photo credit: yark64

Today marks the 68th anniversary of the Japanese attack on Pearl Harbor that initiated World War II. More than 2,400 Americans were killed, including 1,177 crew members on the USS Arizona. Part of this vessel still rests at the bottom of the harbor to serve as a memorial to the people who perished in this tragic attack.

In 1997, I was able to visit the memorial constructed at Pearl Harbor in person. At the time, my husband Kevin (who served in the U.S. Air Force for 10 years) was serving a one year unaccompanied tour in Kunsan Air Base, Korea. We were meeting up at his 6-month, mid-tour mark in Honolulu for a 2-week reunion. The clearest memory of this visit to the memorial site was seeing the oil from the USS Arizona still rising to the surface of the water around us.

Although I was not born until the 70’s, I had learned about Pearl Harbor through history classes and personal stories from my grandfathers who had served in both the U.S. Navy and U.S Army. It was extremely important for me to honor and acknowledge this sacrifice made by so many of our military. I feel fortunate to have not lost anyone personally, but as a military spouse for 10 years, I had experienced what it felt like for my husband to get sent away twice to foreign countries for more than 6 months at a time and return safely on both occasions.

Please keep the military in your thoughts today - both past and present.

There are rare moments in hospital public relations that you know you directly affected the saving of a patient’s life.  For Aaron Hughling, this moment came on Nov. 5.

This was the day that he tweeted about patients arriving at Scott & White from Ft. Hood. After others in his department provided the requisite statement and updates necessary from the hospital during a crisis, Aaron began tweeting about the need for blood donations. More than 400 people retweeted Aaron’s plea, and 1,000 individuals donated blood. Six hundred people were turned away by the blood center and mobile units. Giving blood saves lives. Using Twitter makes it faster than ever.

This week, HealthLeaders reported that a pilot study had been completed with nurses using iTouch to reduce the amount of noise and inefficiency involved in paging nurses. Nurses at Sarasota Memorial Healthcare System reduced the number of pages in eight hours from 172 to 38 in a unit that had at least one overhead page every three minutes. Overall, the iTouches were receiving 4,000 messages a day. For patients wrestling with pain or wanted to rest, iTouch helped their recovery.

Another headline this week was “Survey: When It Comes to Patient Experience, Executives are Enthusiastic, Ambivalent and Clueless.” There is a connection between new tools in the hands of early adopters and the patient experience. Hospital executives who hinder their PR departments from using social media or don’t provide resources to try new tools in patient care areas are missing out. And so will the very patients to whom they are responsible.

Photo courtesy of dotbenjamin

I read a great article by Brian Solis this week about the science of retweets. The article got me thinking about why hospitals don’t use the Twitter retweet function more often.

According to Ed Bennett’s most recent list of hospitals engaging in social media, 297 U.S. hospitals have established Twitter accounts. Yet when you look at these accounts, one thing is readily apparent – most don’t understand the power of the retweet. Instead of using Twitter to engage with the community and to humanize health care, they’re using it as a broadcasting medium to promote their service lines and extend their brand. And when you look at their Twitter stream, more often than not, they’re doing all of the talking.

Why is this? One reason is that not all consultants seem to understand social media and the value it brings to health care . My client shared with me an August 12, 2009 Advisory Board article that pooh-poohed the value of the retweet function saying: “By retweeting…hospitals missed an opportunity to connect the story to a service offering or a call to action. While retweets can be an easy way to boost the number of messages sent to your Twitter following, you’ll want to be selective in order to retain your own voice with your audience, avoid “content spam,” and maximize interest in your specific institution.

Hospitals that feel this way are never going to harness the power of the social media. Here are five reasons hospitals should retweet more:

1. Give credit where credit is due: If someone says something interesting or compelling, you should retweet it. Not only does this acknowledge the person or the organization for saying something noteworthy, but it also allows you to share it with your followers.
2. Prove you’re not a robot: Too many hospitals are talking to themselves – sending out information about their service lines and their clinicians, but not listening to what their followers are saying. By retweeting others, you demonstrate that you’re not a robot and are reading the tweets of others and finding what they’re saying is relevant and worth sharing.
3. Develop a closer connection with the community: We all know health care is local, so it’s important for hospitals to show they’re a member of the community they serve. By retweeting area residents or sharing information about things that are happening in their community, you can become a community cheerleader and show that you care about what happens in your community.
4. Serve as a healthcare resource: Hospitals are a major healthcare resource for the community, so it’s important they share health information with their followers. By retweeting healthcare authorities, such as the Centers for Disease Control or the New England Journal for Medicine, you’re sharing important health information with your community and becoming the place people can go to for health care information.
5. Provide consumers with what they want − health information: While hospitals want to promote their service lines, consumers don’t want to read a steady stream of information about what your doctors are doing or how many times a doctor has performed a specific procedure. You can share this information, but you should also provide consumers with what they want – health information. By retweeting health information and providing links to where people can go to find additional information, you’re providing real value.

