Editor’s Note: This post was originally published in January 2021 when information on the timing of Google Analytics 4 (GA4) replacing Universal Analytics (UA) was limited. Google has since provided an expected transition date of July 1, 2023. After this date, UA properties will stop collecting new data. Beginning in January 2024, you may not be able to reference data from UA properties at all.

As a result, the move to GA4 should be a top priority for your team if you haven’t started. By making the change sooner rather than later, you ensure you have historical data available when you can no longer reference your existing UA properties. And in the words of the great philosopher Ferris Bueller: “Life moves pretty fast.” Similarly, exporting and saving needed historical data from UA should also be considered and prioritized. If you need help with this task or with safeguarding your data during the transition, please reach out for assistance. We don’t want anyone to lose access to information they’ve worked long and hard to create.

What is Google Analytics 4?

For eight years, the way you measure website traffic and behavior has remained largely unchanged. Google Analytics has been the broad standard, and while they’ve made changes and updates, the overall experience has been consistent since 2012.

Until now.

The version of the platform we all know and love was called Universal Analytics (UA) and was the third iteration of Google Analytics. Then, in October, Google rolled out a new update, GA4. Since then, the digital team at Geonetric has been testing the platform to understand how it affects healthcare websites and what impact it will have on your day-to-day data needs.

What has Google changed?

With this update, Google’s main goal was to make it easier to track users engaging with a website via both browser and app. However, there are changes to the platform—changes both beneficial and challenging—whether a website has a corresponding app or not.

Let’s look into the good and the bad – and what your next steps should be.

The good: Goodbye, bounce. Hello, engagement statistics.

Google is removing the concept of a bounce—a session that does not trigger a second action on the page—and bounce rate from its platform. Digital marketers often rely on that metric as a shorthand to measure user engagement with a given page, or even with a website as a whole, so it may seem like a loss. However, Google is using an Engaged Session and an Engagement Rate instead.

Engagement Rate is the percentage of Engaged Sessions vs. non-Engaged Sessions and the definition of an Engaged Session is any session that includes:

1. The website or app in the foreground for at least 10 seconds
2. A conversion event
3. Two or more screen/page views

This change is particularly beneficial because you can now customize a conversion event to fit the on-page content and user experience. Whether or not there is a direct call to action present on the page, you now better understand how a page is performing.

Better understand your users with expanded event tracking

Additionally, Google is adding the number of data points available to digital marketers. When Geonetric launches a new website, we set up a robust amount of event tracking to ensure our clients have a more comprehensive picture of user behavior over a standard Google Analytics implementation. With the change to GA4, the amount of potential data points you can draw from our tracking has increased eightfold. This enhanced tracking requires set up to take advantage of, but is undoubtedly a great opportunity.

The bad: Missing features and historical data

Besides removing Bounce Rate and the additional set up necessary to take advantage of the new Event Tracking opportunities, there are a few additional challenges that come with GA4 as well.

First and foremost, it is still a new product, and there are a few areas—areas that we may currently rely on in UA—that are either not included or still in progress:

• Filtering capabilities
• View options
• Internal reporting options

Sunsetting of UA

Further, as the future of Google Analytics, GA4 will be the standard. There is no set date for this change, though it will happen just as Universal Analytics supplanted Google Analytics 2. Currently, new Universal Analytics/UA properties can be both created and accessed. In the future, this will likely change, although no one knows exactly when.

Loss of historical data

The most considerable challenge is that data will not be contiguous between UA and GA4. The two iterations are so distant that GA4 does not carry over historical data from its predecessor. When you upgrade, the historical data continues to live in a legacy Universal Analytics property, while a new GA4 property collects information moving forward. This update will make comparing data month-over-month or year-over-year challenging until you have used GA4 long enough to have its own historical data.

Your next steps with GA4

Given the impending loss of historical data, the work needed to migrate event tracking into GA4 format, and the uncertain future of Universal Analytics, we recommend setting up a GA4 property and running it alongside your existing UA properties.

Doing this allows you to build up historical data and get your team and stakeholders used to the new platform, data, look, and feel before a hard switch becomes necessary.

If you’re looking for help, reach out to set up some time with one of our digital marketing experts to discuss the benefits and implications specific to your digital presence. We can go over the next steps necessary and get you started on migrating to the GA4 platform.

