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Download our report, Good People, Flawed System, here.

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Alyssa Ellis built a powerful digital community by doing what healthcare often struggles with: meeting clinicians where they are. In this HLTH 2025 interview, she shares how Beyond Assisting is using short-form content, peer-to-peer education, and purpose-driven storytelling to inspire the next generation of surgical techs and change the OR culture from the inside out.



At HLTH 2025, Dr. Olivia Richman shared how Docfluencer MDO is mobilizing a nationwide network of physician influencers to lead bold, unfiltered conversations on everything from vaccines to insurance reform. In this interview, she breaks down how storytelling, shared purpose, and social media are powering a movement that’s reshaping healthcare, one reel at a time.

At HLTH 2025, Jacob Plummer shared how Ada Health is using AI to solve some of healthcare’s biggest system-level challenges, from specialist access to patient engagement. In this interview, he unpacks how AI can scale clinical capacity, prep patients, and even extend a health system’s reach from regional to global.

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In a time of financial headwinds, the smartest systems aren’t retreating — they’re doubling down on strategic talent and growth leadership. At HLTH 2025, we sat down with Neil Ravitz of Klein Hersh to unpack what’s ahead for the C-suite, the evolution of the CMO, and why AI and commercialization are reshaping healthcare org charts.

Are you at HLTH and want to be a part of The No Normal Show? Shoot us a message using this link here.

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Our blog, The Einstein Divide, is available on our website. Be on the lookout for our official report, coming out soon.

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The blog discussed in this episode, The Einstein Divide, is available on our website. Be on the lookout for our official report, coming out soon.

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Download BPD’s report, “The Future of the CMO” here: https://bpdhealthcare.com/insights/guides/the-future-of-the-cmo/#download

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Read BPD's latest article, "The Einstein Divide": https://bpdhealthcare.com/insights/blog/the-einstein-divide/

Check out our latest case study, “It’s Zo Time” with Baptist Health South Florida and Alonzo Mourning.

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Read our blog, "You're Full, But Are You Growing?" here.

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Read our latest blog here: https://bpdhealthcare.com/insights/blog/the-einstein-divide/

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Join our upcoming webinar, The Future of the Health System Chief Marketing Officer, to learn how to measure marketing performance, align metrics with organizational goals, and present impactful data to the C-suite. Register here.

Articles to read:

AdventHealth employees surprise coworker with bridal shower

Mayo, Nvidia launch AI supercomputer to diagnose diseases more quickly

Poppi’s $8.9M Settlement Sends a Warning to Wellness Marketers

Doctors Have Lost Their Mount Olympus of Medicine

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Join our upcoming webinar, The Future of the Health System Chief Marketing Officer, to learn how to measure marketing performance, align metrics with organizational goals, and present impactful data to the C-suite. Register here.

Join our upcoming webinar with Chris Bevolo, Christine Kotler, and Andrew Chang, where they'll be discussing the future of the health system chief marketing officer. Register here: https://www.healthcarestrategy.com/listen/webinars/future-healthcare-chief-marketing-officer/

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Show notes:

Best Buy Divests Current Health

Download our latest report, The Future of the CMO

A new approach to employer health care? Give workers money to buy their own plan

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Should CMOs stay in their marketing lane, or take the comms wheel and drive reputation, strategy, and even policy influence? The team gets into the tension between doing more and doing it well—and why the structure of the CMO’s team might be the real power play. This episode is your roadmap to relevance. Tune in now.

Download our latest report, The Future of the CMO.

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Stephanie and Desirée discuss how the focus of marketing is moving beyond traditional brand buzz and viral moments—and toward something more enduring: influence through community, trust, and relevance. They reflect on how SHIFT Nursing, a collaboration between BPD and the Robert Wood Johnson Foundation, built momentum beyond traditional campaigning by helping real nurse leaders drive conversation and change from the inside out. While mass reach can still drive broad impact, meaningful influence is increasingly coming from smaller, trusted circles—where the right voices carry the message forward.

If you're rethinking how to measure success, or how to create marketing that sticks, this episode offers insights into the power of storytelling, specificity, and shared ownership.

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Nicole shares her career story from Canadian roots to becoming one of the most visionary brand voices in the industry. She shares how brands like Snoop Dogg, the WNBA, and even Wonder Bread shape her thinking—and why innovation, risk-taking, and emotional relevance are non-negotiables in today’s healthcare landscape.

From internal engagement to external impact, Nicole reminds us why listening deeply, leading with empathy, and saying “yes” to crazy ideas might be the best branding strategy of all.

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Our new white paper, The Future of the CMO, is now available! Download our latest report here.

Check out our latest report: "The Future of the CMO"

Our new white paper, The Future of the CMO, will be available early to subscribers! You can sign up here or even subscribe via BPD’s LinkedIn.

Vote SHIFT. Name your AI. Throw an unhinged dinner party. Press play.

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From their skeptical, independent nature to their deep distrust of inauthentic marketing, Gen Xers don’t buy into fluff. Let’s be clear—if your healthcare brand isn’t speaking to them in a real, no-BS way, you’re missing a massive opportunity.

We break down why this “forgotten middle child” should be at the center of healthcare strategy, how their unique experiences shape their expectations, and what health systems need to do to reach them before it’s too late.

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AI has been an exceptional tool for creatives and non-creatives alike to bring their ideas to life. So why the backlash? We touch on this and other important topics as we cover Stephanie Wierwille's latest blog for BPD, "The AI Era: The Golden Age of Healthcare Marketing," which emphasizes the importance of innovation, the democratization of creativity, and the need for marketers to adapt to new technologies while maintaining a human touch.

Read Stephanie's blog, "The AI Era: The Golden Age of Healthcare Marketing".

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Google gives up trying to eliminate cookies

Population shifts, risk factors may triple U.S. cardiovascular disease costs by 2050
https://newsroom.heart.org/news/population-shifts-risk-factors-may-triple-u-s-cardiovascular-disease-costs-by-2050

Salesforce State of Marketing (PDF)
 

Introducing GPT-4o

Google I/O 2024

Apple Will Revamp Siri to Catch Up to its Chatbot Competitors

• Ageism in healthcare: https://www.npr.org/sections/health-shots/2024/03/07/1236371376/bias-ageism-older-adults-geriatrics
• Amy Webb's 2024 Emerging Tech Trend Report @ SXSW: https://www.youtube.com/watch?v=5uLSDbh6M_U
• President Biden Takes New Steps to Lower Prescription Drug and Health Care Costs, Expand Access to Health Care, and Protect Consumers: https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/06/fact-sheet-president-biden-takes-new-steps-to-lower-prescription-drug-and-health-care-costs-expand-access-to-health-care-and-protect-consumers/

Apple Vision Pro

• New England surgeon says Apple Vision Pro has the potential to ‘redefine’ health care
• 3 health systems share their Apple Vision Pro plans

The Funnel Wars Takes Two Steps Back

• Amazon Health goes through layoffs

1. The pace of innovation is accelerating
2. Storytelling matters more now, than ever
3. Patients are still profiles, not people—and that must change
4. Physicians are experiencing a dethroning
5. Be fearless. Be bold.
6. Generative AI is here to stay.

Breast Health Check https://www.webershandwick.com/work/a-love-hate-relationship/

Bevolo brings 20-plus years of healthcare industry leadership, previously serving as Revive’s chief growth & brand officer

Headlines Shared:
TechCrunch - Seen at CES: Nuralogix uses AI and a selfie to measure your heart rate, BP, body mass, skin age, stress level and more
Fierce Healthcare - JPM23: Carbon Health nabs $100M, CVS Health partnership to pilot primary care in retail stores

Obstacles left and right

• It’s challenging to sell bold marketing ideas anywhere, but the nature of health systems and their power dynamics make it especially difficult.
• Health system leaders are predisposed to resist the unknown – the risks – because they deal with life and death every day. What makes them good at their jobs is, in many ways, the opposite of boldness.
• Given differences in expertise between marketers and senior health system leadership, marketers must also overcome a large understanding gap. The more you know about the marketing craft, the more difficult it becomes to explain to non-experts. In his book, To Sell Is Human, Daniel Pink calls this phenomenon “attunement.”

Strategies for selling bold marketing ideas

Master your story

• Marketers need to build stories that compel their leaders to take a chance on bold marketing, much of which has to do with perception.
• For example, in 2017, scientists found that they could increase the quantity of fruit and vegetables consumed by creating a dedicated space in shopping carts for fruits and vegetables. In response, the average consumer purchased more fruits and vegetables because they were psychologically nudged in that direction.
• Marketers can nudge leadership teams to take specific actions by giving them options. Like pricing tiers, you can bring the whole set upwards in boldness by offering three options knowing the middle one is most likely to be picked.
• However, when presenting options, never offer an option that you wouldn’t be comfortable executing because sometimes that is the option that your audience picks.

Recruit influencers

• A way to build confidence in those you’re trying to influence is through social proof.
• To sell bold ideas, health system marketers need to understand which parties influence key decision-makers. In many systems, physician and service-line leaders are key influencers.
• Chris gives the example in which one of our clients loved a bold concept presented to them but needed to sell their organization on the idea. One of the system's top neurovascular surgeons stumbled upon the campaign concept and raved about it. Since this individual generates so much revenue for the health system, his opinion drastically influenced the CEO’s decision to accept the idea.

Express limitations

• Physicians are natural skeptics because their practice centers on science. Marketing doesn’t always inspire confidence because not all marketing is based on science.
• When presenting bold ideas, don’t be afraid to acknowledge the limitations of your research and hypotheses. By not having all the answers, health system marketers can increase their audiences' receptiveness.

Selling bold ideas in practice

• VCU Health is an academic system that runs on its own authority, which is unique because most are run by the state.
• VCU Health hired Revive to help their team fight vaccine hesitancy in Virginia. Our research showed three populations that were particularly hesitant – young, Black, and Hispanic populations. These groups didn’t feel like the vaccine was for people like them.
• To resonate with these hesitant groups, Revive created the campaign, This Sh*t Matters, placing a heart over the third letter of “Sh*t” to indicate a double entendre. The campaign featured members from each of the hesitant communities and why the vaccine mattered in their life.
• While Revive came up with the idea, VCU Health’s Chief of Marketing, Cynthia Schmidt, championed and sold the idea internally, tapping into both university, hospital, and peer influencers prior to pitching to senior leadership.
• These glowing endorsements gave her the credibility she needed to get approval to launch “This Sh*t Matters” out in the market.
• When crafting her story, Cynthia appealed to the topic that was top of mind across the system: a huge increase in the number of young people in the ICU. Cynthia crafted her story based on this priority, communicating that VCU’s mission is lived out in the moments when they step up to do something bigger and bolder.

