Webinar: How marketing and brand can drive the trajectory of health systems post-COVID

Full Transcript below:

Adam Rubenfire:

Welcome. My name is Adam Rubenfire, and I’m thrilled to introduce today’s Modern Healthcare custom webinar: how marketing and brand can drive the trajectory of health systems post-COVID. During this webinar, a panel of three leading CMOs will discuss the steps that they are taking to drive positive outcomes for healthcare systems in this new era. Before we get started, we’d like to thank our sponsor, BrandActive, and offer some brief housekeeping notes.

Adam Rubenfire:

We want this webinar to be an interactive experience for you our audience. You’re encouraged to ask questions using the questions pane in your go to webinar attendee panel. Our speakers will try to address as many of your questions as they have time for. Should you need any assistance during the webinar, please don’t hesitate to contact us via the questions pane in your attendee panel. And now it’s my pleasure to introduce Philip Guiliano, a partner of BrandActive. Philip, the floor is yours.

Philip Guiliano:

Great. Thank you, Adam. It really is a pleasure to bring such a great plan together for modern healthcare. As Adam said, I’m Philip Guiliano. I’m a partner at BrandActive, former engineer, org change consultant, and now about 14 years into my time here at BrandActive. For those of you that don’t know me or don’t know BrandActive, just some context is that BrandActive really focuses in on the financial analysis and the logistics of rebrand implementation and marketing operations.

Philip Guiliano:

So really what that means is if there’s M&A, if there’s rebrand, if there’s partnerships, things of that nature, we do all the scoping, budgeting, and cost analysis planning and implementation of that to make that an efficient program. And then we also look at marketing operations when there isn’t a big change initiative to really drive efficiency and refocus resources on things that really drive strategic value.

Philip Guiliano:

I only share that to share that that’s the lens that I’ll be bringing to the panel as the moderator today. And I’ll also say with really thank you all for choosing to spend your time with us. I know that all of us are busy, probably most of us more busy than we’ve ever been, so thank you for taking the time. With the group that we have gathered here, I think you’re going to get some really good insights and some good takeaways.

Philip Guiliano:

So, with that, let me go ahead and introduce the panel. So, we’ve got Jigar Shah, SVP and chief marketing officer from Providence. Hi, Jigar. We’ve got Nick Ragone, executive VP and chief marketing communications officer from Ascension.

Nick Ragone:

Hi.

Philip Guiliano:

And Amanda Todorovich, Senior Direct of Content at Cleveland Clinic.

Amanda Todorovich:

Hello.

Philip Guiliano:

Excellent. So from an agenda perspective, really quickly, we’re going to be talking about three main topics: how healthcare systems are building perception to maximize brand impact, new ways that organizations are looking to marketing to drive better business outcomes. This is more of a how are we collaborating differently within the organization and relying on each other to drive business results? And then also thinking about how have our internal priorities, or the way that we’re looking at our internal operations shifted in order to refocus our resources? Think about technology, process, repeatability, that kind of stuff for short and long-term strategic and financial value.

Philip Guiliano:

So we’re going to begin our conversation on the brand side of things, and I thought it would be good to just share some slides with you around some research that we got from Binary Fountain and also from Edelman. For those of you that don’t know Edelman and their trust barometer, it’s, I think, by far the best and the most respected global measurement of trust. This spring readout that they did surveyed the general population of 11 of the world’s largest economies to ask them to rate their performance of the institutions in responding to this crisis.

Philip Guiliano:

This research took place in the middle to the end of April of this year. So starting in general, really important to see that across government, business, NGOs, media, et cetera, the trust of these things are at all time highs for the period shown here, 2012 to today. Interesting of note is government is the most trusted of these four. That’s the first time that’s ever been the case. Little split in that is local governments being a lot more trusted. That trust has really increased it. National governments, not so much. That’s actually [inaudible 00:04:37].

Philip Guiliano:

Just setting the stage. Now let’s look at healthcare. Healthcare in a five month period has seen an eight point jump. It’s the largest jump that Edelman has seen in this, and that’s obviously really great. But also coming with that comes quite a bit of risk as well. Short-term increase in trust can also lead to very rapid disappointment if for some reason that trust is not leveraged, not built upon, not delivered appropriately, if there’s some sort of betrayal, that kind of stuff.

Philip Guiliano:

Really great. You guys are at the front lines. You’re out there in this crisis. It’s very reasonable that there would be a massive increase in trust, but it also comes with a lot of responsibility and a lot of risk. So breaking that down into hospitals, pharmaceutical companies, biotech, you can see health systems at 81% trusted. It’s phenomenal. Pharmaceutical companies… Healthcare systems typically lead the overall trust within the healthcare sector, but to be at 81 is a massive jump. Wanted to share that breakdown real quick.

Philip Guiliano:

Breaking this down also into who do we trust. Doctors, scientists, national health offices, that kind of stuff. Those are the most trusted and there’s some interesting opportunities in that. So having doctors out front, having doctors and scientists lead this messaging, that’s all very important. Having them be the spokespeople for the company, announcing updates and breakthroughs, and fighting COVID, that kind of stuff. And then on to our fearless leaders.

Philip Guiliano:

This is the CEO trust barometer, which basically says there is very high trust in our CEOs and they’re doing a really horrible job, which is an interesting sort of dichotomy there. Going back to the previous slide really quick. Who do we trust? Doctors and scientists. So where is the opportunity? Many CEOs are formerly doctors and scientists. So is there a different role that they could play? And also is there a role that they can play internal to the organization to engage with employees more, so that the employees understand what the CEO’s role is, how they’re helping to maintain financial viability, and how they’re really driving innovation?