Internet Privacy Background

The past five years have been a slow crawl to a more private internet. The European Union has demanded more transparency of what trackers are being used on websites. Apple has worked to limit the amount of personal tracking being mined from iPhone users. And, in April 2019, Google announced that they were going to deprecate third-party cookies on their Chrome browser. They charted their course to finish this process by mid-2022.

However, in June, Google issued an update: the timeline is to be extended to late 2023. They recognize the process is complex and they are giving themselves the extra time to get it right. That means you have more time to prepare.

How Cookies Work Now

For many years, cookies have made it easy to track and collect data on internet users. As marketers, we have used this boon of information to direct advertising with precision based on behavioral data, interest data, and user data. If we identify an audience, we could create a custom-targetted ad and direct it to that audience, no matter how specific, and feel confident in its success. With this tool leaving our toolbox, it underscores that we need to refocus our efforts in collecting as much data without the crutch of cookies.

First-party data will become more critical. First-party data is the data that you can collect from your own sources—user behavior on your website, survey responses, CRM data.

Third-party data, however, is information collected by a company that does not have a direct relationship with either the first party—in your case, your hospital or health system—or the second party—the user.

It will be even more important to make sure your data collection efforts are set up and running to capture as much information as possible. You may be losing information about users once they are off your website, and that makes it more necessary that we collect information while they are on our website.

How Can I Start Planning Today?

Make sure your analytics are set up. This is a great opportunity to make sure that Google Analytics 4 (GA4) is implemented and set up. GA4, as an updated platform, is more focused on user behavior where Universal Analytics (its predecessor) was more focused on session information.

Sort Your Analytics

The updated event tracking capabilities in Google Tag Manager are necessary so you don’t have any data gaps in the user journey. Ensure you have robust hard conversion tracking (think phone calls for appointments) as well as soft conversion tracking (email list sign ups, news or blog shares). Both conversions can help us to better understand what is and is not working with our ads.

Start Collecting Data

Collect additional first party data. Consider the information that can be collected in a CRM. Of course, stay conscious of HIPAA restrictions when it comes to putting the data that you collect to use, but you can still be precise enough to maximize your data while protecting patient privacy, as well.

Don’t Forget to Leverage Offline Data

Consider offline data sources. Surveys and patient feedback can be valuable sources of information on your geographic audience and can help give you clues for advertising purposes. In marketing, finding out who your audiences are can be half of the battle. You can avoid some of this challenge if you let your audience will tell you who they are through their own feedback.

Consider Alternate Channels

This is also a good time to dust off some of the advertising paths that may have taken a second seat to third-party, cookie-based, behavior-targeted ads in our portfolios. Looking at our content, looking at our users, and looking at their interests will be the key to success moving forward.

Remember, content is king (and drives conversions)

Content, both site content as well as marketing content, is still king when it comes to your online presence. Ultimately, this is why website users come to your website.

By using your expertise as leverage alongside insight from your first party data, you can develop a comprehensive website content and content marketing strategy. For example, using a bariatric weight loss email drip campaign to drive people to sign up for an informational seminar, or creating a Facebook group for new or expecting moms and creating resources and content marketing materials relevant to that audience. This approach lets you tailor your site for our audience and drive conversions.

Keep your audiences in mind

If you set up our first-party data collection correctly, specifically through non-analytics channels, you should be collecting information on who your audience is.

While it may be true that your audience image will not be as defined as what you can currently see with third-party cookies, this approach can also provide insight that you may not have from other sources. Information collected from Analytics will be limited to their behavior and the demographic information they have shared with Google. There are additional touch-points, like family information or specific care needs, that can be better communicated straight from the members of the audience themselves. To that end, you can still use user targeting on these audiences to cater marketing based on demographic information as well as website behavior.

Consider additional targeting strategy moving forward

The deprecation of third-party cookies will have no effect on contextually based targeting. For example, consider Pay-Per-Click (PPC) advertising. Since this advertising is run based on searches that users perform and not on behavior/user information from cookies, it will be unchanged. Reorienting your marketing plan around that type of outreach will prove to be a recipe for success.

Next Steps

Given how central third-party cookies have been for marketing plans, it is important to use the time Google has given you to come up with a transition plan. We are always happy to talk with you about your current initiatives and help craft a strategy to move you away from third-party cookie-based advertising channels and shore up your data collection techniques.

