Selecting a Web Content Management System for Your Health System

Redesign, re-structure, re-platform, or all of the above?

Nearly 1 in 5 healthcare organizations are currently planning to change their content management system, according to our recent survey. It’s a critical decision that impacts your ability to deliver on consumer engagement, physician strategies, and service line growth for years to come.

Whether you’re in the selection process, or wondering if you should be, this webinar will provide the information you need to make an educated choice.

You will learn:

  • Signs your CMS isn’t working for you (and how to know if the problem is really something else)
  • To maneuver the landscape of approaches and options for managing web content from both a technical and organizational perspective
  • Healthcare-specific considerations — including functionality, governance, and security — for selecting a web CMS


David: All right. Welcome, everybody, to this month’s webinar. I wanted to start out, and thinking about CMS’s and being on the call, and how Cole just described what we do around here, I wanted to acknowledge the elephant in the room. You’re obviously here listening to a webinar on selecting a CMS from a company that helps folks provide CMS solutions to folks. And so I just wanted to call that out up-front so, you know, you’re not gonna be sitting through a sales pitch today. Really, what I wanted to do with everyone today is walk through a lot of different things that you need to know about if you’re thinking about content management, how to be more effective with content management, or possibly selecting a new system. Even just going through a redesign and trying to use the system you have a little bit better. So we’re not gonna necessarily go through a head-to-head comparison today. There’s just too many options out there to really do that in the time that we have. But really try to get some of a different perspective and some things to consider as you kind of wrap your head around that space.

So with that said, let’s dig in and take a look. So I wanted to start out and say, is it time? What are some of the signs that your CMS might not be working for you? How do you know it’s really a CMS problem? If you’re like a lot of other healthcare organizations that are out there, you may be thinking about this. We just completed a survey of the industry and got some numbers back on who’s out there looking at redesigning their site and who out of that is actually looking at re-platforming as well? Found about 50% of those we surveyed had a redesign in progress or in the planning. And one of the things that I should mention, that we asked a little bit differently throughout this whole survey process, was talking about main websites versus other websites, and acknowledging that most organizations anymore have multiple websites out there, they have multiple content management platforms that they’re working with across those different sites, and trying to accommodate some of that information in the survey as well. So, out of the 50% that said they had some sort of a redesign in the works, about half of those were also looking at changing their CMS.

So it’s a big decision that’s top-of-mind for people. It’s a significant investment, both in effort and in expenditure, and it has an impact on your online efforts and can be anywhere from, you know, 3, to 5, to 10 years into the future. Some of those decisions have lasting impact. So, a lot of times we get asked, how do we know if it’s time to redesign? What are some of those triggers? What might be those indications? The first one is really being clear and acknowledging the business context and any changes that are happening there. So this could be anything from your organizational level, if your organizational structure has changed, if you’ve gone through some mergers or acquisitions, if you’ve gone through a rebrand, things like that that really affect that business context. If you’re facing new competition in your market, if there are changes in the industry, as we’ve seen over the last several years with the ACA and different changes in payer models that we are trying to reach within the industry is constantly changing, that can have an impact on your overall site design and strategy.

So, all of this really comes down to that strategy level. And so, sometimes, it’s not just…you know, it feels like it’s just a change in strategy, not anything in the business context, but it’s really about having more clarity about the business context. Maybe you get some new leadership and they have a different perspective on exactly how you’re operating, really affects the strategy. So these are things that we typically see in redesigns that are really, you know, from the business side, pushing things almost top-down. What we see almost from the bottom-up side is taking the current state and seeing if you’ve kind of plateaued. So, if you’ve got a site that’s out there, it’s just not producing the results that you need, if you’re not getting conversions, user engagement numbers are suffering, you’re not able to move any further forward in SEO efforts, or if what you have out there is just not maintainable, it’s become really inefficient for your team to maintain, those are other indicators from that bottom-up process that it might be time to be looking at, what is the redesign? What is the strategy? What is the platform that we’re on? How do those things fit together to make us more successful online?

As you pull all of those things together, you’ve got a lot of different problems all circulating around a lot of different options in front of you. So you’ve got some technology things coming into that, you’ve got content issues that may be going on, things out of date or, you know, just trying to work through governance issues. You’ve got business problems in the market that you’re facing as well, and you’ve got, of course, the people that are involved. And one of the things that tends to happen with organizations is they start to confuse some of these problems, and things that are really people problems are assumed to be technology problems, vice versa. You know, content problems are kind of at odds sometimes with the business problems that you’re trying to solve. And so, really, it becomes about trying to realign all of those efforts, really trying to understand what are the human resources, and the processes and that side of things, as well as how can the technology that you have, or that you’re evaluating, help you to do a better job of matching up all of these different concerns? One of the ways to do that is actually by starting into a content strategy process earlier on, kind of preceding any big decisions about what kind of moves you might make. And the reason that that can be really helpful is that, typically, a content strategy evaluation would look at all of these different areas, trying to understand, what are those business goals? Who do you have as content authors and editors, and what does your publishing platform look like? And how to all of those things fit together with the struggles that you’re having?

