How can hospitals innovate in the use of social media?

In thinking about social media use by hospitals, I was struck by the innovative actions of Rhode Island Hospital that took Google Glass which was deployed to consumers, and creatively applied the emerging technology to healthcare. Physicians at the hospital use Google Glass with it being the first in the nation application to study its use in real-time bed-side consults.   This story was developed by the newspaper Providence Journal.  They also used YouTube to tell the story. And that is the genesis of today’s topic.

As we have been discussing, and my thanks to all those who have taken the time to share their thoughts in the social media discussion on various LinkedIn groups, social media is little used, but slowly growing in hospitals for patient or healthcare consumer engagement.  For example, Via Christi  is using social media and finding success.

So moving beyond Facebook, YouTube, Twitter and blogs which I would consider to be the basic building blocks and starting points for any social media initiative, how can hospitals and health systems use lessons in social media from other industries to engage the healthcare consumer and patient?

Consider the use of Foursquarefor example. It’s not just a location service that connects to a person’s Facebookand twitter account. It’s a useful tool for business to drive customers and engage the customer.

The other day I was with the family eating at Chili’s Bar and Grill and used Foursquare to check-in. No sooner had I done that, I received a message from Chili’s thank me for dining there and provided us with a free appetizer as thanks.  Then a short while late I received another text message from Chili's asking what they could do for me that day?

What does this have to do with healthcare and healthcare consumer engagement?  A lot.

Whether the hospital or health system or any healthcare provider realizes it or not, they are on Foursquare.  The consumer can add any business they want with a review as well.  Maybe the healthcare consumer statement will be good. Maybe it will be not so faltering. But it will be out there every time some checks in at the healthcare location with Foursquare.  

Beyond that little ditty, here is the Foursquare application to healthcare.  

What if when someone checked into one of the hospital or health system network locations, they received a welcome message?

What if the hospital or health system, was following patients and healthcare consumers on Foursquareand when they checked into a restaurant, sent a wellness message with tips or ideas on ordering from a menu for healthy eating? That is technology driven by the way and someone in the marketing department doesn't have to manually send a message. It’s really 24/7 engagement.

Or when a person checking in fitness clubs a message that encourages the person to continue their efforts at a healthy lifestyle through exercise?

What if the hospital or health system was actively managing its presence on Foursquare and was using that opportunity as a marketing channel for engagement in a host of other areas?

These are just a couple of small ideas on using one aspect of social media. But if the hospital or health system is not engaged and innovatively using social media, you can bet the healthcare consumer is wondering why there is so much silence.

Where should a hospital start the social media effort?

I say start from the easiest and move progressively forward into more sophisticated social media platforms.  It would be easy to bite off more than one can chew in social media. After all, with the availability of more than you can imagine social media outlets, an organization could pick too many the first time out and fail at all of them.

The most important point, and I really cannot emphasis this enough, is that social media is not a mechanism for being a billboard for hospital programs and services. Social media is a platform and medium to engage the healthcare consumer in order to create a meaningful engagement dialogue. A dialogue that is transparent, meets the healthcare or patients needs, provides meaningful information and enhances the experience with the hospital or health system.

But let’s start about what not to do. That can actually be more important than doing.

Sometimes a story is the best way to learn.   There was a hospital that will remain nameless, that I was following on Facebook. It wasn’t the most engaging or enjoyable experience.  The hospital postings were all about them. Nothing about the value brought or even the reason why a healthcare consumer or patient for that matter would actively engage with the hospital. 

The crowning moment came one day when the hospital marketing department posted a picture of the marketing staff, standing behind a table full of marketing communications award trophies for various campaigns and activities. In the end all it did was loudly proclaim as well as the content provided, look at us. It’s all about us.

Really? And the point of that Facebook post was? I hate to tell you this but the healthcare consumer doesn't care.  

So please, when you start the social media program to engage the healthcare consumer, try to control the organizational impulses of leadership who have little understanding of social media  and marketing.  Things like this only devalue the brand and make an organization look foolish.

Now it’s time for what to do.

These five steps taken sequentially can get the hospital started in social media. As experience and expertise builds you can expand.

