:07:54] physician, employment, all those sorts of things. And that’s actually…I think it’s down a couple of percentage points from 2016 but it’s in that same neck of the woods. I think maybe it was 41% last year. So lots of M&A activity continuing here in 2017. And you know, many, many organizations obviously using a combination of those tactics. It’s not strictly one or the other. But many of the organizations that are doing M&A are also looking at an organic growth as one of their primary drivers and vice versa.

In terms of the reasons behind this, certainly I think, there’s lots of strategic reasons why organizations are buying capacity, buying feeder networks, you know, trying to change the competitive landscape etc, etc. But one of the things, just looking at size as a driver that I think stands out is, the need for capital as we go into the future. Part of that is having a war chest that allows organizations the breathing room to make the changes they need. But also, as we move to more retail healthcare we are delivering different things in different places and just we need some different technology in many cases to do those things. The capital demands on healthcare organizations are going up and up and up. And a lot of smaller organizations and frankly, a lot of nonprofit organizations just have bigger challenges getting access to the capital that they sometimes need in order to accomplish those things. So the growth in general, I think is in part at least driven by that. And certainly, the very large growth that we’ve seen amongst the for-profit sector, I think is being driven in no small part because of the growth expectations in the capital needs that are there to do those things.

So again, I think most of us on the call here today are not likely to be negotiating merger and acquisition deals. However, we’ve seen over the last couple of years as we’ve seen you know, big mergers, lots of organizations growing in many different ways. That these big organizations are not just larger but they are far more complex. And under the covers, there’s a lot of messiness in these organizations. That’s true if you’re growing organically. I think it is more true in the merger and acquisition scenarios. But you often have, many, many different pieces of the organization often trying to do the same things. You have internal channel conflict, you have people that have been competing bitterly with one another, non-speaking terms, where now at least on paper, on the same teams. You have different pieces the organization that you know, one group will claim are doing the same thing, and another group may be is…which is a board-certified provider, say, they do something differently or meaningfully different in some way. Lots and lots of messiness under the covers. And I think our role as marketers and communicators is really an access role, you know, very much our role, at least in part, is to make sure that when someone needs care that we can help them identify what they need and where they can get that care within our organization. And so, we play kind of a unique role in the digital realm amongst the communication span that we cover out there. So you can run 30 second TV spots all day without ever having to deal with the true complexity that exists within your organization. But when you get to the web and you have to present in one place, hey, this is all of the services that we provide as a health system and this is where you can actually get those.

And increasingly as were trying to present ourselves in a system way often trying to tell one story around orthopedics or heart care or neurology or any one of these services when under the covers again, you may not have that consistency operationally or clinically. That is a real challenge for us. And you know, we kind of have to peel back that band-aid and sort of expose the world with the goal still of making the internal complexity kind of invisible to the end consumer. That we’re really trying to hide those things and make sure that they can still get what they need. So the website from that perspective really becomes key to telling those stories and the messaging of those individual services, those individual pieces of the organization as we go forward. Now in every organization where we’ve done that, you know, as we work with a lot of clients who are in that boat, we find the marketing and particularly, the digital area gets out ahead of operations and you know, clinical capabilities, right, so it takes a long time after a merger to really set up a center of excellence around you know, cardiac care, for instance, and to make sure that everyone’s you know, got the same set of standards and the same protocols, and is approaching things in the same way and so on and so forth. You’re gonna be telling a story that sounds like you’ve got one cardiac vision long before that might be a clinical reality within your organization. And so, you have to get out ahead of it. And hopefully, you can work with those services to understand where they wanna go. So you’re telling a story that’s representative of where they’re heading. And then it just becomes a question of how far ahead of operations or clinical can you really get as you’re telling that story out there? But there’re some real challenges for that. And so, content strategy, information architecture, those sorts of things become much, much more complicated. And getting those things right has really high stake attached to it.

All right, trend number three, transparency. Transparency can grow considerably. That said, we still have ways to go here as we continue forward. So I think one of the things you know, as we look at consumers and things like that, it’s difficult for consumers to make decisions in our space because there’s really not a lot of data for them to compare one option versus another option. And so, there’s been a big push over the last several years to put quality data online. And that’s been great but a lot of cases that data is really very granular and kind of obscure you know, understanding what STEMI Time is and what that means for my particular interaction in the hospital, for instance. It’s kind of sometimes hard for consumers to wrap their head around. And it’s scattered across an awful lot of sites. It’s kind of hard to pull information together. But I do think that health systems have done a better job of telling the story there. The experience side of the equation and I should say, you know, I tend to look at transparency as a three-legged stool with quality, with experience, and with pricing. The experience side, I think we’ve seen some really nice expansion here in the last couple of years. Primarily, through the addition of stars and ratings on our individual physician profiles.

