Integrated Branding Blog | Movéo

Driving Patient Loyalty and Hospital Revenues Now

Some conventional wisdom…

1. The healthcare industry fared better than most during the recent recession. 

2. The healthcare field continues to be less advanced, savvy and competent versus others when it comes to technology, marketing and customer focus. 

3. The practice of cultivating existing customers is far more profitable and productive today – or at any time – than seeking new ones. 

While the first assertion (the healthcare industry is healthier) is true, providers and hospitals are not immune from the effects of the current economic condition. Higher unemployment means fewer people are insured, resulting in fewer admissions for non-emergency procedures – not to mention an increase in provider costs for non-covered, indigent care. Nurses are being laid off. Philanthropic donations and state Medicare and Medicaid reimbursements are declining, according to the American Hospital Association. 

The second assertion (the healthcare field is less advanced) is also a fact; but this means now there is a great opportunity for the progressive hospital to stand out and gain competitive advantage in the market. The third assertion (it is better to focus on current customers) is correct, too, and relates to that opportunity. 

How to compete and drive results

What can a hospital facing some strong headwinds do in order to improve marketing effectiveness and patient retention? What can a provider do in the short term to drive desired results and in the long term to increase customer loyalty, brand competitiveness and strength?

Today many hospital marketing heads have been forced by CEOs to cut marketing and communications budgets. Many are now focused on immediate, quarterly based, measurable direct and e-marketing tactics. Few may be considering market research, as patient and community studies do not actively generate revenue and there are often issues with speed of execution and actionability.

But a simple, powerful research metric – the Net Promoter Score^® (NPS^®)* – has emerged, which a notable few providers are employing. NPS shows a strong linkage between survey results and the bottom line — hospital profitability, customer loyalty and brand value.

The static, status-quo hospital research

Actually, most hospitals have been conducting patient and stakeholder satisfaction surveys for a long time. But how have they been applying the results? Toward building patient brand loyalty? Improving the care or service? The reality is that very few provider marketers or staff know how – or if – the survey information is applied.

Much of the impetus for patient satisfaction surveying is driven by the federal government’s quality mandate and establishment (HCAPS). Moreover, enterprising satisfaction survey research companies have taken full advantage of the need for hospital compliance to successfully sell ongoing survey products (not consulting) to providers – in effect creating client loyalty to the patient satisfaction survey process. But few employees in a hospital (including marketers and executives) really know how the complex survey reports, tables and data symbols are used or who within the organization owns the program. Does the hospital’s CEO regularly keep tabs on the ratings? Are strategic marketing or customer service plans created based on the feedback? Doubtful.

NPS may even have greater relevance in the hospital, where the customer experience is defined by so many intangibles, touch points over time and people. So a provider that can successfully apply NPS will have a good chance of standing out in the market, driving needed change and building powerful stakeholder loyalty … creating real economic and brand value.

*Net Promoter, Net Promoter Score, and NPS are trademarks of Satmetrix Systems, Inc., Bain & Company, Inc., and Fred Reichheld.

By Kevin Randall, Director of Brand Strategy & Research Movéo Integrated Branding

3 social media marketing tools that track your brand

As a company, it's important to know what others are saying about your brand. Thankfully, there are tools to help us keep track of what is being said and who is saying it. Here are three tools to help discover these online conversations:

socialmention
This site allows you to create alerts, just like Google Alerts. You'll receive e-mails of the latest mentions of your company on blogs, bookmarks, comments, images, events, news, videos, audio and Q&A.

TweetDeck
Download TweetDeck and you can keep track and organize conversation on Twitter and Facebook that involve your brand. You can also save searches and see who is replying to your Tweets. Best of all, it's all in one window that you can customize.

Keotag
Search for tags that mention your brand (or any keyword). It's simple to use - just type in the keyword you'd like to search and then click on the engine you'd like to search through. There are a number of engines available including Technorati, del.icio.us, MSN, Digg, Reddit, Yahoo! and YouTube.

