Originally Published MX March 2001
To ensure success, healthcare marketing professionals should make their Internet-based marketing efforts part of a branded strategy.
Patricia Malone
It's ironic that a
high-tech medium that sometimes appears to be emotionally distancing and even
alienating can be a powerful force for one-to-one, highly personalized communications
between healthcare providers and their patients. Yet when used responsibly and
effectively, the Internet provides superb opportunities to disseminate targeted,
relevant information and to encourage two-way communication throughout the world.
The Internet is not only a force for the powerful global marketing of medical
products and services, but more importantly, it can be an impetus for better-informed
patients and physicians, with improved two-way communication that ultimately results
in better medical care.
It's no wonder, then, that so many are jumping on the Internet bandwagon. One company that is acutely aware of the push toward using the Internet in healthcare marketing is Stratagem Healthcare Communications (San Francisco). In fact, at this medical advertising agency, staff members have come to view the current marketing climate as the "cybertsunami." This trend is global, and it's reaching into all phases of the medical marketplace. There is little doubt that healthcare marketing professionals must either learn to ride this powerful wave or risk being drowned.
A growing body of surveys on the Internet and its uses in healthcare confirm what marketers of medical technology products experience daily: the Web is growing rapidly in importance and will play an increasing role in educating patients and physicians about medical products and services.
Consider these statistics and projections:
- The Internet is becoming increasingly global in its reach—and at a rapid pace. In 1997, the United States and Canada had about 80% of the Web-user population. By 1999, this figure had dropped to 55%, and projections are that by 2005, only about 20% of Web users will be in the United States and Canada, with the remaining 80% in countries outside of North America.1
- By 2003, approximately $356 million (3.3%) of the estimated $10.8 billion invested in healthcare advertising will be spent on-line, up from only $8.9 million in 1998.2
- 55% of Americans view the Internet as a trustworthy source of medical information, while only 30% find newspapers reliable and 28% find TV reliable.3
- By 2005, it is projected that 88.5 million American adults will use the Internet to shop for medical products, conduct medical research about their health concerns, and communicate with their physicians and insurance companies.4
The reason for this growth in Internet healthcare marketing lies in the fact that many people are disillusioned with managed care and are having a harder time gaining access to physicians. In addition, patients today tend to take a more active role in healthcare and find the Internet an effective medium for accessing information previously unavailable to them. Physicians are also increasingly embracing the Internet as a way to keep current on medical news and practices, as well as to ease their workloads in a variety of ways.
BioSpace.com (San Francisco), for example, has launched a community in cyberspace whose aim is to share information relating to the life sciences among such varied groups as physicians, medical suppliers, and the scientific community. Virtual communities of this sort can streamline the communication process among formerly disparate groups, leading to more efficient sharing of scientific and business information and, ultimately, to new medical discoveries and products.
The question for those in the medical marketing field is no longer, "Should we enter into the world of Internet marketing?" Rather, the key question has become: "How can we work best with this new global medium to meet the needs of our clients and, ultimately, contribute to better healthcare for patients?"
Globalization and Market Niches
The concept global Internet healthcare marketing embodies three major marketing trends. First, there is the trend toward "narrow-casting," or marketing to more-specialized niches within healthcare; second, the movement toward marketing on a global basis; and third, the increased use of the Internet as a marketing medium.
Each of these trends builds on and reinforces the other. For example, narrow-casting is ideally suited to communications over the Internet, which enable particular audiences to be targeted with messages sent in an affordable manner.
Similarly, the Internet is the premier medium for global communications, since—unlike print publications, television, and radio—one can access the Internet instantly from anywhere in the world, provided one has the required and comparatively affordable software and hardware. The Internet thus allows communication to move dramatically from broadcasting to narrow-casting, reaching more-specialized audiences with information that is highly targeted.
The Healthcare Marketing Niche
Over the past several decades, there has been a vast increase in the number of media outlets that focus specifically on the healthcare marketplace. The 2001 Burrelle's Media Directory lists more than 800 magazines and newsletters under the category of "medicine." Yet this figure represents only a fraction of the publications available in any major university library today. Add to these paper-based publications the growing number of electronic medical publications on the Internet, and the proliferation of healthcare media outlets becomes even more pronounced.
