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Lee Aase In DigitaLee, High Stakes, Strategic Positioning

DigitaLee 4: Digitally Enhanced Healthcare, Twitter Alternatives & Execs on Social Media

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Welcome to DigitaLee, the podcast for healthcare marketers, where we look at the digital news, tools, tips and tricks for effective healthcare communications. This week, David Shifrin and digital healthcare pioneer and now healthcare entrepreneur Lee Aase are looking at digital-first healthcare – haven’t we been talking about that for years, now? – whether more obscure social media sites like Parler that tend to attract subsets of wider society are worth healthcare’s time, and how healthcare leaders and execs can balance the personal nature of social media with the value of promoting their organization’s brand.

Listen and subscribe to the podcast, or read the transcript below.

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David Shifrin: So the headline that we’re going to be talking about this week, the news story is titled, it’s from HIMSS Healthcare IT news, and it says, “Like Banks, Healthcare will become Digital-First in 2022.”

And there’s a comma and the rest of the title is “Zoom Healthcare Lead Says.” So Lee, I saw this, and thought there’s a headline I have seen in some form or fashion, probably every four months for as long as I’ve been doing this, which hasn’t been that long, but it’s been more than 2022. And it even starts with digital transformation as the topic du jour in healthcare today.

So we’re all talking about it. And everybody’s talking about the digital front door and care delivery being pursued through digital means and hospital at home and all the rest. Is 2022 really the point at which healthcare goes digital first, or is this the optimistic view of a guy from Zoom who has a vested interest in that being true?

Lee Aase: Stock options and stuff, right?

David Shifrin: And stuff, trying to boost things after things have come back down to earth after the pandemic, the pandemic bounce.

Lee Aase: Well, so I think digital first is overstating it. I think digital first is, yeah, it is that thing that a Zoomer would say. I think it’s, there’s no doubt that with COVID digital has made huge strides. That’s just clear. Back when I was working at Mayo clinic, we had some goals for digital going into 2020, and then it was astonishing how quickly things moved because they had to, necessity being the mother of invention. The offspring were a whole bunch of innovations that really were, it made a difference. I think the way reimbursements have changed or did change at least during COVID to say that you didn’t have to be face-to-face to get reimbursed at a reasonable level.

And so because of that it made the telemedicine, made the virtual care much more attractive, much more viable, just economically viable for organizations. I would like to say digitally enhanced is the way of 2022 and hopefully beyond, because I think it needs to be human first.

So the analogy that was used in this article was about banks. Okay. People care about their bank. People care about their money. Not as much as their health and it’s not as personal to them. Banking is much more transactional. And for example, I just deposited a check with my mobile app and that’s perfect.

And like the whole thing about not… just before we were on today, ATMs used to be the big thing. Wow, you don’t even have to stand in line at the teller. I mean, so that the convenience of that, and that’s what it really has to be all about, ‘Is it for the patient’s convenience?’

Is it for the good of the patient or is it just to drive profitability and make it more efficient for providers? So I think from my perspective, I know in a future episode we’ll talk about the other little venture that I’m working on right now personally, but really with that, we’re wanting to establish that human relationship and then use digital where it makes sense for the patients.

If it makes sense to do a phone call or a video visit, because it would be inconvenient to bring the kids in for…to be seen, then yeah. But we don’t want to say if you want your lab results, you need to log into the portal and here are the instructions as to how to do that. No, you can actually talk to a nurse. We’re glad to talk, or your doctor who’ll talk to you.

So I think digital can be a, can and will be a huge enabler and can create some huge efficient…in fact, a lot of the stuff that we’re doing with this new clinic that I’m helping my good friend start, my physician friend start, a lot of what we’re doing wouldn’t have been possible without digital, just in terms of being able to get this going. Having electronic medical record that is cloud-based and that we like, don’t have to have the huge IT expenses; it’s pretty astonishing what digital can make happen. But if that becomes first, digital first is a buzzword, and that’s what the HIMSS guys and the Zoom guys are gonna go for.

But if we lose sight of the human relationship then, and if it becomes not just, not a means to the end of more satisfied patients then we’ll be missing the mark.

David Shifrin: Let’s take a look at the platform or the platforms of the week and in the notes I sent over, it’s Parler, but as you’ve pointed out before, there’s a bunch of these, and we’ve some folks ask about quote unquote, that Twitter alternative, which we assume to be Parler, but that could just be a catch all for things that aren’t the Instagram, Facebook, Twitter.

Lee Aase: Yep.

David Shifrin: With a lot of these, and we talked about this in the previous episode, these are coming about because people feel like they don’t have a place to talk about issues that matter to them. So they are highly politicized, and Parler in particular, tend to cater to specific political segments.

And that also does feed into, I think, to an extent into more of a mistrust of institutions of healthcare. I don’t know if you want a say an establishment, but that potentially that’s there too. So, you know, as you look at all, all these upstart platforms, because at one point Twitter was an upstart and Facebook was and everything else – RIP MySpace – do you see any indication that these are places that healthcare providers should be getting involved in? Is it flash in the pan? What are you thinking about?

Lee Aase: I would suggest this is a – to use the medical term – it’s as a watchful waiting approach that you would apply here. But also I’d start by listening. you can create an account personally if you’re a healthcare marketer or communicator. Get familiar with what’s happening there.

You don’t have to speak, you can be one of the lurkers and just see what people are saying. And maybe try some experiments if you think it makes sense, but I think not paying attention to them at all as the wrong approach.

But I also think given the tenor that will likely be there in most of these platforms, running out there with a whole bunch of establishment kind of messages you’re probably getting the equivalent of a ratio there.

David Shifrin: Yeah.

Lee Aase: On those platforms too. But I do think it’s like, you know, in politics you have to get 50% plus one. Marketers are all about tenths of a percent of market share at the lower end of things and making a big difference in their bottom line by how well they’re reaching people. And so, unless you want to say that this segment of the population is just, we just shouldn’t, don’t even want to treat their kind, you know, then you should be paying attention.

You should at least be hearing what they’re saying and seeing if there’s a way that you could effectively communicate there. But I wouldn’t, I wouldn’t rush into it and say okay, everybody has to have a Rumble page, a Rumble channel and put all their videos on Rumble too.

But I think not at least listening is you know, making the problem worse.

David Shifrin: All right. Last one. The tip let’s…we’ve talked about social media policies, and let’s talk here more specifically about good ways for leadership as individuals to use social media. How do folks in leadership positions in the executive suite build trust and credibility and come across as real people while also presenting valuable information about the brand or the organization as they need to?

And I mentioned before we started recording that I’d love to continue on this thread at some point about how almost the flip side of that is how brands can leverage the corporate voice versus the individual voice.

But let’s start sort of if you’re a healthcare leader how do you balance that and come across as a real person?

Lee Aase: Yeah well, I mean I think healthcare leaders who are going to be or have personal accounts on social media need to be engaged with them, need to be paying attention to them. There are certainly…any public figure who has a social media account is having other people help manage the account just because there’s such a volume of messages.

David Shifrin: Sure.

Lee Aase: But it needs to come across as authentic and that there needs to be some level of the person himself or herself speaking and engaging. And that if it’s all, if it’s all managed and not an individual being involved at all, it’s not going to be genuine. It’s not going to feel genuine and real.

And I think that’s part of what people are thirsting for, is that there would be that ability to, that this is a real person who personifies the brand who personifies the values of the organization. So I think one way, I mean, a lot of that can be accomplished through video by having just the CEO or other leader talking about things but I would say much more like a livestream and “ask me anything kind of thing” versus a highly produced thing with the drone footage, you know, where they’re, they’re coming

David Shifrin: Swooping into the CEO suite.

Lee Aase: Swooping into a CEO suite. It’s like, I mean, I understand there, are different brands that have the different fields and for some that might be just the, like maybe for Elon Musk.

Well, I mean, just let’s think like Elon Musk, okay. I mean, another good example of someone who you’re pretty sure that that’s authentic to who he is and he’s done okay for himself mostly.

David Shifrin: Yeah, it would be hard to ghost write for Elon Musk, he has his own style. That’s a good example because it does show and he does say some things that you can really “Wow, bro.” But he, as you say, he is incredibly successful and he has built real products and he has advanced his brand.