Know of any others? Feel free to mention them in the comments.

Measuring your brand on the Internet

Two metrics that help define your brand effectiveness online are direct traffic and brand-related searches. Direct traffic refers to users that typed your domain name into their URL bar, taking them directly to your site. This can be a telling statistic because it means that the user is aware of you. There was no search involved in this process. The user was cognizant of your brand and went directly to your site. Unfortunately, this doesn’t tell us how the user became aware of your site and how they feel about your site. Most analytic programs will, however, tell us if the user has previously visited the site (within 30 days), but there’s only so much you can assume from that data.

Another piece of traffic data that provides insight to your Internet brand presence is the traffic you receive from brand-related searches. This data includes any traffic that was driven to your site that includes your name in the search. For example, imagine a user that performs the search “3m tape” in Yahoo, we can conclude that the user is looking specifically for that brand and is aware of this brand. Of course, you can only measure the traffic that goes to your site, so it's important to make sure you are visible in the search engines. If not, you can use a keyword suggestion tool to get an estimate of how many searches include your brand name in a given time period.

There’s only so much we can take from these numbers, but they do say something about your brand. Analytic programs are not completely accurate, which is why it’s important to use this data as only a guideline to your sites' traffic performance. By keeping a mindful eye on your direct traffic, brand-related searches and repeat visitors you should be able to some away with something meaningful about your presence online.

You can take additional measures by taking note of what others are saying about your brand. The best way to do this is with Google Alerts. With this tool, you can have an e-mail alert sent to your inbox every time your brand is mentioned on a site that is indexed by Google. If you're not already doing this, I suggest you check it out.

Jeff Swanson

Improve your email metrics by getting rid of dead weight.

Not happy with the results of your house list email marketing campaigns? The problem might not be with your content but instead with your list. Many of you probably spend time analyzing email metrics like opens, clicks, conversions, unsubscribes etc. but what about inactivity? What about those subscribers who do nothing? The disengaged, bored and tired.

List fatigue happens when subscribers no longer respond to your messages. Its not that they don't click on your messages,  they don't open them, not even to unsubscribe, they just ignore them. These do-nothing subscribers are bringing your campaigns down and you're watering down your metrics and jeopardizing your reputation by ignoring them--not to mention missing opportunities to reengage them.

If you send mail to inactive subscribers you put your emailing reputation ability to deliver emails at risk. ISPs often turn old email addresses no longer in use into to traps called "honeypots"  to see which email marketers continue to send to invalid email addresses as a means to identify spammers. Additionally, ISPs also monitor the number of bounces email marketers generate and once you reach a certain threshold your emails won't be delivered.

In addition to protecting your reputation, removing inactive subscribers helps improve the accuracy of the results of your email marketing campaigns, lowers the cost of each deployment and ultimately increases ROI. If you send a message to 10,000 subscribers but only 8,000 are active, you're not only paying to send messages to 2,000 people that won't read them, you're skewing your metrics because every email metric is measured against the number of messages delivered. If 10,000 messages are sent and only 4500 open them your open rate is 45%.  However, if you send 8000 messages and 4500 are opened your open rate is 56% and its more accurate because you are measuring response from your engaged subscribers and not watering it down by measuring response from subscribers who will never respond.

So what do you do? Define a strategy for identifying inactive subscribers and develop a campaign to get those subscribers reengaged. Monitor and ferret out those who do not respond and remove them from your list.

Remember its not the size of the list that counts. Its how well you work it.

Dave Cannon, Director, Interactive Services

How much Data is Best for Split-Testing Ad Copy

When trying to decide what ad copy is most effective in moving a viewer to a click, to a conversion each step of the equation offers it’s unique input into what drives a viewer of an ad to convert.