This is a model of what…you know, this kind of the typical, I guess, classic model of what a website life cycle might look like, pulled from the software development life cycle where you’ve got this stage of planning, a phase that you go through of designing the solution. You implement the solution, and then you go into this maintenance phase and then you start to circle back through that. So this is that ideal picture of what everything looks like. And so I wanted to throw this out there and kind of shift your mindset, maybe, a little bit around what that looks like in reality. So this is that same set of activities, skewed a little bit to what we typically see within healthcare organizations where they’re maybe redesigning in a three to four-year cycle. They’re maybe taking up to a year to plan and budget for that redesign. Typically, it may be, you know, three to six months of design and implementation work, and then going into a maintenance mode for several years. So you can see, as you start to think about how much time is actually spent in those different parts of the life cycle, it starts to shift your priorities a little bit and focus a little bit more on the maintenance side of things. When, a lot of times when we’re headed into an evaluation process we’re struggling with some issues, but really thinking through that next design and how everything’s gonna be better with the next design in place. Not necessarily thinking into that maintenance phase and what things look like out that far.

The other piece to keep in mind is anybody that has been through a website redesign can probably totally understand where this is coming from. The actual reality feels like this. So, unless you’re designing a brand new site from scratch, you’re still gonna be in maintenance mode even while you’re going through that planning and implementation of the new version of the site. So it puts a little bit extra weight and emphasis on the fact that the web is always under construction, and that’s something to really consider as you’re embarking on this process, thinking not only about the next 6, 12, 18 months of this project and of the process, but also what is ongoing operation to look like over that timeframe? So just always like to remind people to take a little bit of a long view with that perspective.

Wanted to take a look, as well, at just really high-level survey of the CMS landscape. So we get a lot of questions about what’s out there and what different organizations are using, especially across the healthcare space. As I have mentioned, there’s quite a range out there. So, again, from our survey in the last few months, this is the whole range of content management systems that folks answered or identified within that survey across multiple sites per organization. So you can see, by and large, the largest one as far as usage is WordPress. And that was something that was very common for folks with multiple CMS’s, they’re using WordPress for some blogging or content marketing efforts, in addition to some of the other content management systems listed here as well. But you can see representation across pretty much everything that you would hear about or run into. Somebody somewhere is probably using that content management system in healthcare.

What you can see here, as well, is we broke our survey into leaders, average and laggards, as far as how they had to answer some questions about where they felt they were in standing as far as features, functionality and how far ahead of the curve they were. And so you can see a real breakdown of folks that are on some various platforms and, you know, kind of aligning with where they’re falling in that curve of maybe falling behind their competition or actually leading the competition in their area. So I bring this up mostly just to say there’s a whole range out there. There’s quite a bit of different options, and so I really wanna dig into what do we need to know about these options, what are some things that we need to consider as we’re going through that process, and how do we have a better understanding of what all of these can do and what they mean for us?

One of the ways that these get broken down, these different systems, is by license type. And this is something that you hear quite often, you talk about open source CMS’s versus proprietary CMS’s. You also hear them broken down in terms of business size, something that’s targeted for an enterprise market versus small and medium businesses. Occasionally, you’ll hear a delivery model comes into the mix, whether this is a hosted solution, something that you can self-host. Is it a software-as-a-service type model, you know, mul-titenant or something like that where you’ve got all kinds of different systems going on within one server architecture? Or the industry focus itself, is it geared specifically for healthcare or is it more of a generic type of CMS that is used across a wide variety of industries? The one thing to keep in mind here is that, at the end of the day, every website becomes a mix of these different types of systems. So, if you’re finding yourself drawn towards open source versus proprietary or going a fully custom route, by the time you get all of the pieces and components that come together to drive an actual website you’re really mixing bits and parts from these different models.

So if we were to go down the proprietary side of things over here, there’s typically two different options. A third party, off-the-shelf type CMS that’s more generic in nature or a vendor-specific CMS or a CMS that has a fewer number of firms out there implementing it. And then, as you start to build out that website using those tools, there’s usually integration of third party components, proprietary components, maybe modules that are from that same agency or vendor, and then custom code that gets written just for your site. And all of those pieces come into play, whether you’re going an open source route or if you were to go a fully custom, “We’re gonna write this whole thing from scratch,” maybe using a content management framework of some sort. And still, at the end of the day, you’ve got these different mixes of tools coming together.

