The Changing Face of Healthcare Marketing: A Q&A with Colin Hung

The annual Swaay Health conference (formerly HITMC, now called Swaay.Health Live) brings together marketing, PR and communications professionals –– including CMOs, VPs, directors and managers – that control marketing budgets in the healthcare space.

I was fortunate enough to attend this year in Atlanta, and was surprised and intrigued by some of the topics that came up in various sessions. I wanted to know more, so I sat down with Colin Hung, chief editor of Swaay Health, editor of Healthcare IT Today and co-host of the Healthcare IT Today podcast, who was generous enough to share his vast knowledge and valuable insights into topics like the buzzword on its way out, a major HIPAA clarification and the future of healthcare marketing.

Q: During the Swaay Health pre-conference, you mentioned that one of the biggest mistakes you see start-ups make is going to the wrong audience(s). How can healthcare companies overcome this challenge and find the right targets??

A: In health tech, many marketers assume that their best target is the CIO or CMIO. Although they are important to the process, it’s very rare that these people are the right initial audience – i.e., buyer – for a technology solution.?

Marketers have to understand that in healthcare, decisions are made by committee. There is no single person who moves the needle; it’s a group. Your champion probably won’t be the CIO or CMIO (unless it’s a cybersecurity play). Instead, it will be the everyday user of your product. For example, an administrator, someone on the RCM side, or a clinician might be the best target, especially early-on in the process.?

A lot of companies make the mistake of just creating content for the CIO, when the CIO will not be the one to bring that company’s product forward. They have enough on their plate – they won’t offer a tool to the surgeons; they will wait for the surgeons to ask for it. While it may feel like the CIO should be the decision maker (and they might be the person to sign off on the purchase down the road), they won’t champion the project/solution. So, you’re knocking on the wrong door to try and get to the CIO.?

To be successful, you have to understand how healthcare purchases are made. Be sure you speak to all the people involved in the buying journey, not just who you perceive to be the final adjudicator of approving your project.

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Q: Have you seen this done well? Is there a secret to understanding how to find the right person??

A: Yes, I have seen it done well, but usually after someone has already gone through the school of hard knocks. So, I think the way I would answer that question instead is: How do you speed up that learning?

Every product and path to purchase is unique. To give a formula wouldn’t be right. The way to accelerate your learning is really by asking questions. Meet with people you think might want to buy or use your solution.?

Ask things you wouldn’t typically ask. Founders are really good at asking things like “Do you like this product?” or “If this problem was solved, would that be of interest to you?” However, the immediate follow-up needs to be, “if you like it, what are the steps that have to happen for a purchase?” You will learn a lot with the answer to that question. For example, they might loop you into an intricate process that involves annual budgets, deadlines and approvals which might take 6 months (or more!). While the process itself can be extremely frustrating, it’s critical to understand it and have someone on the inside who can help you navigate it.?

Once you learn how the budget cycle works, you can work on finding out who is involved in approving a project/solution like yours and what criteria you need to meet. Soon you’ll have the full picture, and you will understand who you need to focus on as part of the buying journey and just as important WHEN you need to engage them.?

You have to ask those questions for every particular project/solution and with every healthcare system, because each one is different.

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Q: You believe that “value-based care” (VBC) is a buzzword on its way out. What do companies that have spun up out of this approach to healthcare need to do??

A: First, it’s not going away completely. VBC is important and is something that, as an industry, healthcare is moving very slowly towards. What I mean is was that VBC is not something that people are buying. That’s the distinction. It’s a buzzword that in my mind, needs to come out of marketing.?

No one is walking around thinking, “I need to do VBC today.” It’s not that companies don’t like the idea of VBC or don’t want to move in that direction; it’s more that it’s a term that doesn’t really mean anything. So instead of peddling VBC, companies have to be more specific. What are you offering under the VBC umbrella? Are you offering community-based care, remote patient monitoring, smoking cessation, or something else? Get to the heart of what it is that you are doing, and just say that. It’s nice to say something is value-based care, but that term is not something tangible that leads to a sale. What I am after is the layer beneath that. What is it specifically you are doing that is leading to a VBC environment??

Also, for most organizations, VBC is not a number one priority, it’s on the 5-10-year goal horizon. You need to find a way to tie it to something they’re already spending on in the next year or so. Something like a home care initiative, reducing diabetes – those kinds of initiatives. Those are all VBC initiatives, but they are very specific programs under the larger umbrella.

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Q: Let’s talk about the 2022 rule that changed how healthcare companies can track online traffic. First, what is it??

A: In Dec 2022, the Office for Civil Rights (OCR) issued new interpretation of what constitutes Protected Healthcare Information (PHI).?