This is something the University of Utah did several years back. We started really over the last year or so to see other organizations taking that up. Still, a relatively small number. This chart here is from our digital marketing survey, the one I talked about at the beginning that you can get by checking the box in the post-webinar survey here. The blue bar on the left is the number of organizations, percent of organizations that have ratings and reviews on their physician profile today, it’s a relatively small number. But it was the number one thing that organizations were planning to adopt in 2017 with 42% of response indicating this was a 2017 priority. So we’re gonna see a huge expansion of that. And for those of you not familiar, they’re taking you know, your CGcap survey typically, the experience surveys you’re already doing with the organization and attaching that to the appropriate doctors and putting that information out there with a little bit of scrubbing and sanitation to make sure that you’re not putting anything inappropriate out there. But it’s a great marketing tool and it’s a great tool for transparency, specifically, around patient experience with the organization. So we’ll see big steps ahead there. As I said, I think, you know, quality, there’s some good data out there although we can always see improvement on that.

I think the sticky bit is on pricing transparency. I will say that you know, every time in the last year that I’ve talked to hospital CEOs and presidents, transparency has been on the radar. And I think they’re particularly interested in pricing transparency. But it is also the area where you know, even at the senior leadership level, there is very little understanding of how to move forward on this. The pricing transparency questions are really complicated. It is difficult to know that you know, two patients going in for what on paper that looks like the same thing. If it really is the same thing or if it’s gonna have a similar cost based on a number of different complexity factors. In addition to that in many cases, the hospital only controls part of the overall billing. If you’ve got anesthesiologist, they’re an outside group, they’re doing their own building. You may have some other pieces of the mix that are billing independently. It’s really difficult to deliver to a consumer what the cost of that procedures going to be when you may not even know what some of the other players within this are charging for some of these components. And maybe, more importantly, the complexity of the way that insurance works, that understanding what plan you’re on and how much of your deductible you’ve used, and what your co-payment level is and so on and so forth. Consumers ultimately really care what their out-of-pocket costs are more so than what the list price on these things is or the charges look like, those sorts of things. So we’ve seen a fair amount of activity amongst insurers in the space. So the image on the left side of the screen there is a United Healthcare’s cost estimator. So they have data from many, many claims that they get from different providers. And so, they’ve aggregated that together in order to provide some idea of what these things cost. And of course, they have a good sense of what your plan is and they have all that information, all that knowledge. And so, they can deliver that to their membership.

However, it doesn’t allow for sort of strategic pricing. And I think that’s eventually where pricing transparency should take us. Transparency is a nice stepping stone along the way. It gives consumers the ability to make some choice. But I think, from the provider side of this equation, the real beauty of this thing comes in when we’re able to use pricing transparency as a tool to be strategic. And that could be filling surgical suites at unutilized times, it could be you know, competing in other in different ways or even just at a basic level, putting things out there so that the quality and experience align with the price you’re paying relative to other options in the market. And I don’t think the price comparison tools come from the insurance company accomplish a lot of those goals out of the gate. We are also seeing a number of startups trying to play in the space. SaveOn and Guroo are two examples of organizations that are trying to do some of this out there. I think at this point, they are still pretty niche solutions out there. I’ve not really seen a great amount of uptake and traction amongst that side of things. But again, we may be seeing a lot of pressure here in the coming year to do more of that. There are a few hospitals that are putting some of this information out there. Although again, I think it’s still a rarity. Billings Clinic who we do some work with is one organization that I’m aware of that has this kind of a tool set out there. And again, it’s an out-of-pocket price estimator and is able to sort of do cash pay or factor in some of the components of insurance to try to translate that into an out-of-pocket cost for an average consumer.