The juice is worth the squeeze

• When your ideas are bold, others start to help you out. There were so many people who wanted to take part in the campaign or lend their expertise/resources.
• For example, sports stadiums opened up extra media placements within their stadiums, people called into radio stations requesting to tell their story for why This Sh*t Matters.
• There’s a newspaper in Richmond that got a note from a complainer who said, “this isn’t worthy of a newspaper like yours.” The newspaper responded by saying that they believe in the work and its mission.
• Vaccination rates increased within the community after the launch of the campaign. The campaign also demonstrated a competitive business impact.

• Answering the health equity wake-up call
• The trust gap is growing, and systems need to build trust
• Redefining “community” and how systems show up in the community
• Marketing’s Role in Health Equity

• Shift Documentary: “Who Cares: A Nurse’s Fight for Equity”
• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• Wendell Potter's book and New York Times Best Seller, Deadly Spin.
• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• Why investors are pouring billions into primary care
• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• One Medical  increases bookings by 20% 
• Walmart increased the flu vaccination rate by 6.8% with SMS

• What is Web3?
• The Latecomer’s Guide to Web3
• The Latecomer’s Guide to NFTs
• The Latecomer’s Guide to DAOs
• The Latecomer’s Guide to DeFi
• Hackers hit popular video game, stealing more than $600 million in cryptocurrency
• ApeDocs – An NFT project for healthcare workers, made by a team of doctors
• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• Joe Public 2030 LinkedIn Group
• Joe Public 2030 Book

• Joe Public 2030 LinkedIn Group
• The Copernican Consumer
• Joe Public 2030

Obligatory Super Bowl commercial commentary

• Joanne's favorite advertisements were Amazon's "Mind reader" ads for Alexa. She found it funny, albeit slightly alarming, as many already feel like Alexa can read their minds.
• Stephanie liked Coinbase's advertisement because it was a rare instance of a TV ad directly driving conversions. The ad was so successful that it resulted in millions of landing page hits in the first minute. Unfortunately, the app crashed momentarily due to a sudden influx of users. You can read about the campaign from the perspective of Coinbase CMO Kate Rouch in this blog.
• Chase liked how Toyota's "Keeping up with the Jones" spoke to multiple generations by starring famous "Jones" personalities from different decades.
• Chris' least favorite ad was "Old friends, new fun" by Meta because he felt like the narrative painted a depressing depiction of the future through the lens of Oculus headsets.

Why Joe Public 2030

• Joe Public 2030 is officially available for shipping on Amazon. If you'd like a copy of the book or would like to learn more about the book, check it out here.
• If you have thoughts on Joe Public 2030 or would like to discuss the predictions in-depth with fellow industry experts, the Joe Public 2030 LinkedIn group is a great starting point. Bring your ideas to the table, put ours on the chopping block, and dig into shaping what's next.
• Joe Public 2030's five predictions are based on insights from 250+ resource citations and interviews with 20+ industry experts. These projections do not work in perfect harmony with each other – and that's intentional. We wanted to paint an unbiased picture of the future that isn't anchored by a singular prediction or trend.
• It's important to think about the future even if it seems daunting because it plants seeds of thought that grow into action and equip us to navigate the future. Right now, hospitals and health systems are moving full steam ahead, trying to manage the pressures of today, a fact that can't be ignored when discussing ways health systems may need to future-proof their organizations.
• Joanne shared a quote from Jim Collins' book, "Good to Great" to demonstrate the urgency of healthcare's transformation for health systems: "You must never confuse faith that you will prevail in the end, which you can never afford to lose, with discipline to confront the most brutal cracks of your current reality."

How do Joe Public 2030's predictions fit together?

Copernican Consumer + Disparity Dystopia

• In the Copernican Consumer, the book predicts that AI, blockchain, and sensors will enable consumers to make their own decisions regarding their health. How will these new technologies impact health disparities in the U.S.? The "haves" will gain access to new technologies to improve their health, while the "have-nots" will continue to struggle to meet basic health needs.
• Disparity Dystopia predicts that unless a "moonshot" initiative happens in the U.S., health inequities will worsen over the next decade.
• The technologies that enable precision medicine like personal health monitors and genome-testing are incredibly costly, potentially exacerbating health inequities.

Copernican Consumer + The Rise of Health Sects + Constricted Consumerism

• The Rise of Health Sects predicts that mistrust of experts and political tribalism in the U.S. could result in multiple health sects that coalesce around political/worldviews and depend on "alternative facts."
• If consumers are increasingly enabled by technology rooted in mainstream medicine, how might health sects and their alternative medicine continue to exist? This question shines a light on the contradictory nature of some of our predictions.
• Similarly, the Rise of Health Sects may result in factors that contradict Constricted Consumerism because more health sects would offer consumers more worldview-specific options for their healthcare.

Copernican Consumer + Constricted Consumerism

• While Copernican Consumer promises a future of personalized medicine and personal health management, Constricted Consumerism posits that consumer choice in healthcare may actually be in jeopardy as payors become more selective in the services they choose to reimburse – specifically in costly higher-acuity settings.
• This sort of payor "choosiness" has long been in motion. Before the pandemic, payors selectively reimbursed virtual care. This stinginess gave way to needs brought on by the pandemic.
• Many payors still do not reimburse mental healthcare even though society is in a mental health crisis.
• With more healthcare industry entrants vying for lower-acuity services, the top of the funnel is becoming more accessible and less cost-prohibitive.
• The splintering of health ideologies already exists but may worsen over time, making it difficult for hospitals and health systems to provide clinically sound care to fragmented communities.
• The danger is that we're being lulled into believing these changes aren't happening or are happening incrementally. The pace of change propelled by technology will usher in a new reality that could make or break health systems' ability to survive.

Peloton spinning out

• After a blowout year, many (including The No Normal Show team) had high hopes for Peloton. Unfortunately, the exercise equipment and media company has hit several bumps in the road over the past few months that have the world questioning if the pandemic darling will survive.
• Rumors are swirling around that Amazon, Apple, or Nike may purchase Peloton, but as of the recording of this show, no official bid has come through.
• Peloton's yearly earnings are actually very strong. The problem resides on the expenses side of the balance sheet. From a per-employee standpoint, Peloton has less revenue per employee than comparable companies.
• While heavy investments in product, operations, and brand have produced a world-renowned customer experience for Peloton, these investments may not be sustainable for the fitness giant.
• In an era of unknowns and rapid change during the pandemic, the stock market spiked for many digitally-based companies. Some posit that these spikes were unnatural, and falling stocks are merely a sign of a stabilizing market.

What are retail media networks, and why should marketers care?

• The Google Chrome web browser will fully block tracking cookies by late 2023, pushing marketers to rethink how they target users. This announcement, alongside other announcements of tightening privacy in big tech, has marketers looking for other opportunities to leverage consumer data. Retail media networks could be the opportunity marketers are looking for.
• Retail media networks are advertising platforms set up on retailers' websites, apps, or other digital platforms within their network. These networks are a digital version of in-store advertising.
• Now, some retailers are acting more like pure-play media agencies, securing and selling ad inventory outside of their own properties.
• According to eMarketer, retail media will be one of the top five media trends in 2022. The report states that "By 2023, retail media will surpass $50 billion and represent nearly 1 in 5 digital ad dollars."
• Now every 1-2 months a new retail media network is born. Around 81% of consumer package brands plan to grow their investment in retail media networks in the next 12 months.

Using retail media networks to advance healthcare marketing

• Health systems should consider these networks as another platform to use in reaching and influencing health consumer behavior.
• Target has been using first-party purchasing data to target potential customers for years. A 16-year-old girl received a personalized flyer in the mail from target promoting baby products. The parents were at first outraged until their daughter confirmed that she was indeed pregnant.
• Health systems should be able to model first-party data to learn about patient behaviors prior to admission similarly to how Target did in the example above. For example, pregnancy test purchasing data could help systems predict when to send patients advertisements for maternity services.
• Programmatic advertising media buys are already placed based on rich data like psychographics, browsing behavior, and contextual data. Tapping into retail media networks would mean adding consumer purchasing data to this already rich pool of data.

Time to dream a little 

• What would it look like if there were more health media networks? HIPAA and health policies could prohibit this sort of data sharing, but perhaps there's an opportunity for health and wellness companies like Peloton to take on this media network model.
• Taken a step further, what might health media networks look like if Joe Public 2030's first prediction, Copernican Consumer, comes true, and all health data points are controlled by the consumer and interconnected using blockchain?
• Amazon Care recently expanded its virtual care services to encompass the entire United States. The company also announced that it would be opening brick-and-mortar clinics in 20 major cities. These moves show Amazon's intentions to deliver a convenient, connected healthcare experience for consumers.
• Will convenience, a known pillar of consumer preference, be enough for health consumers to hop on board the Amazon train? Will Amazon's media network capabilities be part of its healthcare play? To be determined.

Featuring a special guest

• This week, The No Normal Show features Content Strategist and fellow Reviver, Tiera Carlock, as she reviews her research findings on Hispanic and Latino consumers and Black consumers.
• At Revive, Tiera jumps in on all things content strategy, social strategy, and writing. Her years of healthcare experience have made her a champion for some of the unsung heroes in healthcare, like nurse-midwives and nurse practitioners.

Understanding Hispanic and Latino consumers

• Tiera started her research by looking into Hispanic and Latino communities – who are they, what do they like, how do they navigate their home lives, and how do they navigate their work lives?
• From these questions, Tiera found that Hispanics and Latinos are a young, multicultural, and family-oriented people, representing one in six people in the United States.
• This group is not a race, as they are a diverse group of people who can track their origins from one of 20 Latin American countries and Spain.
• Tiera’s findings suggest that Hispanics and Latinos value close relationships and shared cultural experiences and tend to live in larger households that offer those shared experiences. Family takes up a lot of time for these consumers, limiting opportunities to engage in external communities.
• It is common to find undocumented immigrants, citizens, grandparents, and children living in the same household. This unique living experience creates linguistic and cultural barriers as they navigate American systems and shapes how they see themselves as part of the American fabric.
• Hispanic and Latin American people often identify as two hundred percenters – 100% Latino and 100% American – with a strong desire to preserve their cultural roots while also integrating into American society.
• Tiera cites an article about an Afro Cuban woman whose parents never taught her Spanish to simplify her assimilation experience. This woman feels it was a missed opportunity to maintain a connection with her history and culture.
• Household makeup can impact healthcare decisions for Hispanic and Latino people. For example, undocumented parents cannot engage with American institutions like Medicare out of fear of revealing their undocumented status. This fear can also limit their children’s access to healthcare.
• Hispanic and Latino people commonly prefer to take a self-sufficient approach to healthcare while avoiding traditional healthcare settings.
• While this group has a general mistrust of medical professionals, they are more likely to engage with a doctor in a doctor’s office than in a retail center or via telehealth.