Step 1: Impression to Click

The almighty click through rate, CTR, has been regarded by pay per click marketers across the industry as the primary focus of PPC performance. Since this metric supposedly weighs heavy in the computation of the AdWords quality score it seems many marketers have no problem driving up high click through traffic even if it does not convert.
Impression to click is really the least important factor in determining the success of the bottom line of the purpose of the campaign, to convert visitors to clients. CTR is most useful when determining the strength of headlines, but becomes less useful when testing description text and display url’s.

Step 2: Click to Conversion

Conversion rate is a metric many pay per click marketers just felt they didn’t need to pay attention to. When I first began researching and managing PPC accounts I was contracting for an agency in Boulder, CO and was told not to worry about conversions, that was the job of the Web team. The idea was that it was my job to get the people there and their job to make them convert. What happened is a lot of traffic that was generated was not even qualified, much less actually going to convert. Disconnected data led to bad results.
By taking an integrated approach to Interactive design, Creative content, and Search marketing an environment is created in which departments consult with each other about the data collected and collaborate on implementing the best solution.

First, the importance of setting a baseline for when there is enough data to do the analysis is necessary. I draw the line at a thousand search network impressions. It is important to draw this line in the sand and stick to it. By knowing I have adequate quality data to analyze I can be confident that the conclusions I draw will provide the optimizations needed to continue to improve performance.

Can Engagement Mapping Save Publishers?

The Atlas Institute (the research and education arm of Microsoft Advertising, formerly Atlas) has spent the past several months promoting its ideas for a new measurement standard in digital marketing.

Back in May, along with Dan Murray (Manager of Emerging Media at Movéo), I attended a breakfast seminar, hosted by the Atlas Institute.  The topic of the event was Engagement Mapping, a measurement model that allows marketers to attribute credit to multiple advertising impressions--not just the last one (where the click occurred).  In addition to clicks, Engagement Mapping would (they claim) provide flexibility for advertisers to consider other important factors such as ad size, frequency and rich media interactions.

The premise...there is a fundamental flaw in the way we [the online advertising industry] attribute credit for actions that take place as a result of online advertising. In short, that monitoring clicks is a shortsighted way to calculate ROI, and assumes you don't care about what interactions happened before the click occurred.            

As a member of the expert panel held during breakfast, Greg Schwartz, VP of Sales at Zillow.com, had a very reasonable concern.  Understandably, he feels that his site--and the company's product development efforts--has been designed to deliver content this is highly engaging.  But unfortunately, Mr. Schwartz suggests the high degree of engagement among users on Zillow.com has actually become a barrier for him in selling the site's inventory at a premium rate. 

Since his site's visitors are less likely to click on advertisements (because they're too busy enjoying the site's content), Mr. Schwartz has trouble proving campaign performance against the click-based measures that have been established under the "last ad" standard.  As a result, he's been forced to sell a relatively high % of his advertising inventory as "remnant" inventory to the ad networks (at a greatly reduced price).

Although I appreciate the rates I'm able to obtain for my clients as a result of the "last ad" standard, I can sympathize with Mr. Schwartz and Zillow.com (and every other premium online content publisher).  The current "last ad" model actually forces media planners, like myself, to give more credit to those online properties that deliver a transient audience.  Less sticky environments whose visitors are all too willing to click on a message that will take them away from the site's content.  I would argue that, as media planners, in many case we are being forced (by our clients) to ignore the importance of the advertising environment, in exchange for lower CPMs.

To further highlight this trend, a recent study (August 2008) from the IAB and Bain & Company found that the use of ad networks has increased dramatically, from 5% of inventory sold in 2006 to 30% in 2007. And, average CPMs on ad networks ranged from $0.60-$1.10, versus $10-$20 in direct-sold display inventory

I believe that last click attribution is about to become a thing of the past...and in my opinion, Multiple Attribution Protocol (e.g., Engagement Mapping) would be a better lens through which to view a campaign's performance (both DoubleClick and Atlas have active testing going on in this arena). Unfortunately, I also think it might be too little, too late (for publishers anyway).