All right, trend number four is mobile. And you know, every year, or at least, the last couple of years here mobile has been a major, major item on the agenda as we look forward to how things have been changing and how they’re gonna continue to change. I think last year I said, as we’re doing maybe this same webinar, this is the year where we’re gonna stop thinking about mobile and desktop and we’re just gonna think about the web. And it’s gonna be everything to everyone, no matter what device. And of course, mobile hits a couple more philosophical barriers and clears those and we start thinking about these things differently. And the world continues to adapt and adjust to the mobile growth in ways that we can’t sort of stop thinking about it as its own thing quite yet. But it continues to move that way. I think the biggest thing that we saw, you know, the biggest hurdle cleared here in 2016 was in October this year, globally at least, we saw more traffic, more Internet traffic going through mobile devices and tablets than traditional desktops and laptops. It’s the first time we’ve kind of hit that line, at least in a global perspective. And you know, I think you can look at your own statistics and sort of assess where you’re at in terms of your mobile and desktop mix. We certainly seeing organizations that have been majority mobile for several years now. And we’ve seen some organizations that based on a number of factors might not be there quite yet. But really the bulk of growth in terms of traffic across the board has been coming from nontraditional devices, from mobile devices and tablets and TVs and other things. But you know, for our purposes probably, it’s mostly mobile devices and tablets. And you know, so, we’ve seen…and I should say, on the search engine side we see a tremendous amount of that activity as well. So the world is reacting to this. And some of that is, “Hey, what’s going on from experiential standpoint?” Consumers are spending more time on these mobile devices. It’s becoming more normal. Their expectations are changing. The way they interact with these sites is changing. And frankly, from a design perspective, we’ve learned a lot about what works and doesn’t work.

On the other side of things, Google is continuing to try to adapt what it does to really make sure that it’s serving the mobile searcher effectively. And so, that’s been maybe the biggest story this year is how Google has been reacting to this growth in mobile, and the continuing growth in mobile. Two big steps that we saw them take this year and I think it’s also signaling for what we’ll see here in 2017 is, Google has really been focused on, you know, for mobile searchers, making sure that it is sending people to sites that are going to get a great experience for that mobile user. So when people are searching on mobile they should get sites that really work very well on mobile. And that’s been true for a couple of years now. Google has been providing a bump for those organizations that have had mobile optimized sites, responsibly designed sites, and so forth. But they’ve taken this a couple of steps further. Earlier in the year, they announced that there were some more things that they were going to start penalizing sites for that they felt were just you know, bad behavior indicators. In particular, the real focus on pop-ups and interstitials like, you know, pages that that cover the page that you want to see often with an offer of some sort and not always that clear how you get rid of them, you know, there should be a button in the upper right corner or an X in the upper right corner of these things. But because of the way these things present on different devices it is not that uncommon to bump into sites where on a particular device, may be in landscape or portrait or you know, in certain scenarios and not others, but you can get these things where it is nearly impossible to actually make that thing go away. Even if you do make it go away it is negative to the experience in a pretty significant way. So Google’s announced that they’re going to penalize sites that are engaging in this kind of bad behavior.

The other big step the Google took is, what it called, “Splitting the index.” So even though it’s been giving benefit for mobile searchers to mobilly optimized websites, the bulk of the credibility that it gives to website is around the content that’s being presented and the experience that’s being delivered for a desktop user. And so, while, it’s had a couple of leverage to adjust those numbers a bit really the driver behind that credibility and where you land on the search result was being driven by the desktop and not by you know, the mobile experience. And so, they’ve now split the index. So they have made a separate mobile index for mobile searchers. And when you’re going down that channel the credibility is entirely based on the mobile experience you get, the content you get there, and the experience you get there. And so, we’re gonna see greater and greater deviation between how things rank on the desktop and how they rank on mobile or tablets. And so, that is a path that’s gonna continue and I think this combination of things sort of suggest to us the Google is gonna continue to make proclamations about what they consider to be positive and negative in terms of mobile experience, and sort of where we expect some of those things to land, where they expect some of those things to go. There’s been conjecture about other bad behavior items, things like auto-play video with audio and things like that, that on a phone or maybe a more negative experience than on a desktop. But you know, none of those things have been confirmed at this point. I think we wait and see. But I’d say, things that negatively impact that mobile experience are gonna be a bigger and bigger deal as we go forward.

So it’s a good time now for most organizations to recognize that the mobile world continues to change. And so, we see a lot of organizations now that are two or three years into responsive design. You know, it still works, like, you know, the site design that you had still works on mobile devices. But if you’ve got one of those sort of first generation responsive websites, A, consumer behavior has shifted. And B, what we know works and doesn’t work in this world has really grown and evolved. I think we’re much more savvy as an industry, that being the internet, not healthcare, about what really works well on these devices and what maybe is suboptimal. And so, it’s a good time to re-evaluate what that mobile experience is, even if you know that it works. You know, I see a lot of organizations that are still sitting down at the desktop, looking at content, looking at experience there, and not spending the same amount of time making sure that experience really works as well on a wide range of different devices and setups. So great time to do a mobile UX audit and really review that. And sometimes, it’s just going in and tweaking things and doing some minor updates or sometimes it’s time for design. And again, just because you have responsive design website doesn’t mean that sort of three-year rule, that’s been traditional on the web. It’s about the useful life of the design, in most cases that’s still very much true even in old land of responsive design. I think we’re seeing that these sites are starting to feel dated just as quickly, and I think maybe more quickly on the mobile side as that piece of things has been evolving very, very fast.

