Bright Lights, Big Data

Building a platform for optimized healthcare marketing

When my kids first meet other kids their age they perform a funny little ritual. There’s typically some introductory smalltalk and then they start to drill for common interests, normally video games, “Do you play Roblox? How about Minecraft? Fortnite?” They’ll circle around a little bit, find a common interest, and then the rest of the time flows easily with something they’re both enthusiastic about.


One of my favorite parts of going to conferences were the random conversations with other healthcare marketers over dinner or wandering the exhibitor halls. Like little kids the conversations often involved a little bit of drilling to find common interests. Unlike little kids, the topics we rattled off were typically healthcare marketing headaches. “Oh, your CRM vendor closed their doors too?” or, “Have you managed to get direct access to EMR data yet?”


So many long term friendships blossomed from those moments of sharing pain.


And with healthcare marketing sitting at the junction of referral growth goals, tight operating budgets, patient expectations, and systems with isolated inaccessible pools of data there was always plenty of pain to go around and lots to talk about.

Feeling Our Way Through the Dark

I’ve been a healthcare marketer for what seems like a very long time (20 years) with a big chunk of that at Scripps Health in San Diego. Over that very long period of time, I’ve seen lots of seemingly impossible problems vanish and other problems that seemed easily remedied prove to be more tenacious.


One problem that I was sure was going to be a piece of cake was “proving marketing ROI and justifying my operational budget”. How hard could it be? We pay for ads, people click them, they become patients, and we look at how much money they bring to the organization.


It isn’t even hard math.


Then you start trying to follow people on their journey to new patient admission.


“What do you mean the call center can’t tell me if this marketing lead went on to become a patient?”


“I can only get EMR data for lead matching once every six months?”


And now I’ve waded through the various IT Security Committee meetings to get the data, my CFO is telling me that my “... attribution is too vague and that those people would have become patients anyway?”


For years we nibbled around the edges of this problem. We optimized the marketing calls to action. We integrated more tightly with call center operations: first with pre-call ‘whispers’ and then with a marketing-connected CRM that call center agents entered leads into directly. We added referral source IDs to leads to help us to find them (thanks for nothing ‘fuzzy matching’) when they showed up in the EMR.


The problem never went away though. The funnel was leaky. The attribution was too soft. The data was too squishy.

The First Spark

So we found a way to move what we had always assumed was an immovable object. We plugged our marketing funnel directly into the EMR.


The missing piece of the puzzle was the connection between marketing lead and EMR-based patient record. We unlocked a new world of funnel transparency by giving contact center agents (no longer just a call center) the ability to not only qualify leads but to begin that admission or conversion process.


The new process was rolled out service line by service line. For some service lines this meant that the contact center agents needed consultation scheduling access. For others it just meant an extended set of lead qualification criteria. A slice of that conversion step moved out of the hands of specific locations of physician offices and into the hands of a centralized group of marketing-adjacent resources.


Because we had spent so many years building and refining our marketing referral and attribution practices we had great data all the way up to that last moment. With the new API-based EMR integration, we were able to join all of that marketing data to all of the rich data the EMR fed back. Campaign type connected to admission data. Call center agent performance connected to patient conversion propensity. And the holiest of holy grails: individual ad campaign spend connected to reimbursement dollars!


There were literal tears in my eyes when I pulled that fully-connected report for the first time.


Being able to demonstrate true return on ad spend was a dream realized. Having the ability to measure real campaign effectiveness at a high level and then being able to dive in and slice the data by location or region or individual keyword groups or times of days made me feel like I was drowning in something delicious and sweet. Overwhelming and joyful.

Shining a Light on Dark Data

Bristling with this new data we started to root around looking for that big opportunity that was going to help us to blow the doors off referral growth numbers. There were some little ‘aha’ moments but we mostly found lots of small places to round rough corners and smooth small areas of the funnel. The conversion data was used to justify lots of minor usability improvement projects.


But something was wrong with the doctor finder conversions.


Our doctor finder was amazing, award-winning, a thoroughbred race horse of a tool refined and optimized over years of hard work. At the time we used Epic Open Scheduling: a scheduling widget that allows new and existing patients to schedule appointments directly with physicians. Tens of thousands of people made successful physician and provider searches every month… but a surprisingly small number of those people went on to schedule an appointment with the physicians they found. Most people were either fading away into the void or picking up the phone to request an appointment through our contact center team.


Users in focus groups and one-on-one usability sessions consistently told us that they wanted to use online tools to schedule appointments. Why wasn’t this translating to heavier use of the appointment scheduling opportunity we were putting in front of them.


A lot of time was spent exploring the ways to improve the Epic Open Scheduling experience before we decided that we needed to build a native solution.

Illuminating the Entire Pathway

Epic’s wonderful and well-documented APIs allowed us to build a realtime connection to appointment information. Pulling it into our doctor finder and website as a whole, and pushing scheduled appointments back into the EMR.


Following the change appointments went from being an afterthought, displayed in quiet little frames, to being the heroes of the doctor finder experience. We put them directly into doctor finder search results and allowed patients to sort by “next available appointment”. We added them to location pages. We created map tools that showed patients where the nearest and soonest appointments were.


The appointment scheduling workflow changed too. We didn’t need to force people into MyChart (Epic’s patient-facing portal) any longer. Now we had a streamlined and usability-focused set of forms that new patients could fill out to make that first appointment.


The changes were subtle but significant. Within six months, with no additional promotion or marketing efforts, online appointments scheduled rose by over 140%.


People that might have previously decided to pick up the phone or, worse, give up and go to a competitor’s website were now scheduling appointments with our physicians.


And this might just be the beginning. Google is currently running a limited pilot that allows providers to display available appointments directly on the Google results page – deep linking those clicks into your appointment scheduling workflow. This type of syndication can only happen when you pull appointments out of your EMR and expose them in a meaningful way on your website. It also exposes conversion opportunities to an audience you might have never reached.

Funneling Into the Future

A fully integrated and transparent funnel allows you to focus your efforts where they’re going to really make a difference. This has always been important but with tighter budgets, a smaller pool of patients to compete for, and patient usability expectations that things “just work” it is now critical to a healthcare marketer’s success.


The problems we have to solve will only get more difficult (ask me how to track the success of marketing campaigns in a world without cookies…) and more clinically and operationally focused but with the right data and tools, we can all do amazing things. I’m going to be attending the Healthcare Internet Conference in Miami this fall – my first conference since COVID started – and I am so excited to catch up with old friends and hopefully make some new ones.


Do any of you play Roblox?