Our stance remains consistent … page speed is a means to an end. Don’t forget about the larger aim — improving user experience (UX). Consider potential trade-offs between page speed performance and features benefiting your users. Always look at your website holistically and make intentional, informed decisions.

What are Core Web Vitals?

Google’s Core Web Vitals aren’t new. We’ve paid attention to and have had access to these metrics for quite some time. Google has decided to simply package them together and give them a title. Core Web Vitals consists of three metrics:

1. Largest Contentful Paint (LCP): This metric reports the render time of the largest image or text block visible within the viewport, relative to when the page first started loading.
2. First Input Delay (FID): FID measures the time from when a user first interacts with a page (i.e. when they click a link, tap on a button, or use a custom, JavaScript-powered control) to the time when the browser is actually able to begin processing event handlers in response to that interaction.
3. Cumulative Layout Shift (CLS): CLS is a measure of the largest burst of layout shift scores for every unexpected layout shift that occurs during the entire lifespan of a page. A layout shift occurs any time a visible element changes its position from one rendered frame to the next.

How does Google’s Core Web Vitals impact my rankings?

When looking at Google’s Core Web Vitals metrics it can seem overwhelming, especially when tools out there indicate that you’re struggling in one, or all of these areas. However, as usual, things are a bit more nuanced than simple metrics. Consider this guidance directly from Google:

“The page experience update introduces a new signal that our search algorithms will use alongside hundreds of other signals to determine the best content to show in response to a query. Our systems will continue to prioritize pages with the best information overall, even if some aspects of page experience are subpar. A good page experience doesn’t override having great, relevant content.

This is similar to changes we’ve had in the past, such as our mobile-friendly update or our speed update. As with those signals, page experience will be more important in “tie-breaker” types of situations. If there are multiple pages of similar quality and content, those with better page experience might perform better than those without.”

Does Site Speed Matter, Then?

So, site speed is still not as significant a factor in rankings as many digital marketers anticipated. Google is continuing to emphasize quality content over everything and has directly stated that these signals are more of a “tie-breaker” than an outright deciding factor when it comes to your ranking on their results pages.

The driving force behind Google’s focus on page speed? Promoting and improving UX on its platform. Tying page speed to your SEO is a way for Google to get you to care about this too. Faster page load times is just one tactic Google has prioritized — and it’s the one getting the most attention.

This isn’t to say we should ignore page speed or other core web vital metrics. If your page is unbearably slow to load or has content shifting all over the page, Google may demote your site in search engine rankings. But, if you have a generally well-performing site today, improving your page speed isn’t likely to boost your rankings. What helps your rankings and what hurts your rankings aren’t always the same things, and both are still largely driven by who is providing the best information to users for a given query.

How do Core Web Vitals impact user experience?

Though it’s likely these metrics aren’t impacting your rankings, they may affect your UX and other measures of success. If a page takes more than a few seconds to load, or if content is moving around the screen while the user tries to engage with the page, users may get frustrated and leave your site. If you see lower conversion rates, lower engagement rates, or exceptional bounce rates, Core Web Vitals are a solid place to look for some insight. Remember that even Google recommends that you think about how your users experience your site, instead of simply how the page performs.

Page speed is a measurement of how fast your page content loads — so users can see and interact with your content. Page speed can be affected by many things, from the user’s browser to server configuration and front-end script management. Page load times can vary dramatically from user to user.

Still have questions?

The truth about Google’s Core Web Vitals and their impact on your site’s performance is complex. If you’re interested in looking into your site’s UX, page load speeds, or other metrics, know that Geonetric can help. From identifying the pages you should focus on to meaningfully measuring their performance, Geonetric is able to help develop strategies and tactics to enhance your site.

YouTube Monetization Policies

YouTube Advertising is something that many have experienced but few, besides marketers, think about. Marketers use YouTube ads to reach new, potential audiences. Meanwhile, YouTube watchers may only consider ads the cost of watching free videos. For video creators, YouTube ads are often not even a thought unless the video creator are prolific enough to share in advertising profits.

Many in the health industry find themselves in the final group. Health systems across the country use YouTube for their patient testimonials, surgery preparation and information, facility walkthroughs, marketing materials, and scores of other topics. Some of these videos are embedded on a hospital website, some are shared on social media, and some solely live in the YouTube account.