Philip Guiliano:

All good data points, I think, to just set the stage on where are we today. Tangible action is needed. Health systems must protect the trust that they’ve earned. This speaks to the risk element. Really engaging employees, being a source of trustworthy information. Johns Hopkins has done a great job with that. Really being a source of that is huge, and then continuing to prepare for uncertainty and risk. None of us know where this is going to go. So how we set contingency plans and really put ourselves in a good position to maintain that trust and keep moving forward?

Philip Guiliano:

Any element of that there, if anyone wants to know more, Laura [Bottlefield 00:07:45] at Edelman leads the study. She has a specific focus in healthcare as well. So if you want to know more about this, I just wanted to give a shout out to them. We really thank them for providing this data just to lead us into this discussion. And then finally one more slide looking at Binary Fountain’s survey of three hospitals and health systems. Where are we spending our time? Not a surprise. Lots of time spent on crisis communications in COVID.

Philip Guiliano:

Another interesting thing is the decrease in brand investment. And I think we’ll touch on that here as we get into the round table discussion on whether or not that is necessarily a prudent thing to do. So with that I will… Whoops. One slide too far. I’m just going to go to our panel there. All right. So starting with you, Nick, I’m curious. As you think about what’s occurred over the last four to five months, is there any insight that you can share with the group around how you guys are approaching brand, thinking about brand perception, advice that you would give on how to handle this internally or externally within the organization?

Nick Ragone:

Great question. Thank you, and thank you for inviting me to be a part of this, and welcome to the fellow panelists and attendees. I found that stat interesting, the last thing you showed. We’re spending more time obviously on issues crisis management, which is not a surprise. But the part about brand being less significant or less investment, I actually think, and the numbers are borne out in the Edelman trust survey when you look at hospitals and provider systems having a huge leap.

Nick Ragone:

We do our own survey every day in all of our markets about our reputation, brand, and trust, and we’ve seen that similar type of leap. And mostly because I think, and I’m sure the others would agree, our clinicians have done extraordinary jobs. I think they truly are selfless heroes. For us though, we wanted to amplify that message, so we really doubled down on our, what I would call, qualitative awareness and marketing, which is brand. Traditional stuff like TV, radio, even billboards, lawn signs saying healthcare heros work here.

Nick Ragone:

But much of our marketing over the last few years has migrated to quantitative marketing. Digital, online, CRM based marketing. I like to call it NF1 marketing where you’re very targeted. But during this crisis, trust, reputation and trust, safety, gratitude for your caregivers has been really important. And we found that investing in qualitative traditional brand building media has been a critical component, at least for us as a Ascension. We’re a national… We’re a 24 billion dollar healthcare system. Has been really important in our markets for our associates, our caregivers to see that we are grateful for the work in a very public way through branding and advertising.

Nick Ragone:

And then for the community to see how much we’re putting, obviously, the community safety, our associate safety first. So I feel like that’s been a really important part of the last six months. It hasn’t been, from a marketing communication standpoint, it’s not just about issues crisis management and trying to deal with the issue of the day, but also how do we pivot from the good will that’s been rightly earned by providers, by healthcare systems, by the extraordinary work that we’ve all seen? Not just Ascension caregivers. All caregivers.

Nick Ragone:

How do you pivot from that and use this moment in time, this reputational halo that we have to then elongate it so that it’s beyond just the moment? And how to keep that trust? And I think you said it well in your introduction, Philip. With that high trust comes responsibility not to squander it, not to fail, not to let the community’s patience or our caregivers down. So I’ve been thinking a lot about that, and I’ve really been thinking as a discipline for marketing and communications, particularly in the healthcare space and the provider space.

Nick Ragone:

This is our moment to help shine, because we’re storytellers. We tell stories, and we’ve never had a more extraordinary story to tell. Our caregivers, our collective caregivers becoming heroes. They’re part of the fabric of their communities. They’re selfless. We’ve seen images over and over. I think it’s a privilege to be able to tell that story, and we’re using all the channels at our disposal to do that.

Philip Guiliano:

That’s great. Jigar, do you have anything to add to that?

Jigar Shah:

Yeah, no. I think that’s a great question. I think to Nick’s point, we’ve done the same thing, increased actually. It depends on how we define the brand stance. If we just look at the ad spend, it’s probably going to give a not accurate picture of the investment that we’re all making in brand right now. For us, it starts with making sure that we are listening constantly. So we work with Edelman. We also have worked with Binary Fountain, NRC Health, and other national surveys.

Jigar Shah:

But we also built a large community of insight in our patients of 15,000 plus over the last three years. So we are actually doubling down on that listening capacity, going out every two weeks, asking our patients what matters to them, how they’re feeling. And then this morning in the comment we put out, to your point, they see us as a trusted source of information, so we have to make sure that the information we put out is real. It’s based on facts in real time, because information… there’s so much misinformation out there almost every day.

Jigar Shah:

So we put up… I consider all of this investments, whether it’s investing in research or investing… We put up a, similar to Johns Hopkins, we put up our coronavirus.providence.org COVID hub in, I would say, less than 48 hours since this began. And that has been the content hub. And the way I see this, that’s an investment in our brand. We get about 20,000 to 25,000 unique visitors every day on that hub between patients and community looking for information on topics that are concerning.

Jigar Shah:

There’s misinformation and then they come to us and say, “Okay, what do you guys think about this? Because I trust what you say.” So I think that’s and investment in brand. That’s a win-win because it not only fills the information that patients need, but it also is building your, from a marketing and brand perspective, it’s actually building the Google content authority. When you think about SEO from a marketing perspective, it’s going to go a long way, putting out the right content right now. And then the last one is, for us, we have found a really good spend in partnership through this time.