And the reason I bring this up is because it’s really important to understand those components that are going into your website and who is responsible for those at the end of the day. So if you’re going that custom code route, you may be responsible for any updates. If you’ve got internal development staff, they’re going to be on the hook for any security updates and patches that need to be made. On the other end of the spectrum, if you’re going that proprietary route, you have a vendor there who’s on the hook for those kinds of updates. But there may be components that are coming from yet another third party, and watching for updates or making changes to that functionality gets a little bit more complicated as well. So, here it’s really just understanding what is that mix, and then how does that come together into that life cycle? So if you were to mash all of these together and think about these different layers, you’ve got the content, the design, the CMS platform, any third party plugins or integrations, custom code and all of that kind stuff coming together. All of these things end up on slightly different life cycles and they’re changing at different times, and so you it can get a little bit complicated. Don’t wanna scare anybody off at this point, but there’s a lot going on. And so it’s really important to dig in and understand exactly how these things are going to come together.

Let’s step back just a minute here and ask the question, why do we do this at all? Why are we even trying to manage our content through a software system? And more importantly, what is it about a CMS that gives us some power? Typically, the reason we’re doing this is to get some sort of some sort of efficiency out of the process, to improve the speed with which we can put updates on the website, to make changes and to work through things more quickly and reliably. And a CMS has multiple different things built into it, any CMS, to help that happen. To help explain some of that concept, I wanted to start with a concept called pace layering. And this is a little bit out of left field, maybe, but this is a concept developed by Stewart Brand, who is really a kind of out-there thinker about the future, and the way things and systems interact. But he developed this model around the layers out there, you know, going all the way out from our culture out through, maybe, government into infrastructure and commerce, fashion, art, thinking about how different things change, how fast they change in relation to each other and which different layers push us forward as a society.

He’s also applied this model to thinking about buildings. He has a book called “How Buildings Learn.” And if you think about a building, a house, for example, in the same way there are the different layers that get put together when you build that house. You’ve got a foundation, you’ve got plumbing that goes into place, you’ve got the studs that are inside the walls, you’ve got sheetrock paint carpeting the furniture that you bring it in. And all of those things change over time, but they do so at different paces. So I can very easily go out and buy a new couch, and swap out the one that I have at home right now. With a little bit more effort, I can put some paint on the walls and change out the carpeting. If I wanna move a wall around, I’m starting to get into a lot more effort and it’s probably going to stay wherever I put it for quite a while. You get down into making a foundational types of repairs and you’re really talking about the substance of that house. So it’s important to consider, when you’re thinking about your website, to think about some of those different layers in a similar way. What parts of your website are changing frequently? You know, you’ve got content that you’re updating on a daily basis at least, maybe multiple times a day. You’ve got design that maybe is updated a little bit more frequently, versus some of the overall behaviors, the navigation, some of those layers, that are more stagnant over time. They don’t need to change on a week-to-week, month-to-month basis.

So, ideally, what a CMS helps us to do is to break those layers apart, and nearly every CMS out there is going to have some sort of separation of concerns. So this is a programming term that talks about how you divide out these different layers that need to have different speeds that they’re operating at. Typically, within a CMS, you’ll see something like this. You’ll see a separation of the presentation layer. What does everything look like when it gets rendered out to the viewer? And that may be divided out across multiple different devices and different ways that you might interact with that content, but there is usually some breaking apart of that presentation layer from everything else. There’s usually a layer in there that has something to do with just the content. What are the words, what is the information that we’re managing within the system and what are the rules around how that needs be managed?

There’s typically a component around that of the relationships between pieces of content. How do users navigate from item to item? How does the navigation get built out? How does the URL structure get built out? How do things like search or taxonomy work within the system to help connect those different pieces of content together? And then there are different behaviors. Some of that may be more administrative types of behaviors and some maybe interaction behaviors between the various users, both on the front-end and the authoring interface, and how they interact with the content and those presentation layers. And you can kind of see, as I’m talking through this, how those different layers changed differently over time. Like I said, your content is changing multiple times a day. Certain aspects of presentation may change somewhat frequently, but quite often you’re going for that major overhaul a little bit less frequently, where big chunks of the presentation are going to change. The relationships between the content items don’t change quite as frequently as the content itself. Things like your navigation or the categories that you use on your site only change every so often. And a lot of the behaviors get locked in from the get-go and, often, don’t change substantially throughout the life of that design.

In a similar way, there’s the concept of structured content that has really taken off over the last several years and is something, if you’re looking out at content management systems, that you’re probably hearing a lot about. So, I wanted to touch on exactly what that is. We could spend a whole day, probably, talking about what it means and how to do it well, so this gonna be the shallowest little dive into the topic. But basically, the shift within content management has been away from what you see on the left, of a more page-oriented model having large blobs of content. If you think paragraphs, and paragraphs and paragraphs of just open-ended HTML with images mixed in and all kinds of different things mashed together within, what is technically called with within structure content, a blob. And on the other end, much more structured content, where you have an exact field for every piece of information. Every little data point that you might want to use separately has its own place to live and a way to connect it back into the overall structure. So while we’ve, in the past, done things in a very page-oriented model, if you think about, maybe, just a typical WordPress installation a lot of people are familiar with, you go to write that blog post in a lot of different systems. You’re dealing with a large blob of content there that you’ve got all kinds of things mixed together.