Measuring Delayed Response to Online Advertising

Third-party ad serving has tremendous benefits for brand owners...by providing better visibility into the effects of their online advertising campaigns.

Ad servers allow marketers to identify end users—and the actions they have taken—by storing server-side profiles on each user that lands on their site after clicking on an ad (known as a click-through), or even those who did not click on the ad, but visited the site within a specified amount of time after being shown the ad (known as a view-through).

Through the use of pixel tags, marketers can track back-end actions like purchases from an ecommerce site, and tie that activity back to the advertising message (or series of messages) that initially drove the interest. Thus allowing you to optimize your campaign against conversion rates rather than click-through rates.

An even greater (but often ignored) benefit of 3rd-party ad serving is being able to understand the time it takes (on average) for a user to convert into a customer—after they've clicked on your banner ad.  When a user clicks on your ad but does not purchase something in that same session, this does not mean that your advertising message was wasted on that individual.  This person may return to your site later that day, or later that week, to complete his purchase. An ad server allows you to attribute the ultimate purchase to the advertising campaign, even though the purchase conversion itself was delayed.  [So, if you are not implementing pixel tags for tracking these repeat visits, you will lose this valuable information and ultimately underestimate the performance of your campaigns.]

But, a word of caution...when using pixel tags to track delayed response to your advertising, it is easy to distort the view of your campaign optimization efforts.  As you can see in the chart below, if you measure total # of conversions from week-to-week, it looks like the performance of the campaign is steadily improving...

But remember, some of the conversions SHOULD ACTUALLY be attributed to advertising that occurred prior to the week you're measuring (due to delayed response).  As you can see in this example, 100 conversions (25 click-thru and 75 view-thru) of the 250 measured for week 2, are actually delayed response to advertising that occurred in week 1.  This example actually represents NO improvement in the campaign's performance from week-to-week.    

As you become more sophisticated in tracking advertising effects, it becomes increasingly important that you attribute the right effect to the right effort.    

Are you tracking the right Web metrics?

There is no denying the importance of measuring your Web site's visitor actions, how else would you know if your site is working for you? But,  are you tracking the right metrics?

I can't tell you the amount of times I have been in meetings and conversations with clients and colleagues where the subject of Web metrics comes up and the conversation immediately shifts to measuring visitor traffic.  While measuring traffic is important, that really does not tell you anything more then how many people are visiting your site. The real questions are, what are they doing and are they doing what you want them to?  I recall a recent conversation I had where a client was concerned about a decrease in visitor traffic to their site. Understanding this is a concern, we looked at the metrics more closely and found that the total number of conversions (visitors completing a goal) had actually increased.  Looking further we saw that the bounce rate (visitors who land on the site then immediately leave without visiting another page) decreased as well.  So despite the lower traffic figures we were actually getting better, more qualified, visitors to the site. This insight of course made the client very happy because things were not so bad after all, in fact they were quite good.

As Movéo's Director of Interactive Services I work with clients to help them define their internet strategies and how their Web site will support those strategies. One of the key components of our process is defining site metrics, specifically conversions (AKA goals). Often, web and marketing managers, particularly in the B2B space,  equate conversions with ecommerce and therefore overlook them because their site is not an ecommerce site. This of course is not the case. A conversion is a goal and a goal can be anything from a file download, to a page visit, to a completed contact form. The important thing is to understand and define what action(s) you want your Web site visitors to take and then measure whether or not they are taking them. Armed with this information you can optimize you site's user experience and marketing efforts to ultimately increase your ROI.

For some insight into defining your Web strategy, check out my article on Moveo.com titled "A Little Strategy Goes a Long Way."

Maximizing Profits versus Maximizing ROI

It is a common question in advertising...how much spend is the right amount of spend?  As any marketer can attest, answering this question is not easy — especially when it's asked by your CFO.  A straightforward (but overly simplified) response to the question is, "you should spend as much money as it takes to maximize your profits."  But, how can you project profits accurately? 