Jigar Shah:

We’ve launched a lot of ads, ways brought us together back in March in L.A. End of March, early April, as the first wave was tapering off. And a lot of us in healthcare saw that people were pulling back on necessity and life threatening care. So we wanted to go out and talk about don’t delay care public service announcement. Our EDs are open. They’re safe. The idea was it’s a public service announcement. Why don’t we unify our voice instead of health systems going out with the same message? So we did. We unified the voice, put six health systems in one campaign. We went out.

Jigar Shah:

On the outside you might see total brand spend reduced, but the voice has amplified by combining. So we actually have done more than half a dozen such consortium based brand qualitative public service announcements since then. I think it’s very effective. It’s very good for the community and public because they get to hear one voice, one message from health systems. And it’s great for us because we actually get to see one media spend and we are partnering. So that’s what we’ve been doing, and I think we’ll continuing doing that as long as… This is not… This has turned from a sprint to marathon.

Philip Guiliano:

Yeah. You just raised two other questions I wanted to touch on. And those of you that have worked with me know that I kind of think a little bit organically and shift things. So I’m going to surprise you with a couple questions we didn’t prepare for coming up. But Amanda, I’m curious on the messaging side that Jigar just brought up. As we think back to the trust element and we think about how we’re communicating, particularly in Cleveland Clinic with all that you bring to the table, what sort of messaging are you guys taking out right now? How are you looking to capitalize on the trust?

Amanda Todorovich:

Sure. Trust is at the core of everything that we have been doing for a very long time. And our content strategy is similar to what Jigar was talking about. We’ve been putting out COVID related articles every single day since mid-March and we haven’t stopped. Really trying to be as empathetic as we can be to the general population. This has been a complete emotional rollercoaster for people. And so we’re putting out content not just about coming in for care, although that’s obviously an important part of it. It’s also about just surviving this and dealing with the mental health issues that come with it and the boredom that comes with it.

Amanda Todorovich:

And what does this mean for your children who are no longer seeing their friends every day? Just really trying to think through as many of those scenarios and issues that people are facing, and trying to help and be there, and support them through this. And like I said, not just about coming into EDs, although we definitely did similar things and had our own campaign around that as well, and have invested in a safety campaign and ran a TV spot with our CEO talking about what we’ve done to make our facilities safe and make it okay for people to come back in for care.

Amanda Todorovich:

But really, truly, it’s still staying relevant every day and knowing that we’re there for you through this health crisis. Others have said it. We’re in the spotlight right now and it’s really important that we take that privilege seriously, and that it’s not just about us. And while it’s been amazing to see the recognition for our caregivers and for the heroes that they are, it’s also very much about just the general population and people and how they handle this and deal with this and get all that crazy misinformation, and what we can do to help really provide factual, accurate, updated information as much as we possibly can.

Amanda Todorovich:

We have a huge responsibility with more than two million Facebook followers, two million Twitter followers. There are people all over the world looking at us, and again, taking that seriously and really trying to be there in every moment at every turn.

Philip Guiliano:

Yeah, and I’m interested… This is the surprise question part of the conversation. I’m interested in all three of you are large systems, and so when we think about message, and we think about fact and trust and data and all of that, what advice would you give people on the system level aspect of things versus what happens at the local level? What is the role of the system at this time?

Nick Ragone:

You know, it’s a great question. I’ll chime in first just because we’re a large system. We’re in 20 states. We have 2700 sites of care. So we are a very broad system. 160,000 associates. But about five years ago, we started to integrate ourselves. We called it our One Ascension journey where we really brought our clinical operations and our brands into alignment. Five years later, now we’re a fully Ascension brand at all of our sites of care. We’re a very integrated system.

Nick Ragone:

I think it’s been a real benefit to us to have… we set up a command center in late February around COVID. It’s allowed us to be really nimble and flexible in responding to COVID as a system, versus if this was five years ago. We would’ve done it in a one-off way, and each one of our hospitals literally would had to have tackled all these issues, from CDC guidance to changing out your messaging, to clinical protocols and everything else. So I can’t imagine what that would’ve been like, but I know it would’ve been challenging.

Nick Ragone:

Our leadership six, seven years ago was very prescient in trying to create a more integrated system. So our response has been, I would like to say, very directional. It’s been led by our national ministry, our system, with great coordination from each of our markets. And a lot of feedback. We had a daily… I’m sure other systems did this too. We had a daily call, 7:00 AM every morning with our top leaders across the system and really understood what the issues of the day were. But it was a very integrated response, and I feel like it really allowed us, it actually accelerated our One Ascension journey, but allowed us to respond in, I think, a much more timely, effective, concerted way, versus letting each hospital system trying to figure it out on their own.

Nick Ragone:

So I feel very fortunate that we’ve laid all that groundwork the last five or six years so that it allowed us to really have a timely concerted effort in response.

Amanda Todorovich:

Yeah. Almost identical story here. We’re one Cleveland Clinic. We definitely rallied around this in that way and centralized as much of the messaging and communication as we could, try to really use one home landing page for information that then could be shared and utilized, assets shared across the entire enterprise creatively, and just really trying to manage a lot of fast changing things. Policies were changing every day, trying to make sure they were consistent as much as possible across different locations.

Amanda Todorovich:

And it also led to support on staffing where we needed to send caregivers to Abu Dhabi for example to support the team there. Daily conversations every morning with our command center. Streamlining also approval on things, just really trying to be as consistent across the board.

