Spring Parker Accelerating Health Care Performance

Featured Guest: Samantha Arth

What she does:  Sam is the is the Senior Director of Advertising, Analytics, and Partnerships at Cleveland Clinic in Ohio where she works to shape the institution's global brand and achieve transformative results in healthcare marketing.  She leads the enterprise’s advertising efforts, creative development, strategic partnerships, and data science teams.

On risk:  "There's too much information for a doctor to be the sole provider of content or information to a patient … A lot of risks when it comes to health care marketing that is not in other industries. We have HIPAA concerns, run a risk of also investing that much money, sensitivity and personalization, privacy, using information correctly ... Keeping up with regulation and privacy is key, you cannot not do that ... When it comes to spending $1 from a nonprofit, you definitely have to justify that. You have to do that everywhere but that dollar could be reinvested into clinical care. So you need to make sure that you're being very careful and being a good steward of resources … There are a lot of competitors running ads, you see them on billboards, you see them on digital ads, they're all over social, it is a very hot space. So there's definitely concern about that too, because that could just be a spending game. And that could be to what end, we could just go toe-to-toe with other health care competitors. And then we could just be out pricing each other … Patients have a lot of options. And so this should be a concern for you. Because if you aren't doing it, your competitor probably is."


Scott Nelson  0:01  
Welcome to The Risky Health Care Business Podcast, where we help you prepare for the future by sharing stories, insights, and skills from expert voices in and around the United States health care world with a mission to inform, educate, and help health care organizations and individuals, ranging from one doctor practices to large integrated systems and organizations throughout the dental, medical, and veterinary health care industry with risk, while hopefully having some fun along the way. I'm your host, Scott Nelson, a guy that grew up in Ohio and has been working all over the United States during my 20 plus year and counting career in the health care industry, with a commitment to accelerating health care performance through creativity, not just productivity. Let's dive in.

Health care is one of the largest and fastest growing industries.  The Centers for Medicare and Medicaid Services estimates that US national health care expenditures will reach $6.2 trillion by 2028.  To reach and secure patients health care organizations and businesses deploy a variety of marketing efforts. The New York Times published a piece about health care marketing that noted: Approximately 7% of all Google searches are health-related; There are 70,000 health-related searches per minute, every day; And online reviews matter to patients. A Stanford study found that 75% of patients rely on reviews as the first step in finding a new doctor or healthcare provider.

There is risk in marketing.  Risk of misinformation and credibility.  Risk with reviews.  But there is risk in not marketing.  If you don't do it your competitor will.  

Today I'm speaking with Samantha Arth about risk in health care marketing.  Sam is the is the Senior Director of Advertising, Analytics, and Partnerships at Cleveland Clinic in Ohio where she works to shape the institution's global brand and achieve transformative results in health care marketing.  She leads the enterprise’s global advertising efforts, creative development, strategic partnerships, and data science teams.

Let's talk with Sam about risk in health care.

Sam, welcome to the show.

Samantha Arth  1:59  
Thanks so much happy to be here, Scott.

Scott Nelson  2:01  
Before we begin talking about health care marketing and risk, let's go back to the beginning. How did you get into health care and where you are today?

Samantha Arth  2:07  
I actually started as an intern, so I am a lifelong health care person. I started when I was still in college in advertising and brand. And honestly, I've never left my badge still works, thankfully. But I've risen to the organization, had the privilege of working on a lot of really cool stuff, anything from special projects to advertising to sports sponsorships. So I've been with the organization just over 17 years at this point.

Scott Nelson  2:35  
I want to start with a terminology question.  I think sometimes terms like marketing, advertising, promotion are used interchangeably to mean the same thing but there can be differences.  So for you what is marketing?  And what is marketing in health care?

Samantha Arth  2:47  
There are differences. So when it comes to marketing, I'm actually was just reviewing this the other day, it can be defined as part art, part science. So basically we're trying to create value by designing a successful exchange. Now, that's a very academic answer. But in short, it means you know, as marketers, I'm trying to create a successful exchange between our organization and our patients. So for health care, this could take a lot of different forms, it doesn't have to be like advertising is one tool in the toolbox. Marketing is a lot of different things, though, you know, we're trying to build a trusted relationship with patients, hopefully, you know, ultimately influencing their decision to choose us for care. So we could, you know, do a lot of things with that, like, I see, I oversee advertising, that's one side of it. We provide trusted health content online, and we have 1,000s of pages of health information. That's another way. Even on the earned media side, so the PR side, you know, we work with patients to tell their story and make sure that you know, others can see it and feel it and learn about what great things we're doing here at the Clinic. So it can really be vast, but those are at least the few three key areas how we define marketing is like paid, owned, and earned. 