What’s really great about that is it’s easy for people to understand. So if you’re familiar with page layout software, if you’ve worked InDesign or you’ve designed something in Microsoft Word, you understand the idea of laying things out on a page and that that’s gonna show up a certain way for the person that is reading it after it’s been printed out. Similar idea with this page model that I know exactly what URL all of this information is going to live at, pretty much where things are gonna show up on the page. It may shift around a little bit across devices but I know it’s all gonna be there. And you know, I have some comfort in the way that I can flow my content into that. I know that this header is always gonna show up next to this paragraph because they’re within that same blob. You’ve got a lot of flexibility. If I wanna throw an image into the middle of a page, I can do that. I don’t have to think about exactly what that structure needs to look like. So, it’s something that’s really comfortable and familiar for people.

On the other end of the spectrum, you have systems that are very, very structured and you think about much more of a database type of system. What’s great about that is you’ve got unbelievable consistency. You know exactly what is going to be in each content object, how many characters long it’s allowed to be, how it’s gonna show up in different places. That can be a little bit more challenging for content authors to wrap their minds around. So if you’re used to writing pages of content, you’re used to writing magazine articles, taking all of the elements of that article and breaking it up into separate fields that may display in new ways that you haven’t imagined becomes a little bit challenging. So a lot of times, there are different hybrid models. You really wanna find that sweet spot in the middle that allows you to have the kind of reuse that you need. That’s typically why you’re looking at structure content, is you want to reuse the same content across different kinds of presentation, whether that’s on the website, on a mobile application, within a call center system or some other system that you’re sharing that content with.

And you also wanna be able to change the presentation quickly without necessarily reworking content. A lot of us have lived through that with the responsive design shift. As things moved towards responsive, of a lot of content that was held in those big blobs had to be reworked because you couldn’t just make everything around it responsive. The images that were in there had certain widths on them, there was maybe tables used for layout or other things that wouldn’t allow that content to go responsive without some substantive changes. So the idea, with structuring that content, is to be able to switch up that presentation for different uses that we maybe haven’t quite imagined yet without having to necessarily go into that content and rework that. Reality ends up being somewhere in the middle. There is some balance point to be found for types of content that work well, or well enough, as larger blobs, and other types of content that may need more structure.

Another way that content management systems get you some efficiency is through different layers that allow different levels of control and different scopes to that control. So this may be getting just a little bit technical, but let me walk you through what we’ve got going on here. Down at the bottom, we’ve got the broadest level of things, and you’ll see there’s a lot of different terminology thrown onto this diagram. Every CMS system has different words that it uses for similar types of concepts, but what you’ll want to do as you’re evaluating systems is really understand how are the different views, and the different pieces of content that I would look at as an end user, built? Where do all of the pieces come from and where do you have the power to not only control that single piece of content up there at the top, something like, you know, what’s typically been a page, or a panel, a block. How can I control that single piece of content, but how, also, can I manage multiple groups of items? So, I may want to change up everything in a section of the website at once, or everything with a certain category or type assigned to it, all the way down into bigger picture, what we typically think of as template or theme. You know, visual design kinds of things, arranging different layouts of the page, reusing those layouts across many, many pages. Like I said, all of this terminology is quite a bit different from system to system but every system has some level of this. So it’s really important to understand where that balance point is for you and your organization, where your comfort level is with the technical skills needed to change things at those different levels. For changing that single item, it may only require you to put plain text into a box in the administrative interface to change up some of the shared views, or some of these templates or themes that may require some front-end coding experience, and access to source control and all kinds of different things. So quite a bit different expectation from a skill set perspective.

It’s important to understand the different kinds of power that you get with those different levels. So, if I wanna broadly change things across the site, I have access to those deeper levels, I can do that very quickly. Obviously, with that there comes a little bit of risk and, certainly, who you open that up to and their understanding of the repercussions of those changes becomes pretty important. If I’m only going in and I’m changing that single item, you know, the text in one area of the site, there’s less risk with that. Of course, you’ve got less power and some of that comes into play with how those items get reused. And where they get reused, the more efficiency you’re getting out of there. So this is just something to know that it exists as you look at these systems, and really try to understand how your different users, within your organization and within your partner organizations, are going to use these different levers within the system to get you some efficiency and to make changes quickly.

Something else I wanted to touch on in this area, just to throw some terminology out there, is something called a headless CMS. So we’re seeing more systems where parts of these layers have been split out into different systems. So, rather than trying to manage both that presentation and the content itself within that same piece of software, we’re seeing more organizations outside of healthcare looking at different ways of breaking that up and choosing, maybe, one system that is really focused on content and the authoring experience, and something else that is focused on the presentation. And so there’s some really strong use cases for why an organization might want to do that, but with it, also, comes an extra layer of complexity for those authors in understanding exactly how things are going to play out. A lot of technical details that need to be looked into as well. So that’s something to keep an eye out for if you’re exploring different options and looking at having a completely different presentation layer from that back-end content management interface that you’re working with.