Jigar Shah:

Same thing. We’re going through this journey of unifying our brand. But in the backend the operations was, I think it’s like one plus one equals three. So we have the system level response, but you also have a regionalized response. Like Nick, we’re spread out in several states and several markets. When we set up those 7:30 morning calls every day with 200 plus system leaders, and regional leaders, and caregivers joining to align on ideas, but also take the action items.

Jigar Shah:

And on the marketing side we set up a rapid response team that had people from the system team, what we call the services side, and then also the regional teams and communication and website team to make sure that the regionalization as appropriate of the action item was happening. We saw the first patient in the country at Providence Everett Regional Medical Center back in January. Within 24 hours of seeing the first patient, we set up in Epic the screening protocol.

Jigar Shah:

Epics are across our system. But then there were markets in January in SoCal, in Texas that we served, there was no COVID-19. So the reality is that even now we have surging in one market and declining in anther market. So we have to make sure that the rapid response team that we put up isn’t just sending out one and done in our message across all the communities we serve. But it’s contextualized, it’s personalized, it’s aligned with the state protocols and governor’s of guidance. Because otherwise it’s creates a cognitive dissonance.

Jigar Shah:

So what we have done is a lot of centralized response are in supplies, PPE or the operational response. It’s centralized because you can move pharmacy and PPE where the need is. In terms of marketing messaging we’ve allowed the regional approach because that’s what the reality is right now. Different communities are facing different wave of COVID.

Philip Guiliano:

Yeah. Let’s shift to money really quick and I think let’s get a little audience participation and throw up our first poll question if we can.

Adam Rubefire:

Absolutely. I will pull it up right now. Audience, how are marketing budgets shifting for 2021? Let us know. Is it a large increase, greater than 25% increase? Is it increasing, 1% to 25% increase? Remaining the same, decreasing, 1% to 25% decrease, or is it a large decrease greater than 25%? Will give you about 30 seconds, 45 seconds, then Phil, in the meantime, I’ll throw it back to you.

Philip Guiliano:

While we’re here letting this stuff tabulate, Jigar, you mentioned something about partnerships. And since we’re on money I wanted to throw out to the group, and we’ll revisit the poll here in a second, around where are you guys pushing yourselves from a revenue driving perspective, creativity perspective, to look at new partnerships, new revenue streams, that kind of stuff?

Jigar Shah:

I think some of this is going to depend on where healthcare goes. How is this going to accelerate or slow down the shift to value based care? Some of the partnership discussions wait for that trend to emerge. In terms of marketing specifically for us, we really felt the spirit of partnership in the public service announcement campaigns, whether it was the 100 million masks challenge that we launched back in March when the PPE short supply was acute. Within 48 hours, we had pulled together five apparel manufacturers who were ready to make masks, and engaged 30,000 plus in the community, folks who wanted to sign up and sew masks for front line caregivers.

Jigar Shah:

Believe it or not, that whole website we put together in four hours. Back in January, if somebody had told me that, “Hey, you’re going to have a national campaign launched in 48 hours and a website in four hours,” I would’ve not imagined that. But it happened. And I think since then, and now it has been… That campaign has become a national campaign under the auspices of AHA. The campaign that I mentioned that we ran in L.A. around don’t delay care sort of became really good best practice for us in Washington state, in Oregon.

Jigar Shah:

We worked with state hospital associations or other healthcare providers to go with a unified message. I think as long as this public healthcare system continues we look forward to actually a pilot model mode. It’s a really good win-win. Not only does it save us the media spend on each of the health side, but also from a public perspective it’s a unified point, one common message that reduces confusion out there. That’s the partnership I mean from the marketing perspective. I’m sure there are other commercial partnerships that will shape as the healthcare itself decides which way it’s going to go.

Philip Guiliano:

Yeah. Yeah. I’ll shift over to you in second, Nick. But I’ll end the suspense really quickly on the poll question. Not necessarily surprisingly, we have about 50% of the people voted on this and 1% is actually seeing a large increase in their budget. 22% are seeing a slight increase in their budget, 29% remaining the same. So add that up, you’ve got about 50% increasing or staying the same, and then you’ve got about 47% decreasing, most of that being in the smaller decrease 1% to 25%.

Philip Guiliano:

Just thought it would be good to level set with everyone around what we’re all experiencing today. Nick, I know when we were talking prior to the webinar, you had some really good insight around how you’ve driven the business case forward on the investment in marketing. So I wondered if you wanted to share some of your perspective around how you’ve been able to double down on some of the things that you’ve been doing.

Nick Ragone:

Yeah. Thanks for that poll, by the way. There’s probably nothing shocking in there. I think it’s all somewhat intuitive. The last couple four, five years, I’ve actually opined in Modern Healthcare and elsewhere about how marketing needed to play a greater role in healthcare systems, large integrated systems. They needed to have a bigger role at the table. And I think in general is because there’s so much change going on in healthcare has been over the last five years. And it’s not just a move from fees for service to fee for value, but consumer orientation technology, so forth.

Nick Ragone:

Marketing and communication, particularly marketing, plays a much more important role than it ever did for the last 20, 30, 40 years. I think all that’s been accelerated really the last six months, the last eight months, because we’re kind of in a new era. We don’t really know yet what the light at the end of the tunnel is going to look like, but we know that it’s not just healthcare behavior that’s changing. Across society COVID is a disruptor, from working remotely to healthcare delivery, to living in cities versus rural areas, and that sort of thing.

Nick Ragone:

We know behavior is going to change in a pretty dramatic way, and so now is the time to really take some of that good will that’s been rightfully earned by our extraordinary caregivers, the trust that you saw in the Edelman numbers for clinicians, for providers, for healthcare systems, and figure out how do I make sure that I’m meeting consumer needs going forward? Because we don’t really know. We’re doing a lot of research every day with consumers, qualitative and quantitative, to understand what the new landscape is going to look like. But we’re still in the middle of it.