All right. Trend number five, the role of search engines is changing. You know, and so, Google and you know, other search technologies out there are still acting as the card catalog of the Internet, right, you do your search, it’s bringing back results to take you to pages. But increasingly they’re not just that. They’re also trying to be…sort of to carry that analogy, they’re trying to be the encyclopedia, right, so you go there, you look. And you don’t necessarily get a lot of depth but you get the answers that the bulk of people need, the bulk of the time, at least, at a superficial level. Search engines are making that shift now. And they’re making that shift for a number of reasons. But maybe most visibly because of some of these technologies out here. So we’ve got Siri, we’ve got Cortana, which is sort of Microsoft’s version of the digital personal assistant. We’ve got Amazon Alexa, which is the technology that they have in their Echo and docs speakers. We’ve got the Google assistant which is available through some apps within the Android platform. And I think within some other platforms as well. But they’re also selling a speaker set called Google Home Speakers, which are similar to Amazon Echo. Basically, these are voice interfaces, both directions, in most cases. So there’s nothing more frustrating I think to most of us who use Siri for instance, when you ask a question of Siri and it brings back a list of websites, right, that’s very rarely the thing you’re looking for and particularly, if you’re like me and you’re mostly using Siri while driving a vehicle, getting a list of sites back that could possibly answer my question is not even not useful, it’s potentially dangerous. It’s just a bad, bad thing. So I think Google is looking at this as well as Amazon and Apple and all these other organizations. And saying, “Okay, we need the ability to bring them answers to questions and not just references to other sites.”

So as we look at it you know, what this looks like in other contexts we see this percolating throughout the search infrastructure out there. So here’s an example, a research for University of Iowa Healthcare, and what we used to see is, you’ve ads at the top for a listing or two. And then you’d have ads all down the right side of the page. And then you’d have you know, that that top 10 organic search results. And what we see now is Google has all been eliminated ads from that right-side panel. And what we see now is what’s called Google knowledge graph, where it’s trying to return information and results in a variety of ways directly to you so that maybe you don’t have to bother going to that website. You know, we all love our web traffic. But you know, ultimately, it’s more important when someone’s asking a question to Google, the Google’s providing the correct information about our organization. And one of the things that I found interesting here, certainly, we get that common information, you get the address, you get the phone number, you get some basic statistics. You’ve received Iowa hospital work where I worked many years ago, the university actually, and it’s been quite a while, might be 10 years now, rebranded itself. It is no longer the University of Iowa Hospitals and Clinics, it’s University of Iowa Healthcare. But you see within that panel on the right in the Google knowledge graph it still has old naming, old branding going on out there. So it is important that we are feeding Google this information in a good, solid way because that’s the thing that’s gonna make sure that it’s feeding the right information to consumers out there.

That knowledge graph is used for a lot of other things. I think one of the first things that we started to see out there was actual answers to health questions. And you know, it’s pulling the stuff from a variety of places out there, I think they have content deals with a number of places that are feeding some of the stuff as well. But you know, if you search for “Atrial fibrillation” in addition to what you see in the main part of the page, you’re gonna see this thing on the right. Then again, answers the questions that I think the bulk of people have if they’re looking for superficial you know, “What is an atrial fibrillation?” They’re no longer gonna come to your website, they’re no longer gonna go to WebMD, they’re no longer gonna go to wherever, they’re gonna get that information right within Google, they’ll be done, they can move on their way. And that ultimately, I think is what Google is looking for out of this arrangement.

What most are seeing a lot of other things taking space within the page. And we’ll talk about this a little bit more later. This is another element of how search is shifting in this way. And we’re seeing a lot of localization of search. And again, it kind of goes into this how do you provide an answer rather than a link. It could just provide links to all these different organizations and you could go there and you could find this information and so forth. But Google has now implemented what they call “Local packs.” This is…I think local pack technically has seven results, this one is three, I think some folks call this a snack pack. But anyway, it’s, you know, below the top couple of results, so usually be some paid results that may or may not be an organic result or two in there. And then you see this big block that’s taking up a big chunk of the page. So it’s providing access to the website, yes. But it’s primarily there for the mapping, for directions. And again, it’s pushing any other results that you have organically probably further down the page in these scenarios.