This has worked well for some time, as it offered reliability and ease of use and no advertising interrupting important content. For years, YouTube has only put ads on the videos of their partner accounts (those who share revenue) or videos containing a partner account’s content (for example, a video that features another person’s copyrighted music).

However, that may all be changing soon.

Update to YouTube’s Terms of Service

In November of 2020, YouTube updated its Terms of Service for the United States. One of the updates they made concerns monetization:

Right to Monetize

You grant to YouTube the right to monetize your content on the Service (and such monetization may include displaying ads on or within content or charging users a fee for access). This Agreement does not entitle you to any payments. Starting November 18, 2020, any payments you may be entitled to receive from YouTube under any other agreement between you and YouTube (including, for example, payments under the YouTube Partner Program, Channel memberships, or Super Chat) will be treated as royalties.  If required by law, Google will withhold taxes from such payments.

Essentially, YouTube has given itself the right to run ads on any video uploaded onto the platform. They can do so as they please, and that does not entitle you to funds or revenue unless you have a specific agreement or partnership with YouTube. If you have one of those partnerships, those payments will be considered royalties.

What does this mean for your user’s video experience?

As the video creator and account owner, YouTube does not need to alert you that they are running ads on your videos. And these ads will be visible on your videos on the YouTube platform, when they are shared on social media and wherever you have them embedded. That means that a user could be clicking through your website and view an embedded video that is multiple years old and see an ad before or during its runtime.

Effective June 2021, YouTube has rolled out this Terms of Service globally, and this is a scenario that may become increasingly common.

Solutions in the YouTube Partner Program (YPP)

Luckily, there’s an option to either disable advertising on your videos or control the verticals of ads running on your videos and share in the revenue. To do this, you need to look at the YouTube Partnership Program (YPP).

The YPP exists primarily to help content creators control their copyright, access the Creator Support Team and collect revenue for their videos. As a part of this last item, YPP members can control what types of ads run on their videos. This control extends to demonetizing (disabling ads) the channel as a whole. These options only exist through the YPP.

How does my healthcare organization join the YPP?

To join the YPP, you must qualify for the following requirements:

1. Follow the YouTube Monetization Policies
2. Live in a country or region where the YPP is available (the entire USA is an included region)
3. Have more than 4,000 valid public watch hours in the last 12 months*
4. Have more than 1,000 subscribers*
5. Have a linked AdSense account

*To check your public watch hours and subscribers, visit Studio.YouTube.com, click on the Monetization link in the navigation column. On that page, will be two meters to let you know if you have passed these requirements.

If you pass the requirements, you can apply for the program and, if/when YouTube accepts you, you’ll then have access to the advertising/monetization settings for your account. Typically, this review process takes one month.

What if my organization doesn’t meet YPP requirements?

If you don’t currently meet those requirements and are concerned about advertising on your healthcare organization’s videos, you may want to work towards qualifying for the YPP requirements to avoid ads entirely. It is unclear how widely YouTube will be running ads on non-YPP videos, and it may never become a problem. But if it does, if staying on YouTube is a priority for your organization, the only way to disable ads altogether will be through the YPP.

Need help?

Video marketing continues to grow in use and effectiveness for many healthcare marketing teams. If you’re a Geonetric client and need help navigating your video strategy, we’d be happy to help – reach out to your client advisor or account strategist. If you’re not a client and your current agency isn’t supporting you, we’d love the opportunity to work with you. Contact us to talk about your needs!

Digital Marketing from Separate Silos

There’s a problem with how we usually think about digital marketing. It’s a widespread problem, existing regardless of organization size or industry. It’s in itself a large problem, but it can have wide-reaching effects. It’s an often-necessary problem, originating simply as a means to methodically approach the large task of marketing on the internet.

The problem is this: we often treat organic marketing and paid marketing as two separate and distinct avenues. We see, time and time again, one team responsible for SEO and another responsible for Pay-Per-Click (PPC) with neither communicating with the other. Worse, often these teams are not equipped to speak with each other, with multiple agencies accounting for PPC and social media (itself split into paid and organic) and legacy marketing and organic. Some are managed in-house, some are outsourced. Oftentimes, focus can only be made for one, and the others are ignored.