Nick Ragone:

We don’t even have a vaccination yet or advanced therapeutics. So we’re still in the infancy of understanding what’s the world going to look like six months from now, 12 months from now, three years from now, five years from now when it comes to healthcare. I think it makes it even more important for us as marketers and communicators not just to have a voice at the table among leadership in our system, but to communicate to the public and understand what this pivot is going to look like, and what they want to see in us as providers and healthcare system when it comes to safety, when it comes to associate care, how we’re treating our own associates, when it comes to telemedicine and contactless care, when it comes to fee for value opportunities and so many other issues that we thought we had a handle on eight months ago and now we don’t really know.

Nick Ragone:

I find that uncertainty exciting, because we know that we have some wind at our back when it comes to reputation. We know that the public has… we’ve earned that trust through our amazing caregivers. We know that there’s still a lot of uncertainty about what the future holds. And we know that being communicative and hyper transparent has been really beneficial in general to healthcare. And now is the chance for us to leverage all that and pivot to where the consumer is going to go in a post-COVID landscape.

Nick Ragone:

I’ve been arguing for five or six years that marketing as a discipline needed to have a much greater role in healthcare and provider systems. I’m sort of doubling down on that. Now more than ever that reputational trust and that consumer awareness, community engagement, advocacy is going to be so critical to coming out and landing someplace where we could be of real value to patients and consumers after COVID.

Amanda Todorovich:

I think too it’s really important to note how many other industries are turning to us for help as well, as we try to figure out what all this looks like going forward. We have airlines coming to us, help us figure this out. Schools coming to us, other employers. Employer health is a huge thing. They’re all coming asking for support, asking for help, asking for consulting. And so there’s every industry turning to healthcare for support. It’s just a huge opportunity for us as an industry to really step up and help inform and shape the future of what this all looks like. And we have a huge responsibility to do that.

Philip Guiliano:

Yeah. No, definitely. Since you talked about other groups coming to you, or other industries coming to you, I’m curious about other areas of your organization. We’ve seen a lot with our clients where the partnership between finance operations and other areas of the organization is actually thriving during this time as everyone is trying to figure out how to collaborate better and get better results. So from your actual experience and not my consultative experience, I’m curious what your perspective is.

Amanda Todorovich:

I don’t think that we’ve ever been more collaborative than we’ve had to be in the last six months. It really forced it to happen under a lot of duress. But I think that the relationships, the conversations, the frequency of interaction is sustainable. It should be sustained as we move forward. It just really, I think, expedited so much of what’s been needed for so long across the entire system.

Philip Guiliano:

And specifically though, for all of you, to do what? What’s the difference? Not just in the collaboration, the dynamic, but what are they asking of you and what are you asking of them?

Jigar Shah:

I think the big ask that we’ve seen… And these daily calls, the 7:00, 7:30 morning calls have been really guiding posts in keeping a lot of teams that are cross-sponsored teams that are working on meeting the patient needs and caregiver needs. So we’ve seen, for example, we saw telemedicine go from daily 50 telemedicine visits to more than 10,000 a day. Great that the technology team was there and they scaled up and they met those successfully. But then they want us to go out and tell the patients that, hey, this is there. You don’t have to delay care.

Jigar Shah:

Communication based on the personalized patient communication has been a big ask. Outside of the public service announcement campaign, we had the eICU monitoring system that stood up and scaled pretty quickly. So operations in the backend has been solving a lot of operational challenges. Finance has been solving financial challenges, cash flow challenges. Technology team, our technology team worked with Microsoft and really upgraded our AI that is the chat bot who actually direct patient care early back in March. And we launched that within a week of starting all of this.

Jigar Shah:

Their ask is, “Hey, we built this. Can you go tell the patient that this available to them?” And on our side, the big responsibility is how do we, number one, tell it so that it’s personalized? It’s using the right tone, it’s empathetic, but at the same time we’re not doing a message fatigue to our patients. So how do we package it all up and deliver it in a more meaningful way? So that’s been the big ask in patient communications.

Philip Guiliano:

Nick, anything to add there?

Nick Ragone:

Yeah, I would say I agree with everything. The one thing I’d add is that, and this wasn’t a lesson learned for me but it was a reminder, the importance of internal communications, in that we have a 160,000 associates spread out over 20 states. So it’s always been, not a challenge for us, but we’ve always had to work hard to make sure that we’re reaching all of our associates in many different ways because many of our caregivers, they’re not in front of their computers or phones all day, so you have to find ways to really reach them.

Nick Ragone:

During a crisis, internal comms is really the glue that keeps a lot of the crisis response together, not just the marketing piece, but even from setting up a command center to having daily recap calls, and all the other things that all of us, I’m sure, have done. It’s just another reminder for me that internal communications and really being able to in real time be transparent in your communications with all of your associates has been so critical for us to accelerate this One Ascension journey.

Nick Ragone:

There’s been a trust in Ascension as a system responding in one way because, frankly, I think the communications has been really, really good internally. It really helped garner some of that trust that I think it’s critical to responding during a crisis. Our brand journey was a reminder for me that it starts internally and then it’s external. Every major initiative I’ve ever run across as a communicator, it’s always a reminder to me that you start internal and work your way out. The same has held true for this.

Amanda Todorovich:

I would echo a lot of that, and the other thing that I think was a big challenge during all of this is that we suddenly had a huge percentage of our staff working remotely. And it completely changed some of the tools and technologies and the ways we could reach and connect with our caregivers, especially when we were trying to communicate things about when and how to come back into the facilities, and all of that kind of information. And also to other referring providers and how to really stay in touch with people.