Understanding Black consumers

• From HeLa Cell research to the Tuskegee Experiment and beyond, the Black community has a centuries-long history of medical maltreatment and racism in the United States.
• In response to this maltreatment, Black individuals have learned to distrust healthcare institutions and are more likely to turn to internal groups and communities where they feel the safest and the most respected.
• While Black Americans have been routinely neglected and taken advantage of by the U.S. healthcare system, many want to be proven wrong in their distrust.
• Black consumers receive 26% less funding from healthcare initiatives than white, non-Hispanic people but spend 19% more on hospital services and 13% more on emergency services than white, non-Hispanic people.
• These statistics speak to the limited availability of primary and lower-acuity care for Black Americans, forcing Black Americans to become dependent on costly higher-acuity services.
• Diversity Equity and Inclusion (DEI) is not just important from a humanitarian perspective; it’s also crucial from a business perspective as Black Americans have tremendous spending power and influence on widespread consumer behavior, yet it’s common for organizations to treat DEI as a charitable endeavor.
• Brands in the healthcare space that correct this lens to encompass social responsibility and business opportunity will be the brands that lead the way in health.

The "Avengers" of halftime shows

• The Pepsi Super Bowl Halftime Show teaser went viral this week featuring the "avengers" of Superbowl halftime shows – Eminem, Snoop Dog, Mary J. Blige, Kendrick Lamar, and Dr. Dre.
• These performers are among the most popular 90s-era rappers, evoking intense nostalgia among the ad's millions of viewers.

Life gave us lemons ... now what?

• Critical staffing shortages are negatively impacting hospitals' ability to deliver routine service-line offerings. Across the board, hospitals and health systems are wondering if they need to rethink how they serve their patients – if they can serve them at all.
• Unlike other industries facing staffing shortages or business repercussions stemming from COVID-19, health systems are directly impacted by COVID-19 patient volume. While other industries may need to adjust capacities and protocols to be more "COVID-19 friendly," health systems must pull resources from more lucrative service lines to increase capacity for money-draining COVID-19 care.
• Navigating the pandemic amidst staffing shortages is perhaps the biggest "lemon" the healthcare industry has faced. Could marketing, branding, and communications teams play a role in solving this challenge?

Thinking out loud

• Revive is helping a health system to think about the future and design a vision for how the marketing communications team will deliver value to the organization down the road. One of the health system's marketing leaders shared that their vision for their team is to shape the best workforce in the industry – a rare objective in the healthcare space.
• This inquiry got the team thinking. How can marketers help recruit and engage employees in ways that connect with our larger brands?
• Other industries more commonly use their workforce as a brand differentiator. While health systems invest in talent, customer service, and patient satisfaction, most do not have a clear differentiator for how their workforce lives out their brand.

Brands that use workforce as a differentiator

• Apple's Genius Bar is a good example of how the right workforce can make a difference. Apple opened its first store in 2001, despite the widespread belief that retail was going to fade out. Yet, today, Apple stores are a massively successful element of the world-class brand, much of which can be attributed to the staff and how they help you.
• Another example of a company that invests in developing its people is Chick-fil-A. All of the stores are corporate-owned, which means that becoming a store manager is very difficult. The selection is about culture fit, philosophy, and personality rather than the ability to shoulder the cost of a franchise location.
• While companies like Apple and Chick-fil-A are able to offer stand out consumer experiences based on their workforce, not many hospitals and health systems use that differentiator. This might be because most are focused on a generally good patient experience rather than a different patient experience.
• Of course, we recognize that selling chicken sandwiches and phones vs. healthcare delivery isn’t an apples-to-apples comparison. But this differentiation is also starting to shine through in larger, more complex organization such as airlines.
• For example, Southwest and Delta Airlines invest heavily in their workforce brand by selecting and training employees to embody the airline’s brand personality – each personality very different from competitors. Could the healthcare industry begin to embrace a similar strategy?

Is now the right time to evaluate workforce brand?

• With the staff shortage stress in the healthcare industry, it's fair to ask ourselves: is this the right time to talk about something as aspirational as workforce brand differentiation?
• It’s a toss-up. If health systems had focused on workforce as a brand differentiator five years ago, it could have paved the road for a simpler employer experience today. It would still be challenging to hire and retain staff, but these brands would have something to hang their hat on to say, “we are different, and here’s how.”
• Baystate Health took inspiration from Chick-fil-A recruiting by hosting open-house recruiting sessions. The system hosted these events at different hours to accommodate schedules, and attendees were guaranteed on-site interviews.
• There is also an angle to connect brand position to recruitment. For example, Amazon’s mission is to be earth’s most customer-centric company. Amazon makes that a prominent part of their hiring process, showing employees why Amazon is the right fit for them.
• This helps employees feel ownership over their roles in developing a brand. (this feels weird as it's own bullet point. Is there a source for this?)
• If we feel like we are at rock bottom when it comes to our staffing efforts, investing in differentiating our workforces may be an opportunity to start to recover. As marketers, we know brand consistency is imperative to build a strong brand. But what about employer brand consistency – how do we create a consistent employee brand experience to build a differentiated workforce?

• Our new book, Joe Public 2030: Five Potent Predictions Reshaping How Consumers Engage Healthcare, is now available for pre-order.
• Joe Public 2030 is Chris Bevolo’s 7th book. His writing journey started when an industry publisher came to him to write a book on brand for health systems.
• To write the book, Chris assembled a team of Revivers – Team 2030 – to collect as much research as possible. The team identified trends across literature, which evolved into Joe Public 2030’s five predictions.
• These findings were supplemented by in-depth interviews with healthcare industry leaders across verticals, including health system CEOs, venture capitalists, entrepreneurs, researchers, and physicians. Interviewed thought leaders come from some of the top brands in healthcare, such as CVS, Geisinger, Intermountain Healthcare, Optum, Johns Hopkins University Medical Center, and Mayo Clinic.

Prediction #1: Copernican Consumer

• Enabled by sensors, AI, and other technology, consumers are becoming the center of their own health universe.
• Potential results could include a dramatic reduction in the need for primary care clinicians, an entirely new sector devoted to personal health management, and true precision medicine combined with health management.
• The Copernican Consumer prediction is more than just patient-centric care. Instead, the Copernican Consumer is a prediction that places consumers as the central force in their own health, with physicians, health management tools, and other health-related services “orbiting” around them. Consumers will rarely go anywhere to receive health support or care – it all will come to them.
• Another difference from today is the frequency of consumer health engagement. Consumers will be able to continually monitor their health using aggregate health data. Instead of seeing a primary care doctor once per year, consumers will be able to access all the data they need and will be empowered to make care decisions.
• More sensors are being developed to enable this trend but are not yet in a place where they are sophisticated enough to support a Copernican Consumer.

Prediction #2: Constricted Consumerism

• Consumers will become increasingly responsible for their own health and use of healthcare services. Yet, they will actually become less and less empowered in the choices they have for care, especially in higher-acuity, higher-cost situations.
• While many in the industry will continue to sing the praises of choice, the reality is that most consumers will have far fewer choices moving forward, often in ways they might never consider or see.
• The biggest spender of healthcare money in the United States is the federal government. Employers are the second biggest healthcare spenders as they support employee health plans. For this reason, the federal government and employers are the consumers with the most power to determine how and when consumers receive care.
• For example, PBMs don’t always work in favor of the consumer. Instead, they work to control costs for the payor. Similarly, 72% of ACA health plans are considered “narrow networks.”
• Health insurance companies are the driving force behind these restricted networks and benefit from them. For example, UnitedHealth just reported a 12% increase in revenue for 2021.
• This prediction, in some ways, conflicts with the Copernican Consumer prediction, which places consumers in control of their health.
• The tension between predictions comes from consumers’ current inability to interpret and take action on their health data. How do we ensure that experts guide consumers in understanding their health information?
• This new advisory role may allow industry players to monetize this service, which would significantly impact the market landscape.

Prediction #3: Funnel Wars

• Non-healthcare organizations such as Walmart, CVS, Walgreens, Amazon, and Apple are entering healthcare through low-acuity services like primary care and urgent care.
• Health systems may not currently perceive these organizations as a competitive threat because low-acuity services are less profitable.
• These new entrants pose a competitive threat because they control referrals to higher acuity services – which health systems need to survive.
• Moving forward, we could see the splitting of the health system model, with some systems moving even further to the larger, more comprehensive “health” organizations, others retracting into solely acute-care destinations – the “giant ICU on a hill” – and others somewhere in the middle.
• How does the aging population fit into this? What will health systems’ role be in the future?

Prediction #4: Rise of Health Sects

• Challenges to and skepticism of the mainstream medical field have exploded in the past two years because of the pandemic and political tribalism in the United States. Taken to its potential, this trend could result in multiple “health sects” that coalesce around people’s political affiliations and worldviews.
• These sects will not only follow the medical thinking that best fits their worldview, but may also create their own reality through alternative research, diagnosis, treatment approaches, and models for care delivery.
• Health systems, built to serve entire communities, will find it increasingly difficult to deliver care due to splintering care ideologies. Health systems have a duty to provide science-backed medical care yet face resistance from those who don’t believe in mainstream medical practices.
• A significant factor in The Rise of Health Sects is the loss of trust of health experts. Some medical schools train students to build a thought leadership presence online to combat this loss of trust in the healthcare system and disseminate mainstream medical thought.

Prediction #5: Disparity Dystopia

• The pandemic shone an ugly light on the disparities that have plagued the U.S. healthcare system for decades, and unfortunately, that health gap is more likely than not to expand.
• This shift will be compounded by the mental health crisis, which disproportionately affects systemically disadvantaged populations and groups outside traditional healthcare access channels.
• While those entities that might address these disparities increasingly struggle financially, others lack the incentives to focus on the growing issue.
• The CommonWealth released a report that found that healthcare is better for white people in nearly every state. At the same time, we see a growing list of trendy startups looking to disrupt primary care, with many companies focusing on healthy, relatively well-off patients.
• Looking at the availability of PPE, ventilators, COVID-19 tests throughout the pandemic, you can see that populations with higher incomes are favored in resource distribution.
• According to Rand Corporation, the bottom fifth of low-income households are spending nearly 34% of their income on healthcare.