1.       Understand organizationally that social media is alive. It is not static and unchanging. Social media platforms change and evolve on a constant basis. This means the organization has to monitor to see what people and competitors are talking about and sharing. Build internal support and educate the entire healthcare organization.
2.      Do the market research. If you don’t know what social media platforms the healthcare consumer and patients are engaging in, then how can you decide what social media platforms to choose? Oh, and because one may engage in social media, that is a meaningless experience to use as a basis for program decision making. Know the audience. Know the markets. Know what information the healthcare consumer is searching out. Know what social media platforms they use to gather information and engage. Secondary research may give one clues in how to proceed with primary market research in the hospital service area, but these are guides only. 
3.      Build a social media plan that is integrated into the overall marketing plan and strategy of the hospital or health system. Include in your plan, goals and objectives, key messages, engagement strategies. How it will be measured and evaluated and who is responsible for executing the plan. What gets measured gets done. Obtain executive by-in. If leadership does not support the plan or is not engaged in the effort, stop now and go find something else to do.
4.            Don’t boil the ocean. An organization has to build capacity, experience and expertise in social media.  Start with one platform. Be the best you can be on that social media platform and then expand and add capacity. Learn what the healthcare consumer likes and doesn't like. Test messages. Test engagement strategies.  Fail fast and become the learning organization and not repeating the same mistakes.
5.           Engage and build a meaningful relationship with the healthcare consumer. Stay away from meaningless fluff and anything that looks like it’s all about the organization. And listen. Listen very carefully to what is being said in social media and responds accordingly.

Okay, time to get started. The market is changing and the hospital is being left behind.

Is social media in hospitals easy?

Last week I wrote about what don’t hospitals  get  about social media. This week’s topic, is social media in a hospital or health system easy,  is about some ideas to re-energize and move forward with a social media program.

In hospitals and health systems, it really comes down to three questions to be answered. First, is there an organizational understanding  standing of the power of social media to engage the healthcare consumer and patients and its place in the annual marketing plan? Secondly, do you have the marketing  talent  to construct, execute  and evaluate the effort? Finally, can marketing resources - capital and human, be allocated to the social media program?

I am not going to debate whether or not a hospital or health system should or should not have a social media program.  That train left the station a long time ago and its catch up time for healthcare organizations.  But, if you can’t answer all three question positively, then you have some basic ground work to do before you move forward.

In the new world of healthcare where price, quality and a newly insured healthcare consumer paying more out-of-pocket costs for healthcare, social media represents an opportunity that can be used advantageously  to meet healthcare consumer’s and patient’s for that matter, demands for better direct engagement and experience.

Social media is an opportunity for establishing a one-on-one relationship with the patient, aka the healthcare consumer, directed by the healthcare organization that breaks from the pack, by creating an  experience that is memorable and can exceed an individual or families experience and expectations.

When you have constrained marketing resources, and you have to have a continuous presence in the market place to shift healthcare consumer’s attitudes, preferences and choices, a social media strategy that is fully integrated into the marketing plan and the healthcare organizations can achieve that end for you.

Follow these steps and you're on your way to developing and implementing  a strategically-focused, comprehensive and fully integrated, organizationally transparent social media strategy:

1. Strategy first, tactics second. Any old road will get you to where you want to go without a clear identifiable strategy. This is no different than a traditional marketing approach. Integrate the tools and techniques of social media  into your overall marketing efforts.

2.  Be clear about  your messages and what value using these tools will bring to your healthcare consumers.  The purpose is to engage in a dialogue not shout at them.  You have to understand what type of information and content your consumers want.  Without that knowledge you can say whatever you want, but chances are no one will be reading, responding or listening.

3. Take an integrated approach.  What goes on your web site is also on facebook and used in twitter to drive traffic to you.  Twitter is a great way to send out links for health related articles or news and information.   Have a video? Post it on YouTube. Writing a healthcare blog? You should be if you're not. Make sure twitter, facebook, YouTube, flicker etc follow you buttons are on your site. Running  Back-to- School, Sports or Camp physicals? Put it on twitter, facebook and even those coupon sites like Groupon. Holding a health and wellness event, ditto.

4. Use QR codes with your web site or specific page links or phone number embedded  in them to drive them to your site, call center or service line. Through the use of QR codes you can make your print and traditional activities social in nature.

5. Remember at all times your are building brand, perception and experience. This just isn't nice to have, people will remember what you say and do.  Be right the first time.