Amanda Todorovich:

We launched several new pieces in communication, websites, new landing pages across the board for lots of different audiences. I would absolutely echo that. Communication with patients is the biggest request. We definitely dramatically increased how frequently we’re reaching out to our entire patient database, sending out actually a weekly communication from our CEO to our entire patient list is something that we launched in the middle of all of this and continue to do now. The list is never ending. The amount of work that we’ve done is massive and extensive, and again, a lot of it will be sustained. I think it’s really highlighted how we can connect better with patients, like Jigar said earlier, really listen to them and understand how we can help.

Philip Guiliano:

Yeah. Okay. Well, let’s grab a little bit more audience participation and drop into our next poll question as we shift into marketing operations.

Adam Rubenfire:

Excellent. Thank you. We’ll launch our next poll. The next poll is, which area of your brand and marketing operations would most benefit from being streamlined? That poll is going to be streamed to your computers now and you can go ahead and start voting. The options are marketing and technology suite, standardized repeatable processes, evaluating how we work with current vendors and agencies, current use ROI quality and consistency of brand assets, or free up marketing resources to focus on strategic action. You may choose one, and we’ll give you some time, but Philip, I’ll take it back to you.

Philip Guiliano:

Yeah. I’m just curious, maybe Jigar, where are you guys focusing?

Jigar Shah:

I think it’s not… It’s all of them, and we have to. Because we are looking at marketing stack and we had invested quite a bit in the CRM and automation in the last two years or so. We’re getting some rewards from that, but we are looking at investing more in data compliance and also the attribution model to answer the question that’s eventually going to come from finance, if there’s an increased investment, where’s the return? So we are working on that.

Jigar Shah:

I think we are looking at having marketing resources. Some of them freed up to work with our clinical teams, with ops teams. We’re looking at end-to-end patient journeys and see how this is going to change the patient journeys, whether it’s in telemedicine or some other options, and how marketing can actually be a part of that journey of resolving patient pain points.

Jigar Shah:

To us, it’s all of that. The biggest one that we are actually spending a lot of time on right now is the standardized repeatable processes. I think we all, I’m sure, all of us in this audience, we all found this new muscle called agility that we had not known until last year. And I think the question is how do we keep that, and a lot of that answer comes from actually standardize repeatable processes. A lot of the work that has gone out, which is very agile right now, has been very manual. A lot of that through collaboration, good relationship, good partnership, collaboration in teams.

Jigar Shah:

But simplified processes and repeatable processes can solve a lot of that going forward, because as this goes from, like I said, from a sprint to a marathon, there is some level of fatigue setting in our caregivers also. Everyone has been responding, not just marketing, but operations, finance, supply chain. Everyone has been responding at 120% of their capacity, and there’s only so much that goes. So fixing processes and making things easier for our caregivers, as we call our employees, is the number one priority now for us.

Philip Guiliano:

That’s great. I’ll come to you in a second, but just looking at the poll results, these are actually surprising to me. 9% are investing in the marketing technology suite. 24% standardized repeatable processes. 7% evaluating how we work with our current vendors and agencies. 31% on the current use ROI quality and consistency of the assets we have, and then 29% on freeing up marketing resources to focus on more strategic initiatives.

Philip Guiliano:

Before I come back to you, Amanda, I wanted just to share a perspective with everybody on the line, just to think about marketing operations. Because it’s an area that a lot of people, especially in healthcare marketing where you’re responding to things and active and reactive so often of the time, to take a holistic look at how we do what we do, who’s involved in all of that, how repeatable is it, how standardized is it, what is the ROI of those things? Taking that kind of a holistic view is something that people don’t generally get the chance to do.

Philip Guiliano:

So I want to just throw this framework up and highlight a few things. People, processes, and assets, technology and training. Roles and responsibilities, vendors, agencies, guidelines, documentation. Do you have playbooks? Are your processes and the way that people are doing things squared away? And do you have the technology and support models to support them? That’s the things that you look at to evaluate where are the opportunities? And then you look at do I have performance, tracking, and dashboards, and onboarding support and that kind of stuff?

Philip Guiliano:

The other thing I want to mention is on the right hand side. It’s an easier thing to look at what is marketing doing and where can I find the money within marketing? There is also brand experience, patient experience, marketing asset, brand asset, things happening in ITH, our facility’s fleet, all these other areas. And these all represent opportunities for marketing to play a different role. M&As for example. Nick mentioned getting marketing to the table earlier in very strategic discussions. That’s a huge miss for a lot of organizations.

Philip Guiliano:

Thinking about how are we involved in these things, how should we be involved in these things, what are we spending on those things, how could we be spending less, and where are the efficiencies? I just wanted to throw that model out there, and then I’ll toss it back to you, Amanda, and say how are you looking at operations at Cleveland Clinic?

Amanda Todorovich:

Yeah. Right now, definitely a big focus on CRM, marketing automation for sure. And also really a lot of workflow issues, because like I said, we started a lot of new things during this pandemic, and that means we have to figure out how to sustain them. In a crisis, it’s all hands and everybody just jumps in and we just get it done. Then when you pile on more and more of those things, eventually if they’re going to continue for long periods of time you have to figure it out and really make sure that they’re actually delegated and assigned to the right people and going through the most efficient process possible.

Amanda Todorovich:

There are circumstances where we had to make decisions in minutes about a vendor to do something that we weren’t set up to do before. So now it’s kind of backtracking a little bit and looking at all of that and making sure that we’re, again, doing it the right way, setting up the relationships longer term, looking at what’s working, what’s not working. What did we do during the last six months that we want to improve upon or potentially build on? And that’s really, I think, where some of our CRM and automation work are coming into play now, where we’ve looked at things like underfilled orders, for example. How many patients have procedures they’re supposed to be coming in for and aren’t, and what’s that outreach look like?