To fellow bookworms

• As of this recording, Joe Public 2030 is officially available for pre-order. Backed by more than 250 resource citations and input from 22 industry experts, including health system CEOs, venture capitalists, entrepreneurs, and physicians, Joe Public 2030, makes five game-changing predictions about the future of health engagement. 
• What are our predictions, and how will your organization be impacted? Order your copy of Joe Public 2030 for a deep dive into the potential future of consumer health engagement.
• A bookworm and avid learner, Stephanie Wierwille finished 95 books in 2021. Her recommendation for other bookworms looking to read more? Carry multiple formats of books at all times – you’d be surprised at how often you can pull out a book or plug in your earbuds in a day.

New & noteworthy

Here comes 23andMe

• DNA testing company 23andMe took its first drug to clinical trial, using clinical insights derived from saliva test DNA results from consumers.
• This news, coupled with 23andMe’s recent acquisition of telehealth platform, Lemonaid Health, indicates the newly-public company’s intentions to grow beyond DNA testing and into personalized medicine.

That no good, very bad word: COVID-19

• Just when we thought we were out of the hot water, COVID-19 surges have forced hospitals to postpone elective surgeries … again.
• For hospitals and health systems, pausing elective surgeries means pausing critical revenue streams while patients’ untreated symptoms often worsen.
• Hospitalizations due to COVID-19 seem to be plateauing in major metropolitan markets.

The advertising market, party of three

• Alphabet, Meta, and Amazon are projected to account for 50% of the $1 trillion ad market by 2025, including non-digital advertising.
• If you’re a small business, you’re probably running digital ads, which means that your reliance on these three companies is greater than that of a big brand.

ICYMI: Advocate Aurora at J.P. Morgan Health Care Conference

• In addition to being a non-profit hospital system, Advocate Aurora is moving to become a health-related company and gave a rundown of its latest moves to do so.
• This year, the system will continue to invest in “become[ing] more evolved in healthcare beyond just hospitals and doctors,” Advocate Aurora CEO Jim Skogsbergh said.
• Advocate Aurora detailed how it is buying stakes in innovative consumer health tools. This investment includes a 20% stake in the telenutrition business FoodSmart and the complete acquisition of the home care and wellness company Senior Helpers. The system also bought a 17% stake in the digital and analytics platform Xealth.

The latest trends in telehealth

Virtual care on the decline

• Virtual care, which boomed during 2020, has reportedly experienced a significant decline in consumer usage in 2021.
• It would be interesting to know if this decline results from lower demand for virtual care or lower supply. Do consumers no longer want virtual care, or are their health systems not supplying it?
• Some data shows that no shows were significantly higher with telehealth which could de-incentivize providers to offer virtual care services.
• Telehealth was primed for its big moment but ultimately disappointed many because the industry failed to integrate it into the patient experience.

When consumers prefer telehealth

• A month ago, eMarketer released a US Telehealth Trends 2022 report, which found that the number one reason people use virtual is to avoid contracting a disease.
• While adoption is low, it could be possible that the market hasn’t reached the tipping point where telehealth will prevail yet. If you look to other industries, it took time for consumers to become comfortable with a digital experience, so perhaps healthcare is no different.
• Health systems need to prepare themselves for when consumers are ready to embrace telehealth because those leading the charge will end up on top.

CES took place during the recording of this episode. The No Normal team reviewed the health trends and technologies featured at the event. 

A health perspective on the Consumer Electronics Show (CES) 2022 

• Health had a more prominent presence at this year's CES than in previous years. For the first time, a healthcare executive took the main stage.
• Abbot CEO Robert Ford delivered a keynote presentation on human-powered health, talking about topics such as at-home testing, biome-based medical nutrition, and wearable sensors.
• This spotlight on health at a consumer goods conference is interesting because it demonstrates the blurring of lines between healthcare, retail, and the consumer world.
• Whereas medical devices used to be associated with healthcare alone, brands commonly feature these technologies at major consumer electronics events.

Health technologies that made a splash at CES

• Senglad Smart Health Monitoring Light: The WiFi- and Bluetooth-connected Lightbulbs track consumers' heart rate and sleeping patterns throughout the household. This technology is an alternative to on-body sensors.
• Withings Body Scan Smart Scale: Withings' scale goes beyond standard measurements, offering users insights into body composition per body part. It also makes ECG measurements for atrial fibrillation, vascular health, and changes in nerve activity — all of which users can send to doctors directly from the scale.
• Sleep Number 360 Smart Bed: Sleep number debuted changes to its 360 Smart Bed. The bed, which already detects movement and makes adjustments automatically, could detect illnesses and disorders like insomnia, sleep apnea, or cardiac events in the future.
• Toto Wellness Toilet: Toilet retailers have presented at CES for the past few years. This year, Toto launched its Wellness Toilet, which scans the user and "key outputs" to determine the individual's level of wellness.
• Mind-controlled earbuds: These earbuds use a neural interface to control music and answer calls by detecting users' neural or facial movement activity.
• With all of these advancements, the health industry still has a long way to go. In fact, 70% of U.S. hospitals still rely on fax machines to communicate patient records.

Personalization meets privacy

• Consumer preference for personalization has been a hot topic for a while, but what's interesting now is how the trend increasingly clashes with consumer privacy concerns.
• According to Forrester, 72% of consumers only engage with marketing messages tailored to their interest, but 86% are concerned about data privacy. How do we meet both needs when they work against each other?
• In this new world of consumer health sensors and a growing amount of consumer health data, privacy concerns will likely become an even larger topic of discussion.
• This weight on privacy is also evidenced by the whopping 96%  of users who deny applications access to cross-tracking on Apple devices.
• Enforcers are also cracking down on data privacy. In fact, France recently fined Google and Facebook millions of dollars for failure to obtain proper consent for data tracking.
• Which organizations do consumers trust the most with their data? Around 50% of respondents identified Amazon as the most trusted data steward, above Apple, Google, and even banks.
• We explore the personalization of healthcare — what we call the Copernican Consumer — and its relation to privacy preferences in our upcoming book, Joe Public 2030.

Splintered societies

• Our book, Joe Public 2030, also predicts The Rise of Health Sects, splintering societies based on political affiliation related to health.
• This phenomenon is commonly referred to as political tribalism. However, tribalism may not be the correct term as the language implies ancestry, race, or culture.
• In-group and out-group dynamics dramatically shape individual value systems and political views. When individuals belong to a group, they will look to those they trust — their group — for signals on how to think.
• The way someone thinks or acts on a health issue is highly correlated with their political affiliation. We've seen that with masking and vaccination, and other health-related issues.
• In 2022 this trend will continue, which will have implications for brand strategy, creative, and business in general.
• Historically brands have focused on speaking to "universal truths." In this new age of splintered societies, we can no longer group our audiences as we have in the past, just based on age or demographics. We need to go beyond traditional consumer segmentation and lean into the power of group influence. As marketers, we need to reevaluate how we partner with trusted entities across different groups.

In this episode, Chris, Stephanie, and Chase each reviewed one health brand, discussing why the brand is notable in today's landscape.

Cityblock: Better care, rooted in communities

• Chase chose to discuss Cityblock, an emerging primary care organization for low-income communities.
• The pandemic highlighted and exacerbated health inequities, spotlighting the growing need to make quality healthcare accessible to low-income populations. In fact, The Commonwealth Fund found that in nearly every state, healthcare is better for white people.
• While we see more organizations getting into primary care for the commercially insured, Cityblock is making care more accessible for Medicare-insured populations.
• Cityblock is unique because they meet people where they're at – existing schools, churches, and community centers.
• Cityblock hires a lot of its medical care team members from the communities they serve. This helps the primary care innovator build trust and understanding with the communities it serves.
• Cityblock recently announced their Series D round of funding, bringing total funding to $900 million.

Hims & Hers: A modern approach to health and wellness

• Hims & Hers is a company that encompasses prescription medicine, primary care, supplements, and CPG products.
• The company is built to provide better care to consumers with stigmatized conditions, such as those related to sexual health, mental health, and beauty.
• The company uniquely brings together prescription, beauty, and home health using a telemedicine platform and retail distribution networks.
• The company's valuation at IPO was about $1.6 billion, which is on par with what we've seen with OneMedical, showing gradual revenue growth over time.
• A lot of companies have tried to disrupt the pharmacy business, but many have failed because of cemented power dynamics and complex inner workings.
• Hims & Hers is breaking into this arena by making medicine less intimidating through beautiful design and branding. The No Normal team posits that consumers may find it less scary to receive a prescription in a beautiful bottle than a regular sick package.

Apple: Think different

• Chris chose Apple to focus on as a health brand because most people don't consider apple a health brand, despite Tim Cook's bold belief that Apple's legacy will be in health.
• From fall detection features to EMR integrations, Apple's progression into healthcare has been steadily marked by high-tech devices, including wearables like Apple Watch and AirPods.
• Walking steadiness is a particularly notable feature because it is a new clinical metric that can be credited to a "non-healthcare" brand. We use quotes here for a reason. Apple, whether you believe it or not, is one of the fastest-growing health brands out there.
• Apple may have faltered a time or two as it entered the healthcare arena, but these stumbles are merely learning opportunities that the giant will use to inform future efforts.
• Apple was the first company to reach $1 trillion after 42 years of business. It took only two more years to get to be valued at $2 trillion. They are known for design and innovation and have enough capital to invest in healthcare. If you connect the dots, the reality is clear: Apple is ready to take on health care ... whether systems are ready or not.

• Thinking Fast & Slow 
• Noise
• Nudge
• Priming: Programming the Mind for Habit Change and Success
• Judgment in Managerial Decision Making

Takeaways

Life is what happens to us when we're making plans

• Peloton's stocks plunged after Sex and the City spinoff, "And Just Like That..." killed off the beloved character, Big, by way of Peloton-induced-heart-attack.
• What makes the story notable isn't the massive dent in shareholder value — it's Peloton's witty, lightning-fast response that has left marketers starry-eyed.
• Within two days, Peloton released a video featuring the very undead character himself talking to a Peloton instructor about his next ride. Comedian, Ryan Reynolds, narrates the end of the parody citing the medical benefits of Peloton. Reynolds closes the ad with a quick, ironic "he's alive."
• While Peloton could have sued the show's producers, they took an endearing, comedic approach to correct the perception that Pelotons cause heart attacks.
• The response also included statements issued by a team of physicians on its Health and Wellness Advisory Council stating that Peloton can improve cardiovascular health.
• The Council, announced in September of 2020, shows Peloton's growing focus on the company's interest in health beyond just fitness.
• Since the recording of this episode, two women accused actor Chris Noth (Big) of sexual assault. Peloton removed all placements of the ad, making the formal statement that "every single sexual assault allegation must be taken seriously."
• While there is no way to know what's to come in Peloton's "Big" saga, Peloton continues to earn its chops when it comes to its quick, socially-in-tune responses to the viral moment.