Here is a simplified explanation of the new interpretation: the combination of IP address + a page on a healthcare provider’s website = PHI. For example, Person A visits Hospital X’s website and searches for diabetes information. Person A also searches for available appointments with Hospital X’s endocrinologists. Under the new guidance, that is considered PHI and cannot be shared with a third party outside of the covered entity (the Hospital) unless that third party is under a Business Associates Agreement.?

Sounds pretty reasonable…except that most healthcare organizations use third-party web tracking services from companies like Google (i.e., Google Analytics) and Meta (i.e., Facebook pixel). Any organization sharing that IP Address + the pages that person visited is suddenly in violation of HIPAA.

This change in HIPAA interpretation was a shock to healthcare organizations who suddenly had to turn off many of their digital front door and marketing-related website capabilities. This included retargeting campaigns, website analytics, and personalized website experiences.

All of a sudden, healthcare organizations can’t do re-targeting and they have to turn off tracking on their websites, so they can’t see who’s visiting from where, or what they are looking at. Marketers went blind pretty much overnight. A very effective way of getting new patients and getting existing patients to book certain types of appointments was lost. The effect rippled to anybody now doing, say, digital front door solutions trying to market to marketers inside of healthcare websites.

Marketers are now quite distracted trying to figure this out and what they can do to come up with a new way to do business.?

[NOTE: Since we spoke to Colin, the Texas courts have made a ruling that vacates the core of OCR’s guidance. The courts sided with the American Hospital Association’s claim that OCR overstepped with their December 2022 guidance. OCR may appeal the decision.]

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Q: What do healthcare marketers need to know in the wake of this rule change, and how can they pivot?

?A: To start with, if your product was dependent on knowing who was visiting an organization’s website, it may not be viable because healthcare organizations aren’t allowed to do that type of tracking anymore.?

And even if the guidance is modified or nullified completely, there are millions of dollars’ worth of lawsuits working their way through the legal system, so providers are very aware of this potential privacy landmine.

In general, it has heightened the awareness of HIPAA and what you do with any data in the healthcare community. Healthcare organizations are taking more of a magnifying glass to their practices and asking: what vendors are we using that are doing something with our data and where is that data going??

I think this whole issue means vendors are under much more scrutiny – regardless of whether you provide digital front door solutions, websites or something in the back office. Providers want to know exactly what you are doing with the data that they share with you, and if there is a risk that they need to be aware of.?

Vendors should also be aware that this change will likely have an impact on contracts moving forward. I think it’s already manifesting in a ratcheting up of caution from providers towards vendors that store a healthcare organization’s data. I expect a lot of healthcare organizations will change contracts to require approval for anything a vendor wants to do with their data, including preventing it from being used for marketing purposes.

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Q: Let’s talk about the margin problem in hospitals right now. What opportunities and challenges does that present for companies selling to them??

A: Like a lot of other things, the margin problem came about as a result of COVID. During and after that period, there was a huge problem with revenue at hospitals. People stopped going. A lot of consumers lost their jobs – and with that, insurance coverage – so they couldn’t get care. Coming out of the pandemic, there was a huge focus on addressing the revenue problem by getting patients back to the hospital.

This seemed to make sense, but what we didn’t know at the time was that skyrocketing costs and labor shortages were compounding the issue. Hospitals and health systems tried to bring as many patients as possible back in, and then quickly realized, they didn’t have the capacity to actually see them all. Also, the cost of everything went up because of supply chain issues––supplies that had been $5 were now $20.

Eventually, providers realized that all revenue is not equal. Many are actually lost money providing necessary services. There became an awareness that we have to look at margin and not just revenue. We needed to account for both sides of the equation: how do I reduce cost and improve margins at the same time??

There are two ways of dealing with the margin problem that I have seen gaining popularity.?

First, is reducing costs by reducing the number of vendors so providers have more power to negotiate (not EHRs necessarily, both other types of solutions). Health systems are asking why they have 20 vendors for wireless services and 15 different phone providers across their facilities, for example. When health systems consolidated, they didn’t look at individual vendors. Now, there is a push for IT and Clinical Engineering departments to cut this down and go with one or two vendors.

Second, providers are looking at what kinds of patients and services are adding to their profit lines. More profitable services can fund those that are necessary but aren’t making money. There’s a lot more thought and math being asked of marketers. You have to match your organization’s capacity to your marketing campaigns, and you have to ensure you’re bringing in more of the patients that create a profit. (They need the higher margin on some patients to make up for the 0% (or negative) margin on others.)

So, in order to succeed, vendors need to talk about how they can improve the margin situation. All of us are under tremendous pressure to deliver on these goals, especially those at rural hospitals where there is a higher problem. Instead of talking about efficiency, vendors should be talking about bringing patients through the door, vendor consolidation and cost removal.