Amanda Todorovich:

That’s not something we would’ve done before. We would’ve really done more of the service line approach the way that we’ve traditionally done. So really slicing and dicing what’s going on with different patient populations in different ways today. And really, again, understanding the tools, the technology, and most importantly the workflows to make those things happen, because our structure is just not really there yet.

Philip Guiliano:

I’ll switch over to you, Nick, real quick on this topic as well, operational efficiency and where you’re focusing, and then we’ll have one more question and switch over to Q&A.

Nick Ragone:

I agree with much that’s been said. I do think there’s so much… We’re focusing on our marcom stack. We’ve been doing that work for a while. I think after we get through this initial phase of COVID, whenever that ends, we are going to return to something that looks like normal business. I think focusing, again, in a very tactical specific way about different groups are going to want to hear different things from us when it comes to coming back to our sites of care, whether it’s elective surgery or primary care, or using urgent care, the ED.

Nick Ragone:

And we need to be as marketers and storytellers really aware of more than ever that customer sentiment around a particular site of care that might be important for them or their condition state. Could be a service line, could be oncology, heart care, whatever it might be. But they’re all going to be filtered now through this COVID lens. It’s going to be a lot of work for us to understand that, and then use the right channel to communicate a message that is inviting for them to come back and get that hip procedure, or to make sure that they’re doing their pediatric visits, or getting their colorectal screening, or whatever it might be. Or using urgent care, the ED properly.

Nick Ragone:

A part of it is I think we’re going to need to put aside a lot of assumptions we’ve used for a long time about patient journey, segmentation, messaging, sites of care, that sort of thing, and say okay let’s understand how they’ve been shaped over the last six months. Maybe some sites of care and some types of services, and some condition states won’t have been changed that much. But my guess is they all will have been impacted. I think it’s really, again, it’s so important for us not just as marketers and communicators but as strategic partners to really understand that, because that’s the crux of getting back to normal in a post-COVID world.

Nick Ragone:

That’s a big responsibility and opportunity for marketing communications as a discipline to really drive that new consumer patient journey map.

Philip Guiliano:

Yeah. All right. I’m going to switch over to Q&A now, because I want to make sure we get some good audience participation. I’ve got another question for you that maybe we’ll wrap up with, but… Actually, you may have got the question I was going to ask. What advice would you give regional midsize small health systems looking to improve their brand operations? What have been your go-to research sources when it comes to consumer references and trends throughout COVID-19?

Jigar Shah:

I work for a large healthcare system but I started my career in a very small company. I think when it comes to small organizations there are some inherent benefits, inherent strengths that you can tap into that I don’t necessarily feel like we have access to at large health systems. Usually in the smaller organizations you have what I call Swiss army knives, a lot of people who can actually play so many roles really effectively. And that actually makes the process very nimble. Take an example of patient communication. Getting a patient communication out could be a lot more faster at a smaller organization than a larger with footprint in multiple states and multiple regions with different realities of COVID.

Jigar Shah:

You have an advantage to a large system in your market in just getting out in patient communication. Media mix is the second one I would say. Pay close attention to the media mix. Right now, everyone is looking at an email from their physician’s office or their healthcare provider. The email open rates have jumped through the roof for us. This isn’t the time to be spending a lot of time on paid media. This is the time to doubling down on personalized email communication with facts and information about your clinic hours, et cetera. And that goes a long way without a lot of money.

Jigar Shah:

Speaking of clinic hours, just tap into free low cost resources. Just managing Google My Business for your clinics, and making sure that the clinic hours are posted accurately, because that’s where a lot of people will go and see if they want to see a physician, not go and check our emails. So just using some of those low cost resources can be very effective also for smaller systems, and for everybody, for all of us. We manage that as well very well to tap into SEO reach to the patients.

Amanda Todorovich:

I would say, too, leveraging your own data. What’s happening on your website? What are people going through? Or your site search, what are they typing in and trying to find? How can you help them? Do you answer the right questions? Also understanding what kind of calls your call center is getting. What kinds of questions people are calling and asking because they ask everything of the operator. We’ve started weekly touch bases with the leadership of those areas to just understand so that we can align the website to the call center frequently asked questions types of things.

Amanda Todorovich:

So I would just definitely make sure you’re tapping into the things that are at your fingertips every day.

Philip Guiliano:

Yeah. Okay.

Nick Ragone:

I think even if you’re a smaller midsize or smaller system, don’t overlook the importance of continuing to do consumer research, both qualitative and quantitative. Find a good partner. We do it all in house at Ascension, but I think it’s just going to be so critical to understanding the landscape, and that we shouldn’t make assumptions based on information in the public domain or anecdotal evidence we’re hearing from caregivers. It should be a full picture of secondary research in the public domain, stuff that we’re hearing from caregivers, but then marketing and communications doing both qualitative and quantitative research continuously to truly understand as a country where are we headed when it comes to expectations around healthcare delivery.

Nick Ragone:

I just think that’s going to be such an important piece of what we bring to the table as communicators, and what health systems bring to the table in a post-COVID world. So I would find the resources to make sure we’re investing in that.

Philip Guiliano:

Yeah. I think that’s a great point. The only thing that I’ll add to this is as we look to the budget element of this, the smaller regional midsize health systems are typically the ones whose budgets are being strained. So looking back at that model for marketing operations, I would take the time to look at how you’re doing what you’re doing, what you’re spending your time on, what resources you have, that kind of stuff, and the ability to simplify everything you’re doing. It can uncover a lot.

