Laying the foundation for experimentation-based digital marketing in healthcare

The headlines are everywhere: biosensors, point-of-care diagnostics, artificial intelligence, next-generation sequencing—the healthcare industry is evolving rapidly. The way healthcare is marketed and delivered to consumers and patients? That’s another story.

The Current State of Digital Disruption in Healthcare

Overall, the global digital health market is growing steadily. In 2015, it was valued at $80B. By 2020, it’s expected to increase to over $200B. The estimated global electronic health records (EHR) and electronic medical records (EMR) market in 2020 alone is $24B. The forecasted global telemedicine market size in 2021? $41B.

Healthcare digital industry growth
Source.

Perhaps that explains why a 2018 study from Ernst & Young found that 91% of healthcare companies already had or planned to begin a digital health initiative within the next year to improve patient experience. How? 51% of healthcare companies said data analytics were the top initiative, followed closely by competitive benchmarking, among others.

Medical startups are securing ample funding in 2019. In fact, the total digital health industry funding worldwide in 2018 surpassed $14B.

Healthcare startups growth
Source.

A study conducted by a team of scientists last year indicates that the best way for large companies to approach digital disruption in healthcare is likely through collaboration. Corporations must learn from startups, and vice versa:

Digital transformation is an opportunity to accelerate health care performance by lowering cost and improving quality of care. At an economic scale, business models can be strengthened and disruptive innovation models enabled. Corporations should look for collaborations with start-up companies to keep investment costs at bay and off the balance sheet. At the same time, the regulatory knowledge of established corporations might help [startups] to kick off digital disruption in the health care sector.

The study looked at how technology corporations, life science companies and medical startups are investing in digital disruption. Technology corporations are investing heavily in adherence hardware and treatment platforms. Similarly, life science companies are investing heavily in adherence hardware and software. Treatment services are also becoming a priority.

Medical startups, on the other hand, are more diversified, actively exploring all six major customer needs: adherence, diagnostic, lifestyle, patient engagement, prevention, and treatment.

Healthcare startups areas of focus
Source.

With the proper funding in their pockets, the increasing demand and their diversified efforts, medical startups will only add to the mounting pressure to tackle digital disruption head-on.

Currently, however, most companies are falling short of consumer and patient expectations.

Michael Song from MedImmune presented some surprising numbers at Digital Pharma EAST late last year:

  • There are 325,000 health and fitness apps on the market.
  • Only 41 of them have more than 10M downloads on Google Play.
  • In fact, 85% have fewer than 5,000 downloads.
  • 50% of mHealth apps will never break even the 500 downloads mark.
  • Over 50% of apps see a usage drop-off rate of 64% after just 30 days.

Yet, according to a survey conducted by Transcend Insights, 64% of patients say they use a digital device (e.g. mobile apps) to manage their health. 71% believe it would be useful if their doctor could access that data as part of their medical records.

Again, the demand exists, but isn’t being met (yet). All of this information paints a clear picture: consumers and patients want the way healthcare is marketed and delivered to catch up to the pace at which healthcare as a whole is going digital, yet companies are consistently falling short of those expectations.

The tricky thing about this industry shift is the sheer number of factors to consider. For example, according to Bain and Co., the five pillars of digital disruption in healthcare are:

  1. The Amazon Effect: As non-traditional healthcare companies, like Amazon, enter the space, competition and innovation are heating up.
  2. The Digital Revolution: Tech innovations, such as smart devices and machine learning, are making digital treatment and care a reality.
  3. Regulatory Change: New and complex regulations, like the debate over the US Affordable Care Act, make for an unpredictable future.
  4. Consumerism: Consumers and patients have more choices than ever before.
  5. Personalized Medicine: Medical products and services will be increasingly tailored to specific consumers and patients based on their unique medical history.

This digital disruption is a healthcare evolution, not revolution. You will notice the impact in small pockets of the industry first, but it will continue to spread. The best time to start thinking about this shift was yesterday, but today is the second best.

What was going on in your business when you decided to start running experiments?

“It goes back to Providence’s mission. We’re here to help the poor and vulnerable, to ease their way. How can we make the experience as smooth as possible so consumers can get to the healthcare solution they need faster? Answering that question seemed like a really important, worthwhile task. A combination of analytic thinking with that desire to make the consumer’s way as seamless as possible prompted us to drive toward experimentation.”Marc Schwartz, Director, Growth Marketing at Providence Health and Services

John Ekman from Conversionista shared a few industry-agnostic tips for companies looking to chase digital transformation at CXL Live 2019:

  1. Digital transformation is a result, not a goal.
  2. Digital transformation is largely the result of combining momentum, proper resources and strategic evaluation.
  3. There are five ways to “go digital”: digitize the product itself, add a digital service layer to the product, digitize your processes, digitize your marketing and sales strategy, and come up with net new digital products.
  4. Allocate budget and resources to new projects first.
  5. Listen to what your consumers need, act quickly on those needs, and scale.