Hospitals need to realize that they can’t just talk about themselves – they need to provide information that is relevant to their community and their followers. Retweeting others is a great way to do this.

As organizations adopt social media and create corporate pages on Facebook, they have to take a closer look at themselves and decide who their friends really are. This is especially true in the health care industry.

When you look at hospital Facebook pages, it’s surprising how many hospitals have only a handful of fans. Yet, as one of the biggest employers in a community, you would think they would have lots of people who want to follow them. 

The problem is one of trust and control.

Many hospitals don’t allow their employees Internet access at work because they are concerned their staff will spend too much time updating their Facebook status. While this is a valid concern, it’s important that someone from the organization to monitor the hospital’s Facebook and Twitter accounts to see what people are saying and answer any questions they might have. The key to great customer service is responding quickly and transparently to these queries – and to do this, the marketing team needs to have Internet access.

Other hospitals have actually blocked people from commenting on their Facebook page, making it just an online brochure.

Rather than limiting access, hospitals need to engage their employees in their social media efforts. They represent a large portion of the communities they serve and while they may not be able to comment during work hours, they should be encouraged to join the conversation. After all, employees serve as a hospital’s brand ambassadors in the community.

One hospital that is doing a great job at this is Sarasota Memorial Hospital. Shawn Halls, a market research manager at the hospital, manages the Sarasota Memorial’s Twitter account at @SMHCS perhaps said it best during an interview with The Side Note: “We’re not just Sarasota Memorial Health Care System, we are 4,000 individuals who are part of our larger communities, and we enjoy communicating with our customers because they’re also our neighbors and friends.”

To provide ground rules for helping employees engage in social media, hospitals should provide their employees with a social media playbook or Code of Participation that outlines:

1. Who will represent the organization online? This may be specific individual or a team of people.
2. How will the organization respond if employees post something inappropriate online? For example, emergency staff at an English hospital were recently suspended for posting photos of them participating in the “lying down game” on Facebook.
3. How to respond to questions and/or negative comments? Quickly responding to negative feedback can help diffuse the situation and put it into perspective.

This is an exciting time for hospitals, as they use social media to find new ways to engage with their community, their patients – and their employees. By being open and extending their hand in friendship, hospitals can make a difference in how people view health care.

One hospital launched a Facebook page but gained so much unwanted attention from employees during their work hours that executives blocked employees from the venue. As one of the largest employers in the community, this probably turned off the very people the organization needed as its ambassadors.

These types of situations are not social media issues; they are communications issues that hospitals find themselves confronting as new tools become available. While there are 350 hospitals using social media, the United States has thousands of hospitals. At this stage, the early adopters are stepping into messes that the naysayers warned about and everyone was hoping to avoid.

What if hospitals developed a code of participation that provides guidelines of how the hospital and its employees are going to involve themselves into social media and how they are going to relate to the online community? What if hospitals applied the principles of issues management or crisis communications to online issues? In the first scenario mentioned above, the hospital would have guidelines on whether to respond or ignore the blogger.

Social media is a community relations tool - it builds and reaches new communities that two years ago didn’t exist. Not everyone is going to love your hospital, but having a plan for handling attention that is up to no good makes it easier to cope with the stings of criticism and the people who want to jumble your day.

Image credit: Jashar Awan

While politicians are busy talking about universal health care, if you work in the hospital industry, you know that health care is local.

That’s why I was so excited when Twitter announced it is going to tie location to tweets with its new geolocation feature. Hospitals focus their marketing efforts to reach people in the communities they serve, so their social media efforts need to be focused on a specific region, city, or neighborhood - what I call hyperlocal. That’s why this feature is right up their alley.

By localizing Twitter, hospitals will be able to identify Twitter traffic by latitude and longitude coordinates. This will make it easier for them to listen to the people in their community and ultimately, share important information during times of emergency.

Location-based applications like Loopt and Brightkite have been increasing in popularity. At the same time, there are a growing number of location-based Twitter applications - like Twitterfon, Ubertwitter and Tweetmondo. Many of these are mobile applications tied to specific devices, they allow people to find and filter their timeline with tweets within a certain geographic area, as well as locate these people on a map.