Scott Nelson  4:04  
Cleveland Clinic has grown immensely over the past 50 years - now a global health care system with 22 hospitals in the US, Great Britain, and Abu Dhabi, so it’s an international health care system but it also serves the local community in Cleveland and Northeast Ohio.  You have responsibility for Advertising, Analytics, and Partnerships at Cleveland Clinic.  What does that mean and entail?

Samantha Arth  4:24  
Yes, so it's a several different areas as you've identified, but it's mainly paid media. So anytime you see an ad on TV, or you see our signage at a baseball game, if there's a Cleveland Clinic logo on it, it's been through my team. And so that's obviously the brunt of what we do. We also have analytics though this has been a growing part of our organization over the years. I recently took it over just about a year ago. And this is a small team of data scientists who literally help us track our campaign effectiveness every day, tied into our patient databases so we can figure out out what you know what tactic cause what action and what it resulted in. We also have a few digital marketers on our team who really are in the back end of Google Analytics and other campaign analytics forums so that they can glean insights and share it amongst the rest of our team. They also help us keep our things data compliant, and and under the correct regulatory rules. So just a lot of different areas.

Scott Nelson  5:27  
Transitioning to risk, patients access and consume health information in many ways today from the Internet to social media to family and friends - many ways that in the past usually came from one source being the doctor.  There is risk in HIPAA, privacy, and other issues.  How do you think about risk in health care marketing and in your work?  

Samantha Arth  5:45  
Yes, I'll start with the doctor piece. There's just too much information, there's too much information for a doctor to be the sole provider of content or information to a patient. And if you think about it in your own life, when you're learning about something new, or you see something and you want to learn more about it, you know, you you type it into Google, one in five searches in Google is health care related. That's like a billion a day. It's incredible. But that's where consumers go. And so we need to be there. And there's a lot of bad information on the web as well. I mean, there was, particularly during COVID, it was running rampant, there was a lot of just misinformation or inaccurately analyzed. And so even Google came to us and a few other big Academic Medical Centers and said, Hey, these, we need these areas shored up, will you help us we need to get the right information out to people so they can make informed decisions. And so information is just so critical. And our marketing team did that, you know, that didn't come from a sole provider, it was reviewed by providers, absolutely. But that's something where we have an engine of writers who are able to help and react to situations like those. So when we think about risk it, you have identified the key areas, right? I mean, we have HIPAA concerns, I can apply that to what if I were to feature a patient testimonial, in a TV spot, which I've done, you know, I need to make sure I have the proper releases in place, I also need to make sure that if we're using this over a long period of time, you know, does that patient still have a good outcome, and you have to keep track of those things. So you definitely run a risk of also investing that much money in advertising for a patient testimonial. But you also have other areas of risk. So a lot of places are amping up their personalization on their digital channels. So think about like when you go to a news site, you read an article and it says at the bottom of it, well, you might want to be interested in this, you might want to read this. And that's personalization, that is AI behind the scenes, reading your behaviors and suggesting what you should read next. Now that that's great, but when it comes to health care, you might not want that you might not want to be reading an article about cancer and then have something more custom come up. You know, it's very sensitive. So you have to be very careful with personalization when it comes to health information. Another issue I could think of is really privacy, you've you've definitely touched on that. And that is a constant theme throughout anything we do here in the US more so in Great Britain with our London team. So from an advertising perspective, like I also can't run an ad that says, hey, come to us for heart care, and then try to remarket to you later. I can't like find you on CNN later after you've you know, seen this ad before and serve you with another heart ad I can't do that. That's retargeting. So imagine if you were on your iPad, and you saw an ad and interacted with an ad on heart care. And then your son or daughter was on that same iPad later, and then was served an ad on that. So you need to be very careful when we're trying to you know, use those retargeting skills. And I think that honestly, the the most scrutinized, I would say headline that's been in place over the past year and a half is how are hospitals and health systems using digital information? So if you've come to our website, how are we using that data? Who sees it? You know, who has access to it? Is it shared with anybody? You know, some of those instances require then you to have agreements in place with other companies because for example, if I if I run an ad, and then somebody sees it clicks on it comes to our website, you know, I might need to feed information back to that media outlet to say this type of person clicked this ad you should serve our ad to more people like this. So those types of things get into very gray area. It's it's very common in any other industry, but just obviously very sensitive when it comes to health care. So you might need to add things to help mitigate risks you might need to ask your media partners to sign a business associate agreement, so that they, you know, they're basically signing up for responsibility of if data is tampered with or anything like that. Or if it's an it has to be anonymized. There's a lot of different stipulations you can put in there. So definitely a lot of risks when it comes to health care marketing that is that in other industries.