So it does show that people are interested in the human behind the brand. And in some cases they might be inextricable, but it’s not necessarily a bad thing.

Lee Aase: Yep.

David Shifrin: Okay.

Lee Aase: So that’s what I have to say about that.

David Shifrin: All right. Thanks, Lee.

David Jarrard In Change Management, High Stakes, J|Insights, Quick Think

Arnold and the Art of Capturing Attention

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: Arnold Schwarzenegger speaks to Russians in emotional plea against war in Ukraine

A masterclass in communications.

The headline tells you exactly what happened late last week. But it comes nowhere near capturing the why, the how, the pure power of one public figure wading with deep authenticity into geopolitics. But powerful it was. Catching our attention. Holding us rapt. Moving us.

Watch it twice. Once to feel it. And then again to understand how it works.

I love the Russian people. That is why I have to tell you the truth. Please watch and share. pic.twitter.com/6gyVRhgpFV
— Arnold (@Schwarzenegger) March 17, 2022

We’re witnessing an extraordinary moment of powerful communications and communicators.

Russia’s brutal invasion of Ukraine has unleashed a parallel communications battle the likes of which we haven’t seen in this generation and which is beyond the scope of our weekly Quick Think. No surprise if textbooks are written about the situation, featuring, among other things:

The eloquent, razor-sharp messages – delivered through words and deeds – of Ukraine President Volodymyr Zelensky.

The harnessing of social media for “You Are There” journalism and “Are You Really There?” manipulation.

The Orwellian efforts by Russia to change the narrative against a sea of troubles, to block a tide of digital and tragically tangible information that cannot be denied.

But for today, we look at a single example from someone whose career trajectory broadly mirrors that of Zelensky – from kitschy actor to prominent politician. That training alone is worth noting when it comes to communications.

Outlandishly long in our distracted age of no attention spans, Arnold Schwarzenegger’s unexpected video – viewed by more than 30 million watchers within in 24 hours of its release – speaks directly to the people of Russia. We’ve captured several outstanding aspects of his compelling, at times personal message. If you take away just one thing, let it be this: The messenger must match the moment. Nothing brings home profound facts and difficult calls to action more than clear-eyed honesty and personal stories well and sincerely told.

Beyond that, a bit of video analysis…

It’s built for maximum reach. Schwarzenegger starts by telegraphing a basic communications principle. He says that he’s posting the video on multiple channels to make it as accessible as possible. It’s also subtitled in both Russian and English.
It’s built to target specific audiences. Difficult to pull off in a single piece, Schwarzenegger speaks sequentially to Russian soldiers, Russian citizens and Russian leaders – and then even more directly to Putin. The core message remains consistent as the specifics are adjusted for the audience. And in doing so, he is never manipulative. He tells viewers exactly who he’s speaking to – no games, no obfuscation, full transparency.
It’s direct about the goal from the start. Schwarzenegger begins by looking into the camera and giving a personal message to the people of Russia, expresses his life-long connection and affection for them, and then explaining where he’s going with it all. The environment is set to emphasize the directness and empathy: a tight shot of him at a table with a sober, but soft, expression.
It’s anchored by stories. After his intro, Schwarzenegger tells a story about his connection with Russia and the conflict that connection caused between him and his father – because of his father’s own painful connection to Russia from World War II. Throughout the remaining minutes, he continues to weave in personal stories.
It establishes credibility and rapport. Before detailing how the Russian people have been lied to, Schwarzenegger says, “No one likes to hear something critical of their government. But…as a longtime friend of the Russian people, I hope you will hear what I have to say.” By this point he’s already demonstrated his affinity for those very people. He also points out his consistency. He’s not targeting Russians but is “speaking with the same heartfelt concern” that he did to Americans after January 6, 2021.
It points no fingers (except at Putin and the Kremlin). He is surgically careful to separate the people to whom he is speaking from their leaders. He is explicit that they are not to blame. On the contrary, he assures them they have been misled. In effect, he comes alongside them with an arm around the shoulder rather than facing them down.
It’s methodical. Schwarzenegger knocks down the major points of current Kremlin propaganda one at a time. The Russian people, he said, have been told the invasion is a rescue operation to de-Nazify Ukraine. “This is not true,” he intones. He states facts and frames them with stories. Not only is Ukraine not being led by Nazis, but the current president is a Jew “whose father’s three brothers were all murdered by the Nazis.”
It offers emotional context for facts. For example, he shares the fact that civilian centers have been targeted and backs it up with the emotional stories and images from the deaths of mothers and children in the maternity hospital bombing. Even relatively dry data is given emotional weight. He doesn’t just say that the UN has condemned Russia. He adds that 141 members voted against Russia – with only four voting in favor.
It includes clear calls to action. Schwarzenegger asks the various audiences to understand they’re being fed propaganda and to consider that what he says is the reality. He asks people to spread the truth. He asks soldiers to consider the effects of the action they’ve been told to take. More than 11 million Russians have family connections to Ukraine and so, “Every bullet you shoot, you shoot a brother or sister.” He calls on Putin, by name, to end the invasion. But for every viewer, an unspoken challenge is clear: Now that you know, what will you do?
It ends with words of support and encouragement. To those Russians who have protested and spoken out he says, “The world has seen your bravery. You are my new heroes.” It’s true, and it helps the medicine go down.

A masterclass indeed.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

david_shifrin In High Stakes, , Quick Think

When Is a Win Not Really a Win?

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big (?) Story: Jury sides with Sutter Health in federal antitrust case

“A jury sided with Sutter Health on Friday in the long-running federal lawsuit accusing the health system of anticompetitive business practices that drove up healthcare costs by more than $400 million.”

What it Means for Health Systems

(3-minute read)

The short version of what the Sutter result means: One specific health system won one specific legal battle.

That’s it.

Time for more? Read on.

The California health system’s case is making waves in the healthcare trades and among industry insiders. Understandably so. A large system received a favorable jury verdict regarding alleged anticompetitive practices in an environment where that outcome was far from a foregone conclusion.

But while Sutter can take a breath, the provider side of the industry can’t. Or at least shouldn’t. Because this legal result does nothing to change the big-picture issues that are facing hospitals and health systems. Remember that this case began a decade ago and has focused on insurer contracts and antitrust issues, which have direct implications for the cost of care and patient access. Those topics are as hot today as they were 10 years ago.

A few key points stand out when looking at the decision. Note: We’re not making any statements about the legal issues. For that, we’ll recommend this concise piece from our friends at Bass Berry & Sims.

“It’s complicated.” In coverage of the jury’s decision, the words “technical” and “complex” came up repeatedly. It was clearly (and rightfully) a challenge for the experts to break down for the jury. The implication is that the complexity of the case made it difficult to clearly determine that Sutter had done wrong. So the default, when faced with a binary choice, was to side with Sutter. Another Modern Healthcare article that discussed this case and its “cousin” case – which Sutter settled – makes this very point. It’s that subtle philosophical difference between “innocent” and “not guilty.”
The narrative continues. What happened in the courtroom isn’t likely to mean much in the court of public opinion. The fortunes of one health system aren’t likely to alter the ongoing barrage by critics who maintain that hospitals are Big Business focused on profit over mission, they engage in willful anticompetitive practices, they harm patients through financial malfeasance.

So, yes, the case may have an effect on contracts in California going forward. But this verdict is a sidenote when it comes to the overall trends in healthcare and public perception thereof. The critics are simply reloading.

So how should providers react?