So this is another software development term. We often talk about software being opinionated, and pretty much all software, all good software, is opinionated. And what that means is that there’s some sort of built-in bias to the system. The software and the makers of the software have decided to favor one thing over another, to make it easier to do one set of tasks within the system than another set of tasks. And this is a good thing because it makes it a lot simpler to do those tasks that are favored by the system, but if you end up mismatching the tasks that you’re trying to do with the way that the system is opinionated, you run into some problems.

So let’s walk through a few examples of what that looks like. So, content types is one that you see quite often within content management systems, the way that the system tries to organize content. You may have a system that is really built around structured content, breaking everything into small little bits and then putting them back together into the different views. You have other systems that are built much more on that blob model. Everything is going to be large, flexible chunks of content that are very big and can contain many different items within them. Another way that that plays out is the idea of streams versus pages. So, a blog-oriented engine, something like WordPress, is often a little bit more opinionated towards content that is published over a period of time. So, if you think about WordPress and you’re putting out those blog posts every day, several every week, it’s really good at handling that. It has a lot of tools built into the system to manage all of those date-based, time-based things. And only in the last several years have they really built up the ability to manage, you know, pages or things that are a little bit more fixed in terms of timeline, kind of outside of that flow of the stream.

Another way that this plays out is in roles and workflows. There are some systems that are those enterprise CMS systems that are really heavy on building out all the different kinds of roles that you might have, all kinds of custom workflows. And then you have other systems that go the opposite direction, that are much more lightweight and may be more flexible in terms of the limitations of those rules that are put in there. So, something that you want to look at and understand what opinion the system has about those things. Content relationships is another aspect of this. So, different CMS systems will have different approaches to how to handle navigation, how to handle things like taxonomy or categorizing your content, or how to build out URL structures. And so these are important things to consider as you’re defining, you know, what does that user experience going to look like? How are people going to navigate the site? Matching that back to what the particular content management system is capable of doing, and not only what it’s capable of doing but what it kind of prefers to do under the covers. A lot of systems are very flexible in this regard, but it’s just there are different levels of complexity involved in getting at these things.

The last piece that I bring up is the author experience, and this has really got a lot more attention in the last several years. A lot more folks are thinking about, not only what is the experience that we’re creating for end users, the visitors to our site, what do they experience, but also finding that one of the challenges with the site is keeping it up to date and that authors don’t like to help keep the site up to date if they have a horrible experience on the back-end any time that they go to make changes to content. So there are some systems out there that are much more logical for authors to use and, again, it goes back to that that page model versus the structured content. A lot of writers are much more comfortable with that, thinking about things how they’re actually going to appear on the page, versus some other systems are much more logical for developers. And if you are familiar with databases, and how things get pulled together into databases and that’s the way your brain works, they’re gonna have an experience on the back-end that really fits with that. So it’s something to think about, how the folks that you’re going to have helping you to maintain this site are going to react to that experience.

Overall, how do these kinds of things impact your project? A great example of how to think about this is just thinking about SEO. This is not something that you wanna think about after you’ve gone through a web redesign and re-platforming, and then come back and say ”Hey, we should do some SEO work on the site that we just built.” SEO is something that you’d wanna be considering upfront, very early on in that process, at least at a high level, “What is our search strategy? Where are we trying to rank well for certain things? What are the domains and how are they gonna fit together? What is the overall URL structure of the site gonna look like?” Having made some of those decisions, or at least gotten some direction on which way you wanna go with that, you’ll have a much better idea of understanding whether a particular content management system is going to easily support what you want to accomplish from an SEO perspective, it or whether you are fighting more of an uphill battle with.

Structures content factors into this as well, with Google looking for more detail about the information you’re providing, that you’re publishing out there, using things like markup. The more granular detail that you have within the content itself, the easier it is to publish things out using Schema. Things like physician’s office hours, whether they’re accepting appointments, upcoming classes and events with dates and times. All of that, once it’s broken out into those small chunks, is a lot easier to mark up using some of these different microdata formats. Site performance even comes into play with your SEO rank. And that’s something to consider as well, is just how does the site come together all the way through that user experience? When I go out to the site and load that web page, how rapidly can that happen? How do those pieces come together to create a really rapid, responsive type of experience. So, in summary, they’re something that you want to think about upfront and really start to understand, what are those different trade-offs you’re making within the content management system? Thinking a little bit beyond the content itself, so we’ve talked a lot about some of the issues around content, about the words and the information within the site, there are some other things that are typically considered within healthcare organizations as you’re thinking about your website and your CMS that is powering that.