On the topic of efficiency: efficiency doesn’t take out cost. This is a myth. If you are saving my nurse .70 hours, I still can’t get rid of that nurse–in fact, I need more of them. Saving that time is nice, but It’s not actually helping with my margin problem. You have to look for hard dollar returns in addition to some of the efficiency gains you get. This has been a big “AHA!” moment for people trying to sell in this environment.

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Q: What area of healthcare are you most excited about and why?

A: One of the areas that’s most exciting is the realistic application of AI to healthcare. The highest profile one is ambient clinical voice – having something listening to an encounter with a patient and then summarizing or taking notes. This saves the doctor a lot of time. There is a growing acceptance and momentum of this capability among doctors, and patients will get used to it over time. Currently, it is only used for transcribing and summarizing notes, not diagnosing or treating. AI can also be used to match inbound documents to patient records automatically, summarize lab results and spit them out in plain English, and craft communications. All of these are very exciting.

Another area that has me excited (which is not usually on people’s radars) is some of the tech being used in conjunction with revenue cycles. I’m talking about back-office operation stuff. There’s a lot of exciting things happening in that space to make the process even more streamlined, and allow more transparency with patients. Transparency is a huge challenge. Without it, people can’t make real decisions about their health. The more we can do to give patients more information before treatment – such as the real costs they are going to pay – the better.

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Q: Let’s pivot to your role as editor. What stands out to you when someone pitches a story? What gets you to say ‘yes?’

A: First, we get a lot of pitches. People are always surprised at the volume. On a daily basis, I get anywhere between 20-30 pitches. That’s what you’re up against.

Something that stands out to me is a truly personal message, as opposed to a slightly personal message. Everyone changes the name in the greeting. That’s not real personalization. But if someone reminds me they were at Swaay Health Live in Atlanta and calls out a session they really enjoyed, or if I’ve met someone at a prior conference and this is a follow-up to that chance meeting, their message will stand out. If we have some type of prior relationship, put that in the first couple of lines. Even if the rest of the pitch is copied and pasted, at least that one part is personalized.

My next piece of advice would be to make sure the pitch is aligned with what the journalist actually covers, not just what the publication covers. I’ve never personally written a story about pharm tech, but I still get those pitches. Right away, I file that. I don’t have expertise in that subject, and I’m not interested in it. Make sure you align with what I write about, am passionate about and am known to comment on.

Lastly, take a look at our recent pieces. If I have already written a story about ambient clinical voice in the last few weeks, I am not likely to cover it again right away.?

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Q: Are you seeing a lot of pitches written by AI??

A: Absolutely, and it’s very obvious. Right now, you can tell when something is human written and when it’s not. When it’s not, it has overly flowery words and very complex medical terms in places where it’s not needed. It’s very easy to tell when something is even partially AI generated. When we talk as people, we have a certain short form of communication – we don’t write the same way that we talk. AI bases its writing on published articles, not how we communicate more casually. I think that’s the biggest difference.

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Q: What is the future of marketing in healthcare? It seems like more people are getting laid off, and organizations are getting rid of CMOs. Should we be worried??

A: I’m optimistic about the future of marketing. We will always need it, even if people don’t recognize the value of it from time to time. I think what will be relevant in the next few years for a marketer who wants to grow their career is to become very good at becoming a team player with the C-suite. You have to find a way to get along with the chief revenue officer (CRO) and the head of sales. There can no longer be a fight between sales and marketing; as a marketer, you will always lose that battle.?

You also have to learn to demonstrate value. A campaign or strategy can’t be solely based on one big end goal. You have to build in ways to show value along the way. If it’s going to take six months before someone’s going to see the results of a thought-leadership campaign, for example, that’s probably four months too long. Sooner or later, people are going to start asking: what are we getting for that spend? If your answer is, you have to wait another three months before you see results, that will not be acceptable. You have to demonstrate value more frequently… at every step. That means coming up with better metrics, tracking more benchmarks, and being more proactive in how you communicate marketing’s progress to the rest of the executive team or to your managers.

In addition to being creative and bold, these are two things that are in store for marketers in the next two years. If you can get good at that, you will thrive.?

Q: What do you anticipate covering more of in the second half of 2024?

A: We’re looking at:

• Patient experience
• Digital front door technologies that are getting better at matching capacity
• The online appointment booking movement and the complications that come with it
• Positive stories to counteract everything going on with HIPPA
• AI around the edges––digging than ambient clinical voice to how AI is deployed in revenue cycles, patient communications, cyber security, and used to optimize operations inside the hospital

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Thank you, Colin, for the incredibly valuable insights