This increase is partly due to the expanding amount of medical knowledge available and the growing medical specialties that require publications of their own. In addition, with the advent of desktop publishing technology in the mid-1980s, it became increasingly affordable to publish magazines and journals with small but motivated readerships. Such an innovation also created new "ad spaces" and ways for those in healthcare and other advertising niches to reach their clients' markets.
As we continue to explore our work with the Internet and other new media, however, we must keep in mind that there are particular characteristics of healthcare which are central to its marketing, and that these do not change regardless of the medium in which advertisers' messages occur. First and foremost is that medical advertising must be solidly researched and its key messages must be grounded in science.
Although there has been a movement toward direct-to-consumer advertising in the medical technology industry, the fact remains that the primary audience for most medical products and services is still the physician. Without the physician's buy-in, no matter how enthusiastic the consumer may be, medtech companies are at a distinct disadvantage in the marketplace. And without solid evidence in support of the medical value of a company's product or service, physicians will rarely be convinced. The pharmaceutical giant Merck (Whitehouse Station, NJ), for example, has developed an outstanding reputation among physicians as a result of the company's extensive research and clinical documentation, and its advertising campaigns to physicians have capitalized on these strengths.
We are also currently witnessing a dramatic number of technological innovations in medical technology fields such as medical devices and instrumentation, diagnostics, pharmaceuticals, biotechnology, and healthcare Internet services. In the area of cardiovascular medical devices alone, for example, we have witnessed innovations such as minimally invasive heart surgery. Instead of cutting open the patient's chest, surgeons can now perform the operation through small ports, with technology under way that will soon allow them to work on a heart that is still beating. Building on this innovation, companies such as Intuitive Surgical (Mountain View, CA) take the surgeon from the operating table and place him in front of a console where he can perform the surgery in virtual reality.
Equally complex and highly technical innovations are occurring in almost every specialized field of medicine, requiring marketers to become experts in medical science. Whether in direct-to-consumer communications or those with physicians, the Internet will play an increasing role in these communication efforts, and medtech advertisers will have an important role to play in differentiating among healthcare organizations on the basis of their technologies.
The Particulars of Marketing over the Internet
As with all media, the Internet has its own particular requirements and attributes that marketers must take into account. Early efforts at marketing on the Internet have been dubbed "brochureware," which basically means taking a print brochure and slapping it onto a Web site. The problem with this approach is that it does not take advantage of the strengths of the Internet, which include the ability to have direct and two-way communication with visitors to a site.
Clearly, there is a gap between Internet-savvy patients' desires for interactive experiences on the Internet and what they are receiving. A recent Cyber Dialogue survey found that 48% of on-line users seeking healthcare information want to communicate with their doctors via e-mail, but only 11% know their physician's e-mail address.5 In addition, 74% said that a recommendation by a doctor or a pharmacist of a particular Web site would increase their trust in that site. However, only 4% said that they were obtaining such counsel. One of the central challenges of marketing and educating effectively about healthcare through the Internet will be to get doctors and other key players in medicine to more thoroughly embrace its interactive capabilities.
To accomplish this, the Internet will need to become an integral part of the physician's practice, in which patients are brought into the fold, creating almost a virtual house call that will lead to more satisfying communication between physicians and their patients. Branding strategies that count the Internet as an integral part of communications rather than simply a marketing tool have a better chance of creating a community not only of prospects, but of evangelists. The Web site should make a healthcare professional want to return to it—not just once, but again and again. To do this, the site must offer more than static information; it must offer a personalized and meaningful interactive experience.
Some Promising Early Indications
There are already indications that the Internet can be a very effective approach to healthcare advertising. The Cyber Dialogue survey calculated that direct-to-consumer pharmaceutical advertisements over the Internet resulted in one prescription request for every $12 spent. In contrast, television ads cost $246 per prescription and print ads $373.
A technique known as permission marketing is one effective way to maximize the value of Internet marketing. As its name implies, this approach presents marketing materials only to consumers who have expressed an interest in receiving them. A typical scenario is one in which healthcare organizations ask their patients if they would like to receive medical information on a particular topic. If permission is granted, the organization places the individual on an e-mail list and sells that list to a marketer of a related product or service, who in turn sends out these targeted messages.