Now that Twitter has released its geolocation code to developers, it’s a matter of time before there are more applications like TwitterLocal, an Adobe AIR application like TweetDeck that takes a location, postal code or a state, together with a mile radius, and generates feeds based on location. 

Why is this different?

Currently, Twitter relies on either location info provided in profile settings or the mobile device being used. Now, they’ll be able to collect location data directly from someone’s tweets. However, in order for people to link to their location data, they’ll need to opt-in.

What does this mean?

With this new functionality, it will be easier for hospitals to find community residents who are engaged in social media and add them to their Twitter stream. It will also help them keep their fingers on the pulse of community issues and hopefully help streamline communications efforts with the same precision of direct mail campaigns.

A marketer?  Competent marketers have to be good strategists and tacticians, and with competitive fire.  Military history teaches great lessons in how to win, and lose, with stakes far greater than market share.  It’s pretty hard to find a good book on business strategy or read a marketing plan without dozens of references that borrow military terms and apply them to core strategic approaches.

In roughly 510 B.C., the Chinese general Sun Tzu probably wrote the first guide on how to win at business, called The Art of War.  It also just happened to be a military strategy masterpiece; a map to success for sage generals that followed the path, and an explanation for failure for those leaders that strayed.

The Art of War has spawned a number of books on business strategy, but I’ve yet to see a compilation of business cases that demonstrate Sun Tzu’s principles in action (for both success and defeat).  Over the next several months, I’ll attempt to break down Sun Tzu’s war strategy principles chapter by chapter, with the goal of generating reader responses demonstrating marketing application of the principles in a business case.

The potential to learn effective marketing approaches from military strategy first became apparent to me when I gained a heavy dose of history in Richmond.  During the Civil War’s Peninsula Campaign, Richmond was successfully defended by a small group of Confederates that marched in front of the Union forces in a continuous loop, convincing those troops they were far outnumbered.

At the time of this lesson, I was running the Robitussin brand for a company (A.H. Robins) that was in Chapter 11.  So we had limited resources and were competing with P&G’s Formula 44, each trying to take a controlling share of the market.  Robitussin eventually won this “battle”, and one of the ways we succeeded was by identifying ways to appear much stronger than we were in advertising and product development.  But “deception” is part of Sun Tzu’s Chapter 7 – Armed Conflict.

Chapter 1 is about preparation – understanding the factors that lead to success, before you take action.  If you aren’t familiar with Sun Tzu, www.artofwarplus.com/ is a convenient starting point.

For those interested, A.P. Hill was a favorite son of Richmond, and one of Stonewall Jackson’s key division commanders (and in his final thoughts as he lay on his deathbed, far from military action).

Engaging in social media goes against everything health care marketers have been taught. After years of controlling the message and living in fear of the Health Insurance Portability and Accountability Act (HIPAA) and the Food & Drug Administration’s Division of Drug Marketing, Advertising, and Communications (DDMAC) regulations, health care organizations now have an opportunity to embrace social media and transform the way they do business. 

Yet, by playing it safe, hospitals and pharmaceutical companies could actually be engaging in risky behavior — hampering their ability develop closer relationships with key influencers and providing an opportunity for their competitors. 

Why is conversation important?

New research from BlogHer, iVillage and Compass Partners shows that women, traditionally thought of as health care gatekeepers, are embracing social media, with 42 million visiting social networks on a weekly basis. By reaching out to women, hospitals can directly influence the people who are making health care decisions. 

Research also shows that doctors are spending more time online, with 15 percent of U.S. physicians participating in the Sermo network. Others are creating blogs and engaging on Twitter — joining the health care conversation and sharing insights. The opportunity here is for companies to:

–Monitor and engage in discussions to learn about physicians’ experience with various treatments

–Quickly & cost-effectively learn re: new off-label uses and possible side effects.

The health care organizations that conquer these fears and move forward have an advantage because the information they gain and the relationships they form will set them apart and provide them with a way to rapidly dispel any negative media stories. 

With so much to gain, health care organizations are dipping their toe in the social media water and hoping that no one slaps their wrist. Case in point, many hospitals are using Twitter and Facebook to push out content and help build their brand online, rather than engaging in conversation. 

According to Lee Aase (@LeeAase), the manager of syndication and social media for Mayo Clinic, while publishing content isn’t the purest form of social media engagement, it’s important for hospitals to protect their brand online. Hospitals can’t have an empty Twitter feed, and according to Aase, “the safest way to populate it is through an RSS feed.” Over time, the hope is that as hospital marketers become more comfortable with social media, they will engage in online conversations. 