6.  Devote resources, budget, time and personnel for the task.  Your challenge is to keep in front of your audience with relevant information, all the time.  Attention spans are short.  If someone sees no changes on a pretty regular basis in your content or information, they will fall away.

7. Measure everything.  Evaluate.  Adjust based on your findings.

8. Be creative, don't limit yourself to the tried and true or what a competitor is doing. Be an innovator.

9. Use social media with your physicians and employees to communicate, build organizational support and loyalty.

10. Build excitement around what you are doing.

The budding  healthcare consumer and patient of today is social media savvy and networked to the nth degree.  They expect the same of you.

What don’t hospitals get about social media?

When I was reading the February 2014 issue of Hospitals and Health Networks, I came across a gatefold insert “Social Media What Your Hospital Should Know”.  I found it mildly interesting and a superficial treatment of an important topic.  But beyond the simplistic steps provided at best , what struck me were the following statistics reported  in the gatefold for hospitals;  1,292 have a Facebook page; 1,090 use 4Square; Twitter comes in at 998;, 716 for YouTube; and only 209 blog. The source is listed as “Health Care Social Media List,”Social Media Health Network, Mayo Clinic.

Really? Maybe it’s time for hospitals to get with the changes in the market.

I have written a lot about social media over the past few years. I guess it’s just falling on deaf ears.

A social media healthcare consumer engagement plan and platform isn’t a nice to have, or one to take a caviler attitude of “oh that’s nice”. Not having an active and engaging social media platform is costing revenue.  That’s right; lost revenue.  

Understand, 43 percent of healthcare consumer use social media for information gathering to make choices about which medical provider they will use. The healthcare consumer is also the new paparazzi and saying what is good and bad about the hospital.  And more often than not, it’s not good.

So what are the implications of not having an active and engaging social media program?

The healthcare brand is at risk. The organizational reputation is at risk. Utilization from revenue is at risk because the shift from production of care to risk and value based reimbursement will take time. The ability to attract high caliber employees is at risk. Patient engagement strategies are not as effective. The healthcare consumer’s experience suffers as well to name a few.

And the great lie in healthcare for not doing this is HIPAA.

It’s simple really; you do not put identifiable patient information on social media. End of the discussion. And if someone does, they are gone.  Period.   HIPAA does not preclude an organization from having an engaging and active social media program.

Social media is more than a marketing and communication channel. It’s about building relationships by engaging in a two-way conversation with the healthcare consumer, who at some point would generate revenue and for enhancing the experience. Social media can even assist in keeping a patient in network so you can decrease leakage.

I am not going to answer the question of  how to create a social media plan or platform that is fully integrated into the organizational marketing, engagement and experience plans. 

But if leadership is sitting back and asking that question, at least there is a glimmer of hope in beginning to understand they don’t know what they don’t know.  If leadership is not asking that question, then leadership is probably in a world of denial thinking he or she has the answers and knows all about social media

.

And to those in the second category I say, best of luck in surviving in what is evolving into a semi-retail, healthcare consumer driven market.

How are you retaining and engaging the healthcare consumer?

The financial stakes have never been higher as healthcare change steamrolls along. There is the growing and choice confident healthcare consumer demanding price and quality data. Reimbursement declines in Medicare and Medicaid continue unabated. Then there is the shift from fee-for-service to risk-based payments and new care models appearing nearly every day resulting in inpatient utilization declines.

And all of this has the greatest effect on how an organization engages and retains in network the healthcare consumer across a wide variety of touch–points, encounters and channels.

You know the old adage, it costs five times as much to find a new customer than to keep an existing one. 

It is truly a new day in healthcare.  Patients are becoming highly informed consumers making purchase decisions based on price and at some point will be utilizing quality data in that process.    

So what does that mean for the healthcare provider?  Without strong healthcare consumer engagement and retention strategies, the financial ramifications of losing the healthcare consumer to other providers and seeking care outside of the network can be ruinous.

This means that one needs to understand the healthcare consumer as never before, anticipating their needs by being proactive in establishing a meaningful relationship with a consistent stream of two-way communication.

It is an opportunity to reinforce your key brand promise and messages.

It's an opportunity to create customer evangelists for your healthcare organization, which through word-of-mouth marketing will bring additional healthcare consumers and revenue.