For the rest of the article, we’ll focus on how to digitize your marketing and sales strategy.

The Challenges of Digital Disruption in Healthcare

You will encounter a number of contextual challenges as you start to digitize your marketing and sales strategy, from stakeholder support to resourcing. Universally speaking, though, there are two major challenges that make going digital particularly difficult in healthcare: Personal Health Information Protection Act (PHIPA) and Health Insurance Portability and Accountability Act (HIPAA); and the lack of a traditional online transaction in healthcare.

1. Health Insurance Portability and Accountability Act (HIPAA) and Personal Health Information Protection Act (PHIPA)

As Bain and Co. suggested above, regulations, both new and old, have a big impact on the healthcare industry. HIPAA and its Canadian counterpart, PHIPA, complicate the collection, use, and disclosure of personal health information.

These acts are incredibly wide-reaching and nuanced. HIPAA is designed to protect patient rights and promote the safeguard of electronic protected health information (e-PHI). Here is a high-level summary of what’s covered under HIPAA:

  • All e-PHI created or received must be kept confidential and available to those entitled to access.
  • Anyone with access to e-PHI must take all reasonable steps to identify and eliminate potential threats to the security (and integrity) of that e-PHI.
  • Anyone with access to e-PHI must take all reasonable steps to identify and eliminate potential impermissible uses, disclosures, alterations, or deletions.
  • Anyone with access to e-PHI must take all reasonable steps to ensure HIPAA compliance within their entire organization.

Here is a high-level summary of what’s covered under PHIPA:

  • Consent is required if you want to collect, use or disclose personal health information.
  • All personal health information is considered confidential and those in possession of it must take all reasonable steps to maintain its security.
  • Everyone has the right to access their personal health information at any time.
  • Everyone has the right to instruct those with their personal health information to not share it with others.
  • The rules around using personal health information for research, fundraising, and marketing purposes are even more rigorous and nuanced.
  • Everyone has the right to correct errors in their personal health information at any time.

There are a lot of gray areas here. These acts cover everything from a single practitioner medical office to multi-national health plans. What’s important for us, as marketers, to remember is this: PHIPA and HIPAA make sourcing usable data for marketing activities in the healthcare industry particularly difficult.

How have HIPAA restrictions impacted your strategy?

“HIPAA is always top of mind as it should be for healthcare companies. Consumer privacy is of top importance in dealing with such sensitive issues like health. It was interesting to learn In some of the research we did around personalization, that one of the assumptions that people have about healthcare companies is that we’re going to be trustworthy and reliable. Because HIPAA exists, that’s implicit.

We also found that consumers give more data use latitude to a healthcare company if it helps them. So it puts the onus on the healthcare company to ask, ‘Is what I’m doing helpful for the consumer?’ It should never just be helpful to you.” — Marc Schwartz

2. The missing transaction

As Marc Schwartz, Director of Growth Marketing at Providence Health and Services, explains, there is often a lack of a traditional online transaction in healthcare: “There’s no basket. There’s no actual care that happens on our site; the care happens in the doctor’s office. Our doctors and their services are our product. So how quickly and easily we get someone to a doctor’s office becomes really important. Your measures of success need to be different.”

This forces you to adopt a utilitarian mindset. Your visitors already know what they want to do and they’re already convinced they need to do it, they just want to get it done as painlessly as possible. They need to find a doctor with availability, they need to find a clinic close by, they need to book an appointment with a specialist, they need to understand the science behind their unique condition—you name it.

The burden of persuasion is lifted, but this forces added pressure onto your user experience (UX) and customer journeys.

Why Experimentation is the Crux of “Going Digital”

Think of experimentation as your emergency vehicle through this complex period of digital disruption. Why? There are the internal benefits, of course:

  • Experimentation brings voice of customer data to the forefront by prioritizing consistent research and improvement.
  • Experimentation encourages strategic resourcing and unbiased digital decision-making.
  • Experimentation processes can be applied to every element of your sales and marketing strategy.
  • Experimentation fosters a test and learn culture.

More importantly, though, experimentation benefits the end consumer.

Schwartz explains: “Experimentation has made us realize how many hoops we make our consumers jump through just to do a transaction, and how frustrating that is. Experimentation forces you to ask why and the more you ask why, the more you realize your language is confusing, the number of steps required is too daunting, you don’t give enough direction, etc. Frankly, experimentation has shown us how hard we’ve made it for consumers to do what they want to do.”