Unless you’re Sutter, don’t relax. Talk to your legal team. Appreciate that the federal case was an overreach and perhaps too detailed for the plaintiffs to win. Certainly don’t assume that the FTC, DOJ, insurers or anticompetitive activists will back off.
Evaluate the opposition. A single legal loss in a high-stakes and very large scale, systemic dispute won’t deter those siding with the plaintiffs. If anything, hospital critics now have more information about what works and what doesn’t when it comes to pushing the anticompetitive narrative. They’ll use their notes to build a stronger and, presumably, clearer case for next time. Frankly, we’ve consistently seen that hospital critics do a pretty good job of telling a compelling story. Expect this setback to both encourage them and provide them with new resources to further refine their narrative.
Prepare for more. Continue reviewing both your operations and your communications. As always, get everyone in the room for discussions about how your organization is approaching the myriad financial issues raised by critics. Look for gaps and misalignment between clinical, ops, marketing and comms, government relations, community outreach, legal and payer relations. Then, for the marcom team specifically, double down on telling your organization’s story.
Speaking of payer relations… the Sutter case with several other recent high-profile public provider-payer disputes, show how quickly things can escalate once that tension first appears. Avoid escalation. Have your GR team engaged and building relationships with policymakers. Same thing for your payer relations team. That way, if – when – things get tense, you’re starting with a base of personal relationships and mutual understanding. We’re not naïve enough to suggest that occasional drinks with a payer rep is enough to stave off a contentious negotiation, but a bit of human connection won’t hurt. Additionally, even if you “win” a nasty battle, the critics will have had plenty of chances during the process to put dents in your reputation. Over time, dents can become cracks and, well, that’s not ideal.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think

The Quick Think: Engage Your Readers With This One Simple Trick

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

A good Monday morning to you: Today’s Quick Think is 773 words, a 3-minute read.

1 Big Thing: Axios Wants Us to Read Everything in Bullet Points

A four-year-old media company has risen rapidly to provide excellent reporting in an ultra-consistent, bullet-based format that is arguably changing the way we look at our inbox.

Katie Robertson, writing an Axios-style article in The New York Times, says, “The company’s executives think its short-format writing will build back trust in the media among busy audiences and can teach corporate America to quit its long-winded jargon.”

Why it matters: because in true absurdist fashion it gives us an excuse to pile on and, like the Times, pay our own homage to the newsletter phenomenon sweeping our inboxes. Seriously, we just checked our subscriptions and came up with Axios AM, Axios PM, Axios Vitals, Axios Sports and Axios Nashville. Not to mention competitors Morning Brew and 1440 Digest.

Why it really matters: Because the Axios style of communication works, and we see it every day with clients. Lament short attention spans all you want, but tight prose and well-written bullets are extraordinarily effective at getting the point across.

What’s happening: The rise of sound-bite newsletters is one of two things, or more likely a bit of both.

It’s the latest signal in the ongoing evolution of how America consumes media – short and sweet, but with rock-solid reporting behind the tiny word counts and templated format to capture our ever more fragmented attention.
It’s a market response to the interest people have in consuming a lot of information. Axios is communicating in a way that their audience tells them they want, but, impressively, with both high volume and a commitment to quality on every level from national to local.

Between the lines: During the pandemic, we observed – and may have occasionally participated in – the overwriting of a lot of content.

Provider organizations were trying hard to get large volumes of rapidly evolving, complex information out their communities.
Confusion and skepticism led many to use a lot of words. It’s very difficult to explain in soundbites how pandemics progress, or how a virus functions, or why we need the vast majority of the population to get vaccinated.
“During the pandemic we may have overcorrected from the Twitter approach and now we’re seeing a swing back to the middle,” mused our CEO David Jarrard.

Reality check: The Axios model provides lessons for healthcare marcom, as well.

When navigating any kind of change, offer consistent, concise information through channels that your audience is already connected with.
That means building FAQ and toolkits your team can adapt with the details of any given situation, and then delivering those messages through email, posters, direct voicemail, townhalls, etc.
The ultimate goal is to give just enough detail to get the point across and drive a desired action. Then, if people want more or you need to backstop with additional data or context, you can point them to supporting long-form material – in Axios’ case, “Go Deeper.”

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Lee Aase In DigitaLee, High Stakes, Strategic Positioning

DigitaLee 3: Spanish Misinformation, Meta’s Dive & Apple’s Privacy Rule

Listen and subscribe to the podcast, or read the transcript below.

Episode Links

Read the Transcript

David Shifrin: Welcome to DigitaLee, the podcast for healthcare marketers, where we look at the digital news, tools, tips and tricks for effective healthcare communications. I’m David Shifrin with Jarrard Phillips Cate & Hancock, and I’m with Lee Aase, digital healthcare pioneer and now healthcare entrepreneur. Today, we’re looking at the Spanish language misinformation crisis, Meta / Facebook’s recent dive and Apple privacy rules.

So for the first section, I wanted to talk about, we’re back to talking about misinformation in the news. This one is a little bit different. A story on Axios about Spanish language misinformation crisis, and I think everybody’s pretty aware of what’s going on. As far as misinformation, it’s not quite as hot of a topic as it was a few months ago at the peak of the vaccine push, but certainly is still an issue.

And I thought that sort of the core point, the thing that really stood out to me in this article, was between the lines and says where platforms are quick to remove misinformation posts in English, some identical posts in Spanish remain online. And just something that I hadn’t really considered is the multi-lingual nature of everything that’s going on and the need to reach out to so many different communities.

What’s your gut when you see this article?

Lee Aase: I have a little bit of a different take and I thought it was actually a good launching pad to be able to talk about some of this. So I think there is a crisis. I don’t think it’s a Spanish language information crisis, and I think it’s a different one. And we’ll get to that in a little bit.

When I started advocating for social media use by hospitals about 15 years ago now, there were definitely a lot of people interested and then I got a lot of objections because people are saying “what about all the bad information on the internet?”

And my response was, there will always be bad information on the internet. That’s just the way it is. If you have a free and open internet, you’re going to have people publishing bad information. So my answer was then if responsible medical professionals don’t engage, we’re ceding the territory to the snake oil salesman and to the people, the charlatans, the people who are putting out bad information.

And so that’s why I was arguing that health professionals had a moral responsibility to put out good information. I have a good friend of mine that a lot of folks listening to this will probably know. Andy was the founder of the Word of Mouth Marketing Association, or was the president of that.

Anyway, he founded a group called the Blog Council—now that’s socialmedia.org what it later became—anyway, he had a saying that he said he learned in high school chemistry that the solution to pollution is dilution. You know, that if there’s bad stuff out there, you need to overwhelm it with the good, okay. You need to put out reliable, trustworthy information. And the way that we have thought about it for 15 years in social media is that the good information will drive out the bad, the good information that people like it, they’ll comment it, it’ll get up-ranked. There’s a thing on Twitter called the ratio. The ratio is comments versus retweets or likes, and if your comments are much higher, that’s meaning that people are taking issue with what you’re saying versus what, versus liking it or passing it along.

There’s a quote that’s been attributed to Voltaire: “I may disagree with what you’re saying, but I’ll defend to the death your right to do it.” We’re a long way from that right now. You know, we’re saying, yeah, we need to tamp down, we need to drive out this information.

I think that’s a big part of the problem for the polarization that we have now, is that it is viewpoint discrimination and that opinions that align with the governmental or large entity positions are…are those that are aligned are promoted and others are suppressed.

So, over the last several months, users have been banned from Twitter for messages that today we know are true. Cloth masks don’t work. Posting that previously would get you, could get you banned from Twitter. And if the goal is to prevent respiratory infections, they don’t work.

Okay. Cloth masks don’t work. And they’re saying, ‘No, yeah you got to wear N-95s or KN-95s.’ You know, some messages that previously came from government or medical authorities have been shown not to be true. Okay, Israel has a vaccination rate of about 95% for those who are over 50 and about 85% have gotten the booster, and as of February 3rd COVID deaths were at an all-time high in Israel, okay.

The president of the United States, the current one, not the previous one, the head of the CDC and a whole bunch of others have previously said, and the tweets are still up, if you get vaccinated, you won’t catch COVID and you won’t spread COVID. And there aren’t any warning labels on those. There aren’t any things saying this may contain misinformation.

So I think those messages are still up, and I think another issue in addition to this alleged Spanish misinformation crisis is if you can’t be heard on the normal platforms where everybody’s speaking, well, if you park your truck on a bridge and don’t move it, and it’s a bridge between two countries, people are gonna pay attention. They’re gonna listen.

David Shifrin: Going to get noticed.

Lee Aase: Yeah.