Scott Nelson  10:20  
Well along those lines, what are areas that are of concern to you and your work? What should be of concern to health care professionals and organizations related to marketing?

Samantha Arth  10:28  
Definitely a lot of concern areas, I'll probably be a bit redundant here. But I think regulation and privacy is one for sure. This is something that we're constantly dealing with. And as more analytics tools become available, we have to be very careful with how we use them. And so different organizations need to set up different standards, so that everybody's using this information correctly. And it is above bar and all those things. So that's definitely one area, that's been a concern, I'll say resources as well. You know, this is something that when it comes to spending $1 from a nonprofit, you definitely have to justify that. I mean, you have to do that everywhere. But it's that dollar could be reinvested into clinical care or something else. So you need to make sure that you're being very careful and being a good steward of resources. And I don't know about anybody, but honestly, we never have enough marketing dollars, I wish I could find the person who says they have enough, but it's challenging to get, you know, executives, specifically physicians, or physician leaders, those types of things interested in marketing, when you know, they see the impact of patient care every day and have to make a decision on budget. The last thing I'll say about concern areas are really competition. This is one where it is very heated when you're looking at paid media space. There are a lot of competitors in there that are running ads, you see them on billboards, you see them on digital ads, they're all over social, it is a very hot space, and a growing space for a lot of media outlets that are trying to basically build up their business in this category. So there's definitely concern about that too, because that could just be a spending game. And that could be to what end at this point, we could just go toe-to-toe, toe-to-toe with other health care competitors. And then honestly, we could just be out pricing each other. So we just need to be concerned about that too, to make sure that we have a sound strategy. And we're not just spending against competition, but we should know about what they're doing. So I guess I would say I'm trying to put this into practical terms, you know, keeping up with regulation and privacy is key, you cannot not do that, at this point. This will help you in digital marketing, this will help you in AI since that's the big buzz now, advertising all of these areas, you need to stay up to date on regulation of privacy, you know, and that could even be maybe you find an attorney who specializes in regulation or communications agency that specializes and has inside counsel on that. So you can you don't have to do everything, you can find the right people to get on your team to make sure you can stay ahead of those types of regulations. The other thing I'd say is competition. So this is one where patients have a lot of options. And so this should be a concern for you. Because if you aren't doing it, your competitor probably is. And so you want to be there when it comes to somebody making a decision. And having you know, having a choice, you want to be top of mind, you want to be in their consideration set. So that should definitely be a consideration. And I'll just say one more thing. I know what one thing we're trying to work to overcome is that justification of dollars, you know, if I have a meeting with our CFO, and I tell him if you give me $1 I could turn that into $10, you know, that's a deal that we would do all day long. If if I can tell them that our closest competitor is outspending us in the market by two to one or even more that's another easier conversation. So I think that marketers really need to work hard to try to tie any dollar spent back to the benefit of patients coming in the door. And that is the way you'll have much easier conversations at the executive level.

Scott Nelson  14:29  
A brand, quote unquote, may not be the first thing that comes to mind in health care, but your expansion shows that there's demand for your services and I have to believe brand plays a role in that. So what is a brand?

Samantha Arth  14:41  
Brand in simple statements, it's your company's identity. It's your personality, how you present yourself to consumers. And that's not just marketing, by the way. I mean, when you're talking about health care, there are a ton of different touch points that represent your brand. It could be every appointment, it could be a call center interaction, everything counts against your brand or for your brand. So marketing our role, we just represent it. But it is definitely present in a lot of other areas. So I think when you think about how brand can help in health care, obviously, we all know it's very slim margins, this, you know, the differentiation and brand could help you in very competitive markets, if somebody's offering a similar product down the road, you know, you have to convince somebody to choose you over them. And that's where brand plays a role. So it's very important to keep working on it. You know, again, I can't necessarily talk you into like cars can do that I can't talk you into buying a car or buying the latest technology, those types of things, you know, I can't convince you to have a heart condition like other industries can convince you to buy a car or technology or anything like that. But I know that when you do need care, because you will need care, we need to be in that consideration set. So we need to be out there talking to you far in advance of you ending up being in that situation. So that's like your long term brand building work. Being top of mind when that day comes. You have a friend, a relative, anything like that, who all of a sudden has a health scare, or some sort of condition they're diagnosed with, you can say, You know what, I've read this great article, or I know of this hospital that's doing the latest and greatest and innovations, you know, you want to be that hospital that they name, and Cleveland Clinic, we've been working really hard for that over the past, you know, you could argue 100 years, but we're really trying to put out there now as our brand, we are experts in clinical care. And we compare that with compassionate care. So we are thinking about the entire family thinking about what life you want to get back to all of those things. So you should hear that feel that think that after seeing any of our communications,

