From Events Planner to Strategic Partner

1. From Events Planner to Strategic Partner WHPRMS Fall Conference Sept. 13, 2007 Kathleen L. Lewton, MHA, APR, Fellow PRSA Principal, Lewton, Seekins & Trester

2. Blogs Podcasts DTC ads PR Websites VNRs “Traditional” press Webinars Buzz marketing Social marketing Brochures Celeb spokesperson Special events Billboards Mascots Mobile vans Refrigerator magnets! Today, it’s all about TACTICS

3. But as Sun Tzu wisely said: “Tactics without strategy is the noise before defeat.”

4. Of course he also said: “Strategy without tactics is the slowest route to victory.” We aren’t anti-tactic. We’re just pro-strategy, as the foundation for successful tactical execution.

5. Today we’re talking “pre-tactics” • How to scan and span the healthcare organization’s external environment • How to use a strategic approach to make PR a critical function within the HCO • A.R.M. -- three key first steps for a strategic communications plan • And how these three steps are the foundation for a communications plan that does include tactics

6. What’s out there? Scanning the External Environment • If the communications operation isn’t taking charge of environmental scanning as part of taking a lead role in organizational strategy planning… • WE SHOULD BE!

7. Doing the scanning. . . . . • Having a structure in place to systematically • Review what is happening in the healthcare environment, • Determine its implication for the organization • Recommend initiatives and strategies in sync with the organization’s business plan.

8. . . . . . And owning the role • Means that communications becomes a major force within the organization’s strategic business planning. • And becomes a major contributor to the organization and its bottom line.

9. With that in mind . . . . It’s only appropriate that we begin with a quick scan of “Healthcare 2007” OR Caught in the Campaign Crosshairs

10. Barak, Hil, Rudy and the rest agree:Healthcare makes a GREAT target! • And when the industry’s reputation is at an all-time low, the target’s more tempting • We used to take turns wearing black hat • Now, we’re all in the same barrel • Inefficient, life-threatening hospitals • Greedy doctors • Unethical pharma and device companies • Black-hearted insurers

11. It’s dog eat dog • In an era of shrinking resources, competition is at an all-time high • Within the industry • Within the HC systems • Within communities • Within the company • Every sector of the industry is pitted against the others so that instead of waging a united battle for adequate financing for health care for all – we all fight over the scraps

12. Greyer, fatter, sicker • An aging population, yes • But the new oldies – the boomers – refuse to age and demand solutions from the HC system • Stents, knees, hips – keep ‘em coming • Obesity truly an epidemic • Newest study – kids’ BMI already leading to increased LV Mass • Medical science means once fatal diseases aren’t • Chronic disease burden terrifies employers

13. Account-ability • It’s not just costs – it’s who should pay • Payors shifting as fast as they can • Workers/unions accept inevitable • The uninsured flood the ERs and we all pay • Payors – biz and government -- demand quality and quality measures that can be understood • Development of tiered plans for reimbursement???

14. Talking Tech • Technology seen as CRITICAL variable, but there are issues • Development funding • Technology affordability • Technology competitiveness • Capital demands for acquisition • Device development

15. Info Challenges • Medical record keeping and transmittal • HIPPA challenges • Communications expectations increased all around • Physicians, nurses other staff • Patients • Internal communications • Community support

16. May the (work)force be with us • Staffing issues loom large • Do we have enough of the right kind of physicians and are they were the patients need is greatest? • And will all the good ones retire or become hedge fund analysts? • Not enough nurses – and way not enough nurse educators • Job stress exacerbates staff turnover in almost all job categories

17. The watchdogs bare their teeth • Regulatory environment is more challenging • From FDA to JCAHO, regulators respond to consumer demand and politicians’ rants • Legislators on both sides of aisle, in DC and state capitals, see Medicaid and Medicare as ripe for budget cutting