The recipients of the permission-granted messages are periodically given opportunities to unsubscribe, further refining the quality of the list. Again, this type of marketing emphasizes the Internet's capacity as a two-way communications medium. In addition, it makes use of the enormous role e-mail is playing in communications. According to The Industry Standard, 40% of Americans use e-mail, and there are 333 million e-mail addresses in the United States today.6
The Essential Role of Strategy
Internet marketing, like all successful marketing efforts, must be based on sound strategy. Sometimes marketing professionals get so carried away with the technical issues of building a Web site or which hardware and software to use that they forget the fundamentals. The most essential question that must be addressed is what the marketer wants the site to achieve—both now and for the long term. Again, the Web site must be part of a branded strategy, and will be most effective when it draws upon the interactive capacities of the Internet to build a community of users.
From there, the marketer must evaluate the kind of infrastructure required to support the site, and determine whether the site is achieving its purposes and how it will contribute to return on investment. These and other core strategic questions must be examined thoroughly during the planning process for Internet-based marketing and educational efforts. Otherwise, the oft-quoted adage, "If you build it, they will come," may simply not apply. Or if the buyers do come, there's a good chance they won't come back.
The Global Reach of the Internet
To say that the World Wide Web is a global medium is a redundancy. One would almost have to move to the realm of mental telepathy to share information more instantly, effectively, and affordably. Although many of us have gotten over the sense of wonderment at being able to send and receive virtually instantaneous written and pictorial messages throughout the world for no more than the cost of a local phone call, the Web is remarkable for its potential to break down national barriers and encourage affordable, multimedia information exchange internationally.
This capacity also presents enormous communication challenges, not least of which are those of language and culture. Essentially, designers of Web sites with global audiences have two major approaches to communicating with those global audiences—what Web guru Jakob Nielsen has dubbed "internationalization" and "localization." "Internationalization refers to having a single design that can be used worldwide," writes Nielsen, "and localization refers to making an adapted version of that design for a specific locale."7
With internationalization, for example, the language is often English, but a simplified version without local references. In contrast, localized sites often have many different sections within the site that offer different languages and imagery targeted toward the specific country or culture being addressed. Take, for instance, the Eli Lilly (Indianapolis) Web site, which is noted for its highly decentralized and localized approach. The company offers different Web sites for different countries.
However, the fully globalized Web site risks being so dumbed down and culturally bland that it does not reach any audience effectively. For those who wish to have an effective international Web site, Nielsen strongly recommends testing the site by having usability experts from the pertinent countries look it over. He cautions that this testing process, along with translating pages into a variety of languages and visual styles, can be prohibitively expensive.
It is not uncommon for the Web site of a multinational medical technology corporation to run well over 1000 pages in one language. When localized into several languages, inspection, translation, and production costs can run millions of dollars. Nielsen points out that many sites reach a hybrid compromise, in which most of the pages are in a primary language—often English—with certain sections of key information widely translated.
On the matter of global communication over the Web, Nielsen offers this advice: "Don't give up because you cannot implement the ideal international usability study the first time. You may have to start with a single country, and you may have to start with self-administered tests. The important thing is to do it. There is a huge difference between a site that is designed for domestic users only and a site that knows that the rest of the world exists."
One important caveat: Healthcare marketing professionals must always remember that FDA is watching the Internet marketing activities of medical technology companies. For such companies, it is vital not to be perceived by FDA as advocating the international marketing of products that have not been approved for all markets. FDA has and will continue to send warning letters to companies that market medical devices irresponsibly on the Web.8
Conclusion
As we enter the information age more fully, trends in healthcare marketing that have been with us for decades are becoming much more pronounced, particularly in the area of narrow-casting. New communications portals made available by the Internet are in many ways ideally suited to the kind of two-way, highly targeted, international information exchanges that the explosion of medical knowledge and a more tech-savvy and assertive population has necessitated.
At a time when insurance challenges, rapid technological and scientific innovation, and less-hierarchical relationships between doctors and their patients are creating dramatic shifts in healthcare, the Internet can be a powerful force to navigate these sometimes bewildering waters. As we all experience the cybertsunami, occasionally getting tossed and turned, keeping this principle in mind can motivate us to hang on as we learn to make sense of and benefit from the ride.