Scott Nelson  16:57  
When you talk about the brand being your company identity and the entire company how do you and marketing work across the entire Cleveland Clinic organization?

Samantha Arth  17:06  
It's definitely a challenge. And I can't say that there's a secret sauce to this. But you know, we are a global enterprise yes as you've noted, 300 locations across three continents. We also have a different language as our one institution is in Abu Dhabi. So there's a lot of complexities to our organization. Not only that, but COVID obviously changed the way everybody works, a lot of us in the division of marketing still are home, we work remotely. And so we have to work really hard as a team to make sure we're staying connected via Teams or whatever it is to make sure that we can still produce the best quality work that we have. Lastly, I'll say I think culture plays a role in this too. When I was having a conversation the other day, I heard somebody say that, you know, at Cleveland Clinic, we don't say no. And they were talking about it in the context of a health situation. But that permeates our entire organization. We don't say no in our clinical care, we try to find an option, and be able to be that trusted partner for people to come to for solutions. And we even also call our entire team caregivers. So I'm a caregiver, I'm in marketing, I play some sort of role in getting patients to our doors and getting them the best high quality care. So I think it's more culture things that really have helped us grow as an organization and then continue to work across as a team between locations.

Scott Nelson  18:40  
Becker's had an article in 2022 that labeled Cleveland Clinic as a digital-first marketing organization. What is digital-first? What does that mean?

Samantha Arth  18:49  
Yes, digital-first is you are thinking literally about everything you touch, every communication, anything you put out, how can that be digital? We used to have this mantra, we still do, we just don't say it out loud, because it's more ingrained in what we do. Our chief marketing officer challenged us to be digital, mobile, or measurable. How can we approach projects and communications with that mindset. And so that helps us prioritize resources for more digital channels. And going back to the status and before about Google, digital is so important for decision making in health care. It's like you can't underestimate the power of digital channels. And there's a lot of positives to this. I mean, digital offers you huge scale, huge audience, global audience. Also, it has significantly helped us track our marketing effectiveness. Before I might be running a print ad in something and I can basically get the circulation from it, but now I can see how many impressions it got last week. I can see how many people engaged with the ad did they come to our website and make it some sort of action happen, did they download information or or, you know, requested appointments. So there's lots of great positives when it comes to being digital-first. On the converse, there are risks, as we've talked about, there's HIPAA, there's privacy, tracking, but you can make yourself at any scale, be safe in this area by finding those partners that are experts in this area. You do not have to be the expert you find one. If that's an agency, if that's a health care agency, any types of resources, you can find, I would definitely tap into those help make sure that you're compliant and also that's not the core of your business, it's the core of their business, and you can really focus on the value that you can provide. So yes, we still use digital, mobile, measurable that's how we approach projects. There's other instances too, that you can use. If there's, you know, think about your website, I guess, if you're a small practice, think about your website. Analytics might tell you that most of your traffic is mobile, it's coming on a mobile device, some sort of smartphone, well, you know, 60% of your traffic is coming from mobile, is your site mobile optimized so that people aren't pinching and squeezing on a webpage, you know, it should be designed and built for experiencing your your content on a phone. You could also look at something like advertising. So in print ads, you know, they're declining in readership, a lot more has shifted to digital, you know, I might not have the resources to get somebody to design an ad or place the ad and all of those things. But, you know, if I can't even afford an agency, Google makes that really easy. You can log in right now, and set up a few keywords and give it information about your practice. And it will shepherd you through this process to put digital ads out there in front of the right audience. So it's definitely scalable. Also, I was thinking about social media for this, you know, if you don't have a social media presence, you should this is one where we struggled with this years ago of is it right for our brand? Is it appropriate? Are we prepared for responses, you know, all of those things, yes, those need to be taken into consideration. But think about how you'll be able to interact with the community. And this is also you know, an audience that you can continue to remarket to for free. This is you're putting out content about a promotion or health awareness month or something like that. And you could just keep building this audience up and you'll have you can pay less than in paid media, because you already have that audience.