Here are five items one should consider for proactively retaining and engaging the healthcare consumer:

1.) Transparency and Quality dashboards.  This is about improving care, using best practices, learning and improving as a system to the individual level by engaging the patient.  A provider must be prepared to provide individual level utilization and quality patient reports, to engage the person in a meaningful way to create change in health behaviors, and foster appropriate utilization of services in the right setting.

2.) Voice of the Customer (VoC) program.  One has to be in constant contact and monitoring member attitudes, beliefs and reactions.  It's all part of the patient experience program and process. Engagement and retention strategies are all based upon the needs of the healthcare consumer, not the organization.

3.) Understanding the ongoing customer experience management program and process.  This isn't just about delivering an exceptional customer service at the point of care. You must identify all customer touch-points, from beginning contact to end point, and manage that experience across all of those touch-points. 

  

4.)  Developing comprehensive member communications that are transparent, meaningful and drive engagement customized to the individual level. This is really ongoing communications beyond health and wellness tips. They must also be delivered the way that the member wants them, be it on an Ipad, member web portal, email, hard copy, direct mail, telephonic etc.  One size does not fit all.

5.) Engaging the healthcare consumer through social media. Social media methods in engaging and retaining the healthcare consumer as a customer are nearly immediate and regardless of age group or demographic characteristic are growing exponentially.  Failure to include the social media channel in the organizational engagement and retention strategy is well, inexcusable.

With so much on the plate of healthcare leadership in trying to survive, healthcare consumer retention and engagement can appear at the bottom of the list. Going forward in the brave new world of healthcare consumerism, it’s one of the new critical essential business mandates whether one realizes it or not. To engage and retain is to survive and grow.

Happy Birthday to Healthcare Marketing Matters! On February 17, 2007, I started writing Healthcare Marketing Matters blog, and it hardly seems like HMM should be seven years old. But it is with hundreds of post and tens  of thousands of page views, here’s to the next seven years.  Thank you for reading, commenting and working so hard day-in and day-out to make healthcare marketing more strategic and visionary.  

How is healthcare consumerism changing provider marketing?

Technological and care delivery innovations, specialty pharmaceuticals, social media influences, data releases on price and quality, the healthcare consumer sending more out-of-pocket and exhibiting consumeristic behaviors in insurance choices and provider section, have come together to create the perfect storm.

How has this affected healthcare provider marketing?

It's a tough balancing act when an organization has never really marketed in an evolving semi-retail healthcare market, or communicated with the healthcare consumer in meaningful price and quality terms. Terms that grow your brand, build stronger customer connections and answers the question, what's in it for them?

So why should this be on leadership’s radar screen, as if there isn’t enough to worry about already?

I can give you five reasons why:

1. Retail medicine; 2. Price competition; 3. Newly Insured; 4.Consumer choice; 5. Social media.

These five market shifts are changing how healthcare organizations will do business. And if healthcare marketing is not changing, then what follows are the critical steps you need to take to leverage and move ahead to survive and thrive in an increasingly tough market.  

1. Market Research

Do the research on healthcare consumer behavior, what motivates them, how to communicate with them, how they make purchase decisions and price points they are willing to accept. Healthcare consumerism screams for market research. It's about the healthcare consumer, their needs, expectations, experience and engagement.  And thinking you know about them is not the same as having the quantitative date that knows them.

2. Business Savvy

Make the healthcare marketing department business savvy. Out with the marketing communications focus, and in with a data driven ROI marketing coupled with an understanding of finance, project management, and operations so that the marketing can be transformational. Going from saying "we care and provide world-class care" to building brand, engagement and experience as well as measuring that change in real terms requires a deep understanding  of the organization on many levels in order to be successful in the market.

3. Resource Commitment

Healthcare providers must resource marketing appropriately in capital and human terms in order to compete with retail medicine and pricing competition. Engage the healthcare consumer in a meaningful way and improve their experience. Build your brand and increase awareness. Presence builds preference. It cost money to accomplish market growth.

4. Agility

Be nimble. Be agile. Be quick.  Keep repeating that over and over again. Healthcare marketing needs to move from the tried and true to the exceptional, the innovative, the engaged and the motivational. One can't reach the healthcare consumer on an emotional level to make the right choices, treatment, lifestyle and purchase decisions in your favor unless you are sufficiently engaged.