It’s not enough to simply “go digital”; you have to “go digital” effectively. That means a commitment to fine-tuning the UX and customer journeys, a job that’s never truly done, according to Schwartz: “In reality, our biggest competition is always the latest consumer experience that someone has had. That changes the playing field, you’re never done.”

If digital disruption and transformation is the destination, experimentation is the emergency vehicle with its lights on and sirens blaring. Without it, at best, your digital sales and marketing strategy will be stagnant. At worst, you will be making important business decisions based on bias and subjective opinion.

What’s the most valuable thing experimentation brings to the table, and why?

“It’s helped us understand what’s most important to consumers. The site doesn’t exist for us, it exists for our consumers. Experimentation is one form of research that gives you insight into the mind of the consumer, which then allows us to drive action and results.

One of the questions you have to ask when an experiment wins is why. What makes it a winner? Same thing when it loses. Why did it lose? Were you out of touch with the consumer? Winners and losers, research—it’s all an opportunity to listen to the customer and improve relevancy. If you’re not helpful to consumers, if you’re not of value to consumers… why do you exist, why are you here?” — Marc Schwartz

How to Lay the Foundation for Experimentation

Before you launch your first experiment, you want to master the basics and lay the groundwork for an effective experimentation program that will grow with you through your digital expansion. That means:

  1. Setting meaningful goals and defining your metrics.
  2. Defining scalable, repeatable processes for identifying and prioritizing opportunities.
  3. Mapping your existing customer journeys, defining your ideal customer journeys, and identifying gaps and opportunities.

1. Setting Your Goals

The lack of a transaction makes setting goals and defining metrics more tricky in healthcare than in other industries. Often, it means there are more customer journeys to account for, which means more conversion points to optimize. Take Swedish Medical Center, for example. Here’s their current “Find a Doctor” page:

Healthcare digital marketing example
The “Find a Doctor” funnel.

From here, a consumer might:

  1. Use the search function to find a doctor based on a number of different inputs.
  2. Find a doctor based on a single filter (e.g. “Specialty”) below.
  3. Call the 1-800 number to have a representative help you find a doctor over the phone.

Each of those three options leads the consumer down a separate customer journey to achieve the same result: finding the right doctor.

In e-commerce, on the other hand, you would have a more structured, linear funnel. The consumer visits the product page, they add the product to their cart, they enter their shipping and payment information, they review the order, they complete the purchase.

You need to get aligned on what’s important to you as an organization from the beginning. Is it as simple as the number of appointments booked? Is it how quickly visitors are able to book their appointment?

Ask yourself a few questions before moving on to step two:

  1. What metric restrictions exist currently? What’s feasible and what’s not? What will be feasible in the future? What’s worth investing in now to make things easier and more reliable in the future? For example, only some doctors have online appointment booking enabled on Swedish and Swedish has no control over the availability of the doctors.
  2. How comfortable are you with directional metrics and data? What’s your risk tolerance?

2. Defining Your Processes

Amateurs rely on hacks and tactics. They throw opinion after opinion at the wall to see what sticks. And sure, occasionally, they might get a big win. But they won’t know why or how to replicate the success. Instead, they’ll simply continue to throw more ideas at the wall.

A better way to approach experimentation is through repeatable, scalable processes that prioritize insights and learning. Pros design experiments in a way that brings value, regardless of whether or not the experiment won.

At WiderFunnel, we use the Infinity Optimization Process to generate experiment ideas and lift revenue:

Infinity Optimization Process (TM)
WiderFunnel’s Infinity Optimization Process™

On the green “Explore” side, we gather quantitative and qualitative data to generate informed experiment ideas. That means looking at old experiment results, diving into digital analytics, conducting user testing, interviewing consumers, etc. On the blue “Validate” side, we:

  • Prioritize experiment ideas from the “Explore” side.
  • Create hypotheses for our high priority experiment ideas.
  • Develop an experimentation plan and design the experiment.
  • Loop in UX/UI designers.
  • Conduct quality assurance for the experiment.
  • Run the experiment.
  • Analyze the results.

Note the infinity loop surrounding both sides! Experiment results feed back into the green “Explore” side.

Also, notice how the “Explore” side revolves around the airplane icon in the middle? That’s our LIFT Model®:

WiderFunnel’s LIFT Model details the 6 conversion factors.

By focusing on these six conversion factors when evaluating your website and conducting research, you will focus your efforts and avoid subjective opinion (as much as humanly possible, anyway).

We’re using this to drive smarter hypotheses that fuel experimentation. Research and experimentation go hand-in-hand. All of the data we collect… all of the website click data, all of the heatmap data, all of the feedback from visitors—we use every data source we can come up with to get to the heart and into the mind of the consumer. Then we drive experiments using that information.