Scott Nelson  22:36  
Health care is experiencing many challenges these days, workforce and staffing for example. How can marketing be used to help risks such as staffing?

Samantha Arth  22:43  
During COVID this, this really challenged us, that's for sure, you know, everybody had staffing shortages, that was peaking. It was a very dire time for everybody and tested a lot of systems. Recruitment and Nursing actually came to Marketing, which we had never really talked to before this time, and they said we need help, you know, we need nurses on the floor, we need additional providers. How can you help us? So we actually worked with them on a communications plan. You know, how do we talk about ourselves? How can we talk about the benefits of working for the Clinic, you know, why it's important, why why our mission is important and how we're different all of those things. And we put together a full communication plan. It was all the things paid media owned media and earned, we put it on, you know, for example, if you were at a Cavs game, we put out an ad or digital signage while you were there that said, hey, you know, a nurse, think about a career at Cleveland Clinic, those types of things, which we've never done before. But the situation required it. This is something that was a huge challenge for our organization for every organization. And it's like the business required it. So we were flipping assets, you know, even like that, to talk about recruitment. We even also did things like, you know, developing an ad campaign for nursing. So I had a challenge that was thrown upon me and my team that said, you know, how can you get us on TV, we need broad mass appeal. And so we flipped a TV spot in three days. We used existing footage and we had the right agency partners that came into it really helped us out. But it's like you need to be nimble and reactive to your organization when it comes to situations like that. So workforce has definitely still been a challenge. It's not as dire as it was with COVID. But those are probably the most extreme examples I can think of. Yes, we still help with recruitment, because we always need great talent. We're always recruiting, but those are probably the most extreme.

Scott Nelson  24:43  
What are marketing strategies and tactics? Many topics are discussed such as content development, is that a strategy or a tactic?

Samantha Arth  24:50  
Sure, there are tons of tools these days and we think about marketing as a funnel, essentially. So you start at the top, and that's where you have the broad mass appeal. You're talking about, you know, your brand level attributes, those types of things. And then, as people move down through the funnel, when they actually have something, they need to get care for something, you know, then we deploy different tactics. But that's at least how we think about it as a funnel. So if I were to put that through the lens of I've mentioned, paid, owned, and earned a couple of times, you know, that's when our marketing is most effective when we have three, all three of the three legged stool working together. So for example, you know, on the earned side, when you're talking to PR, you know, what you want to do is you can talk about grateful patient stories, or you can talk about the latest innovations. And we have a whole team around that. But that doesn't mean you need a whole team. That means you could also hire an agency or if you want to go build a relationship with your local news outlet, hand them your card and say, hey, if there's a story that comes up on "x", I can be your subject health, our I can be your subject matter expert in that health topic. So something as simple as that could definitely make a difference for a practice. But I'd also say for owned you did mention content production. Yes, we pump out a ton of content. We publish articles, we have podcasts, we have a massive social media presence. Again, all of this is scalable, it's what you think you can do and sustain for your practice. Because social media is one of those things that's, that's a beast that constantly needs to be fed, you need to interact, you need to respond to people. So you know, it's not taken lightly when people look to that as a tool. And lastly, paid, you know, people aren't thinking about health care all the time, as much as I want them to, when they're watching a Cavs game they're thinking about other things. But you know, I can engage in broad tactics like sponsorships, like I just mentioned, or broadcast TV, when somebody's watching the local news at night, you know, I can make sure we're still top of mind with ads in that regard. Or if I don't have that kind of budget I could move down the funnel and say okay, well, if somebody has something, and they're searching for it on Google, I need to be there, I need to show up. So I would deploy something more like paid search, where I want to make sure our ad is coming up first, when those search results come up. And that person needs to make a decision right now about care. So there's lots of different tools and different strategies you could put behind those tools. But everything is scalable, it's what you can do or what you can outsource and maintain.

Scott Nelson  27:31  
I'd like your thoughts on marketing resources. Technology continues to expand and evolve in health care - AI is a big one. What's the role of technology in marketing? What resources have you found helpful or critical?