Going back to the survey results again here, just for a minute, these are some of the features that we looked at within this survey and looked at adoption across a wide number of web-oriented features. And so you can see a lot of organizations already have in place, or are rapidly planning to add, things like responsive design. If they’re not there yet, they’re gonna be in the next 12 months or so. They’ve got patient portals in place, they’re looking at physician ratings and reviews in the next few months. These are the kinds of features that are coming down the road and that our content management system is expected to handle, in addition to simply delivering the content to the end user.

So I’ve lumped a lot of this together inside of, what I’m calling, transactional functionality as a second area that we’re gonna look at in addition to that content itself. And this is just a checklist of things to consider within a healthcare organization thinking about content management. Some of that functionality, whether it’s content-oriented or other transactional types of things, is really around the content types and the interactions that happen with those. So, if you’re a health organization, you probably have some form of a provider directory, a list of physicians somewhere within your site. That’s fairly common functionality but thinking through exactly what the structure of that is, what are all the different fields and types of information we wanna display about those providers, what are all the different types of providers and relationships that we need to acknowledge within that, is something that’s pretty specific to healthcare. As I mentioned, there’s some specific functionality and we’ll dig into that a little bit more that it comes into play with healthcare specifically. There’s also industry-specific integrations that you wanna consider. So, if you go out and create just any B-to-B marketing website, you’re gonna want to integrate with certain CRM systems and certain marketing automation systems. If you’re creating a healthcare website, you have a certain pool of those systems that are really geared towards healthcare and are pretty common across the industry. And so, thinking about how your website is gonna integrate with those types of marketing automation, with those CRM systems, with analytics and things like that.

Content governance is something that is pretty critical within healthcare. So you’re dealing with content that needs to be reviewed on a fairly regular basis and have some kind of structure around when that happens, to ensure that the information that you’re publishing is accurate and up to date. So, a little bit more of a concern in healthcare than it is in other industries, and so really thinking through any content management system that you’re looking at. What is it gonna take to know which content might be out of date? How are we going to identify those items and route them the appropriate ways to make sure that they are staying up to date?

Security and privacy is the thing that always comes up when we’re talking about healthcare and CMS. And typically, what we’re thinking about there that’s top-of-mind is, of course, HIPAA and PHI . But really, I think you’ve got to think broadly about privacy. And that’s not just from a legal requirement around protecting health information, personal health information, but also from kind of that brand perspective. It doesn’t matter whether it’s technically PHI. If some user data gets exposed, that’s just not a good thing for a healthcare brand to have those sorts of privacy breaches. And so really thinking through what are all the privacy and security protections that are in place with a particular system and thinking through all the layers, from hosting all the way through to that front-end experience, that could be impacting both security and privacy. A piece of that that comes in, as well, is having those audit trails. It kind of ties both into content governance as well as some of that security and privacy. Being able to tell what users in the system have done and what changes have been made over time, or to track back in case that you need to dig in and find out exactly what happened in a given situation.

Digging deeper into that functionality and some of the integration that we typically see happening, certainly the physician directory, often integration with credentialing, or maybe call center systems, in order to get that information pulled together and keep it up to date. Frequently, there’s a calendar of events type of functionality with, maybe, online registration can be tied into call center data systems as well. We’re seeing more and more appointment requests of different types going on online. So this is, again, when you get back into that map of third party functionality and integration with other systems, all of those mixed types of things that are happening inside of any healthcare website. We see appointment requests happening through custom development types of forms or other interactions, built-in modules within a particular system, all the way to third party integrations or widgets that are taking users off to other sites to do those appointment requests and scheduling processes.

Capturing data, any kind of patient data, like preregistration patient history and feeding that through to CRM platforms and marketing automation systems to make sure that that data is flowing throughout your whole internal ecosystem. A lot more folks have gone to using Active Directory or LDAP to manage their security roles on the back-end. So a lot of IT organizations are really liking having that all controlled in one place, simplifying who has access to what and when. And then any kind of custom APIs. So, getting data in and out of the system, and mixing that with data from other systems to do all kinds of different things. All things that you wanna think through and consider as you’re looking at the systems that are out there.

So, the third and final component of this that I’d like to touch on is personalization and optimization. So, what may not be obvious to somebody who’s less technical is, as people are visiting your site, they’re interacting with the content that’s stored in your CMS, there’s a whole lot of information that is exchanging hands as they visit that page, and pull up a URL and share some information back-and-forth with that server. It provides a number of opportunities to really understand your audience, see who’s out there and to actually improve their experience in a number of different ways. So, the first thing is to really think through some of the analytics and where that’s coming from. So there’s analytics that may happen from the content management system itself, but there are tons and tons of things that can be done through tools like Google Analytics to push data from the system, and from the user’s behavior, into a dedicated reporting platform and make really good use out of that information. So it’s something, again, like the SEO strategy, to think about upfront. What kind of information and data measurement are we going to want out of this and how are we going to set up the site to really think through all of those problems?