Principles to Market ByThe phrase global Internet healthcare marketing may roll trippingly off marketers' tongues nowadays, but each element of the concept adds dimensions that make the whole more difficult to wrap one's mind around. Following are reminders of some principles to guide medtech marketers who are getting ready to take their e-marketing global. Global Marketing. For a company marketing globally, it is important to determine when it is necessary to localize the company's Web site (including translations into the language of the target region as well as imagery that is meaningful to its culture). But it's just as necessary to determine when a global site for multiple audiences need not be localized, or which portions can be global and which localized. To ensure that they're hitting the right notes, companies should arrange to test their sites by enlisting people from the markets they wish to reach. Internet Marketing. Early efforts at Internet marketing of healthcare products were little more than published materials tossed onto a Web site. Such a "brochureware" approach has limited value because it is essentially static and does not take advantage of the interactive nature of the Internet. Companies should find ways to encourage interaction through such techniques as permission e-mail, and should also consider using video and other multimedia approaches when appropriate. Healthcare Marketing. Company marketers should keep in mind that although direct-to-consumer healthcare marketing is on the rise, it is still essential to communicate with physicians and other healthcare professionals. Even when direct-to-consumer marketing results in a patient approaching his doctor about a particular treatment option, the products used for that treatment will stand a much better chance of adoption if the doctor is already informed about them. Also remember that doctors are scientifically trained; they are unlikely to accept marketing messages that are not thoroughly researched and grounded in solid clinical evidence. |
Page-Turners on Internet MarketingThe Internet offers users access to vast amounts of information, but not quite everything you want to know is available on-line. The following recent publications provide useful discussions for medtech executives looking to explore the key features involved in developing a strategy for global Internet marketing. Ellis, David. Technology and the Future of Health Care: Preparing for the Next 30 Years. San Francisco: Jossey-Bass, 2000. Flory, Joyce and Douglas Goldstein. The Online Guide to Healthcare Management and Medicine. Chicago: Irwin Professional, 1996. Holtz, Shel. Public Relations on the Net. New York City: American Management Association, 1999. Morrison, Ian. Health Care in the New Millennium: Visions, Values and Leadership. San Francisco: Jossey-Bass, 2000. Ries, Al and Laura Ries. The 11 Immutable Laws of Internet Branding. New York City: Harper, 2000. Seybold, Patricia. Customers.com. New York City: Random House, 1998. Stauffer, David. Nothing but Net: Business the Cisco Way. Tulsa, OK: Capstone, 2000. Zyman, Sergio. Building Brandwidth. New York City: Harper Collins, 2000. |
ConnectionsThe following list provides information on some useful healthcare Web sites, sorted by category. Sites directed primarily toward healthcare consumers. Sites noted for their interactive approach. http://www.cardizem.com/cardwel.htm http://www.cardisense.com/wellnesscenter Sites offering survey results about Internet marketing and its effectiveness. Sites noted for their educational value. Sites noted for their effective approaches to global communication. Sites providing medical statistical information. Sites containing useful on-line guides, lists, and directories for healthcare marketers. |
REFERENCES 1. Jakob Nielsen, "International Use: Serving a Global Audience,"
Designing Web Usability (Indianapolis: New Riders, 2000), 314–344.
2. eHealth 2000: Healthcare and the New Millennium
[industry report] (New York City: Wit Capital, January 31, 2000).
3. A recent study commissioned by WebMD; available from Internet:
http://www.webmd.
com.
4. A May 2000 study conducted by Cyber Dialogue; available from
Internet: http://www.cyberdialogue.com.
5. Taking the Pulse: Physicians and the Internet [survey
conducted by Cyber Dialogue and Deloitte Research Health Care Institute]
(New York City: Analytical eCRM, July 2000).
6. "Overhaul Your Internet Business Plan to Promote a Web-Enabled
Culture," in The Industry Standard [on-line] April 27, 2000;
available from Internet: http://www.thestandard.
com/article/display/0,1151,13604,00.html.
7. Jakob Nielsen, Designing Web Usability (Indianapolis:
New Riders, 2000), 315.
8. Kristen Green, "Marketing Health Care Products on the Internet:
A Proposal for Updated Federal Regulations," American Journal of
Law and Medicine 24, nos. 2 and 3 (1998): 365–386.
Patricia Malone is a principal of Stratagem Healthcare Communications (San Francisco), an advertising firm specializing in healthcare. Copyright ©2001 MX