18. Consumers in demand – and demanding • “Empowered?” • Yes, no, maybe, sometimes, it depends • Seek info . . . . . . to take to doc • Paying more, trusting less • “Now I don’t know if my drugs are safe!” • Don’t understand  don’t comply • Knowing more  behavior change

19. Physicians confused – and confusing • Frustrated, angry, fed up • Less control, even less RESPECT • More and more data, less and less time to grasp it • ALLHAT: “Doctors have little time to read medical journals” • Public M&M stats change behavior --for the worse • Tarred with same brush as Rx sales force

20. Control is key • Who is in charge here? • Teaming in an unteamed world

21. And yet . . . . . • There are many more issues and challenges • What does it all mean? • And what do PR people DO about it?

22. Clearly HCOs need to change . . .

23. But there’s a slight problem: • Frustrated employees see volume growth and cost containment as more work/less pay • Fed up payers see adequate payments and volume growth as eating into THEIR profits • Resentful doctors see volume growth as added competition • Legislative reformers see a big target for the coming elections • The key question: How do we manage relationships to get what we need from these stakeholders • Hint: Can you say “public relations?

24. SO . . . . . • How do we get a seat at the decision-making table to help solve the problems and address the challenges?

25. The answer lies in strategy • Stakeholder relationship change is a strategic issue dependent on but not 100% driven by good PR • The HCO has to change, too • But PR can be a driver of management behavior change and an advocate for effective stakeholder relations IFwe have that seat at the table • And to get there, we have to be seen as strategic in how we work – and as contributing to organizational strategy

26. So first, think like a strategist • The key step is to focus on OBJECTIVES • If we understand the desired outcome, we can figure out the key audiences and how to move them to action • SO, why do we need this ad/brochure/campaign? • Increase “awareness” – why? • Increase volume of procedures • Increase inquiries as first step to an appointment • Change perceptions of poor quality • Increase donations, employment applications, physicain referrals, etc.

27. One we know the objective . . . • We can create a plan with an outcome that can be tracked, monitored and measured • And measurement is critical • Not everything can be measured precisely, but most things can be counted • Calls, inquiries • Appointments • Changes in awareness, perceptions • Donations • Etc.

28. Ask the right questions • Who do we need to reach? • What do we want them to DO? • What do we need to say? • How do we need to say it? • When? • How often? • How do we measure success? ROI?

29. Also, PR strategy must map to corporate strategy • Which corporate goal does this initiative (campaign, ad, brochure, etc.) support? • If the answer is “none” or “I don’t know” – how do we justify spending time on it?

30. Selling your strategic capabilities to management • Everybody’s fighting for: • Control and/or • Resources • PR can be seen as an adversary for both • Or as overhead that eats operational resources • They may not like me, but how can I make them NEED me?

31. Focus on THEIR concerns • Align strategies to THEIR metrics • Give them fresh strategy, not more product • Interactive Web • Call centers • Personal communications skills

32. Become a valued partner • Treat peers as customers or clients – literally in terms of operations, and attitudinally • Help them re-engage their employees and physicians • Help research THEIR interests • Plan collaboratively and take them seriously • Solicit and act upon candid performance feedback • Defend them • Criticize honorably (behind closed doors)

33. And show them that PR operates with a very structured approach…

34. The ARM Approach Identify the right Audiences Use Research to understand, test Create Messages that deliver results

35. Using ARM means beginning with O • Once again, what’s our objective? • What audience do we want to do what? • It isn’t grammatical, but it’s the key question • Once we know that, we can ARM ourselves for success!