The first thing to remember is that, when calculated as a percentage, maximizing return on investment (ROI) is NOT the same thing as maximizing profits. 

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ROI as a %...

Revenue Generated [minus] Investment [divided by] Investment [multiplied by] 100

So, if you spend $1,000.00 on a campaign, and you attribute $2,000.00 in revenue to the business generated from that campaign, your ROI is 100%.  Or, the campaign returned a profit equal to the amount of the initial investment.
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Now, back to the original question...how can you predict the profits you're likely to achieve from a given marketing investment?  It becomes a little easier if you can focus on a single marketing activity, and if you have the ability to attribute revenue to that activity in isolation.  So, for the sake of simplicity, let's consider an e-commerce company that generates customers only through its online banner (display) advertising.

Assuming the company had enough historical data (from testing), it could begin to predict customer conversion rates at different banner impression levels.  Simply put...serving X number of banner impressions will likely result in a customer conversion rate of Y.  But remember, similar to the Law of Diminishing Returns found in economics, there will be a point at which each additional advertising impression will become less effective than the one that preceded it.  Consider the three different points along the curve on the graph below.

Maximizing ROI (the first point) is based on finding the highest point in the distribution curve.  Maximizing profits (the second point) is based on finding the point JUST BEFORE you begin overspending (the third point).  [note: assumes the cost of each impression is the same, and the value of each new customer is the same at each point, at an $8.00 CPM and a customer value of $465.00]

In this (admittedly simple) example, if you were managing against an ROI metric (%), you'd choose to serve 70 million impressions.  But, if you were managing against a profit metric, you'd choose to serve 140 million impressions. 

Managing against profits represents a higher risk, because it increases your likelihood of overspending.  But as you can see, if you're focusing too much on ROI, you could be limiting the profits your campaigns generate for the company.      

Is your Dashboard getting in the way of your Objectives?

Imagine you're driving from Chicago to St. Louis to meet an old friend for dinner.  To effectively calculate whether you're on target to meet your stated objective (arriving in St. Louis by 5:00pm), the only instruments you would need are your car's clock, its speedometer and the gas gauge.  By monitoring these devices, you could easily determine whether any adjustments would need to be made in your travel plans — leave a bit earlier, increase your speed (slightly), take shorter and/or fewer rest stops, etc.

Now, imagine that you sit down in the driver's seat of your car, and the dashboard looks like the cockpit of a Boeing 747.  With hundreds of dials, levers and gauges.  It would be overwhelming.  In fact, it would likely impede your ability to meet your objective.

This may seem like an extreme example, but this is the way many marketers choose to manage their online advertising campaigns.  With a heightened desire to prove ROI, and accessibility to campaign-level data at a moment's notice, online marketers are spending enormous amounts of time trying to make sense of all the data. 

Many of today's marketers are consumed with finding their answer to the question that plagued John Wanamaker at the turn of the last century. However, instead of finding the necessary insight (from the data) to eliminate advertising waste, they often find themselves too confused to make ANY decisions about campaign optimization at all.

The reason: they're looking at too much stuff...Impressions, Clicks, Visits, CTRs, Pageviews, CPCs, CPAs, CPVs, Time-on-Site, Bounce Rates, Referring Source, Recency, Visitor Loyalty, and on, and on, and on.  And worse, they don't always know why they're looking at all this stuff.   

Obviously, information is good, but information is not the same as insight.  Too much information can actually cause indecision. This is often known as "paralysis by analysis," a phrase applied when the opportunity cost of decision analysis exceeds its benefits.

Remember, campaign optimization is not a destination, it is a process.  It requires clear establishment (up front) of the metrics you will leverage to assess the present state of performance, and to prescribe a course of action.

Any metric that is reported on should have a purpose that is understood by anyone involved in managing (or funding) the campaign.  Simply put, any metric that is reported on should be actionable.  Otherwise, ignore it.