Samantha Arth  27:43  
Yes, this is certainly top of mind for everybody just over, you know, even the past 18 months. So AI is something that is the new frontier, everybody's trying to figure out how to work with it. I think there was a lot of concern at the beginning that AI was going to replace teams and people, that's not true. This is supposed to be more of a tool for marketers. So it's not going to replace the fact that I you know, have a certain knowledge skill set that will help guide decision making, it might help me make that decision. But ultimately, I need to be the one that call the ball on it. So we found a few areas that we're trying to focus on in our division, you know, we're looking at productivity, how can our AI tools just help our writers, for example, like, are there designated templates that AI can help us with to help make us write faster and publish faster? You know, we're even looking at creating our own large language model like ChatGPT, we're not using ChatGPT what we understand like, how can we ingest all of our information and health content into a large language model that could help us with writing further things in the future. We're also looking at it for personalization, I mentioned before about suggesting the next news article we are looking at how can we make your digital experience the best and get you the right information at the right time. So AI will be powering something like that. We've also started to look at it for creativity. You know, I think this is one where we have to be just very careful, because this also needs to be brand safe. Like I've seen case studies of other industries where, you know, they're looking at a creative idea that's generated by AI, and it could just go awry, it could be a public embarrassment, which has happened to a couple of very visible brands. So I think this needs to be more selectively used, probably more to prove concept internally than actually externally facing with consumers. The last thing I'll say is data cannot not talk about data since I oversee the data science team. But data synthesis is another thing where we have a tremendous amount of data in health care and I have a very small team that's able to process all that information, but then we have to apply insights on top of it and make it actionable for everybody else. So AI can help us with that, how can it automate a lot more of the manual analysis that we've done? How can you have it look for patterns and identify those insights, so that it can just essentially cut time out of our day, so we don't have to do it. So there's a lot of different ways nobody has the secret sauce yet on AI. But all you have to do is start a pilot, like in these areas, if you want to try something, make it small, make a small investment, define a problem, and really, then just try to get into how do you solve that with AI. It might be that AI isn't your solution. And what you have now is perfectly fine. But where we can let's let's try to see where we can aid our marketers with AI.

Scott Nelson  30:51  
You've mentioned your data team and then agencies, who should be involved in these marketing efforts?

Samantha Arth  30:58  
So many people, it's it's definitely a team, you know, internally, we all have our clinical teams that we work very closely with. So we're double checking things, making sure it's focused on the right things, we are working very, very closely with our clinical teams. Also legal and compliance. Those have been newer relationships over the past couple of years, given the regulations that have increased, so we've definitely made strides with them. We also have a supply chain team who helps us make sure that each of our locations are using similar vendors, we're all paying the same rates, you know, all of those things. Definitely finance, there's another one that we've definitely forged relationships with. Because when I spend $1 I need their help to justify it. So I definitely need to work with them, and be able to track a patient's activity after I've run an ad, because otherwise, it's gonna be really hard to justify that dollar next year. Lastly, I'll say IT, that's something that there are multiple digital platforms that service a lot of our organization, we are very large, and we are have been around a very long time. So there are disparate systems, but IT can help us in terms of well, I, you know, this area's using this system over here, maybe that'll benefit you. So there's definitely a lot of internal stakeholders that help us with marketing. You know, I think when it comes to a small practice, that might just be your leadership team, you know, it just might be you sitting around the table, talking about what you think you need to focus on. And you're the end all be all of calls, and you can make a quick budget decision to put together a pilot. So it definitely ranges major Academic Medical Center, small practice, you know, it's just is a difference of scale. I will say for externally, we lean on a lot of our agency partners, we have a large department, no doubt, we have over 300 people in marketing, but our agency partners are extensions of our teams. And, you know, although we're large, it doesn't need to be a huge cost. You know, if you want to stay top of mind with discoverability, you want people to know who you are, and be able to find you at that point of need and you're a small practice, you can find a freelancer, go on Upwork, find somebody who's well versed in search engine optimization, or SEO, just find somebody who knows the strategy and can work with your budget, they can optimize it for you, you don't need to be an expert in SEO, you pay somebody who will do that for you, who might do that for a lot of other organizations too. And that's just how they make their business. And they can even draw conclusions. If another campaign resulted in something, they might be able to apply that learning to yours. So agencies can do a really, they can do a lot of things, but also doesn't have to be an agency, it can be just a sole contributor who's really just helping you with a very basic level of your business and making sure people find you.

Scott Nelson  33:56  
Focusing on two areas in your work, Partnerships and Data and Analytics. What are Partnerships in Marketing?