So what this means for all of us is that search has become not just a question of providing great content. There is a lot of activity that’s been going on. Google has drastically changed algorithms in number of different ways, localized search algorithms as well as all this knowledge graph stuff. And so, you really need to have someone helping to drive content strategy for the organization, who’s keeping up with everything going on in these spaces. And so, one of the things that we’ve seen really become much, much more important to the success of our sites from an SEO perspective as well as, presenting this information with a knowledge graph and things like that is the inclusion of structured, of microdata. So you need to have content that structured. You can’t just have a page that’s a physician with the stuff laid out there. You need to have the stuff in fields. And then under the covers in addition to the way that a consumer sees this page when it’s presented, you’re also saying, “Hey, this page is a physician,” for example, that physician is named, they have a specialty, they have maybe an area that they provide service to, they have office hours, they have all these things. And we’re gonna feed it to Google in a way that Google understands exactly what that thing is. So Google decides it’s gonna present office hours, it knows from the information that you’re spoon feeding it what the right answer to that question is. So it’s presenting that information correctly as you go forward.

All right, trend number six. We continue to see digital marketing just surging in general, not strictly in healthcare. I think last year, I think I shared a slide that’s very similar to this that had 2014 numbers. Actually, as I’m looking at this, this is from Mary Meeker state of the Internet report, and I thought I had a reference on there but apparently, I didn’t. But that’s where this comes from. She’s pulling data from all kinds of different places. But this is showing, in the yellow, time spent on different channels. And you know, the arrows that equal above that is are people spending more time, less time, the same amount of time, as they did the previous year, in those things. And the blue bar is how much of our ad spend goes to this channels? Right, and the two things that immediately jump out at us is print, we’re spending far, far more on advertising than maybe it’s justified based on the amount of time that people are spending consuming that content. And in the mobile realm, we’ve got exactly the opposite situation. We have huge amounts of time being spent on mobile and relatively little being spent on mobile advertising. You can also see the general trends, print is down, TV is down, mobile is up, radio and Internet are pretty stable. So the interesting thing that happens here in 2017 are, and these are 2015 numbers, you add up Internet and mobile and you see that our ad spends in those two channels is 35% in 2015, TV ads spend 39%, TVs continue to come down a little bit. Mobile has continued to go up, Internet’s held pretty steady. 2017 is the year where we expect more money to be spent on digital and that’s desktop and mobile and that is being spent on TV. So more in the digital realm than on TV. So that’s again a big psychological shift there. And so, you know, I think it’s not any different than the trend that’s already been happening. But I do think it’s sort of an important thing to recognize that, if your spending isn’t getting in line with each other in those two channels then you’re probably out of sync with the consumers you’re trying to reach.

Now marketing through these channels, well, it’s becoming more common and proliferating in lots and lots of different ways. It’s also sometimes becoming more challenging. We’ve seen greater use of ad blocking software in general. Around beginning 2015 early or late 2014, we started seeing mobile ad blockers coming into the mix as well. And so, a lot of the advertising that has been traditionally sent is not getting through. So we know we have some very generational splits around this and things like that. But suffice to say, the simple ways of getting messages in front of people are becoming more complicated than they used to be. We need to start looking at a wider range of tactics to make sure we’re really connecting with folks appropriately.

Likewise, the sort of organic reach that we’ve had to Google, through Facebook, through a lot of these channels is being pared back as well. You know, Facebook, really for the last two years has really been putting the brakes on organic reach by brands. So to continue to get your message in front of even your followers to the same level you did before, the bar needs to be much higher in terms of how much they’re engaging with that content, how much they’re clicking through it and so forth. Even then they obviously are looking at their bottom line and they want more people spending more money to get messages in front of consumers. And so, they have been you know, tightening that spigot and we’re gonna continue to see more need to spend in order to reach those consumers. Likewise, you know, we’ve got the stuff that we’ve already talked a bit about on Google. We’ll dig into it here in a little more detail. Here’s a great example. Someone types “drug store.” has a paid ad. The right side is a knowledge graph thing about So if you’re that’s great. You’ve got a local pack going on there. And the thing you don’t see anywhere above the fold is you do not see a single organic search result the way that we currently thought of that.

So again, Google is trying to do a lot of things differently. And part of the implication of that is those organic results are being pushed down the page and you’re getting much, much more exposure to paid results as well as to some of these other things you talked about that are nontraditional search results. So again, the pressure’s on for us to pay. And in fact, it was whoops, we’ve talked a little bit about this but just to get a sense of how many different things Google has introduced for different kinds of pages for different kinds of searches. We’re at a point now where only 3% of pages get that traditional you know, 10 organic search results on the first page that used to be our sort of mark of quality, right, we used to think of, well, if you’re in the top couple then you’re gonna be above the fold and if you’re you know, top 10 then pretty much guarantees you’re on that first page. That’s not at all true anymore. You can be in the top 10 still be relegated to page two of many of these things. And again, we’ve you know, we’ve all seen traditionally the stats on how much that decreases your organic reach when that occurs.