A growing way that that information gets used is to try things like geo-targeting. So, using some of the information from the user’s browser, from information that they provide, to tailor that web experience to their local area. So, especially if you’re spread out across a larger geographic region, this can be huge. You wanna know about the clinic that’s down the street from you, not the one that’s in the next state. And so we see more and more health organizations embracing geo-targeting as a way to filter down the options and provide that personalized experience. Again, this is really driven off of that information that’s flowing through that website and through those interactions in real time. That can be taken in a number of different directions if you think about other content that is contextually relevant. So this may be simply things that are related to the pieces of content that are being currently viewed by the user within a page or view on the site, could be things that are related to demographics, previous campaign targeting, other actions or behaviors that they’ve taken on the site and some other algorithms that can run. Something to consider, and again, this becomes a balance point between how much time and effort is involved in setting up all of the different variations, how much of this can be automated and what is kind of that cost-benefit to doing that.

So the final area to think about is, how do you go through that process of choosing a partner? So, typically, healthcare organizations, you know, don’t have a lot of the development and technical services available in-house to do this all themselves. They’re looking for somebody to come and help give them a little bit of advice, maybe provide the platform, and some support service and ongoing strategy around that. A lot of different considerations as you dig into that process as well. The first thought I have about that is really thinking about, what is the right process for you as an organization? And what we see a lot of times is, you know, hospitals are very large organizations, thousands of employees, billions in revenue, and in some purchases they behave very much like that very large corporation. If you’re buying an EMR system that’s gonna be in place for dozens of years, is gonna affect many, many departments, makes sense to do a lot of big overhead process. But what we typically see is, despite the large overall size, the marketing team looks a little bit more like the picture on the right. There’s a handful of people in the web team, in the digital marketing area, that are largely responsible for maintaining the site. And so you get a dissonance happening between some of the organizational behaviors and expectations, maybe around different types of user rules and workflows, and just the overall size of the software system and complexity of it, versus the need for a handful of people to get their work done on a day-to-day basis. So, it’s something to be aware of through the process. A lot of times, when marketing comes together with IT to go through this type of purchasing process, things can get skewed one way or another based on all of the people that are in the room.

This is a little bit more survey data for you as well. So this is thinking about that idea of distributing authorship. So this kind of goes through cycles within the industry where everything becomes centralized within an organization, and then there’s a push to actually get more authors outside of, maybe, marketing team or the digital team to contribute content to the website. What we found in our recent survey is that most organizations fell into that range of having maybe one to five people in the organization outside of their own team that were contributing content to the website on a regular basis. So again, thinking about what exactly is the complexity that you need, how many people need to be involved with the system itself and realizing where that balancing point is for your needs.

Another thing to think about, looking at what are some of those barriers to being successful with your marketing. Thinking about that very long maintenance phase that you’re headed into after you get through that initial project, what are some of the things that are holding organizations back today? And this, I think, is a pretty interesting chart. Some of the differences between those organizations that identified themselves as maybe trailing their competition versus leading, those that were trailing really were identifying a lack of skills, was one of the biggest things that jumps up there in the middle, around 20% for them. Versus, the leaders felt like that was not something that they were lacking at all, that wasn’t holding them back. They were lacking more things in terms of analytics and reporting, measuring effectiveness and ROI. So, really understanding where you’re at as an organization and how you could lean on a partner to fill in some of those gaps, whether it’s expertise, whether it’s getting the analytics and the data together for you, helping you to be more effective with your budget, looks like it would fit for everybody, really understanding what that win-win relationship is going to look like.

In order to do that, I’ve got a few tips here. The first is to really, thoroughly understand your organization, your team and your goals. Be the expert on you, is how I phrase it. You’re the one that is going to know the best out of the whole process, about what your team is capable of, what you can expect, what it’s gonna look like two or three years down the road, what’s your team structure going to be, what are your organizational goals? That’s something to really get familiar with and be conversant in as you dig into the process, because it’s not just about that first six, nine months, it’s the next two, three years after that that you wanna be thinking through as well. Really encourage organizations to be open to dialogue. So there’s a lot of different approaches to this. Some of them really seem to shut down conversation and I think, from what I’ve heard from folks that have been through this process, is that that can sometimes result in less than ideal outcomes. You’re really starting a collaboration, and so the more that the process can be open to learning and developing an understanding, that can help to you to figure out exactly what is this relationship gonna be like with this collaborator down the road.

An additional aspect to this is to be thinking about that implementation process, thinking about the ongoing process and looking for a process and a partner that can really help facilitate an ongoing dialogue among the many different roles that will be involved. So you’ll have your own team, you’ll have your own stakeholders. There will be a technical team, there’s gonna be content authors, visual designers, user experience folks, content strategists all coming together to make this site a reality. Everything is changing throughout that process. There’s a lot of stuff going on. The more that you can have collaboration in that process, the better the results will end up being. So, really look for ways to avoid one team throwing things over the wall to the other, one vendor throwing things over the wall to another vendor without having some sort of dialogue and collaboration.