Samantha Arth  34:02  
Partnerships can definitely range. I mentioned sports a lot. That's definitely what I oversee. So I'll go to that first. You know, we have professional marketing deals with teams, we also provide medical services to those teams. So it's kind of a natural fit that we'd be a much larger partner with them. And I've even seen where smaller hospitals have traded for their services for marketing inventory. So they're not even paying a fee. You know, it's covering their physician time, but they might get signage that's on the court. They might get signage that's seen on TV, those types of things. So you can do that at the professional level. You can also do that at the community level. It's great to be able to support your neighbors and have them see that you care about the things that they care about. So it definitely ranges you even have philanthropic relationships. So we have a great relationship with the Guardians and they help support cancer research and we're trying to find a cure and they support our effort that's called VeloSano. You know, you could even forge those types of partnerships with folks and they give us inventory at their games, we're able to run some VeloSano messaging to encourage people to volunteer for the event, or donate and all of those types of things. So it can definitely take different forms. And there's, there are positives, there are risks associated with this. Sports, for me, it's like sports provides scale. They are also aligning with something consumers are passionate about. So again, you're connecting with consumers in a space that they might not even be thinking about health care. But you're there and saying, Yes, this is important to us as well. I was even thinking about an example of this, we had the opportunity for, to care for the Premier League when they came to the United States last year. And it was a huge undertaking by our medical team. But the great thing about that is we have a hospital in London, we can connect that back, after the players go back to give them continuity of care if they need a scan, if they need a physical, those types of things. So although we negotiated this deal in the States, we were able to then leverage it across locations and make sure that there was continuity of care. So people see that you're caring for pretty much the people that are at the top of their game and the best of the best, then you're thinking, well, that's probably good enough for me, and you might be interested in coming to this hospital over another one. But there are negatives associated with that. So what if you have a losing team? What if I'm investing in a team that is in one of their growth years, there's less interest, I have less eyeballs, you know, it's it's costing me more to get to people than previous years. That's just the nature of the business. It's a risk you run, when you're talking about sports. You could also have a negative news story with somebody in the organization or an athlete or something like that, you know, you need to make sure when you're talking to these organizations, that you're aligned with them in terms of how they select players how they conduct business, because if there was a negative story, you're going to need to defend why you are aligned with this organization. So definitely some trade offs. But the positives far outweigh the risks.

Scott Nelson  37:18  
Now thinking about data and analytics, what's important to track and monitor? Is it things like dollar spend, return on investment or ROI? What do you look at and think are important?

Samantha Arth  37:30  
Anything we can, anything and everything. The one thing about doctors, they love data, it is critical to their practice is familiar to them, it is also the diplomat in the room when you're trying to make a decision. So again, we're nonprofit. And so we need to be good stewards over dollars. And if we spend $1, I better be able to say this dollar represents "X" if it's return on investment, those types of things. And in health care, it's really hard. There are there are not a lot of people who can do that. We're fortunate to have an in-house data science team. Again, you could probably work with somebody who's out of house, if you have the proper privacy regulations in place and those type of things. But health care is a long decision making cycle. So if somebody interacted with an ad in last January, you know, they might not even be through the system at this point, maybe it's a long decision cycle, it's orthopaedics and they can wait a long time to make a decision. It also depends on when they can get into your system if they choose you for care. Then that visit happens then you have to worry about billing and insurance coming through. So now you're talking about tracking over multiple years, it's super difficult, because if our team has been able to forge relationships with our enterprise analytics teams, who tracks all that patient information, so we can do that but we understand that that is definitely the exception. When it comes to health care marketing, at least. The other thing I'd say is important to track is really consumer perception. So this is a very tricky thing to monitor if you don't have the right tools. But you can find out a lot of things through market research, for example, you can look at qualitative data, every few years if you want and make sure that you're capturing people's sentiment and what they think about you. You can also do it on a quantitative basis where people are just getting online surveys and they get that once a quarter or once a year or whatever it is. And you can really track then consumer perception. So people, you know, you know what people are saying about you. The other thing I'd say too, is competitive. I know I've harped on that a few times. But I need to know what other people are spending. I need to know if I'm getting lost in the dust associated with competitive. Are we just being drowned out by everybody else who's talking to way more people and are way louder than us? So we need to be able to monitor that too. And there's tracking systems that you can pay for. I mean, we use one that literally tracks ads and sends me daily ads, and I can understand what other hospitals are saying and doing and trying to reverse engineer their strategy. You know, that's a really helpful tool. You can also look at things like that market research, I can take it a step further in advertising and say, Okay, well, if I have a new campaign that I want to run, what if I tested that with a small group of people online? I just tested storyboards, where it's not a full concept. But if I do that work, then when I go have a conversation with our clinical team, or our executive leadership, there's where that data becomes the diplomat again, and we can say, No, we've tested this, this is a great idea to move forward with this should be an easy decision. So it's captured in different ways. It's used in different ways, but there's certainly any data you can get your hands on, you absolutely should. I think it was actually somebody reminded me of this the other day, Ginni Rometty, from IBM said this 10 years ago, that data is a natural resource of the 21st century, the person with the most data and will have the most power because they have all the information and can make those decisions. So where you can track, track.