So there are shifts going on and there’s a lot of I think creative ways that organizations and brands are trying to reach out. And frankly, a lot of platforms are trying to accommodate that by coming up with creative ways to let us spend our money on advertising. So this is Pinterest, and I have a wide range of interests on Pinterest as you can see. And you know, what might not immediately jump out at you here is this box over on the right. It looks just like another card within the Pinterest layout. If you look at the bottom it is a paid advertisement that’s being presented in exactly the same format as all the content that I’m consuming through permission based marketing, right, and so, it is entirely folded in, the ad blockers really don’t do anything with this. And it’s not interrupting my experience in the same way that a lot of other digital marketing vehicles might. And now, in this case, they’re not really targeting me in a very effective way but nevertheless you know, the idea that you can take advertising not just on Pinterest but through a number of channels and present it in the same way as the rest of the content that people are consuming has becoming more and more popular theme. And that’s called native advertisers. That’s one of those things that I think you’ll be probably hearing more and more about in the coming year. And again, another possible technique to look at as you look to reach more consumers more effectively.

So again, what this means to all of us, the free reach, the organic reach, those sorts of things, you know, all of those spigots are closing. It’s becoming harder and harder to reach the same number of consumers for free. All that effort you spent to build up those you know, huge Facebook follower groups and things like that, you know, now when you pay you’re gonna get that much more for having made that effort. But you don’t get as much kick out of just the organic sharing as you used to. It’s gonna require you to really get creative to understand the range of different options out there. And I would say, you know, the thing that I see organizations, the opportunity I see the missing out on within the digital marketing realm is, you do not need to set this and forget this. Like, if you do a billboard it costs a ton to print it, you drop it up there, like, you don’t really know what is doing, whatever. Here, you’ve got great metrics and you can change everything as many times a day as you want to. So going in there, putting things out there, testing, watching the data, and iterating on that to make sure that your ads are as effective as they can be. It is a technique that every organization should be embracing wholeheartedly. And I just don’t see enough organizations prioritizing at the top of their list. And there again, the idea that because we can’t rely on Facebook to necessarily deliver the stuff, you know, it’s still gonna be a great tool out there. But looking at more permission-based channels, more direct channels, emails made a huge resurgence in the last year and a half, two years. We’re gonna continue to see a lot more use of that channel because we don’t have to worry about Facebook’s algorithm of the day. Those are great ways to continue to get our message out. And then been looking at new channels and things like that, like native advertising, there are other good ways to potentially cut through that clutter and put messages in front of people as they’re experiencing things out there.

All right, trend number seven. We’ve entered in age of storytelling. Let’s be fair, storytelling has always been really important. But it feels like with so much more content out there, the great storytelling has become just…it just really exploded here in the last couple of years. The first thing that really drove this concept home to me was the Serial podcast. And if you haven’t heard of it and if you haven’t listened to it you know, go out and experience this thing. It’s coming from the This American Life folks who are already fantastic storytellers. But they’ve gone from a short form storytelling, where in an hour show they might have three to five different pieces and obviously, sized accordingly, to an entire season of content that’s really telling one story. And in a lot of ways, this is very reminiscent to me of old time radio, right, we used to have a lot of audio that was longer form, that was a regular weekly kind of thing, stuff like that. And if you haven’t, the Shadow is a great example of that. But you know, I think we’ve seen people…because we’re spending so much time on our phones using them different ways this idea that we’re only gonna consume short-form audio or short video, like, that’s one piece of the way that we communicate. But we’re seeing all kinds of other formats when they’re done when they’re having some fantastic success out there as well.

Couple of other ways that storytelling is happening that maybe didn’t even exist you know, a year, two years ago. Facebook live video has become a bit of a phenomenon. Facebook has that…I think it’s less than a year now, and they started out to sort of see things, they were paying a bunch of content providers to do high-quality live video. And we’re at a point with it now where they’ve already announced that they’re cutting those programs off, they’ve got enough traction with this, that this has now become part of the lexicon. It’s not something that I’m seeing healthcare organizations using a lot yet. But I think there’s some great potential. This was something that I’d seen playing with a little bit. But the thing that really drove home, the power of it to me was when we had some flooding issues here in Cedar Rapids, last fall. And you know, all of downtown were shut down and we had a couple of people including this guy, who has a high-end drone and you know, has a business where he does drone photography and video and stuff like that. But he was live streaming from the drone doing a spoken commentary all the while, having back and forth conversations with people while doing all of this. And there were some other people who were sort of getting into the areas that you know, were sort of off limits for most of us, and giving us reports as to what was going on, kind of, day to day, minute to minute. Really powerful stuff. And we’re seeing more and more organizations, more and more brands looking at how they can take advantage of this as a new format to go out there. You know, it hasn’t been a format without its problems. If you know, doesn’t have a place in the NFL locker room, for instance, a lesson we learned the other day. NFL locker room is not a good place for a live Facebook video. But I think, as a storytelling tool it has some really great potential. And again, largely untapped space for healthcare right now.