36. Strategy starts at A – for Audience • Solid strategies begin with a thorough and deep understanding of who the organization’s key audiences are • It’s not enough to focus only on the target customer audience for a specific product or service – it has to begin with a 360 view of every audience that’s out there, watching and listening • Because they all can have an impact, pro or con, on the target audience

37. Patients (when they’re sick, consumers when they’re not) Families, “caregivers” Physicians, surrogates Legislators, regulators Employees Shareholders Media Stakeholders Supporters Critics Influencers/Info Givers Advocates Disease groups Clergy et al FRIENDS AND FAMILY HCOs have a myriad of audiences:Customers, Influencers, Stakeholders, CriticsALL are important, ALL overlap & overhear

38. When creating marketing/PR strategies, every audience counts • The marketing questions: • Q 1: Who makes the final decision? • Q 2: Who impacts the decision? • The reputation question: • Q 3: How will other audiences react?

39. Q1: Who makes the final decision? • The myth of the “empowered consumer” • Empowered? Yes, . . . and no • Some are, many are not • Even web searchers download the articles and take them to “my doctor” • Only 31% of heavy users (over 65) go online • Hospital choice -- “where my doctor goes” • Sophistication overrated -- witness the demise of whole-body scan centers

40. Consumer role varies widely • Decision maker – sometimes, when there are no constraints • Active participant – the self-confident • Influencer – asks question, expresses self • Order taker – many still are, limited by: • My doctor only prescribes, my doctor only practices at . . . . • My insurer only covers, my insurer only pays full price for . . . .

41. Q2: Who influences decision? • The doctor, of course • But also the office nurse, the PT, other HCPs • The insurer, both directly and indirectly • Advocacy groups (depending on Dx) • Unexpected sources – clergy, other trusted sources • Still significant, still overlooked too often: FRIENDS AND FAMILY

42. Slogging through the audience ID process can be a struggle • Too often service line managers and product marketers want to default to consumer promotion • Identifying who really makes and impacts purchase decision can be like peeling an onion -- takes a while and can be painful • BUT focusing on the wrong audience -- or ignoring a key participant -- can lead to “less than success”

43. In general: • The more sophisticated the decision, the less confidence the consumer has • Choosing an ortho surgeon vs. demanding a specific brand of hip implant • It’s important to know what factors impact YOUR consumer audience • CEOs/administrators/marketers tend to overestimate consumer “empowerment” • Doctors tend to underestimate it • To know for sure is to ask, via research

44. Q3:How will other audiences react? • Never forget that any marketing or organizational decision is observed by “non-targets” • Messages are overheard and can be misunderstood unless the impact on these audiences is considered

45. Research shapes strategy, provides essential insights • The 3 A’s of research: Don’t Assume, don’t Adapt – ASK • “Oh we KNOW how they feel” • “They did this in Birmingham” • “It worked for Coke” • Research not only provides insight into target audience, but also creates benchmark against which to measure

46. The methodology mix: • Consumer research -- the more qualitative, the better • Surveys -- hard #s, but no context, nuance • Focus groups and personal interviews allow you to probe, ask why and what if • What you want to know: • What they know and how they know it • How they receive and process information • What they care about, worry about • Who & what impacts healthcare decisions

47. Research:Critical tool to learn how to impact audience behavior • Physician research -- hard to come by, but invaluable • Key questions: how do you get info (channels), who do you trust, what do you believe • Check the “surroundsound” effect -- who also plays a role in MD decisions • Personal interviews help avoid the “mob effect” in MD focus groups

48. The ideal methodology mix: • Focus groups and personal interviews ↓ INSIGHTS • Surveys (phone, online, intercept) ↓ DATA • Focus groups and personal interview ↓ CLARITY

49. Research also critical for Message development and testing • The reason many marcomm campaigns fail is simply because the message doesn’t work, for one of four basic reasons: • They don’t understand it (Comprehension) • They don’t believe it (Credibility) • They don’t care about it (Relevance) • It doesn’t touch their emotions (Resonance) • C2, R2

50. Comprehension – do they get it? • HCOs are huge abusers of jargon • Acronyms, science terms, insider info (Magnet) • And we pile on the FACTS, FACTS, FACTS • Plus the “average” consumer audience includes: • Illiterates • Semi-literate • Anti-literate • Low vision skills