Scott Nelson  41:10  
Marketing can be seen as a very broad area, and an organization may or may not view it as doable or important. Cleveland Clinic had a significant marketing campaign in 2021, its Centennial campaign. With either that or another example, what is the process of a campaign like that? And how can an organization approach marketing in a doable way that doesn't create issues?

Samantha Arth  41:30  
You know, this was a very interesting time, because that marketing campaign was straight through COVID. So there's a lot of complications that came with that one, that's for sure. But when it comes to marketing, it's like, if you don't do it, your competitor will, they're going to capture the hearts and minds of consumers, and they'll market and they'll grow. So you need to be able to stay ahead of that. And it's doable, at a small level, at a big level. It's all about scale, prioritizing resources, finding the right team to help you pull it off, you can definitely do marketing in any way, shape, or form, even if it's just starting with discoverability and search. Now, when we talk about our Centennial campaign, that was, that was a different one for us. You know, there's none of us are sitting around going gosh we're great at anniversary marketing. It's not something that you touch, often. And as marketers, we're sitting in our chairs going well, how can we make this relevant to people? What do we have to do? Who are stakeholders? All of those things. So we were actually approached a couple of years before the centennial set by our executive team, to say, yes, you guys are going to be the leads on this on the communications. Now go put a plan together. And we were jokingly saying, we were like, This is great, this is great. But then we were all saying now what, what there's no playbook for this that we know of. So we ended up finding an agency partner who specializes in anniversary marketing. And we thought that was really helpful because they just grounded us. So it was talking through what are the foundational goals and objectives? Who are our target markets is that staff is that previous staff, probably our patients, our local communities, the board could be our donors. There's a lot of different audiences we need to talk about here. But we also need to talk to them all differently and make them feel differently. So what are those objectives associated with that? So this agency was able to help us put together essentially a document that was the Northstar for all of our decision making. So for messaging, we actually have a unique challenge. We have 100 year old brand, but those systems or hospitals might have come into our system at a very different time. Maybe they're 10 years old, 15 years old, etc. They all have their own unique histories. But this was about celebrating at the core, what Cleveland Clinic is about what our mission is what unites us. And so that also was our guiding principle for talking with our global locations, even though they might not be 100 years old. So we did start with a cross functional team, we across marketing, but then we also expanded it. We had people in there from recruitment or HR and onboarding, to physician training. There were lots of different folks, we roped into this because we wanted the centennial message to permeate every area of our organization. We also had a multi-year plan. This was something that we of course, had to redo because of COVID. But we did get a lot done before COVID. And then were still able to maintain some of the tactics afterwards, thankfully. The other advice I'm thinking of is start early. This is something that you can't start soon enough. We started about three years early on specifically the centennial campaign and we also realize really early on, we're not going to have the budget for this in marketing. I have all these other things I need to support. How are we going to fund this incredible opportunity. And so we did put a budget together and went back to our executive team. And we created a special separate budget for this. And also, I'd say staff up if you need to, we ended up pulling in outside staff, temporarily project managers, because we all have our day jobs and somebody needs to help move these projects along. And so that was also a big help.

Scott Nelson  45:23  
Well, that's a great way to close our conversation. Sam, thank you very much for your time and sharing your thoughts and experiences today. I really appreciate it.

Samantha Arth  45:30  
Absolutely. Thanks for having me.

Scott Nelson  45:34  
Thank you for listening to The Risky Health Care Business Podcast. You can listen to all episodes from the resource center page of the SpringParker website, springparker.com, or click the Listen link in the show notes to listen and subscribe for free on your platform of choice. And remember, accelerating health care performance is achieved through creativity, not just productivity.

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