So I think the fact that things are being suppressed, pushing down on that is kind of why we get, and I know in another…in a future segment, we’ll get into talking about some of these other platforms, GETTR or Parlor and others, but the reason those spring up is because the more mainstream platforms are suppressing it. And I think it’s…so that’s where the problem that I see is the credibility. You know, even if you think it’s harmful, then you should speak out against it instead of banning it, instead of banning individuals and banning and putting labels on that feel like they’re putting the finger on the scale.

So that probably wasn’t what you were expecting when you proposed the top.

David Shifrin: But it’s a good note too, that we have to engage. And to do… and this is something that I’ve been really concerned about for a long time, I’m a scientist by training and we need to do a better job of communicating how science works and how the data is collected and how we analyze it, because it does change.

And that doesn’t mean anybody’s being disingenuous or trying to play rope-a-dope or whatever, but it’s just, this is how science works. It’s complicated and it’s hard. And so the guidance will change. And that should be the message. And that gets to your point about diluting the bad information and just being more clear and straightforward about, ‘Here’s where we are today and here’s how we arrived there and this may change tomorrow.’

Lee Aase: Yeah, science, isn’t a person and it isn’t a noun. The science is a process, it’s a verb, and we need to, yeah, and educating people on the scientific method and what we know because of studies and what they can tell us, and then what the limitations of the studies are. And I realize that you get into a pandemic and people say we gotta get some communication out here because there’s all this bad stuff happening and we gotta give them some clear messages, and they want to give a clear message. And I think the risk of that, and I think what has borne out because of it is that we have people that have much less trust in public health than they would previously.

David Shifrin: Yeah. I love it. Thanks, Lee. Let’s look at the platform of the week. Meta, the artist formerly known as Facebook, the artist formerly known as Mark Zuckerberg’s dorm room. A lot of stories going around recently about how the number of active users has dropped for the first time ever, and as a percentage of total users it’s pretty minuscule, but it did drop.

It’s never happened before. Their earnings are down. Their market cap took a hit largely, or at least in part, because of Apple’s privacy rules, which I think a lot of folks listening as marketers are going to be aware of.

It’s something we’re watching here. So is this a big New York Times headline story that’s a big story because it’s a massive company or is this something that digital marketers in healthcare need to be paying close attention to for potential issues?

Lee Aase: Well, I think marketers should always be paying attention to things like that and be looking at performance. So they need to be looking at what’s really happening in terms of click-throughs and business results that they’re trying to accomplish through it. I think being cognizant, at least of the fact that the user base is diminishing a little bit, or at least the active user base, that paying attention to where the attention of users is going is something that just is basic work that marketers should be doing. Marketers, communicators of all types.

I think that, getting back to the previous issue, we talked about when you have the…I think one of the reasons behind, I mean this is a hypothesis, okay? This is a guess even, you know, that 50%ish, maybe it’s 48% of people and maybe 40% that are pretty strongly feeling that way are saying, you know, this is a platform that’s not friendly to me. Or, that is, this is going to put a label on things that I agree with that says this might be misinformation. I think people then maybe hold back and just say, ‘Okay well, I’ll share my family, kid pictures and watch the grandkids.’

But maybe you’re less likely to…it just takes a little bit of the luster off, I think.

David Shifrin: Yeah. And so then if they’re backing away from their engagement, it’s even harder to reach them, obviously, by definition, with good information. So you’re…

Lee Aase: Right. Yeah. And when you’re…I mean the answer isn’t to turn up the volume, okay. It isn’t to turn up the volume and turn down the screws, it’s to engage and to discuss. And I recognize that having been worked in the healthcare system and where you’re posting the messages that you’re, you know, being given to post, and there are definitely, there are unpleasant conversations that are happening there. The way it is right now, for sure.

David Shifrin: Okay, so let’s keep an eye on it and watch the numbers and see what happens next time Zuckerberg testifies before Congress.

For the last piece here Lee, the tip that I want to focus on is Apple’s privacy rules, which I just mentioned. I think, again, I think a lot of folks are aware of this, but the native iOS Apple mail app, which accounts for a huge chunk of email management, somewhere between 40 and 50-plus percent, it now is pre-loading tracking pixels to obscure human opens and geolocation data.

It’s a privacy push. It reduces the ability for us marketers to track engagement and target across different platforms. And again, this bit into Facebook’s revenue. So it’s potentially a problem for pure marketers selling whatever, clothes or widgets. How much do you think this could matter for the types of campaigns that hospitals and other healthcare providers are running?

Lee Aase: Yeah, well, I mean I think the upshot that HubSpot talked about in that article that we, that I think you referenced and you probably put it in the show notes, is just that marketers need to focus on the harder metrics and the ones that are more business-oriented, like click-throughs, like actual, go to the other one we were talking about here, replies. Yeah.

So, I mean, that’s the thing is when people are actually taking some step, you know, I look at shares for instance as well, shares on social, A share is…I used to call it the mother of all metrics, because it’s not just “I like it,” it’s “I want my friends to see it,” and so those are the things that I am typically going to be paying a bunch more attention to.

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David Jarrard In High Stakes, , Quick Think

Speaking Up or Thoughtful Silence

Text that reads "Quick Think" on a navy background with a lightly shaded light bulb icon

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

A Note on Responding to Current Events, from CEO David Jarrard

2.5-minute read / 13-minute podcast

Do you weigh in as an organization?

It’s not a simple answer. It’s a challenge our clients have faced many times over the past two years as outlier events have swept across the globe. This is true again as Russia continues its brutal invasion of Ukraine. Our clients ask us: “Do we need to issue a statement? Can you help us create a message? We’re not sure what to say but we think we need to say something.”

The first question to ask: Why?

Thoughtful leaders want to acknowledge important moments. To take a stand. To show solidarity with those in trouble or in need. As you consider whether to do so for your organization, the answer may lie in how you’ve asked yourself the question. If you’ve asked, “Do I have to weigh in?” when no one is looking for your corporate position, then the answer is very likely “No.” But if circumstances or your mission call you to weigh in, the answer may well be “Yes.”

We all recognize that organizations speak with the greatest authority when the subject is aligned with their expertise and reputation. A healthcare organization opining about important healthcare issues is your natural lane (i.e. COVID vaccinations and health equity). It is expected that your organization would speak to these and other important matters; it’s desired and needed, in fact.

The further the subject strays from your organization’s mission and expertise – to national politics, for example, or events around the globe – the thread connecting the subject and your authority, credibility and relevance weakens. If you comment on one disconnected event to which you bring no authority, you create the expectation that you will be commenting on an array of disconnected matters in the future.

The cliché is true: If you have nothing to say, don’t say it.

But. But! Sometimes what may appear to be a distant matter is actually close to home. There may be local ties in your community that bring it to your doorstep. You may have a service providing care that is directly impacted by the issue. You may serve a community bound to the region affected. You may have staff personally affected by it. Then, the call to speak is strong, local and relevant.

Do you serve a Russian or Ukrainian community within your market? Do you have Russian or Ukrainian immigrants or their descendants working in your facilities? Do you have a unique service that offers aid to that war-torn region or even to others oppressed in or from violent areas? If yes, the call to speak – to make clear your position and expectations – is strong. In fact, you should.

There is a third scenario, one in which you don’t have a direct line to the situation but your heart and mission simply demand your voice. As you speak – and many will – we suggest you simply acknowledge the uniquely and tragically horrific circumstances that call for your voice so, again, you don’t find yourself expected to provide commentary on world events in the many days to come.

An unfortunate byproduct of the social media era is that everyone has an opinion on everything, and people, leaders and organizations often feel like they’re expected to say something. So they worry about getting called out if they don’t. It’s part of that social media hype chamber. If that’s you, and you’ve concluded that saying something isn’t necessary or directly connected to your mission, give yourself permission for intentional silence.

A final note: If someone does come after your organization on social media for not saying something, the best practice is to respond publicly while bringing the conversation offline. Reply, “Thanks for your feedback. I’d love to talk about this and hear your perspective. Can we set up a conversation?” The key is to be responsive and not react disproportionately.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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david_shifrin In Change Management, High Stakes, Special Report, Strategic Positioning

Special Report: Recruitment Starts with Retention

“Mom, today I found out how I can own my own store.”

Was that the first thing you said as a teenager coming home after your first day of your first job slinging guacamole at a fast-food restaurant? Nope? Wasn’t for us either.