Why is this the case? A number of reasons. Bandwidth limitations and individual expertise tend to be the biggest factors. Ultimately, regardless of the reason, the effect is the same: even though there are often multiple points of overlap between organic and paid marketing, many organizations continue to keep them siloed.

What is PPC Cannibalization and Why It Matters

Why this is a problem may not be obvious. If the right hand and the left hand are competent, what difference does it make whether either knows what its counterpart does? Brass tacks, when the right hand is your SEO and your left is your PPC, the difference is this: money.

Let us assume that you bring your SEO and PPC onto the same team.

SEO Work

Consider the work often performed for SEO:

• Pinpoint service lines that are critical for success.
• Perform keyword research to see how your audiences search for those service lines, finding terms that you try to weave into on-page content with an eye for balance of readability and popular terms.
• Write in references to your organization name and service area throughout, on-page and off.
• Use these tactics and many others, all the while benchmarking and measuring the organic traffic flowing in to find success.

PPC Work

Now, you turn your attention to managing your PPC. Maybe you have a specific objective: a maternity class that you want to offer, a flu vaccine clinic that you want to schedule. Maybe you just want to advertise a service line. You do your due diligence. You do our keyword research here, as well. You write your ads. You build your audiences. You set up your tracking and define your conversions.

Bridging the Gap

Finally, consider, your SEO work is working. Organic traffic grows month over month. You perform strongly with your branded keywords and you are making headway in your priority service lines, too. Your PPC is working, too. CPCs are low. Click-Through-Rate (CTR) and Conversions exceed expectations.

However, when you look at the search terms on which you are spending the bulk of your budget, you find your organization name or brand again and again. You look at these same searches organically, and you see that these are also high-performing. The average position is high, CTR looks good, and none of your competitors are bidding against your brand in their own PPC campaigns.

You are, in effect, paying Google Ads for keywords that you have already mastered organically. The name for this, colorfully enough, is PPC Cannibalization.

Bringing Your Digital Presence into Sync

Thankfully, this problem is easy to fix. We can bring keyword lists in line with your high-performing SEO searches, reducing overlap as much as possible. The trick is finding the overlap in the first place. In order to do so, we need to be able to audit both your PPC and your SEO performance.

This can be a challenge organizationally for a number of reasons, some of which I have described in this article. However, it is critical to protect your advertising budget. Every dollar spent in advertising that you lose to PPC cannibalization is a dollar that could be used for another ad auction on a search for which you haven’t (yet) built an organic approach.

Ready to Get Started?

There’s no one-size-fits-all solution to this problem. By auditing your SEO terms and PPC searches side by side, you can help your SEO and PPC work together, in sync, instead of independently. If that sounds overwhelming, request help from our experts. By keeping a holistic view of your digital presence, we can help you pivot to account for changes in the search and organic landscape. So, ensure that your advertising budget works for you more efficiently and more intentionally. Reach out to us and schedule a time with one of our experts to get the ball rolling.

Online listing management can seem like a daunting task. Many healthcare organizations have hundreds or thousands of location and provider listings that require ongoing maintenance. Inconsistent or inaccurate data can misdirect patients and consumers, which can hurt your reputation and your revenue.

But, intimidating though it may seem, online listing management is critical today.

In 2019, Google reported that 63% of mobile searches were no-click searches. This means that Google answered the search query themselves without users clicking through to a website. Through various featured callouts, structured snippets, knowledge panels, and most often, Google My Business (GMB) listings, Google can deliver the information that searchers are looking for without ever sending them to a website. Assuming that 63% of people will not be clicking through to your website, do your business listings give users what they need?

Consumers have come to expect accuracy with everything we find online. Patients looking for care are no different. Ensuring that all of your locations and providers are claimed, verified, and accurate in GMB is a significant first step to addressing this. However, it should not be the last step. It is essential to understand that managing your online listings is not a one-and-done task. Ongoing optimization and management are just as crucial to ensuring your information is accurate for patients, both existing and potential, who are searching for care.