Philip Guiliano:

Another question. I love these questions. What is keeping you up at night? That is the basic gist. As healthcare communicators and market leaders, what is keeping you awake at night? Has that changed since the beginning of the pandemic?

Amanda Todorovich:

For me, it’s just how quickly things are changing every single day, whether it’s about masks or visitation policies, or just testing facilities. We’ve been evolving so fast and it means updating and changing so many things. And the last thing we want to do is provide the wrong information to patients. So just the constant need to stay on top of it and stay accurate and updated is very stressful.

Nick Ragone:

Yeah, for me, similar in that part of the challenge for all of us is, I would assume most of us are still working from home or partially, is the blurring of days or the blurring… your day starts when you wake up and it ends when you go to sleep. And in between that you get emails overnight. You got to adapt to the latest issue that you might have or guidance, or outbreak, or whatever it might be. Honestly, the thing that keeps me up is trying to find a little bit of symmetry in the balance of life.

Nick Ragone:

We’re past the initial sprint phase of this and the adrenaline is wearing off, and we’re in for the marathon phase, is finding a healthy balance. Not just for me, but for my whole team and for everybody that we work with that are going on five or six months of working remotely and adapting to that. But also trying to figure out in this new world what are the boundaries of where you can still preserve a little bit of downtime to be with family? And at the same time be responsive to just the never ending wave of things that come at us. So that really has been the biggest challenge.

Jigar Shah:

Yeah, I think similar to that. It’s the wellbeing of our employees, our caregivers, because like Nick said, this has gone on for a while now. And it looks like it’s going to go on for longer. When I look at the rapid response team we put up with 19 caregivers from different teams together, that team has gone through and produced so much work in the last four months that we would’ve looked at that and said that’s a couple years worth of campaigns and efforts that got processed in four months. Making sure that the caregivers are staying happy, healthy, and like Nick’s point, 24/7 work from home now. How do we not do that?

Jigar Shah:

And then also the second thing is keeping time aside for thinking, because there’s always doing going on right now. One of the things we introduced last month was, at least for the summer, meeting free Friday afternoons in the marketing team. That’s your time to think about things, next steps, just take time off. People take time off. But it’s simple stuff like how do we find time to think about versus just always in the do mode?

Philip Guiliano:

Yeah. You remind me of a good book I read once called Deep Work, taking time to think and be strategic. One more question here from the group. What do you see is the trend for M&A and partnerships in the healthcare industry? What are you watching out for?

Nick Ragone:

I think there’s going to be in the next six to 12 to 18 months quite a bit of consolidation in general with providers, with payers, with everybody, just because we know that as a country we’re going through the most uncertain economic times in 70 or 80 years. So there’s no doubt that there’s going to be a lot of activity in the healthcare space in general. I don’t want to get too predictive on what it all means. But I would assume we’re going to see, as we continue, and we don’t know where this is really going to bottom out yet. We’re still waiting to see where the vaccinations go and therapeutics.

Nick Ragone:

But I think we’re going to start to see some consolidation within that whole healthcare space as well as other industries too. I think there’s going to be a lot of business activity going on as industries try to figure out a new footing in not just the changed healthcare landscape, but really a changed country and world. The way, again, we organize ourselves, the way we work, the way we consume healthcare, the way we congregate with each other. There’s going to be a lot of disruption and change across all verticals.

Jigar Shah:

Yeah, I don’t know about the formal M&A, but the strategic partnerships will come forward in the space of… Access has been a challenge. When you look at the rise of telemedicine and adoption of it right now, I fully expect strategic partnership with the providers and tech companies on improving the access and scale of telemedicine. The second area we’re watching and dealing with on this for several years now is the mental health. As this goes on for a while, there will be partnerships that will need to be formed in the space of mental health to keep the community’s mental health intact and grow. The message of hope needs to come out soon. So that’s where we think the strategic partnerships will start shaping up, and not so much as formal M&A yet.

Philip Guiliano:

Amanda, anything to add?

Amanda Todorovich:

You know, not really. I agree with everything. I think we’re in really crazy unprecedented times. I mean, between the pandemic and it’s an election year, and who the heck knows what the future holds next, I think we’re just in for a lot of change. And we just kind of have to be prepared for anything at this point.

Philip Guiliano:

Yeah. Agreed. Well, I would love to keep going on questions here. There are some here that maybe we’ll be able to follow up and answer, but I will answer the what’s keeping me up at night question as we sign off and just say that I have over 20 healthcare and health system clients right now, and what keeps me up at night is your guys sanity health and wellbeing. I don’t know how you do what you do, and I really appreciate it. So thank you for the panel for joining, and thank you to everybody else for joining the webinar.

Philip Guiliano:

I do understand that we’ll share and distribute the slides that we’ve used here as well after this. And thank you everyone for participating.

Nick Ragone:

Thank you.

Jigar Shah:

Thank you.

Adam Rubenfire:

Excellent. I’ll take it from there and close us out. Thank you so much everyone. Take us to the end of our presentation. Thanks again to our moderator, Philip, and our panelists, Nick, Amanda, and Jigar for their contributions today. And thank you to our audience for such great questions. To our audience, we value your time and feedback. Please take a moment to fill out our brief post-webinar survey so that we can provide the best content and research for you. Just like to thank the sponsor of today’s webinar, BrandActive. For more information, please visit brandactive.com. And as Philip said, this webinar will be available on demand. A copy of the slide deck and link to reporting will be emailed to you within the next 48 hours. Concludes today’s presentation. Have a great day, everyone.

Philip Guiliano:

Thank you.