Behavioral Economics

• Classic economics state that people act in their own best interest, but behavioral economics asserts that we don't always act rationally but instead with biases. Priming and anchoring are two biases we cover in this show.

What is priming?

• Priming is when one stimulus changes your reaction to another later stimulus without awareness of the connection.
• Stephanie demonstrated priming through an experiment with Chase in which she sent him a message, "eat." She then asked chase to fill in the blank to complete the following word: S _ _ P. He responded with "soup" because Stephanie primed him to think about eating.
• In 2016, psychologists performed a priming experiment in which students were asked to assemble sentences using unorganized words. Half of the students were given terms associated with the elderly. Each subject was then asked to walk down the hall to complete another task. Those presented words related to the elderly walked slower down the hall than those who were not.
• Priming can also influence weightier decisions like voting, which raises the question: When is priming unethical?

Priming in practice

• Marketers can prime their audiences by simply asking questions. For example, if you want to encourage someone to floss more, ask them how often they floss. The prompt increases the odds that your participant will think about how often they floss and consequently floss more regularly.
• The same applies to everything from health risk assessments to the emails and quizzes we use as marketers.

What is anchoring?

• The anchoring effect is a cognitive bias whereby an individual's decisions are influenced by a particular reference point or 'anchor'. Once the value of the anchor is set, subsequent arguments or estimates made by an individual may change from what they would have otherwise been without the anchor.
• You can test the anchoring effect by having someone write down the last three digits of their phone number, adding "1" to the beginning of that numeric series. After your test subject writes the number down, ask them what year the Taj Mahal was completed.
• Most people guess a year that uses their phone number as an anchor even though the year the Taj Mahal was built has nothing to do with your phone number.

Anchoring in practice

• Anchoring is the most relevant when it comes to price when the value of the good is not easy to estimate.
• For example, a Fortune 500 consultant could quote $500,000 or $750,000 for a project. Without a clear understanding of what the project entails and the target outcomes, there's no way to know which price represents actual value.
• In negotiations, the first number to be put on the table is the most likely to act as the anchor. For example, in interviews, recruiters commonly ask for salary requirements. The number you give in this conversation anchors pay negotiations down the road to this initial number.
• Over a decade ago, Chris and a team performed an audit of 11 hospitals in the Twin Cities to examine how a patient's first impression with a hospital impacted perceived brand value. The hospitals did not know the audit was being performed.
• Chris found that most hospitals offered a negative first impression that did not represent the actual value of the hospitals' offerings. Yet, because patients' first impression of a hospital is the anchor of their perceived value, the hospitals were losing brand equity from interactions beyond their core competencies.

Obstacles left and right

• It’s challenging to sell bold marketing ideas anywhere, but the nature of health systems and their power dynamics make it especially difficult.
• Health system leaders are predisposed to resist the unknown – the risks – because they deal with life and death every day. What makes them good at their jobs is, in many ways, the opposite of boldness.
• Given differences in expertise between marketers and senior health system leadership, marketers must also overcome a large understanding gap. The more you know about the marketing craft, the more difficult it becomes to explain to non-experts. In his book, To Sell Is Human, Daniel Pink calls this phenomenon “attunement.”

Strategies for selling bold marketing ideas

Master your story

• Marketers need to build stories that compel their leadership to take a chance on bold marketing, much of which has to do with perception.
• For example, in 2017, scientists found that they could increase the quantity of fruit and vegetables consumed by creating a dedicated space in shopping carts for fruits and vegetables. In response, the average consumer purchased more fruits and vegetables because they were psychologically nudged in that direction.
• Marketers can nudge leadership teams to take specific actions by giving them options. Like pricing tiers, you can bring the whole set upwards in boldness by offering three options knowing the middle one is most likely to be picked.
• However, when presenting options, never offer an option that you wouldn’t be comfortable executing because sometimes that is the option that your audience picks.

Recruit influencers

• A way to build confidence in those you’re trying to influence is through social proof.
• To sell bold ideas, health system marketers need to understand which parties influence key decision makers. In many systems, physician and service-line leaders are key influencers.
• Chris gives the example in which one of our clients loved a bold concept presented to them but needed to sell their organization on the idea. One of the system's top neurovascular surgeons stumbled upon the campaign concept and raved about it. Since this individual generates so much revenue for the health system, his opinion drastically influenced the CEO’s decision to accept the idea.

Express limitations

• Physicians are natural skeptics because their practice centers on science. Marketing doesn’t always inspire confidence because not all marketing is based on science.
• When presenting bold ideas, don’t be afraid to acknowledge the limitations of your research and hypotheses. By not having all the answers, health system marketers can increase their audiences' receptiveness.

Selling bold ideas in practice

• VCU Health is an academic system that runs on their own authority, which is unique because most are run by the state.
• VCU Health hired Revive to help their team fight vaccine hesitancy in Virginia. Our research showed three populations that were particularly hesitant – young, Black, and Hispanic populations. These groups didn’t feel like the vaccine was for people like them.
• To resonate with these hesitant groups, Revive created the campaign, This Sh*t Matters, placing a heart over the third letter of “Sh*t” to indicate a double entendre. The campaign featured members from each of the hesitant communities and why the vaccine mattered in their life.
• While Revive came up with the idea, VCU Health’s Chief of Marketing, Cynthia Schmidt, championed and sold the idea internally, tapping into both university, hospital, and peer influencers prior to pitching to senior leadership.
• These glowing endorsements gave her the credibility she needed to get approval to launch “This Sh*t Matters” out in the market.
• When crafting her story, Cynthia appealed to the topic that was top of mind across the system: a huge increase in the number of young people in the ICU. Cynthia crafted her story based on this priority, communicating that VCU’s mission is lived out in the moments when they step up to do something bigger and bolder.

The juice is worth the squeeze

• When your ideas are bold, others start to help you out. There were so many people who wanted to take part in the campaign or lend their expertise/resources.
• For example, sports stadiums opened up extra media placements within their stadiums, people called into radio stations requesting to tell their story for why This Sh*t Matters.
• There’s a newspaper in Richmond who got a note from a complainer who said, “this isn’t worthy of a newspaper like yours.” The newspaper responded by saying that they believe in the work and its mission.
• Vaccination rates increased within the community after the launch of the campaign. The campaign also demonstrated a competitive business impact.

The new villain in town: Omicron

• As the first cases of the COVID-19 Omicron variant appear in the U.S., media and the public speculate whether or not we'll see another wave of shutdowns.
• Will Omicron match the severity of the Delta variant? Is the media overstating the new variant's threat? How long will new variant cycles impact society? These are the questions that sit top-of-mind for The No Normal team.
• While serious questions about Omicron remain, The No Normal team couldn't help but chuckle at the variant's name choice.
• The World Health Organization (WHO) explained that they skipped "Nu" because it sounded too much like "new" and "Xi" to avoid offense to cultures who commonly use "Xi" as a surname, which makes sense. Yet, why did they deviate from the Greek alphabet to name the variant Omicron? Great question.

A review of "The Funnel Wars"

• In early January 2022, Revive is releasing a new book, Joe Public 2030, which makes five bold predictions about the future of consumer health engagement. This episode covers trend number three, “The Funnel Wars.”
• The Funnel Wars refers to competition in the acuity funnel. The top of the funnel is one of the most common funnel entry points. It includes urgent care, virtual care, minute clinics, and even primary care.
• Middle-of-the-funnel services like specialty care and surgeries are much more lucrative than top-of-the-funnel services, yet depend on lower acuity touchpoints to feed patient volume. Without a full top-of-the-funnel, health systems won't be able to feed volumes for more profitable services.
• Competition for lower-acuity, top-of-the-funnel services is heating up as giants like CVS, Walgreens, Optum, Walmart Health, Apple, and Amazon bolster their consumer health offerings.
• If health systems lose the top-of-the-funnel to these new entrants, they will lose control of the patient relationship and will depend on these massive organizations to feed higher-acuity volumes and to survive.

Who will win the funnel wars?

• Will the Amazons and Apples of the world win The Funnel Wars? Or perhaps a health system or multiple health systems? The answer has yet to be determined, but with the top five Fortune 500 companies (1. Walmart 2. Amazon 3. Apple 4. CVS Health 5. UnitedHealth Group) investing billions into their health offerings, it will be a tight race.
• The Funnel Wars will end in a place where we have a large, nationwide offering that integrates the full consumer experience. As more entrants join healthcare’s gold rush, this integration will become more challenging.
• Many health systems still think this is an esoteric threat because no one player has completely figured it out. CVS seems to be the biggest threat to health systems due to proximity to consumers, close relationship with Labcorp, and intention to convert locations to “Health Hubs”.
• It's easy to look at stumbling efforts to "figure out" healthcare (I.e., Haven, Walmart Health) and think that the disruptors are failing. The problem with this thinking is that it discounts the learnings these giants glean from their efforts that they will apply to future attempts.
• In order to disrupt an existing model, you need to improve access, convenience, and cost. Health systems are committed to quality – often to the detriment of cost – while innovators come in at lower cost and build up to higher quality.

• The word "turkey" is a broadway term that describes a show with a lot of previews but later underperforms based on quality. Historically this had to do with increased tourism around the holiday period, making it lucrative to have more shows at the end of the year.
• Our team applies the term "turkey" to marketing in this episode, reviewing this year's most significant marketing flops. We asked our agency for their opinions, and the following campaigns were submitted.

Notable mentions

• Balenciaga released sweatpants that had boxers sewn into the inside that made them look like sagging pants. The United States' history of police shooting black men with saggy pants brings to question the ethics of the wealthy capitalizing on this style.
• That's why we need to take more time to research the history of the products we develop. So much time goes into product development already; this additional step would be a drop in the bucket comparatively.
• From a more lighthearted perspective, the oatly SuperBowl ad polarized audiences – some loved it, and some hated it.
• Bud light has been chasing the seltzer craze and now has taken it a step or two too far with eggnog flavored seltzer.

The not-so-fresh turkey

• Subway has lost popularity amongst consumers and released a new campaign to increase sales. The "Eat Fresh, Refresh" campaign boasted a refreshed menu but offered little information on the changes and availability of new products across locations.
• The issue is that the definition of fresh has changed over the past ten years. Their current menu – which has the same ingredients as before – no longer meets modern standards for freshness. They have, however, reported increased sales which could be attributed to the campaign or a pandemic rebound.