5. Integration

Integrate your marketing plans deeply within the organization. The healthcare consumer is at the center of all that you do. Pay special attention to social media. Social media is not a billboard but an efficient and effective engagement strategy that enhances all the other marketing channels you use.

6. The multiplicity of markets and patient mechanisms

Not everyone will be in an ACO or a patient medical home. Not everyone will have employer sponsored insurance. Some won't have health insurance of any kind. Not everyone will be in expanded Medicaid programs.  Small business may decrease employee’s hours to not have provided health insurance.  Large employers are creating private HIXs and moving to defined contribution. Baby Boomers are demanding a healthcare experience the way they want. And retail medicine is here to stay and will expand.

That light at the end of the tunnel is healthcare consumerism and that Walgreens ACO has come to a location near you.

Can 2014 be the year of healthcare marketing ROI?

With the start of the Chinese New Year and it’s the Year of the Horse, why not make 2014 the year of healthcare marketing ROI? As we all face increasingly reduced marketing resources both human and capital in hospital, health systems and other providers, the only way I know to even begin to turn that around is by proving to the organization the Marketing Return on Investment or ROMI.

It’s not the impossible task. And it does involve a high degree of collaboration with the finance department.

Depending on the type of health care organization that one is employed by the measures will be different. For example, if the healthcare organization is sales drive, then measure the generation of Marketing Qualified Leads, Sales Accepted Leads, and based on that increases in the long and short term funnel compared to YOY. Any organization using email can measure click through rate, open rate, unsubscribed rates, open rate and downloads. For hospitals and health system if you have the right systems then you can pull integrated clinical and financial databases by campaign to calculate the ROMI.

Below is an example of an actual computation that I completed for a multi-hospital health system. Now that being said, I did have the good fortune to have an RN staffed call center which was used heavily in all campaigns.  And because the call center and finance systems were linked, once you have that name then you can track and determine the customer value, revenues generated and a return on investment ratio.

The method can be adapted to any campaign and provides you with the data fields and logical analysis you need.  This is not prohibited under HIPPA, so that is not a reason to say no can’t.

An analysis was undertaken to look at the ROMI of the Physician Referral Call Center. The analysis matched a database of call center name records for the period to financial records which had already been downloaded.  The analysis produced the following results:

      9,102 call records were matched with utilization and financial data.

      9,102 calls resulted in a total of 9,121 encounters in the ER, Inpatient and Outpatient categories of service.

      751 encounters were ER

o   177 returning encounters

o   573 first time encounters

      1,105 encounters were Inpatient

o    530 returning encounters

o    699 first time encounters

      7,267 were Outpatient

o   2,014 returning encounters

o   5,253 first time encounters

      Total charges for all encounters equaled $22,522,649

      Charges for new encounters all services totaled $16,085,198 or 71 percent of the total charges

      Average charge per ER encounter  $1,304

      Average charge per  Inpatient encounter $13,581

      Average charge per Outpatient encounter  $903

      Gallup measures loyalty at 68 percent (would return for service) which means that for every 100 patients 32 would not return for care- therefore:

o   ED- 57 returning encounters captured that would not have returned

o   Inpatient – 170 returning encounters captured that would not have returned

o   Outpatient- 645 returning encounters captured that would not have returned

      Incremental charges counted returning encounters not loyal

o   ER - $74,337

o   Inpatient- $2,308,851

o   Outpatient-  $582,505

o   Subtotal charges counted:  $2,965,693

      Overall market share in primary and secondary service area is 14.53 percent. The number of first time encounters have utilized us above market presence is therefore:

o   ER 573 first time encounters,  83 not countered, 490 counted –

o   Inpatient – 699 first time encounters, 101 not counted,  598 counted

o   Outpatient – 5,253 first time encounters, 763 encounters not counted, 4,490 counted

      Based on an overall market share of  14.5  percent the  incremental charges counted for new  encounters not because of market presence:

o   ER - $638,960

o   Inpatient – $8,121,438

o   Outpatient –  $4,054,470

      Total Charges counted: $12,814,868

      Discount from gross charges for Medicare, Medicaid, Managed Care, Bad Debt and Charity Care @ 65% is $8,326,644

      Net Revenue:  $4,488,224

      PRCC program costs:  $233,410

      Net contribution:  $4,254,814

      ROI 18.22:1

Let’s make 2104 the year of return on marketing investment in healthcare.