Another group, another area that’s absolutely exploded…and it’s sort of under the radar, and certainly not something that we see many healthcare brands or healthcare organizations are tapping into has been Snapchat. And Snapchat has a lot of different tools available to engage consumers and to build brand and to do different things. But one of those tool sets is the stories. And brands are doing some great things. Highly designed stories, telling these stories, very visual. And they’re getting some great play out of the stuff. And Snapchat tends to be younger demographic. A lot of millennials are using it. A lot of Gen Z people or whatever you’re calling that generation that comes after millennials. It’s sort of you know, become embedded there. But I think most of us don’t recognize just how big this has gotten because those of us who are a little older than that, you know, it is not our many groups of friends who have embraced this. Snapchat right now is sharing something like one and a half billion photos a day. Just to give you a sense of the scale of how much this gets used as a platform. So if you’re reaching out to millennials you’re reaching out to people younger than millennials. This is a fantastic storytelling platform. And again, largely untouched by folks in our space right now.

So again, what this means for us is that there is more pressure on us than ever before to generate high-quality content. And you know, it doesn’t have to be necessarily the most you know, really expensive cameras and things like that but the end product needs to be high-quality, it needs to be engaging, it needs to be interesting. And storytelling certainly helps those endeavors. Every health organization is gonna have to generate a lot more content than we’ve done that in the past. And again, this may not look the way it has in the past either. So certainly, the written word continues to be critically important. But you should also look in your staff or in your partners, you know, do we have the skill in photography? Do we have the ability to get great photos at every event at every place that we’re…everything that we’re covering at every meeting whatever it may be? You need to have some design chops, you know, generating those Snapchat stories is great. But you know, someone needs to design those things and having some design chops available really is gonna help. Video production is gonna become…should be part of everyone’s repertoire as they go forward. Again, through internal resources or through your partners out there.

All right. One final trend for today is just the growing marketing technology stack. And this has been across other industries something that we’ve been seeing growing for quite a while. In fact, I think it’s 2014 Harvard Business Review, which is usually not that far out ahead of trends you know, probably something about the chief marketing technologies and it sort of predicted that over the next couple of years…again, in general, we were gonna see marketing technology professionals investing more in new tools and new technology than the chief information officers. We certainly haven’t seen that in healthcare right now but we’re really still trying to get some base you know, back office systems, and clinical system in place in most of our organizations. But we have a need to start really looking at the marketing technology stack in conjunction with that as well. So one thing that we probed in our digital marketing survey was use of CRM software. And so, we found about you know, 40% or so of organizations responding had a CRM in place today, 30% were planning to add one in 2017. So it’s a tremendous leap. A huge adoption of these kinds of tools.

And you know, likewise, we’re starting to see organizations that are going to their second CRM or maybe even a third CRM. So amongst those organizations that had it, we were seeing about you know, 14% of those organizations were actually now looking to replace their CRM, and another 10% or so had replaced one in the last year. So we’re not just seeing that first generation growth which is tremendous but we’re also starting to see some organizations that are moving to their second or third CRM and moving through some things generationally that way as well. And really, you know, CRM’s only one piece of the overall marketing stack that we need. We all have web content management systems at this point, although I think you know, we tend to still think of them in pretty simplistic terms. You know there’s a lot of technology in terms of marketing automation and email, you know, technology around social media and the way that we engage with people that way, you know, web optimization and personalization, there’s a whole set of toolsets that you can bring in for those sorts of things. So there’s really a wide range of different technologies that build out your capabilities as a marketing organization. And of course, the integration challenges around those things are not small. So you know, our final, what that means for you here, you need to be thinking about not just your strategy for what you’re doing campaign wise over the course of the year, but you really need to be thinking about what your technology strategy looks like and how you’re going to get to the place where you really have the full suite of tools that you should have in order to be a modern marketer today.