But that did happen to a teen whose orientation at Chipotle included a pathway to go from line crew to store manager to franchisee. And what a profound lesson for healthcare organizations struggling with staffing, said Dan Collard, co-founder of Healthcare Plus Solutions Group, who recently shared the story with us.

As Collard sees it: Recruitment starts with retention when companies give employees a reason to stay and grow.

Healthcare’s persistent workforce shortage is one of the industry’s most daunting issues right now. Everything’s on the table: large sign-on bonuses, retention bonuses, raises as everyone competes to staff up, whatever it takes. Many, especially rural hospitals, are barely hanging on. A few numbers to illustrate the point:

BY THE NUMBERS

Rural hospitals having difficulty filling nursing roles

Increase in salaries and benefits reported by HCA in 2021

54%

Rural hospitals significantly increased reliance on travel nurses

Nurse leaders citing employee emotional health as key concern

We all know the problem illustrated by those numbers. But how did it get so complicated?

Social context. The great resignation is affecting every facet of the workforce, with retention of hourly employees particularly tenuous.

Damsky

Expectations for greater pay, better benefits, improved work-life balance, career development opportunities and a desire for a better connection with employers are leading employees to push for change and/or leave their position in pursuit of it. Nurses, techs and shared services employees are expressing those same expectations but with the added layer of the intensity of their work.

Different process. “How people are going about getting talent has evolved as nursing recruitment has been empowered by technology. That’s making it more costly and more competitive,” said Pamela Damsky, director and Performance Practice co-lead at Chartis.

Jung

Jeffrey Jung, engagement manager at Chartis, pointed to the rapid rise of placement firms and “matchmaking technologies” that help connect provider organizations with talent. Jung said the matchmaking software can increase the speed at which a nurse can be placed and make better matches on the front end to boost retention. “It’s cheaper than just using placement firms because of the technology, but the overall cost is increasing because there are so many more applicants being hired,” he said.

Jennifer O’Meara, senior digital strategist at digital marketing firm Eruptr,

O’Meara

said the recruitment campaigns her firm ran online before COVID-19 tended to be “as needed” and focused on RN recruitment. Now though, Eruptr is involved in comprehensive recruitment campaigns that run constantly across platforms. Budgets, she said, “are double and triple what we were running previously, and it’s not just SEM, it’s Facebook, it’s Instagram, it’s display ads, it’s YouTube… it’s everything.”

More competition. Atop increased cost due to shifting talent acquisition processes is the pressure to raise compensation through bonuses and higher salaries to compete with other organizations in the market for a smaller and, perhaps, more selective talent pool. Hospitals are vying for the same nurses and trying to fend off the travel firms. At the same time, nurses and other staff have far more options, with outpatient clinics and health services companies delivering outstanding care and offering attractive careers.

Frayed relationships. The pandemic has accelerated a breakdown between title bands. Leaders are working to keep the whole operation running, staff are keeping things clean and caring for patients, managers are liaising between the two. Nurses aren’t happy. They’re being asked to do more with less. The LinkedIn post from nurse Kelly Fassold illustrates it well. Fassold compellingly expresses the anger many nurses feel towards administration, regulators, hospital groups and anyone else trying to codify salary caps – or even just discuss nurse compensation. The relationship between administration and staff is broken, and nurses feel like they are – or actually are – on the outside looking in as discussions about their value take place. It understandably leads to the sentiment of being both disrespected and undervalued. “You’ve left us out of the conversation and you don’t understand what we do so how can you tell us what we’re worth?”

Surviving then solving the nursing shortage

The healthcare staffing crisis isn’t intractable, but it’s not going to be solved in the short term. Right now, healthcare execs and HR teams are doing whatever is necessary to have just enough staff on shift to deliver care. Whatever it takes. That only adds to the unsustainable feedback loop and the feeling that we’re in the middle of a land grab, making it that much harder to plan for the long term. But plan we must. In fact, we must redesign the whole thing.

To do that, we have to establish the environment for long-term change to take root. First, a few thoughts on the tactics hospitals and health systems can employ.

Current Tactics for Recruitment & Retention

Hospitals and health systems are activating a variety of strategies to staunch the bleeding of the workforce crisis. We’ve curated a list of short and long-term interventions in force today and arranged them by feasibility for different types of provider organizations. After all, very few health systems have the financial wherewithal to buy a nursing school the way HCA did with Galen College of Nursing nearly three years ago.

Remember that nursing challenges arise indirectly as well when other areas of the organization break down. Take environmental services. When that department is understaffed, nurses end up with additional responsibilities because who else will change the linens? It’s more rocks in the nurses’ backpack.

Collard referenced a health system that was struggling with retention among environmental services and other support staff. Leadership changed the employee onboarding process so that, instead of following up with new techs after 30 and 90 days, those conversations happened on days one and two. That kept new hires engaged and allowed managers to uncover questions and problems instantly rather than letting them fester, improving the likelihood that the individual would stick around.

Again, wise to stay vigilant on the indirect disruptions that spill over onto nurses and address them promptly.

Building a culture of retention

Our experts agree there’s no easy solution, and the hard, sustainable solutions involve completely rethinking how we deliver care. But then they cite something that absolutely can be accomplished: building a culture that makes people want to stay. And when people stick around, you save on acquisition and training costs, maintain workforce stability and naturally gain advocates who may recruit others.

But O’Meara cautioned: “If you have to talk so much about culture and sell people on it when recruiting, do you really have a good culture to begin with? Is that culture reflected once you get past the advertising and the recruiters who make you feel so great about everything? Is it reflected once a new hire gets into the clinical setting?”

When you look up “employee retention” on stock photography sites, this is a lot of what you’ll find. But this represents a “what not to do” approach.

Professional development

Collard

Back to guacamole. After telling the story of the young man’s first day at Chipotle, Collard drew the contrast with healthcare organizations. “On Day One, we’re more interested in getting people set up with their password for the electronic medical record and showing them which gloves to wear,” he said.

In the push to get people working on their floor as quickly as possible, there are so many priorities to check off the orientation list that nothing is a priority. In contrast, Collard asked rhetorically, what if hospitals were more like Chipotle? “What would it be like if we began to engage our clinical staff on the day they started?” He mentioned research findings that indicate nearly four of five millennials will take a job with lower pay if it’s a job they feel connected with and that provides them a clear career path. It’s not always about the money. (Although yes, the Chipotle post below does feature the money along with the career trajectory.)

Jung emphasized this point, too, but with less avocado and red onion. Before COVID-19 there was less enthusiasm for bringing in a new graduate “because they require so much hands-on involvement,” as he put it. That hesitancy to hire novice nurses and techs is changing, and what’s becoming important now for retention in a smaller labor pool is giving people a clear pathway to move and grow.

Carter

A specific example of this in healthcare comes from Dawn Carter, a veteran healthcare strategist and founding member of the Rural Healthcare Initiative. She said that from the moment they initially consider a healthcare career throughout their time with an organization, people need to see how they can grow in their job or grow into another one. Hospitals that are already helping finance additional technical/educational investments have a massive leg up – they should do everything to make those opportunities known.

Carter cited a speaker from the 2022 South Carolina Hospital Association meeting who suggested hospitals ensure that high school students understand the low-cost path to a high-paying job. Someone paying two years of technical college tuition and coming out of it with an RN can enter the market making $60,000, but there’s the potential for $200,000+ by pursuing a CRNA.

Another example? Take the entry-level hospital employees working in “central sterile” cleaning surgical equipment. The skill level is such that they could work at an Amazon warehouse for more money and skip the dirty equipment. Hospitals, Jung said, can and should create a defined career ladder for techs. Many techs are in nursing school, and if you create those relationships and provide the opportunities, they’ll eventually want to come back or continue employment when they graduate, he said. “It’s the difference between a very transactional, ‘We need you here’ and a relational, ‘We’re going to invest in you – and we’d love for you to go back to school,’” he said.

Nurse-manager relationships

Go back to that LinkedIn post above. The post, and several comments below it, are built on the idea that unless someone has done the job they can’t know what it’s worth. It’s a push against salary caps, but it also reveals the significant gap between the suits and the scrubs. And it’s a fair point. The system is broken, staff see their census and patient acuity steadily increasing and the message many hear from managers and administration is a combination of, “Keep going,” and, “We can’t give you what you want.”

