Care Marketing Matters, Fall 1998
Who's doing what on the web
Health care organizations are turning to the Internet, especially the world
wide web, to market their goods and services. While the movement to digital
communication is clearly in progress, the objectives behind this new involvement
can be more obscure. Some organizations seek greater "awareness"; some want
deeper customer relationships; still others hope to deliver services directly
Whatever the goals, the questions remain the same: What do we hope to accomplish
on the web? How will we know if we have succeeded?
Last summer, Health Care Marketing Plus conducted in-depth interviews with
14 health care professionals in Bostoan area that leads the country in
both the health care and high-technology industries.
Our goal: to get a snapshot of how Boston-based health care organizations are
using the Internet to support strategic marketing objectives.
Using an interview guide with over 30 questions, we engaged in conversations
15 - 45 minutes long with people representing: 3 community hospitals; 2 specialty
hospitals; 3 tertiary hospitals; 2 health plans; and 4 health care-related
companies who are using the Internet to conduct one or more aspects of their
core business. We gave all respondents the opportunity to review and correct
the interview notes prior to publication.
Hit The Highway: Why the Internet Will Matter
According to our research, health care professionals develop web sites for
the following reasons:
expand their market presence (with, for example,
tailor information to the consumer's needs.
engage in two-way communication with target audiences.
find a cost-effective way of distributing current
information to users.
for health care marketers, there is one overwhelming
reason why the Internet is important: because our
consumers tell us so. Consider these important
"Doctor, According to This Study I Found on the Web Last Night .
Consumers are already turning to the web to find information and take greater
control over their own health. As the web continues to grow, and more people
gain home access to the Internet, this trend is likely to continue.
Consumers Are Voting with Their Wallets
Consumers are not tied to getting care through the traditional channels we've
devised for them. They're interested in other options-- and they're spending
the money to prove it.
According to Dr. David Eisenberg's ground-breaking article in the January 28,
1993 issue of The New England Journal of Medicine, "Unconventional Medicine
in the United States," in 1990 more Americans visited providers of unconventional
medicine (homeopathy, acupuncture, herbal medicine, etc.) -- an estimated 425
million visits -- than visited their primary care physicians (388 million visits).
They spent approximately $13.6 billion to do so, 75% of which ($10.3 billion)
came out of their own pockets.
As consumers seek alternatives, we run the risk of losing new opportunities.
More important, we may lose existing revenue streams as consumers seek therapies
through alternative distribution channels -- such as the Internet.
Man the Lifeboats: Women and Elderly First
The population segments in which Internet use is most rapidly mirrors the population
that health care marketers most want to target: women and seniors. Women are
an important target, not just because of maternity and mid-life health needs,
but because they are often responsible for making the purchasing decisions
for the entire family. Medicare Risk products, for instance, are just one of
the competitive health care products aggressively marketed to an increasingly
growing elderly population.
Information is the Antibiotic of the 21st Century
As John Lester, Information Systems Director for the Department of Neurology
at Massachusetts General Hospital, points out, chronic disease is a game of
care, not cure. For years, the chronically ill have found treatment and support
by exchanging information with their peersan exchange in which the Internet,
unrestricted by time and space, excels.
The combined impact of the above factors makes the Internet a logical intersection
for consumers and providers in the contemporary marketplace. So how are we
What We Found
Most of the respondents that we interviewed had launched web sites, or sites
with deliberate marketing objectives, only within the last year. As a result,
most of the respondents noted that they are in the early learning stages.
While many of the respondents acknowledged having had a web presence for some
time, these earlier efforts tended to represent individuals or individual departments.
Their current web sites, on the other hand, mark the first time that the marketing
department has made an investment representing the entire organization.
Even though just about everyone we interviewed has launched, or is thinking
about launching, a web site, most respondents are not making major investments
relative to other marketing programs. The notable exceptions are companies
who market Internet-related products. As expected, none of the community hospitals
in our sample, who generally operate under tighter budgets, have invested funds
in web-site development.
When asked to evaluate the success of their sites, participants responded with
answers that reveal intriguing paradoxes:
half of those who had a site described that site
as "successful," yet many respondents said that
they have not yet implemented ways to measure
one respondent noted, we don't currently know how
to measure ROI -- and without knowing what you
and others have invested, it's difficult to measure
the relative success of various approaches. This
is reminiscent of the HEDIS war song: "If you can't
measure it, you can't manage it."
half the respondents said they had received positive
responses to their Internet efforts, including
email feedback, requests for more information,
participation in on-line services and registration
for appointments. While most said they were satisfied
that the web site had worked, they were uncertain
about the implications for the future: As responses
grew, how would marketing keep pace in a timely
fashion? What level of resources would it take
to realize the full potential of the Internet? ·
two thirds of the respondents cited increases
in leads, call volume, referrals, orders or requests
for information -- yet most did not appear to
have a mechanism for distinguishing web-related
responses from responses they would have received
from other channels anyway. Is the web adding
to, or merely replacing, consumer responses from
some cases, there was only a weak correlation
between what respondents indicated as the purpose
of the web site and what they wanted visitors
to do once they got there. Half of the hospital
respondents who said that they created their
web sites to "raise awareness" later said that
they wanted customers to use the web to schedule
two thirds of the respondents cited increases
in call volume and requests for information as
measures of success, only one said that the volume
was so high that it was difficult to respond
on a timely basis.
the Internet's potential, most of the respondents
said that they didn't expect their web presence
to give them a competitive advantage. Rather, they
said that they were there because they had to be
there to remain competitive.
The study indicates that:
health care companies are relatively new to the
Internet marketing game.
the most part, they are putting a toe in the
water before diving in with large-scale investments.
are not yet really sure how to gain maximum benefit
from this valuable tool.
Spool, founder of User Interface Engineering, a
leading research firm on web-site usability, says
that the results of the study mirror trends that
he has seen in other industries.
"We've seen three stages of evolution. First, people don't do anything with the
Internet because they don't know what to do. Then, they make limited investments
to try and figure out what works.
"In the third stage, someone (often an 'outsider' with a different way of conceptualizing
the sales and distribution cycle) comes in with a new model of doing business
and grabs market share from conventional competitors. Take, for example, the
way Amazon.com flipped retail book sales on its head by selling books on-line.
Or how Travelocity, a site that sells airline tickets on-line diverted sales
from travel agencies.
"In this last stage, everyone else tries to catch up. Unfortunately, they have
a tough time because the innovative company continues to advance along the learning
curve and stays ahead."
Is health care ripe for an Amazon.com? Can we anticipate the intrusion of a
web-based business that has the potential to disrupt the current channels of
health care distribution -- and steal significant market share in the process?
Acknowledgements We'd like to thank the following organizations for contributing
to our article. Please return the favor and visit their web sites.
Israel Deaconess Medical Center www.bidmc.harvard.edu
and Women's Hospital www.bwh.partners.org
Cancer Care Institute www.dfci.harvard.edu
General Hospital (Neurology Department) www.mgh.harvard.edu
Massachusetts Health Data Consortium, Inc. www.mahealthdata.org
Rehabilitation Hospital www.spauldingrehab.org