The tweet you can't take back

• On International Women's Day, Burger King UK announced a program to address gender disparities in the restaurant industry by building a scholarship program for female employees. The idea itself was great, but the execution was not thoughtful (and cringeworthy).
• They announced the scholarship by tweeting "women belong in the kitchen," providing context only in the tweet's thread, which obscured critical context for the tweet.
• Our team expressed that Burger King UK should have chosen a different platform than Twitter to offer audiences more immediate context for the jarring statement.
• To avoid this sort of mishap, marketers need to present campaigns to stakeholders in the same way their audience will experience the campaign. For example, a conference room audience may experience concepts differently if presented in a pitch deck.

 The algorithm gone wrong

• Chris helped his dad sell his townhome this summer using Zillow's Offer tool. The tool gives an estimate for how much the house was worth pending inspection. Zillow purchased the home for the Zestimate price, but the listing price had been cut by close to $50,000 a few months later.
• Chris' experience is symptomatic of Zillow's inaccurate Zestimate tool. The business made a significant bet on the power of its data and the ability of an algorithm to predict which homes are worth buying and flipping to sell for profit.
• Zillow, after significant losses over the past few years, ended this house-buying initiative.
• The future is AI and algorithm-driven, but the technology isn't where it needs to be quite yet. Placing that much money on an algorithm is very risky given the lacking maturity of current technology.

What is inclusive marketing? 

• Inclusive and multicultural marketing is not new, but George Floyd's death, coupled with the health inequities revealed by COVID-19, spotlighted diversity and inclusion.
• When you think of words like "misrepresented," "underserved," or "marginalized" to describe your audiences, it's unclear which populations you're talking about, leaving more room for error of interpretation.
• Be clear about the groups you're referring to and who you're trying to reach. For example, if you're looking to reach a specific audience, identify the audience explicitly. Identifying homeless populations, Black populations, or LatinX populations, for example, offers more specificity and clarity.
• According to the 2020 census, the American population is becoming increasingly diverse. As our population diversifies, it becomes increasingly important to make consumers feel understood through inclusive marketing efforts.
• Marketers and health systems can feel like they have conflicting obligations: mission vs. business. In reality, inclusive marketing has a positive impact on business.

Brands leading the way in inclusive marketing

• Our first interaction with advertisements is through creative, making creative a crucial first interaction with the consumer. Fenti, for example, creates advertisements that represent diverse populations, making their audiences' experience of the Fenti brand more authentic to their lived experience.
• In 2020, Peloton pledged to invest 100 million to fight racial injustice and inequity in the next four years. The money went to increasing wages, supporting non-profit partners, growing learning opportunities.
• For example, Peloton partnered with Beyonce and Historically Black Colleges and Universities (HBCUs) to improve access to fitness through their platform. The takeaway here is that it's not just about advertising or reputation; it's about the entire package. How do we make DEI part of our products, business strategies, and beyond?
• It's also not just about race. It's also about creating content for specific languages. Not just translating content but "transcreating" content in a way meant to resonate with a particular audience. Gary Vaynerchuk, for example, speaks to the power of language in inclusive content.

Opportunities to improve marketing inclusivity 

• Inclusion goes beyond ads and should be embedded in every touchpoint within the consumer journey. For example, an advertisement will lose authenticity with diverse audiences if its landing page doesn't communicate in the same way.
• Health system marketers have an opportunity to improve inclusion and impact business outcomes by auditing each step of the patient experience.
• Expand your circle of influence to avoid groupthink and to expand cultural intelligence and community understanding.
• The documentary, Who gets to be an influencer, talks about black creators' challenges when growing audiences. These challenges have implications for brands' partnership choices. If we evaluate influencers by their following size alone, we miss a large population who can speak authentically with our audiences.

• JK Lloyd, President and founder of Eruptr, estimated that 20% of hospitals in 2011 had used search engine marketing at all. Relative to other industries, hospitals have been slower to jump into digital advertising.
• Digital advertising grew 12.2% in 2020 and continues to grow, with ad spending projected to surpass the 200 billion mark in the upcoming year.
• Healthcare and pharma still only represent a small portion of the media mix across industries. In 2021, these segments represented just 7.2% of the display advertising pie and 6.4 % in 2021. While this statistic only accounts for display (as opposed to search and programmatic — still a relatively small piece of the pie.
• Digital advertising may not be as effective as marketers think. Almost half of all internet traffic is generated by bots, with one-third of advertising dollars wasted on ad click fraud. Global businesses are expected to lose $44 billion to ad fraud by 2022.
• Apple is making updates that limit marketers targeting capabilities by giving users more control over their preferences.
• Several large advertisers have made deep cuts in their digital ad budget — including Procter & Gamble (cut $200M), JPMorgan Chase (slashed ad reach by 99%) — and seen little or no measurable impact on their business.
•  

The multi-billion-dollar question

• With bot traffic and fraudulent activity inflating our metrics, marketers must ask themselves what they can do to reduce digital advertising waste.
• We need to recognize technology's limitations and adjust our strategies accordingly. For example, it's easy to overestimate a platform's targeting capabilities.
• Keep in mind where digital advertising should fit into your program's overall media mix, and get specific about the channel you use. For example, if the goal is awareness, video will probably deliver better results than display.
• If you are running an awareness campaign, however, question why you're running an awareness campaign in the first place. There are way too many campaigns where awareness is the goal and impressions are the KPI.
• Even Peloton started with product marketing advertising and then moved into brand advertising, video, and CTV.

Evaluate your metrics

• Impressions and reach are not adequate measurements for campaign success because users often do not choose whether or not they see an ad. Similarly, impressions do not indicate any targeting accuracy. You could have a high number of impressions amongst a completely wrong audience.
• To effectively drive behavior change, our metrics need to reflect behavior change. Site visit rate, the ratio of page visits to ad impressions, can be a quality measure for consumer behavior change. Although this number may be lower than the engagement rate, it gives you a better view of consumer action resulting from your campaign.
• Ad platform monetization models are based on clicks, which includes accidental clicks. Accidental clicks may inflate metrics to make the campaign appear more successful than it was, ultimately driving more revenue for the ad platform.
• Retargeting can motivate consumer action, but it doesn't necessarily help marketers attribute consumer action to a campaign.
• For example, you may be served an ad for soft pretzels based on your interest in soft pretzels. After seeing the ad, if you buy a soft pretzel, the sale may be attributed to the campaign rather than your unrelated love for pretzels.
• This HBR article calls out the issue of correlation vs. causation and where marketers need to sharpen their skill sets.
• Driving consumer action requires marketers to understand consumer psychology, behavioral science, analytics, statistics, and more.
• By hiring experts in each of these domains and documenting learning objectives for your team, marketing leaders can bolster their team's capacity to deliver results.

• Chris Bevolo initiated our Halloween episode of The No Normal with a tribute to SNL superstar, David S. Pumpkins.
• In the spirit of Halloween, this episode centers on three scary trends facing marketers today, including climate change, political polarization, and you guessed it – Facebook.

Climate change as a public health crisis

• Until only recently, climate change hasn't been recognized as a public health crisis. With the rise of severe weather and natural disasters, brands are increasingly focusing on their role in addressing climate change.
• Climate change will drive more significant public health issues that health systems will have to figure out how to manage. For example, the winter storm in Texas last year made it difficult for patients to receive care and providers to deliver care.
• How to avoid a climate disaster by Bill Gates compares climate change deadliness to COVID-19 deadliness. By 2060, climate change could be as deadly as COVID-19 and, by the end of the century, five times as fatal as COVID-19.
• Hospitals and health systems are significant contributors to global warming because they produce massive amounts of carbon and will need to find ways to address their contribution to global warming.

The politicization of health

• The politicization of health isn't a new concept. During the 1918 Spanish Influenza outbreak, masks were a hot topic of political and social debate.
• COVID-19 accelerated the politicization of health. While health has always been a public issue, platforms like social media have increased the rate at which we share, consume, and react to information.
• Society calls for brands to become more actively involved in public health issues, which puts providers between a rock and a hard place.
• Health systems must stand up for medical truths, but doing so can alienate large parts of a community. As community-based organizations, hospitals and health systems cannot afford to alienate those who disagree with their principles and values.
• As the staffing crisis continues, health systems need to also think from an employee perspective so that they can retain talent. Perceived alignment with a political party could impact staffers' willingness to work for their current health system.

Facebook, enough said. 

• Chris deleted his Facebook account in 2018 because he didn't like how the company manages data. This process took "the better half of a day," demonstrating the depth of Facebook's information on its users.
• Facebook is how many marketers built their careers. What used to be seen as the "cute" side of marketing is now a significant driver in marketing strategy across industries.
• Recent news highlights the potential harm of social media on our society, including its adverse effects on mental health and inflammatory content. Reports show that Facebook has knowingly chosen to ignore these problems because solving them would negatively impact revenue.
• Our team's biggest concern about Facebook's recent scandals is that they chose not to take action. By not taking action, Facebook demonstrates value for the bottom line over the public good.
• Stephanie acknowledges that those in the social media space have known for a while that emotional content goes viral much more quickly than non-emotional content. With this in mind, it makes sense that inflammatory content goes viral more quickly and more frequently.
• Around 25% of digital marketing dollars are spent with Facebook today, which speaks to Facebook's monopoly on digital advertising. With Facebook baked into the digital advertising ecosystem, brands must ask themselves if they want to diversify their advertising channels.
• Chase identified whitelisting as the most shocking Facebook practice exposed by the Wall Street Journal, stating that this is hazardous because it lowers the standards for people with more influence, increasing the likelihood of spreading harm and misinformation.
• A few years ago, Facebook changed its algorithm to prioritize content that gets more engagement rather than content individual users express interest in. Since inflammatory content receives more engagement, the algorithm prioritizes it in users' feeds, quickly leading to "us" vs. "them" dynamics.
• Facebook renamed its holding company "Meta," reflecting its goals to build a metaverse beyond the Facebook platform.
• Stephanie follows a 70-20-10 model for financial investments in digital advertising, with 70% of your budget dedicated to what is proven to work, 20% for platforms that work fine, and 10% for experimentation.
• Experimentation is health systems' opportunity to diversify their media mix and to take ownership over their audiences by investing in building out their CRM and bolstering their email marketing efforts.

Getting a feel for HLTH 2021

• Revive's Gale Pryor and Brennan Mason joined our team on The No Normal Show to share their takeaways from this year's HLTH conference in Boston, Massachusetts.
• The purpose of the event is to bring everyone in the health ecosystem to reimagine healthcare delivery. Brennan and Gale found that the ecosystem has more players than ever.
• A good mix of organizations attended, including Amazon, AARP, Fidelity, AHA, IBM Watson, Maven, Philips, ResMed, Teladoc, Verizon, Vertex, CVS, Walmart, Zoom, Optum, Oak, Cigna, Aetna, Humana, and the Blues+.
• HLTH orchestrated an indoor event of 6000+ attendees while ensuring that everyone in attendance was vaccinated or had tested negative within the last 72 hours of the conference. They made COVID-19 testing accessible in the lobby.