But again, sometimes what people want isn’t necessarily money. “We need to be sure we have salaries that match the market, but it’s more than dollars,” Damsky said. “It’s also treating nurses with respect and meeting their needs and creating an environment where they want to be.”

Carter highlighted the desperate need for leaders to spend time with staff, having heartfelt conversations about what they’re experiencing and humbly – not defensively – discussing leadership’s position on the issues and the various imperatives they’re balancing.

Sometimes it’s effective for managers and executives to share their own stories. We’ve heard from clients whose leadership spoke during town hall meetings about their toughest moments during the pandemic. Showing that level of vulnerability was powerful and helped dampen some of the tension that had been building.

Note that these conversations shouldn’t be used as distractions from or substitutes for practical interventions. They should be a supplement, a way to both solicit helpful information about what staff need and to demonstrate that the organization is working towards a collective solution.

Leadership development

Over the past couple of years, particularly during the omicron surge, we’ve seen an increase in non-clinical staff stepping in to help fill gaps. There are stories of managers running to get blankets, leaders helping empty trash. It’s certainly not happening everywhere or all the time, but more frequently than ever before.

That’s all well and good…but interestingly, our experts noted that it’s not necessarily the best thing. Plugging holes is an important crisis response and it’s great for showing staff that leadership is engaged, willing to do whatever it takes. Even so, there are drawbacks. “Leaders have been rolling up their sleeves and diving in,” Collard noted. “If I’m in that position, it means I’m spending less time leading and more time doing on the unit.”

Reconsidering Compensation

NOT EVERYONE WANTS TO BE A TRAVEL NURSE

— Nurse A 🖤🩺 (@Nurse_Lyss) February 5, 2022

We reference compensation throughout this piece and noted that it’s not always about the money. Two reasons for that:

First, the key thing organizations should be providing people with is an environment that attracts them and keeps them engaged. Which, again, isn’t to say that our industry shouldn’t be taking a long hard look at financial compensation.
Second, the current money isn’t sustainable – for anyone, but especially rural and independent facilities. The key is remembering that different people want different things, and any given organization can highlight the things it offers that will be attractive to someone, if not everyone.

According to Eruptr’s Jennifer O’Meara, hospitals in bigger cities with more competitive markets are relying more on bonuses and the financial incentives, while rural facilities and systems lacking competition but without the financial wherewithal are focusing on the intangibles. Think quality and cost of living. She said that in many recruitment campaigns there’s less emphasis on the standard “great culture” line and “a big push in online campaigns and in discussions about how making this move can be better for your quality of life.”

Cessna

Joel Cessna, Eruptr’s vice president of sales pointed out another example of alternative compensation for rural locations and those that can’t compete financially: creative benefits packages. For example, five weeks of vacation vs. three. “That’s a critical thing nurses are looking for, especially when you think about the exhaustion and burnout today,” he said.

Organizations need to find ways to get leadership out of staffing and back into leading, while equipping them to lead effectively. It’s the management version of practicing at the top of one’s license. It doesn’t mean someone never steps in to do something that isn’t in their job description. It means they’re doing their best so that they can help those in their care and on their team do their best.

“Leadership development becomes really important,” said Damsky. “It’s the thing that falls by the wayside because who has time for it?” There’s a cost when leadership development is put on the back burner and, conversely, a clear benefit when it’s maintained. Damsky mentioned a client who tracks employee engagement against their organizational development work. “They ask questions like, ‘Does my manager make me feel valued?’ and track that against staff turnover. They’re looking for negative correlation,” she said.

Helping staff feel valued involves moving leader rounding beyond checklists and perfunctory appearances. Collard said that it’s training leaders and giving them the space to have relationship-centric conversations. He said, “So when a leader says, ‘How are you doing?’ it means, ‘I’m not just asking, I’m really interested. It’s just me and you right now. How are you? What do you need?’” Collard cited a large medical center where a high-caliber ER nurse quit suddenly. When the team did some digging, they found out she hadn’t left for an agency to make more money. Instead, there were things at home affecting her ability to stay at the hospitals. Per Collard, the nurse executive said, “Oh my gosh, if we’d only known, we could have done something to help her!”

Eventually, healthcare provider organizations will be able to shift some of the focus from the crisis of filling shifts to the long-term structural change that will make staffing far easier. Many had laid such groundwork pre-COVID. And there is an array of remarkable health services companies rolling out software and innovative care models to solve the problem. Artificial intelligence, remote nursing, hospital at home, standardizing meal prep across a system, automated revenue cycle – everything that will put nurses and staff in a position to do what they do best and offload much of the rest.

We’re not there yet, but the foundation is in place and the frame is starting to take shape. In the meantime, provider organizations must step back to ensure that even as they continue the necessary scramble to fill shifts, they’re laying the groundwork. That means giving everyone in the organization permission and practical support to keep going. Starting on Day One.

A Note on Nursing Labor

Nurses unions have been talking about staffing levels and compensation for years. Now, the conversation has come to them. Hospital advocacy groups could push back saying that it didn’t make sense to implement rigid staffing requirements; organizations of different types and sizes and locations needed flexibility. But on the heels of the pandemic, staffing has become a core concern, both among the public and healthcare workers – a point proven by the most recent Jarrard Inc. national survey.

The public citing staffing shortages as a top concern

Healthcare workers citing staffing shortages as a top concern

In addition, the business side has come to the forefront, and with it a rising skepticism among nurses and staff about the intentions of their employers. Some feel organizations are holding patient care over nurses’ heads while, in the background, pushing the business forward. The response is essentially: “We can’t be the only ones carrying the weight of our mission. If you expect us to be the only mission-driven people, we’ll go travel or organize and strike.” In addition, the employee-manager relationship is starting to ring hollow. Historically, a core argument against organizing is that a union only adds complexity, getting in the way of those direct conversations. But more and more nurses are feeling – or recognizing – that they don’t actually have that relationship and their voice isn’t valued. In that case, they’re not giving anything up by bringing in a third party.

There’s no easy fix for provider organizations. The solution is long term – doing the slow, hard work of engaging employees, giving them a real voice in conversations and training leadership to lead effectively. Before making any statement about valuing nurses’ input or taking any action to ostensibly boost engagement, ask whether the move represents a true, long-term commitment or is simply lip service, an attempt at a quick fix. Worried about organized labor? Give people a way to not need that third party.

Questions about employee engagement? We can help.

Sources for By the Numbers

Chartis: The COVID-19 Pandemic’s Impact on Rural Hospital Staffing
Nashville Business Journal: 3 notable takeaways from HCA Healthcare’s fourth-quarter earnings call
AONL COVID-19 Longitudinal Study August 2021 Report

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Lee Aase In DigitaLee, High Stakes, Strategic Positioning

DigitaLee 2: YouTube for Healthcare and Social Media Polls on Twitter and LinkedIn

Welcome to DigitaLee: The home of digital and social media for healthcare.

We’ve partnered with Lee Aase, formerly of the Mayo Clinic and Mayo Clinic Social Media Network. He’s joining us every other week to look at the role of digital and social media in healthcare. Each week we’ll look at a news story related to healthcare social media, a digital platform healthcare providers should (or shouldn’t) consider, and a digital tip of the week.

Today we’ve got a story on how doctors use YouTube to connect with patients and work towards health equity, the value of YouTube as a platform for healthcare providers, and for our tip of the day it’s whether hospitals and physician practices should consider using Twitter and LinkedIn polls.

Listen and subscribe to the podcast or read the transcript below.

Read the Transcript

David Shifrin: This is DigitaLee from Jarrard, Phillips, Cate & Hancock. I’m David Shifrin.

Twice a month, we highlight the headlines, platforms and best practices in digital and social media that healthcare organizations need to keep up and –better yet – get ahead. Today, we’ve got a story on using YouTube to connect with patients to work towards health equity, the value of YouTube as a platform for healthcare providers, and for our tip of the day it’s Twitter and LinkedIn polls.