With states passing new rules that ban pharma representatives from buying meals for doctors, pharmaceutical companies need new ways to reach out to physicians. But engaging in social media is navigating unchartered waters, which all pride themselves as being the most conservative company out there.

Their biggest concern is that the FDA has yet to set rules for marketing drugs on the Internet. Last year, the FDA sent warning letters to Diovan regarding its banner ads because they included risk information only through a link to the full package insert and patient package insert. Another fear pharma companies have is that people may post negative comments or videos on their site. 

To mitigate this perceived danger, pharma companies are creating online communities and Facebook pages where people can discuss their health issues. These types of communities create a great forum for listening, and the risk can be reduced if they are moderated. Some, like Pfizer, are setting up corporate Twitter accounts. However, they are hesitating before putting their brands online. 

The big takeaway is that health care companies can’t sit on the sidelines and wait for an engraved invitation. They need to move forward, albeit cautiously, to join the online conversation. Only by moving forward can they can develop relationships with influencers and help frame the conversation.

But now, Charlotte’s pounding on my door, saying, “You’re supposed to be our marketing resource – hospitals aren’t any different than over-the-counter medicines!”  As I get dragged down the hall, I do the math – “Let’s see, almost 6,000 hospitals, 500 multi-hospital systems, six to 10 service lines…need a quick solution, maybe a standard template, perhaps a blog?”

The annual marketing plan process can be numbing and painful, but it doesn’t have to ruin your summer, and with the right approach can also become a game changing opportunity.  It can actually be fun – really.

Let’s keep it simple with the initialization of MOP.  If you follow MOP, you will be far less likely to have to clean up any messes from the annual planning journey.

Macro, then Micro – Micro details in running a complex business can blur the vision for identifying the truly core business drivers.  Organization bureaucracies often create pet initiatives or issues.  It’s important to listen, but just as important to not be blinded from seeing the key opportunities.  Thinking macro, first, enables you to gain alignment and focus on the essential guiding principles for driving the business.  This is a critical step in helping a plan distinguish the “must-do’s” from the “nice-to-do’s”.

Operationalize the Plan – Don’t create platitudes such as, “We will strive to achieve our goal by becoming more focused.”  What does that mean?  Consider a step approach that leads to specific action:  Business Goal > Strategy to Achieve > Strategic Imperatives that must be accomplished in order to deliver.  Apply the “so what” (what are the implications?) principle to make sure all elements of the plan keep you focused on driving success.  If the “so what” suggests low importance, toss it so your plan stays on message.

Prioritize (and Focus) – Less is more.  Identify the few critical initiatives to do very well, then stay focused.  A more diffused effort may please more stakeholders, but risks delivering success.  Never sacrifice quality on core programs for quantity of mediocrity.  Remember the 80/20 principle; 80 percent of value is driven by 20 percent of the program.

There are many excellent planning tools and approaches for marketers. Our agency developed a process called whatcanbe, a simple, intuitive thinking approach that leads from insights to strategy development to plan execution.  Regardless of the approach you choose, apply the MOP and you might just get your vacation this summer.

While the older docs who are close to retirement age may not be jumping on the social media bandwagon, there are early signs that the Gen X and Gen Y doctors are moving forward and helping to take patient care into the new millennium.

photo credit: a.drian

The New York Times wrote a story recently about how some doctors are embracing Twitter to help them improve care and improve the patient-doctor relationship. And while these physicians are on the “cutting edge” of technology, it doesn’t look like they’ll be alone for long. And it appears we can thank Steve Jobs and the iPhone for being the driving forces behind this groundswell.

iPhones are flying off the shelves. More importantly, a recent Ad Age article reported that people are downloading more than 1 billion digital applications (apps), annually. And surprisingly, according to O’Reilly Radar, the medical category is the third-fastest growing application category, seeing an increase of 132.9 percent during a 12-week period.

Doctors are joining the more than 100,000 U.S. physicians who belong to Sermo, the largest online physician community where they can collaborate and share clinical observations. They’re writing blogs like New Hampshire internist Kevin Pho, MD, who writes KevinMD.com (voted the medical blog in 2008) and has 12,000 followers on Twitter (@KevinMD). And doctors are using their iPhone and medical apps so they can have clinical information at their fingertips.

The most significant development, though, is that doctors are using social media to help provide better patient care. BusinessWeek had a great story that shows how the iPhone has become a critical tool for saving time and improving the quality of the care. iPhone apps like Epocrates Essentials allow doctors to quickly check for drug interactions while Allscripts Remote allows them to remotely control Allscripts Enterprise EHR from any location. There are surely more apps in development, which will change the way doctors and clinicians provide care.

Behold, the brave new world of health care!