 The reinvention of primary care 

• Primary care is attracting heated discussions because many of the core themes in healthcare transformation are coming together in primary care.
• Amazon Care is expanding its virtual and hybrid primary care service beyond its employees, offering other employers a covered benefit in selected cities.
• UnitedHealth is rolling out a virtual-first primary care product, NavigateNow, to select employers with self-funded plans in nine markets, expanding to 25 markets by the end of 2022.
• Primary care is a strangely heated space. This year, Rushika Fernadopulle of Iora Health clashed with serial entrepreneur Adrian Aoun of Forward about tech-based primary care. Adrian equated the entrance of pharmacy retailers to "wanting an iPhone and being sold a Motorola."
• Our hosts found that Adrian came across as disconnected from the reality of primary care and that retailers like Walgreens, CVS, and Walmart have advantages like a massive physical presence, logistical network, longitudinal understanding of consumers, and high net promoter scores.

Digital health, of course 

• Digital health has always been the focus of HLTH, but this year was less about an incoming digital revolution and more about the ways different players collaborate and integrate solutions.
• Walmart Health put it well: It's not just about going digital; it's about having different mechanisms for different consumer preferences.
• Hybrid care was widely recognized as a critical element in appealing to consumer preferences and building trust.
• Much of the conversation was focused on chronic care management and wellness, with Noom, Thirty Madison, Big Health, and Everly Health all present. The goal of digital tools in this space is to become a reimbursed benefit.
• If healthcare delivery wants to transform healthcare delivery, organizations need to take the lead. To lead healthcare delivery, organizations need to change their business model from a pipeline to a platform where all players can connect to your health system.

Plans + employers + digital health 

• As employers take a more proactive role in workforce health, plans seem to be reinventing care delivery using digital health and the workplace to do it. As Divya Paliwal, Chief Clinical Transformation Officer of Horizon BCBS said, "How can we use these dollars better than shelling out to a hospital ED or ICU?"
• The drivers of the growth in digital health are plans and employers. And employers are moving away from PPO, and high deductible plans to incent healthy behaviors – the key focus of digital health tools.
• In a world of remote work, benefit offerings become even more important. When features of physical workspace become irrelevant, benefits are essential in recruiting and retention.
• Employers are certainly stepping up to improve access to health solutions through employee benefits, but this only intensifies the division between the "haves" and "have nots" by excluding small businesses and the unemployed.

Neither here nor there 

• Last week our team talked about minimalism, which resulted in a tangential (a stretch, we'll admit) conversation about Wes Anderson movies. Stephanie was to watch Moonrise Kingdom, and Chase was assigned to watch The Grand Budapest Hotel.
• Both reported on this episode offering positive remarks for the cinematography, yet a skeptical outlook on the quirky style.

A little inspiration from industries outside of healthcare

• The Effie Awards are notable marketing awards that focus on effectiveness. While many awards get a bad rap for celebrating cool ideas alone, The Effies celebrate engaging campaigns that produce quantifiable results.
• What better way to inspire bold marketing initiatives in the health industry than to look at what's working in other sectors? Each member of our podcast team selected one Effie Award-winning campaign to talk about.

Live from the Library

• Stephanie selected the Chicago Public Library's campaign, "Live from the library." The campaign, born in the middle of COVID-19 shutdowns, sought to increase access to books.
• Live from the Library was a daily storytelling series where celebrities, Chicago residents, and others read stories to audiences on Facebook Live. The campaign featured everyone from the Obamas to Dolly Parton.
• In Stephanie's opinion, one of the primary drivers of success was the campaign's simplicity and the naturalness of the content for the platform. Another was that the celebrities donated their time and produced the video from home. So, overall, the campaign cost was extremely low.
• High-profile influencers may be willing to do similar 'pro-Bono work for health systems, provided health system marketers produce simple concepts that support the common good.

"Escape Mountain," Ski-Doo. 

• Chase's favorite campaign was "Escape Mountain" by snowmobile brand Ski-Doo. To engage with a new generation of snowmobilers, the brand launched the three-part reality TV series.
• In the series, participants were dropped in the middle of nowhere on a mountain with GPS coordinates. They then navigated their way back to civilization through a series of clues and Ski-Doo products.
• Together, the three 15-minute videos collected 5 million views. The case study did not indicate whether or not the views were organic or paid.
• Our team discussed the merit of paid media impressions and views and agreed that this metric is insufficient to gauge paid media performance.

"The beauty of no artificial preservatives," Burger King (aka Moldy Whopper) 

• Chris took a different approach, bringing his favorite campaign to dispute. His pick: the Moldy Whopper Burger King campaign.
• The campaign sought to debunk the myth that all fast food is low quality and uses artificial preservatives by creating a time-lapse of a Burger King Whopper aging over 34 days.
• The case study published by Burger King and the agency that produced the work cites a 26% increase in quality ingredient perception, a 22% increase in visitation consideration, and a 14% increase in whopper sales.
• For many (including Chris), these results don't line up. Chris referenced a case study published to Marketing Dive demonstrating much different, less impactful results.
• Chris expressed that audiences who care about artificial preservatives likely were not considering the Burger King Whopper to begin with. Inversely, he predicted that the people eating at Burger King probably cared less about artificial preservatives.
• This campaign could be jolting enough to get people to test it out against competing products. Even if the individual doesn't become a frequent customer, they will have had heightened the consumer's brand awareness.

A question from our listeners

Last week we received the following question from a listener of the show.

“I’ve observed a twist in the very competitive marketing among the four major systems in my city. There are vaccination billboards signed by all four major health systems in the area rather than the typical competitive differentiation.

Would all four health systems benefit from a combined effort focused on prevention? Would their brand image improve if they collectively addressed health and well-being rather than “I’m better than you” traditional marketing?”

 Our response:

• Yes, there are many cases, like COVID-19 vaccine promotion, in which an individual system would benefit from joining a collective. In this sort of situation, you're not losing much margin or receiving a big brand lift from administering a vaccine.
• COVID-19 prevention is where the water gets murky on collectives between health systems. While it would be beneficial for public health, it could potentially undermine a system's ability to differentiate itself as consumers' partner in health.
• A good line to draw when considering collectives with other health entities is whether or not the initiative would impact patients' decisions to return to care at your system versus a competitor's system.

• Consumer behavior changes following COVID-19

Takeaways

Facebook in hot water 

• Last week the Wall Street Journal released a powerful and damning series on Facebook's negative impact on society and repeated decisions to turn a blind eye. Former Facebook employee, Francis Haugen, identified herself as the whistleblower and soon after shared a congressional testimony.
• Following this debacle, the entire Facebook ecosystem, including Facebook, Instagram, Oculus, WhatsApp, and Messenger, went down for six hours with limited response from the company.
• Facebook, following these events, announced that it would be postponing the development of the app 'Instagram for Kids."
• The outage highlighted how powerful a marketing tool Facebook is and how reliant marketers and businesses are on the platform. The outage may be the catalyst marketers need to diversify their marketing mix and experiment with new channels outside the Facebook ecosystem.

Life spheres … but smaller 

• Last year we did a joint study with The Healthcare Association of New York State (HANYS) to reveal the long-term consumer behavior changes resulting from COVID-19. One of the changes listed in that was "smaller life spheres."
• COVID-19 abruptly forced the world to operate from home. From entertainment to education to work to social gatherings – we, as a society, operated from home. Even with fewer restrictions, consumers are now used to traveling shorter distances for goods and services.
• We call this the shrinking of life spheres — a phenomenon in which people have become accustomed to the convenience of at-home or nearby goods and services and continue to seek that convenience. The question has become: How far are you willing to travel for certain activities?
• Our team resurfaced this finding and shared new research that demonstrated the trend of smaller life spheres has continued into the present.
• Stats that support this finding: When it comes to driving, the number of miles the average American has traveled is down to 2007 levels. Air travel is still down 26% from pre-pandemic levels.
• People will think and act differently about how far they are willing to go. This trend is risky for health systems as retailers like Walgreens and CVS live within miles of every American consumer. Because these options are closer and more convenient, consumers may be more inclined to use them as an alternative.
• Not to mention CVS's recent announcement to transform hundreds of its retail stores into primary care outlets.
• Home healthcare is growing rapidly and is predicted to grow almost 8% more by 2028. From a business standpoint, many believe the home is the solution to high healthcare costs.

The wheel of fortune 

• Our team came prepared with three different topics to discuss and spun a wheel to select the topic they would talk about randomly. The three trends on the table included the great resignation, nostalgia marketing, and the rise of minimalism. For this episode, the rise of minimalism was selected.
• The standard definition of minimalism: The movement toward a sustainable self-aware lifestyle where people learn to spend less, save more, and have a less negative impact on earth and resources.
• While this definition applies to many cases, our team expressed that the motivator behind minimalism may vary. For example, millennials are known to rent items rather than purchase them (think Rent the Runway, Spotify, etc.). In many cases, this trend stems from a desire to reduce clutter.
• The team noted that they see this trend represented through brands like Apple through packaging Chick-fil-A through billboard design.

• Amy Webb's 14th annual tech trends report

Takeaways

A little bit of everything

• Last week, we launched a new podcast format and outlined our changes and why we made them. Missed the episode? You can catch up here.
• The podcast team shared a good laugh over the latest marketing spoof to go viral featuring Emily Zugay, a graphic designer who laughably redesigns logos for big brands like McDonald's, Doritos, and the NFL.

That little health brand we like to call Apple

• Despite several roadblocks in Apple's initial entrance into the health industry, the tech giant continues to expand its presence with investments in health features and devices.
• Apple is reported to have cognitive decline and depression detection, insulin level detection, and walking steadiness detection features in development currently.
• Human bodies are becoming containers for data points monitored by devices. With these devices come enhanced insights and the ability for providers to treat more effectively. With so many health data points available, comes a new question of privacy – how comfortable will consumers be sharing this sort of data directly with providers?
• On the other hand, it's possible that these continual monitoring devices will remove the need for physician interaction altogether.
• Since the launch of its first health app seven years ago, Apple has a wealth of consumer health data already and will continue to build this database as it develops new health data-collection devices.
• If Apple is an immovable force in the health industry, where does it fit into the business plans of other health entities such as health systems? As a strategic question, systems must carefully consider where they compete, partner, and invest.
• While Apple's technology could make health systems' digital front door more accessible, a partnership would add a new level of dependency on Apple, giving Apple more control in the industry.