However just getting the dollars in the budget to buy a tool is not sufficient. I see lots of organizations who are spending sometimes upwards of $100,000 a year on a CRM and had zero staff dedicated to working with the CRM, right, these are tools that should be changing the way you’re doing things. And they require people to use them in order to be valuable. None of these things are turning the key, set it, and ignore it kinds of tool sets. Or at least you don’t see anything like the value that you should in those situations. Underutilization of these tools is really pervasive, not just in our industry but it seems to be particularly true in our industry. So make sure that you’re also dedicating your staff time or partner time in resources to making sure that you’re really using these tools. And then you know, ultimately, these are tools that in other industries have radically change the way that marketing organizations work. They are a catalyst for change. They are enablers of change. They are not simply a way to do the things that used to do just a little bit more easily or a little bit more quickly. You should really be embracing these things in a way that different marketing tactics and techniques become part of your repertoire as a result of having some of these new. Oftentimes, just your overall strategy for how you’re engaging consumers changes by virtue of having better toolsets to work with them.

All right. So we’ll stick around for a couple of minutes to do questions here but just you know, sort of closing thoughts here, a lot of exciting new opportunities within healthcare, within marketing, and certainly where these things intersect. But I do wanna remind you that, there’s core things that are critically important that don’t ever change, right, picking new tools, picking the shiny objects out there is great but really those things are valuable when they solve the actual problems you actually have in your organization. And so, making sure that you understand what your strategy is, what you’re trying to accomplish during the year, what barriers you have to getting there. And then looking at a wide array of tools and techniques that might be emerging out there as ways to connect, as ways to make those things happen really is where you’re gonna see the best success. The risk of putting these kinds of presentations together and talking about all the shiny objects that exist out there, of course, is that there is always that potential that organizations are going to adopt more things without being committed to continuing to do everything they do really well. And you know, I think one of the messages that we always try and convey to our clients as we’re working with them is, doing a smaller number of things and really excelling at them is always gonna be more effective than blanketing every channel that you can think of but doing it with mediocrity. So go out there, do great work. And you know, hopefully, exciting things for you and your organization here in 2017.

So with that, we have time for a couple of questions. We have one cued up here. So, can you go over where and how Google gets their health library information? It’s a good question. They don’t necessarily reveal all that information, necessarily. But they are you know, you can look at sourced. So, if you find these examples you’ll look and it will say something like WebMD, it will you know, Mayo Clinic or whatever it is. And I think behind the scenes, for those kinds of things they actually have content syndication deals in place. You know, Google does do a lot of scraping information off other people’s sites and presenting it to people and making money off it. In this case, it goes a little bit further and they actually do have content syndication deals with some of those content providers out there. We do have a question here about where you can get the presentation. And we do put that on in our Learn and Share section. And it may take a day or two before we have that out there. But we’ll have a recording as well as PDF of the deck itself out there at that point.

How do you see storytelling implemented in the healthcare realm? I mean, I think it’s a tactic across the different ways that we present content. So you know, there’s some good examples here, you may be talking about your services and you might just have some informational stuff about, you know, “We’re board certified and we have these things and da-da-da-da.” Like, that’s great as content and it’s a great way just to make sure that you’ve got the boxes checked to say, “This is who we are.” Putting in a patient story, for instance, is a much more effective way to connect with consumers and make that information resonate. So saying that you have a new tool is fine. Telling the story about how this person’s life was probably saved because this new tool was able to detect their cancer earlier has a very different kind of effect. And so, we’ve seen some shift in the…sort of where the content development efforts go. So you know, there’s still a lot of content that’s just quarterly query [SP] our services and how they’re gonna help you, and writing that well certainly has a huge impact overwriting it kind of poorly. However, we’re seeing a lot of additional content being built out from the perspective of you know, patient stories, consumer style you know, pieces that are more in the vein of what WebMD or [inaudible 00:58:30] Health might put out there that has that field, it’s talking more about actual consumer experiences and things like that. We’re seeing videos being built that way. You know. so if you produce this the way a news piece would be produced for instance, rather than the way you might traditionally have put out a PR news release about it. That news piece is gonna be more engaging, more people are gonna watch it, more people are gonna share it. They’re gonna have better recall of the information, all those sorts of things. That’s really storytelling at work. And so, I think we’ve done it in certain ways, you know, many organizations have a, you know, publication that they dropped all households in their community, right, that’s great. You then taking those same pieces…and they may require some reformatting, things like that, but sharing them through a digital channel. And are you producing enough of them to sort of have coverage over the different services you’re trying to promote and so on and so forth? I think the opportunity is there. And again, I think making the information interesting is gonna make it much more impactful than simply making sure you recite all the facts.

All right. I think that is the last question that we have for today. So thank you very much for joining us today and sticking it through.

Marketing & Digital Trends for Healthcare