This is something we see a lot, especially in very, very formal RFBs from large organizations. It seems to be just part of how they’re oriented. But a lot of the questions end up being, “Can this system…” whatever. You know, “Is there a checkbox that will do this?” basically. “Can the system do X? Can the system do Y?” And that’s great for finding out the blackand-white version, but if you’ve ever talked to a software developer you also hear that, well, of course they can. You know, “We can do anything with software.” It doesn’t necessarily get you the goal-oriented answer that you’re looking for. So, phrasing those questions much more around, “How have you accomplished this thing in the past? How have you helped to grow physician referrals? How have you helped to get more appointments for an organization?” Not necessarily, “Can the system accept appointment requests?” We’ll get more of a collaborative feeling going on, and help both the potential partner and you to have a better understanding of the goals and how they might be achieved through the solution. And if you haven’t heard me say already, plan for the long-term. As you’re thinking about this, as you’re budgeting for it, make sure that you’re really incorporating that thought process that the web just really isn’t ever finished. There’s always going to be things coming up, and moving forward and being prepared to manage that, both from a partnership standpoint, as well as ongoing budgeting and internal resource standpoint. So you can see there is an image there of RFP to relationship white paper that we have. That, along with the, “Is it time to redesign?” white paper are both available. If you fill out the survey at the end of the webinar, you can check off to receive those. We’ll get those into your hands.

So with that, I’d like to shift over to questions, and we’ll stick around for a while and see if anybody has questions that we can answer. And looks like there’s one here. Let me see if I can… So, the question is, “Do we recommend looking at CMS’s that are just within Gartner’s Magic Quadrant?” So obviously, there are a variety of different tools out there that Gartner’s, Forrester, different organizations that go out there and look at different systems. One of the things that’s important to understand is exactly how they identify the systems to put within their map, and how do people get into that. You see some systems that are always in there and some systems that are just never included that. There’s a variety of different ways that organizations actually get their products included in that evaluation. So, those are never gonna be really comprehensive across the industry, but I think it’s certainly worth looking at those as kind of helping to understand the field and what’s out there. They’ll give you a starting point to see some of the different types of tools that are out there. And you know, like I was talking about with understanding the opinionated nature of software, really looking to see, “Okay, how is something like Cycor differently opinionated from Adobe’s solutions, differently opinionated from Episerver or something else that you would see on that Magic Quadrant. They all have a different bent to them, and really seeing that mapped out that way can be a good start to understand what might work for your organization and what might not. And then open that up to expanding beyond just those tools that are listed within those Magic Quadrants or wave surveys, things like that.

So, another question here, “In general, do you recommend going with a CMS that’s not industry-specific?” Seems, from an authoring management perspective, it would be beneficial to go with a CMS that you could potentially use later at another position. So there is kind of a trade-off there that this question is alluding to, between that familiarity and ubiquity, I guess, of things like WordPress or Drupal that are widely used by different types of organizations, versus something that might be more specifically tailored towards the healthcare task. And we work with both ends of the system so, of course, we’ve got our vital site content management system product that is very tailored for healthcare and makes it really easy for users, administrators, authors to go in and manage things like physician records within there that would not necessarily be directly supported by something like WordPress. That would have to be some kind of additional functionality.

So there can be, sometimes, a balance between, you know, a healthcare-specific system that is really set up for the particular types of content that you’re managing, versus wrangling a more generic system into supporting those kinds of content. And a lot of it comes down to the implementation, and exactly how those things tie together. You know, getting trained and understanding how things work in your specific site is going to be important if you’re using a generic solution, or really any solution. Even if you’re familiar with WordPress, you may have a general sense of how things work or where things need to be changed to make an adjustment on the site, but you’re gonna need to know exactly for your site. You know, “It’s using this plugin. This is the admin menu where you go and change this setting, or that setting or this content,” can be very different from site to site. So, don’t have a strong recommendation there. It’s important, like I said, to know your team and their capabilities, and the amount of effort that you’re expecting from them, and I’ll leave it with the, “It depends” kind of answer there.

Moderator: All right. Looks like that’s all the questions that we have for now. So, again, just as a reminder, we have our March webinar are coming up that is going to deal with as SEO. There’s gonna be a lot of great information there. There’s also gonna be…you can also go to Right now, there’s a lot of great information out there already, and you can access any of our on-demand webinars. So, if you have some extra downtime it’s definitely worth taking a look.
Also, again, just as a final reminder that our “2017 Digital Marketing Trends in Healthcare” survey results are available for you to download. So you can go to and download your copy of that data. That’s the book that a few slides referenced. So, that feature adoption versus important slide that was used in here, that came from that book. So, again, if you’d like to download a copy of that, if you don’t have it already. And other than that, thank you guys so much for attending today and we look forward to seeing you in March.

Selecting a Web Content Management System for Your Health System