Step into the metaverse

• Metaverse is the concept of a future iteration of the internet, made up of persistent, shared, 3D virtual spaces linked into a perceived virtual universe.
• Facebook is investing heavily in "responsibly" building the metaverse. For those who know Facebook's reputation for living up to civic duty, you'll understand why this gave our team a chuckle.
• In 2003, the first promise of a metaverse came out with the platform, Second Life. Initially, the concept created plenty of buzz in the healthcare industry, showing promise of enhanced patient engagement. But the buzz was just that – hype that quickly faded.
• Now, the big name in the metaverse is Roblox, a gaming creation community with 43 million active users. Brands like Vans, Nike, and Gucci have pioneered experiences in Roblox, setting the standard for brand usage of the platform.
• But where does Roblox and the Metaverse fit into the world of health? That remains the burning question. With no clear pathway yet defined, health brands may have an opportunity but should experiment with caution.

I'm not a lawyer, but I play one on TV

• This segment is our question of the day segment for the show. Today's question: how do you gain approval from legal and compliance teams to engage influencers in your marketing initiatives?
• By nature, good legal and compliance officers will lead you to the safest path. But as we all know, the safest path isn't what will drive results amidst heightened competition.
• Since influencer marketing is relatively new to healthcare, health brand marketers may need to answer questions that may sound intuitive, such as: Are we paying people to be patients? Are we disclosing that we have influencers? Can we rely on influencers to protect our brand and speak to our brand as agreed upon?

• Media Platform Personality Archetypes
• Amazon and Houston Methodist's partnership
• TikTok Advertising

Takeaways

We introduced the new format for The No Normal Show this week. The show changes include: 

• ReviveHealth is now Revive, and to that end, the show will no longer focus solely on hospital and health system marketers and communicators, but marketers, branders, and communicators who are engaging consumers around health.
• The show will no longer be grounded in COVID-19 discussion but will explore new avenues of conversation, focusing on trends shaping the future.
• We will start to talk about marketing beyond healthcare and how to transfer that knowledge to the business of health.
• We are transitioning from a guest interview format to a consistent group of hosts including, Chris Bevolo, Stephanie Wierwille, and Chase Cleckner.
• The podcast will no longer be recorded live on Thursdays. However, we will still post the recording by 11 a.m. (CST) on our site and your favorite podcast listening platforms every Friday.

TikTok may be worth the hype 

• TikTok user activity overtook that of long-standing leader YouTube, with the average user spending 25 hours on the app in June 2021.
• Why is TikTok growing so rapidly? Carefully considered UX factors such as the endless scroll and full-screen experience increase engagement.
• Endless scroll, a common feature across social media platforms, appeals to the human desire for closure. With no concrete end, the user is never fully satisfied, increasing the likelihood of long sessions on the platform.
• Full-screen engagement, which TikTok pioneered, takes up the entirety of the screen, minimizing distractions that could lead the user away from the platform. A recent study showed that this full-screen experience resulted in 280 times more engagement than non-full-screen content.
• Marketers in the health space are slowly dipping their toes in the water to see if TikTok could be a valuable advertising and content marketing platform for their organization.

The time and place for health brands on TikTok 

• Several brands like Cleveland Clinic and Mucinex are already on TikTok and experiencing success. Other brands work through clinicians and other influencers.
• If your team has the resources and capacity to create custom content for TikTok, then yes, TikTok can be a great place to build your brand presence.
• Suppose you don’t have resources at your disposal specifically for TikTok. In that case, influencer content may serve you better because content that is made for other platforms will likely not resonate with TikTok's audiences.
• To be successful on TikTok, brands must be willing to experiment with non-serious tonality, integrating humor and surprise into their content.
• As health brands, we need to use potentially addictive platforms like TikTok in a way that encourages health rather than detracting from it. For example, marketers channel the addictive power of social media platforms by creating content that improves health – like Headspace, Pelaton, or Noom.

Is Amazon flying under the radar in the healthcare industry? 

• While Haven, Amazon’s joint venture with J.P. Morgan and Berkshire Hathaway, disbanded, Amazon’s success in the health space is progressing quickly.
• Houston Methodist and Amazon Web Services (AWS) have been working together for the last year to create a listening platform that is used in the exam rooms and operating rooms. The touchless technology voices steps for clinicians to complete, which can be marked as completed verbally. The technology inputs information directly into the EHR.
• Our upcoming book, Joe Public 2030, will take a deeper look into the next decade in our industry and where Amazon fits into the mix.

• For-profit hospitals saw volumes rebound in Q2, but delta variant poses a threat  
• Kaufman report shows hospital volume recovery is shakey  
• Jefferies lowers medtech outlooks as hospitals project delta pressure into Q4  
• Alabama man dies after being turned away from 43 hospitals amid COVID-19 surge

Takeaways  

The last COVID-19 show  

• Even though we are still navigating COVID-19 and The No Normal, we’re moving away from COVID-19 being the sole focus of the show and transitioning into new, forward-thinking discussion topics.  
• This episode is our final COVID-19 focused show, so we recap the past 18 months, it’s unexpected changes, and projections for the future.  

Lasting changes for health systems  

• With a shortage of physicians, increasing responsibility to help with vaccine communications, and widespread burnout, health systems continue to face staffing shortages.   
• In combination with the emerging competition for skilled workers, these shortages are putting workers in the place of power. We could see this power impact wages, health systems’ competitive standings, and even the ability to stay open.   
• The unknown has extended much longer than many expected, begging the question: are annual marketing strategies irrelevant? While there still may be a time and place for long-term strategies, what they look like may change in the future to be more responsive to change.   
• Our life spheres are becoming smaller as new technologies make it easier to receive personalized products and services without leaving home. To maintain engagement, brands – inside and outside of healthcare – need to invest in personalized marketing.   

How the COVID-19 era surprised us  

• The pandemic gave our industry a wake-up call that many industries don’t receive. While we were caught flat-footed, these deficits have surfaced as an opportunity to regain footing and thrive in the future.  
• Ownership over the patient relationship has changed as organizations from outside of healthcare compete for top-of-funnel services.  
• Because these outside players have the first interaction, they get to define what comes next – including the partners they want to send business to for higher-value services. This change restricts health systems’ ability to control service line volumes.   
• The pandemic became politicized much faster than expected. Events like WWII and 9/11 unified our country for a long time before becoming divisive, so it was surprising that the pandemic had different results. The proximity of the election to the pandemic could be part of this politicization.  
• This polarized environment emphasizes that humans are not always rational. We have to understand how to motivate people beyond logic to become the healthiest they can be.   

Technological Innovation Meets Reality 

• Patient volume has increased exponentially since the 80s, making time the most significant commodity for health systems and physicians.
• With narrow margins, health systems cannot sacrifice patient volume and therefore must find ways to operate more efficiently.
• Technology is often developed independently from the clinical user experience, resulting in inefficiencies that defeat the purpose of the technology.
• Electronic medical records (EMRs) can add value to health systems. However, if developed without the patient and clinician experience in mind, EMRs can become too cumbersome for patient and clinician needs.

Tales from the "dark side" 

Examples of what goes wrong when innovators don't understand clinical needs:  

• Carolyn gave the example of EMR prescription entries. With a pen and paper, it would typically take 30 seconds. But with numerous fields and seemingly infinite options, writing scripts has become time-consuming.
• More input options are not necessarily better, as too many choices can become overwhelming. A clinical perspective could help developers prioritize EMR fields.
• The patient's user experience is often missed in technology development because their convenience isn't always factored into development decisions.
• For example, Chris worked with a health system that was implementing a new EMR. The marketing team was brought into the project after the developers had created multiple logins for patients across different units (hospital, urgent care, primary care clinics). Had the patient experience been considered, only one login would be necessary.

Technology done right 

• Before EMRs, patients communicated with providers via fax and received responses through the mail. This process didn't allow clinicians to confirm that patients had received their messages.
• New EMR technology allowed Carolyn to close the communication loop by notifying her when the patient had received her communications.
• Machine learning for prescriptions is another example of a positive technology-to-clinical experience in which the technology made recommendations based on past prescriptions.

Improving the patient experience

• Clinicians know that listening is crucial, but listening becomes challenging with limited time due to significant data entry requirements.
• Facilitating clinician workflows results in more time with patients to listen and understand their problems. More time with the patient leads to better connections, better diagnoses, and more referrals.
• Historically health systems have focused on the "Triple Aim" – population health, patient experience, and resource stewardship. Now, Carolyn believes it should be the "Quadruple Aim," adding clinician experience as a pillar of focus.

• UCHealth has always tried to show diligence in learning about patients and empathizing with their experiences, but COVID-19 accelerated that understanding as public health conversations became more frequent and urgent. 
• When COVID-19 struck in March 2020, they had to reset priorities overnight because people were now looking to health systems for information.  
• UCHealth’s marketing team essentially turned into a communications team, with 70% of their marketing staff focused on supporting COVID-19-related communications.  
• UCHealth started to gain deeper insights into public stressors and pain points because patients were having more conversations about health. 

From listening comes understanding  

• COVID-19 highlighted health inequities because these disparities showed up in ICU admission and ventilator usage volumes.
• UCHealth started to realize they’d never mapped out the entire patient experience from a cultural perspective. So, rather than looking at disparities exclusively from a care interaction perspective, the team started to look at disparities as a continuum.  
• The impact on certain populations is much higher than it is on others. Take, for example, downward trends in life expectancy. White Americans’ life expectancy average dropped a little over one year since COVID-19, but Black Americans’ average dropped almost three years.  

Social media becomes a crucial learning channel

• Social media has always been part of UCHealth’s marketing strategy, but since COVID-19, it’s been the dominant channel of focus for the team. 
• UCHealth makes concentrated efforts to make sure the patients’ perspective is represented before the system’s perspective. This focus on the patient has dramatically increased engagement, offering UCHealth more direct patient communications to learn from.  

Shifts in public expectations and local legislation 

• Provider reputations have been a rollercoaster over the past few years. First, price transparency laws put providers in the hot seat. Then, when COVID-19 struck, providers became celebrated heroes. Now, providers are back to scrutiny from the public, media, and legislators. 
• Colorado is in the process of passing legislation that would rely heavily on health systems to bring healthcare costs down.
• The public is missing the “whole picture” when it comes to care delivery value. Health systems need to communicate their value to the community wholistically – beyond the itemized bills.  
• For example, health systems shouldn’t be faulted or penalized for seeking commercially insured patients to make up for the millions in losses resulting from unpaid medical bills.