So if you’re looking to invest more in business listing management, here are seven tips to optimize and help your listing rank in Google:

1. Work with internal stakeholders

If you are in charge of creating and maintaining your business listings, reach out to the key people at the different locations or within your organization. Let them know the importance of having accurate data in your listings. Request that they let you know when a provider leaves or if information changes for their location. Let them know who to contact if they receive comments or questions based on inaccurate information. They are the ones who hear the patient feedback most: “Google says you open at 8:00 a.m.” or “I couldn’t find the building,” etc. Encourage them to pass that feedback onto you so you can resolve the misinformation online. Or, consider creating an internal ticket system to request changes to establish an efficient flow of information.

2. Choose the right primary category

Google is going to show listings that are most relevant to the user’s search query. Although you can add multiple categories to your listing, the primary category should best represent your location or provider as it is the only one that users can see on your listing. Look at your listing insights to see what terms users are searching for when they come across your listing. For example, if you use the primary category of “Medical Center” when “Urgent Care” would be a better fit for that location, you may be missing out on potential traffic or rankings. If your category isn’t an option in the GMB dashboard, you can reach out to GMB Support and request it be added.

3. Make sure your website is the source of truth

One of the top foundational ranking factors for Google listings is that there is synergy between the name, address, and phone number (NAP) and the corresponding GMB listing. If necessary, create a web governance checklist so that when people make changes to a name, address, phone number, or hours on the website, they also make them on the Google listing or notify someone of the changes.

4. Drive the user to the right page

Imagine this scenario: a user conducts a Google search for “urgent care near me.” Your listing shows up first in the local 3-pack, the prominent map listing in search results that presents users the three businesses that Google considers most relevant to their query and location. Great! The user sees that the location is nearby and clicks the website link to learn more about provided services. If this links to a service line page that doesn’t include location information, the user can become frustrated. It is good to remember that every search is really a question and every click should be an answer to that question. The information on your website must match the listing so that it can most accurately answer the searchers’ question. If you have a listing for urgent care, there should be information for urgent care locations. If you have a listing for a cardiology department and you link to a cardiology service line page, you should ensure that page has location information in sync with the corresponding business listing.

5. Add photos and videos

According to Google’s own data, “Businesses with photos receive 42% more requests for driving directions to their location from users on Google and 35% more clicks through to their websites than businesses that don’t have photos.” It is essential to upload your own, professional photos to each listing so that your images have a better chance of displaying over images that Google users can upload. If you have videos of your providers or virtual tours of a location, consider adding them to the appropriate listings. Photos and videos encourage engagement with your listing, and that is a key ranking factor on Google.

6. Check for updates regularly
Take the time, preferably on a weekly basis, to check your listings for updates in the GMB dashboard. These updates could be based on user-suggested changes or Google’s crawl of your site. Often times, these updates can be a change to the business hours or website URL. If this task is left to Google’s automation, you may find incorrect, inconsistent, or outdated information on your listings. This leads to frustration and poor user experience but can be avoided with a regular maintenance task.

7. Use UTM Parameters

Also known as Urchin Tracking Module (UTM) codes, UTM parameters are snippets of code that are appended to URLs to track different sources of traffic to your website from various advertising and marketing channels and tactics. While having UTM parameters won’t affect your local listing ranking, they will allow you to get a better understanding of what listings are driving the most traffic to your site and how users are engaging with your site from there. You should use UTM parameters for both your website and appointment URLs, if applicable. There are several tools to help you create your UTM tracking code, such as the Google Campaign URL Builder. You can also use an Excel spreadsheet to build and keep track of all your UTMs. Make sure you’re using a consistent naming convention for all of your online listings, so your data aggregates as accurately as possible in Google Analytics.

Take control of your data

Maintaining an active and ongoing role in your online listings management is important. While the first initial time investments can be significant, ongoing maintenance may just take a little bit of time every week or every month. That continuous pruning and care can make all the difference in preventing issues from coming up and snowballing into more significant problems. Plus, it helps ensure you are meeting the needs of the 63% of people who inevitably don’t visit your site.

If you need help getting the ball rolling or locating the most substantial pain points, we can help you. We work with healthcare organizations around the country to manage their listings and can use our insight to help you optimize your listings. We can perform a business listings audit and help create a plan of action for addressing any problem areas that we find as well as create an ongoing maintenance strategy.

Remember, Google and other listings providers rely on automatic algorithms and user input to provide information. Do not leave your information up to that process. Take control of your data and maintain it for ongoing digital health.