The news theme of the day is from an article in Business Insider. The title was, “This Doctor Says YouTube Is a Crucial Way That She Connects with Patients, Here Is Why.” So, with that clickbait headline, the point is that Dr. Lisa Fitzpatrick works in underserved communities trying to improve access and health equity and has found that YouTube is a powerful tool for approaching that work.

So, Lee, what was your take when you saw YouTube being considered as a platform for health equity?

Lee Aase: Yeah, I think YouTube is a platform for health equity and just general health information for people, because we’re talking about doctors who are the well-respected voice due to the fact that it says MD behind their name. People are trying to sort out: “What should I believe? What should I know?” What I found in my career at Mayo Clinic was that sometimes even the longer videos that were going into more depth on a topic could be among the most valuable ones because they’re really reaching people at their moment of need. They’re giving them that in-depth information that they really need about their condition. Being able to address commonly held questions and beliefs and being able to address them authoritatively is a great, scalable way to reach a lot more people who maybe wouldn’t even come into the doctor’s office regularly. But they find someone with whom they identify, with whom they resonate and can build up some trust. It’s a great way to get some good health messages to people who maybe otherwise wouldn’t darken the door of a medical office.

DS: Let’s keep going with something that you mentioned: The value of in-depth medical information, because that runs a little bit counter to so much of the marketing, communications, social media and digital principles where everybody’s talking about how attention spans are shorter than ever.

Normally, you have to keep it tight. What are you seeing when it comes to “in-depth?” How far can you go with that before you start to lose people?

LA: Yeah. I mean, attention spans are shorter when it’s something like a public health message because it’s something that’s intended for a mass audience. But, when you get a particular kind of sick, that’s all you care about. It’s something that you’d really like to hear about from someone who knows about it. Say, “How do I deal with acne?” or, “How do I deal with some other condition that’s affecting me?” So, the beauty of YouTube is that is the place where people can have essentially unlimited time to follow a bunny trail of information that relates to what they’re interested in, since YouTube also serves up related videos on those topics.

One of the better videos that we had in my Mayo Clinic days was 10 minutes, it was on a particular kind of cancer, a blood cancer, and it got tens of thousands of views. It wasn’t millions of views – it wasn’t funny cat video territory – but it was the right kind of patients or their family members who really had that as an interest to help them to better understand the condition.

DS: So that’s a perfect segue into the second part of this, which is looking at YouTube as a search engine. It’s about not just thinking about YouTube and kind of the news and trends, but also as the platform that we want to focus on here. YouTube is owned by Google, of course, and it is a massive, massive search engine – I believe it’s the second largest in the world.

So, when you’re in it, Lee, you just mentioned the ability to serve up related videos and content to whatever you happen to have pulled up in your initial search. Because it’s such a powerful place for people to go and look for information, what should providers be thinking about in terms of their strategy around using video and YouTube in particular, to make sure that they’re serving up the content that people need where they’re looking for it?

LA: I think one of the keys with YouTube is to be sure that you’re effectively using your titles and your descriptions, putting in captioning as you can, both for accessibility with ADA compliance, but also because it makes it easier. Doing so gives more terms to be found within search – so, titles and tags and descriptions.

It’s important to recognize that it’s the number two search engine owned by the number one search engine. When you’re searching on Google, one of the tabs is “Videos,” and for some things, the first thing that’s going to show up is a video.

It’s often geographically contextualized as well. So, some of the things that may be nearby would show up – there’s some geographic preference with it. I think you just need to be sure that you are not only communicating to humans in the video, but communicating to the algorithm by how you tag, describe and title the videos.

DS: Cool. Okay, thanks. Let’s move on to the tip of the day.

We’re going to switch platforms here and look at LinkedIn and Twitter polls. I’ve been seeing more and more of this. I think maybe it’s died off a little bit over the last couple of months – kind of tail end of the summer of 2021 – but lots of organizations and lots of people have been posting quick polls on LinkedIn and Twitter.

Anecdotally, I’ve seen this coming more from the marketing and businesspeople in my network than from the healthcare provider folks. But that said, I think we all have seen those, and we’ve all probably responded to them. Some of them are goofy, some of them are a little bit more serious.

I guess the simple question is, “Is that a useful tool for healthcare providers to be considering, or is it just yet another social media, digital fad that’s going to be gone in six minutes and we’ll all forget about it?”

LA: It all depends on what you’re trying to accomplish. I’ve seen some people use them for education. For example, where there is actually a right answer to the question and they’ll put up a quiz and then they’ll do a follow-up with the right answer, and then they can use it. That’s the educational perspective.

Now, Twitter does not represent the world, okay? It’s a subset of…

DS: Hold on, hang on, hang on. Whoa. Back up.

LA: Twitter is opinions. It’s especially the opinions of those who are posting. There is a distinct minority of people who do so much of the posting that they aren’t necessarily reflecting the rest of the user base and Twitter users in and of themselves. It’s a distinct subset of the country, of the world. And so, Twitter polls are certainly not a scientific representation of what people really think.

However, probably, you get more engagement among the regular lurkers on social media and on Twitter in a Twitter poll. Because it’s anonymous, people can vote what they really think versus what they are supposed to think. If you reply to a comment, your name can be traced to what you’re saying versus on Twitter the poll, where the responses are anonymous.

I think depending on what you’re trying to accomplish, it can be helpful. I also think that LinkedIn polls are probably more reliable because they’re less susceptible to some kind of an organized, “Okay, somebody put up a poll and I’m gonna torture them with the answer that they didn’t want.”

That has been known to happen definitely on Twitter, for sure.

DS: Alright, I think we’ll call it good there.

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Ian Petty In High Stakes, , Quick Think

The Quick Think: Command Stations on Tax Exemptions

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

3-minute read

The Big Story: Not-for-profit hospitals don’t earn tax exemptions, researchers say

“Not-for-profit and for-profit hospitals report similar levels of unreimbursed Medicaid costs even though not-for-profits receive billions of dollars a year in tax subsidies, new research shows.”

Key graf: “’The nonprofit hospitals have not done enough to deserve their tax subsidy,’ said Ge Bai, an accounting professor at Johns Hopkins University and lead author of the study. ‘Taxpayers subsidize hospitals to help struggling, working-class Americans, but many nonprofits are not doing enough.’”

What it Means for Health Systems

Another brick pulled out of the wall.

Hospital critics have picked up another powerful, compelling dataset in the national campaign to paint hospitals as Big Business more focused on profits than on care. Painful though it may be to hear, the Modern Healthcare article is a strong piece about the situation some hospitals across America find themselves in. Even our own research shows that just 41 percent of people strongly feel their hospital is a good community partner. In addition, these situations signal the expectations among the public and state and local regulators about where those community benefit tax-equivalent dollars are spent. In short, they want to see more than just sponsoring the local minor league baseball team.

This conversation isn’t going away. The Big Business narrative will continue to build momentum if hospitals don’t tell their own story, are unable to or, worst of all, have a story that doesn’t line up with the reality.

Two things to bear in mind about these articles:

There’s a careful, data-driven and emotionally charged campaign by critics seeking to pin the blame for our dysfunctional healthcare system squarely on hospitals.
There’s misalignment within hospitals in getting their mission-driven story across the finish line and making sure their words are backed up by their actions. The door to criticism is cracked open when there are disconnects between different departments and different initiatives. And – critically – between the different levels of the organization to identify problems and ensure that every move made is in service to the mission. Hospital critics then shove that door wide open, leading to Congressional hearings and class action lawsuits.

So here’s our advice this week:

Check your story. Now – Put time on your calendar to have a real conversation. Soon.

Non-profit hospital or health system execs – Connect with your marcom, finance and clinical leadership to compare notes about how your organization is talking about the work it’s doing in the community and how that lines up with what it’s actually doing in the community. And is it what the community actually needs? Baseball team sponsorship vs. affordable housing. Your call.
Marcom leaders – Initiate that same conversation with your colleagues and C-suite.
For-profit leaders – Sure, the tax-exempt piece won’t apply, but that doesn’t mean you should miss the chance to review where and how your charity care and other community benefits are delivered. You, too, have a mission and a story…and critics.
Health services company execs – Bring your leadership team around the table to discuss ways that you’re giving back and aligning ops with mission. You may not be under the gun for IRS status, but, like the for-profit crew, it’s still worth taking a look. Private healthcare companies, particularly those backed by private equity, are taking hits as well.
Healthcare attorneys – On your next call with a non-profit hospital or health system client, ask them if they’re checking their story. Encourage them to think beyond compliance and consider the whole picture around charity care and tax-exempt status as a function of their mission.
Strategy or operations consultants – Ask how the project at hand fits into the mission to care for your client’s community. Ask your client to review the numbers and projections and then work with marcom to align those outcomes to the story they need to tell.