— Marc Schwartz

The optimization and experimentation process looks a bit different at every company and you will undoubtedly end up tweaking it to suit your unique needs. What matters is that you’re relying on a process that you can run through repeatedly. Experimentation is the act of consistently, purposefully mining for minerals, not striking gold.

3. Mapping Your Existing Customer Journeys & Identifying the Opportunities

Now it’s time to map your existing customer journeys. What’s the current state of your website (or other digital asset)? Here are a few questions you should ask yourself at this stage:

  • Where are visitors arriving from?
  • What do visitors come here to do?
  • What am I asking them to do here?
  • How many steps stand between them and their end goal?
  • How many of them make it to step one, step two, step three, etc.?

This is where the LIFT Model comes in handy. You can evaluate the current state based on those six conversion factors as well: value proposition, relevance, clarity, urgency, distraction, and anxiety.

Using Behavioral Science to Gain a Deeper Understanding

Providence works with WiderFunnel’s behavioral science team to conduct in-depth research that illuminates the existing customer journey.

In one study, 10 participants were asked to complete four key tasks (find a doctor, find a location, schedule an appointment, and register for a class) on a Providence-owned website and on competitive websites.

The study had two parts:

  • Part 1: Task-based, unmoderated interview.
  • Part 2: Self-reflection questions. For example:
    • How easy or difficult was it to complete this task?
    • How would you rate your experience completing this task?

WiderFunnel’s team of behavioral scientists then examined all of the video recordings, and assigned ratings based on their observations of friction and ease. They also conducted a sentiment analysis based on what respondents were saying while attempting to complete each task.

Watching these 10 participants try to use their website has been invaluable to the Providence team. Seeing (and hearing) pain points, clarity gaps, distractions, etc. helped map their existing journeys and visualize their ideal journeys, effectively fueling their experimentation pipeline.

Once you have a firm understanding of the current state, you can move on to mapping your ideal customer journeys. Your job now is to imagine how you can get your visitors to what they want as quickly as possible. In other words, your job is to improve the user experience and your customer journeys.

Healthcare digital marketing customer journey example
An alternative to Providence’s original “Find a Doctor” funnel gives consumers the chance to “Book an Appointment”.

What does your research tell you about what your visitors want and how effectively you currently deliver that value to them? Are there any technical limitations or gaps that you need to solve for to bring your ideal state to life? Essentially, what opportunities exist for you to close the gap between these two states? Those opportunities are the breeding ground for your data-informed experiment ideas.

What results have you seen because of experimentation?

“We’ve definitely seen an increase in consumers moving through our doctor funnel and our location funnel. We’ve seen that we’ve eased the way of the consumer, which has led to big learnings overall.

We’re always looking for opportunities to anticipate intent and then meet that intent. Experimentation has helped us understand where we’ve gotten intent wrong. It helps solidify our thinking and also inspire our thinking.” — Marc Schwartz

Maybe your findings indicate you should experiment with something as simple as fewer steps, a shorter customer journey. Or maybe they indicate you should experiment with Tealium to provide your phone representatives with live, anonymous consumer data. Whatever the case may be, you’re ready to turn your opportunities into hypotheses, your hypotheses into experiments, your experiments into insights, and your insights into revenue.

Examples of customer journey improvements

We’ve improved Providence’s mobile hospital pages to increase engagement with nearly every action a user can take on that page, from finding additional information, getting directions, or calling the hospital itself.

Healthcare Digital Marketing Experiment Example 1

In another experiment on Providence’s location search funnel, improvements to the user interface (UI) dramatically improved engagement with all elements on the page. We were able to reduce frustrating back-and-forth visits to the second, third, fourth page of results, indicating a much better overall user experience.

Healthcare Digital Marketing Experiment Example 2

Tackling Digital Disruption with Experimentation

Digital disruption isn’t coming, it has arrived. (It’s even had a few years to unpack and make itself at home.) Here’s what healthcare companies can do to tackle it head-on:

  1. Recognize experimentation as the crux.
  2. Use the Infinity Optimization Process as inspiration to define relevant internal experimentation processes ahead of time.
  3. Map all existing customer journeys.
  4. Map all ideal customer journeys.
  5. Plug the gaps between those two states (existing and ideal) into the experimentation processes defined in step three.

The great thing about experimentation is that it’s a positive feedback loop. The more experiments you run, the higher the quality of your future experiments. It’s simply a matter of getting started—before you’re left behind.

Are you a marketer in the healthcare space, facing digital disruption? We’d love to hear from you! Leave your thoughts, challenges, questions, and strategies in the comments section below.

Author

James Flory

Senior Experimentation Strategist

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