From Events Planner to Strategic Partner

WHPRMS Fall ConferenceSept. 13, 2007

Kathleen L. Lewton, MHA, APR, Fellow PRSAPrincipal, Lewton, Seekins & Trester

Today, it’s all about TACTICS

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!

But as Sun Tzu wisely said:

“Tactics without strategy is the noise before defeat.”

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.

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

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!

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.

. . . . . 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.

With that in mind . . . .

It’s only appropriate that we begin with a quick scan of “Healthcare 2007”

OR

Caught in the Campaign Crosshairs

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

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

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

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???

Talking Tech

Technology seen as CRITICAL variable, but there are issues

– Development funding– Technology affordability– Technology competitiveness– Capital demands for acquisition– Device development

Info Challenges

Medical record keeping and transmittal HIPPA challenges Communications expectations increased all around

• Physicians, nurses other staff• Patients• Internal communications• Community support

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

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

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

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

Control is key

Who is in charge here? Teaming in an unteamed world

And yet . . . . .

There are many more issues and challenges

What does it all mean? And what do PR people DO about it?

Clearly HCOs need to change . . .

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?

SO . . . . .

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

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 IF we 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

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.

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.

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?

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?

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?

Focus on THEIR concerns

Align strategies to THEIR metrics Give them fresh strategy, not more product

• Interactive Web• Call centers• Personal communications skills

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)

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

The ARM Approach

Identify the right AudiencesUse Research to understand, test

Create Messages that deliver results

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!

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

HCOs have a myriad of audiences: Customers, Influencers,

Stakeholders, CriticsALL are important, ALL overlap & overhear

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

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?

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

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 . . . .

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

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”

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

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

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

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

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

The ideal methodology mix:

• Focus groups and personal interviews ↓ INSIGHTS

• Surveys (phone, online, intercept) ↓ DATA

• Focus groups and personal interview ↓ CLARITY

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

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

Credibility – do they believe it?

Overpromising, directly or indirectly Overendorsing Overqualifying Overhyping things that have no inherent

credibility to the average consumer• Ratings, rankings• Awards• Credentials

Relevance – do they care about it?

Do they care about:• Service or product or procedure they figure

they’ll never ever need or use• Reputation of product/service sponsor• Hospital that’s two hours away

• We, us, our . . . . . . . all about YOUR assets rather than their real-life needs and how they will benefit

Resonance – does message touch their feelings?

For a message to move audience to action, it has to touch heads and hearts• Real people with real stories• Showing rather than telling• Same old phrases, same old pictures

Only one way to ensure messages will work

Test, test, test• In your market(s)• With your target audience• With a talented moderator/interviewer who can

play word games Great free advice re doctors, from Joe

Smith at Guidant: “If you’re going to provide information to

doctors, it has to be mainstream, familiar and actionable”

Necessary elements of a communications plan

Customer origin analysis Competitor analysis Internal communications position Marketshare/marketshare change Corporate strategic growth targets SWOT analyisis Identifying/segmenting the ideal customers Identifying ideal messages:

• What do we want them to know• What do we want them to DO

Tactics Timetable Budget Measurement

And NOW . . . .

Let’s talk amongst ourselves!

And later:• Klewton@lstllc.com• Sseekins@lstllc.com• Ktrester@lstllc.com