The knives are out, the narrative has taken shape and the numbers very often don’t look great. It’s not a time to spin and, frankly, even if you wanted to it’s not going to work anymore. It’s a time to buckle down and get it right, to match the desired outcome with the actual outcome, to match the stated mission and the desire and passion of you and your team and your clinicians and staff with the way care is delivered – both medically and financially.

After those conversations, get ahead. What’s interesting about the tax-exempt line of attack is that there’s no mention of outcomes. The criticism is purely financial. The push from critics as currently constructed is to spend the money, not to spend the money and achieve <X>. So that’s a fantastic opportunity for provider organizations. Align on where the money is going – get clear on charity care and all the rest – and then talk about how you’re not just spending it but also moving the needle towards better outcomes and equity. “Our critics say we don’t spend enough in the right places. We’re not just spending it but investing it in our community, and here are the returns.” That’s a winning, mission-driven message to leapfrog the Big Business naysayers. Just make sure it’s true.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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Lee Aase In DigitaLee, High Stakes, Strategic Positioning

DigitaLee 1: Finding Health Information on Social Media, Clubhouse and Effective Healthcare Social Media Policies

Welcome to DigitaLee: The home of digital and social media for healthcare.

Today we’re covering a story about the use of social media for finding health information, an overview of the audio platform Clubhouse, and considerations for how hospitals, health systems, doctor’s offices and health services companies can build a good social media policy.

Listen and subscribe to the podcast or read the transcript below.

Read the Transcript

David Shifrin: This is DigitaLee from Jarrard, Phillips, Cate & Hancock. I’m David Shifrin. This is our first real episode. So, if you stumbled in here and are wondering what it’s about, please check out the intro, episode zero, on whatever platform you’re listening on now. In short, we’ve got Lee Aase, a pioneer in digital and social media for healthcare who just retired from more than two decades at the Mayo Clinic, among other positions. Every other week, Lee and I will review three things: a trend or headline related to digital healthcare, a social media platform, and then a quick tip for healthcare Marcom and digital teams. Today, we’re covering a story about the use of social media for finding health information, an overview of the audio platform, Clubhouse, and considerations for building a good social media policy.

All right. So let’s kick this thing off with our first news story, an article from Forbes saying that one in ten Americans turn to social media for health information. I’m going to bias the conversation a little bit before I kick it over to you, Lee, by saying that I was really surprised that the number was only one in ten, only about 10%. I would have guessed, I don’t know, 40% maybe? But what’s your reaction to the rise of social media as a health information platform?

Lee Aase: Yeah, well, I think you need to put it in context that in the survey of a thousand patients like me, they found only 16% went to traditional news.

So, if you’re only at 16% for traditional news, the fact that you’re at 11% for social media isn’t that far behind. They did see that Google and disease and condition sites like WebMD and Mayoclinic.org, were kind of in that 30%-ish range, 30, 35%.

So, I think the reality is that people don’t go to social media, they go to their friends. It isn’t like social media in general, but they’re looking at what did the people that they connect with on social media have to say? So I think that’s the question: Who do they really trust?

And I think we’ve seen a declining trust in some of the various news outlets that has probably brought that down. I probably would have been predisposed to think it would, that number would be for social media going in, but I think what we’ve kind of just generally seen in society is kind of a breakdown in who your trusted source is.

DS: The participation versus trust gets to another finding in there, where they found only 2% of people actually trust social media. Nine or eleven, depending on which number you’re looking at, go to social media for information, but only 2% trust it. So, that implies that it’s exploratory.

All right. Let’s turn our attention to the platform of the week or whatever we want to call this thing. There’s a new-ish, I guess it’s really not that new at this point, but still, a relatively obscure platform called Clubhouse, which is essentially live audio rooms. And I think it’s become more popular among business types over the last year or so, it’s a different way for folks to engage.

But because we are starting to see more folks bring up the idea of this interactive audio approach rather than either live chats or text-based social media. Should healthcare providers be paying attention to Clubhouse? And if so, why?

LA: Yeah, Clubhouse is a really neat platform. Twitter Spaces is an analogous platform within the Twitter universe. The whole idea behind it is it’s live interactive audio chats that instead of just listening to a recording (for the most part), you’re able to interact directly with people. Compared to regular, old-fashioned Twitter chats where people are texting, where anybody can run into the conversation, they’re much more moderated and orderly. I think there’s been a lot of growth. I think Clubhouse had a good strategy when they made the platform invitation-only at first to give it a more consistent user experience and make it feel somewhat exclusive.

That way, people had to get an invitation to be able to join, and so they perhaps valued it more.

DS: So, my first Gmail address.

LA: Like that! Or, The Facebook back in the day, you know? Because it was somewhat exclusive, it was kind of a cool thing to get an invitation, to be able to participate in it.

I have found for a lot of the same reasons that people use podcasts, and where there’s been this resurgence in podcasts as led by Joe Rogan and then so many others after that, where the fact that you can multi-task by listening and driving is a great advantage. Also, you can listen to a podcast on something of very personal interest and go into it in great depth. Likewise, some of these Clubhouse chats can go on for half an hour, forty-five minutes, maybe even an hour where you’re having a conversation and it’s moderated by leaders who are inviting people in to share their perspective.

So, it isn’t as noisy. It’s got audio, but it’s not as noisy as a Twitter chat where anybody can use the hashtag and jump in with a point.

DS: Should providers be considering using this for, a weekly health chat and getting their physicians out in the world? Or is there relevance for Marcom teams?

LA: I think there’s something to be explored there to at least test it, to see how it works in your particular context. One of the beauties of it is that, unlike Zoom, Facebook Live, or some of the other platforms that include video, there just isn’t as much production.

It can be much more informal. You can just do it with a smartphone because that’s the only way you can do it. You don’t have to be worried about hair and makeup and lighting; you can be focusing much more on the nature of the content of the conversation without having to worry about some of the aesthetics. It’s kind of like video killed the radio star, you know, back in the day.

This is sort of like the radio stars’ revenge.

DS: All right, let’s move on to the final section. We’ll get better titles for each of these sections. Tip of the day. With so much happening around nurses and doctors getting more involved in talking about their field, work, and what they’re seeing within the four walls of their facility, there is much more noise and, frankly, anger on social media, on all sides.

Consequently, it’s a really good time to be evaluating your social media policy.

What are one or two key tips for a good, strong social media policy for a healthcare provider when they’re looking to ensure that their employees are staying in line without stifling the conversation?

LA: I definitely agree with wanting to facilitate it and make it encouraging, and putting up guardrails instead of roadblocks. I think the other one of the other elements is just to make sure that you’re legal with it. A lot of times people will want to put in a policy that says, you can’t say anything bad about our organization online that reflects poorly on us. The National Labor Relations Board has said that concerted efforts and discussions around wages, hours, and working conditions are protected speech and you need to guard people’s ability to do that. So, you have to realize that there will be the good with the bad, but that you can have standards for professionalism and for mutual respect.

That rule applies whether people are on duty or off. I think the other part of it is effective communication of the policy, and that the idea isn’t to be a “Gotcha!” thing. It isn’t, “Oh, good, we can fire you.” It’s, “How do we keep people out of the ditch. How do we keep people from doing things that will reflect poorly on the organization?”

It just isn’t good practice – they get into a heated discussion and they kind of spout off on something. It’s important just to be in front of people, to be giving them guidance with examples of the kinds of things that they can do and should do, then the things that they would be best to avoid. Training and education, I think, are the really key elements.

DS: Alright, well, thanks. First episode, first conversation, in the books.

LA: Magically edited to sound super smart!

DS: You know, that’s what I do.

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