Core Exchange: The Fundamentals of Healthcare Reputation Management

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Episode Transcript:

Laila:

Welcome to the Core Exchange, a podcast for healthcare marketers. I'm Laila Waggoner with Core Health, Core Creative's specialized healthcare marketing practice. We are delighted to have Celine Patterson, healthcare strategy and consulting manager from Reputation, with us today, to talk about the fundamentals of reputation management for healthcare systems. Celine, welcome to the Core Exchange.

Celine:

Thank you.

Laila:

So for those who aren't familiar with you and your organization, could you tell us just a little bit about yourself and your background and a bit about Reputation?

Celine:

Absolutely. So, as you mentioned, I am the healthcare strategy and consulting manager here at Reputation. And what that means is I am responsible for supporting the healthcare vertical strategic initiatives. I also serve as a consulting partner to healthcare organizations to help develop consumer experience programs that deliver both on the goals, but also enhance the patient experience. Prior to my role at Reputation, this is a fun fact, I was actually on the provider side for about six and a half years as a client of Reputation. I built and I led the online reputation management team at one of the largest providers of hospital and healthcare services in the nation. While I was there, I wore a lot of hats during those six and a half years, so I partnered with key stakeholders across marketing, patient experience, quality, risk, you name it, to provide real-time service recovery. We launched review requesting. We drove process improvement through operational insights, and I worked very closely with the marketing teams to utilize that online sentiment data, to help guide their marketing initiative.

So I have done a lot of things in my prior role, but now with Reputation, we are the creator of the Reputation Experience Management category. So we're changing the way that healthcare organizations are gathering and acting on patient feedback, to drive that decision making and enhance the consumer experience programs that they have in place. So what I love about Reputation's Interaction-to-Action Platform is that it translates vast amounts of solicited and unsolicited feedback data into prescriptive, actionable insights that healthcare users can actually learn from, but also improve their operations. So in short, Reputation helps those healthcare brands manage their online presence, helps them learn from feedback and then use that feedback as fuel to grow their organizations.

Laila:

Wow. So I just love that you have this really rich background and your clients must just love it, because you know what it's like to have sat in that seat and-

Celine:

Oh absolutely.

Laila:

The complexity really of, it feels like it should be simple, or the requests come in from the physicians... I'll never forget when I was first sitting on the client side as well. And very early in my tenure got a request from a doctor, ''How do I get rid of that review?'' And I'm like, ''Oh my gosh.'' I know we'll talk about that in a minute, but I just... That's really great. And I know reputation management has emerged as a category, like you said, your organization has really led the way on this and it's become such a critical aspect of what healthcare marketers are focused on. Can you just, for those who maybe haven't really been exposed to a lot of the great resources that you all have put out into the marketplace, can you just talk a little bit about the basics of reputation management? What all does that involve? When we say reputation management, what are we really talking about?

Celine:

Yeah, that's a great question. I think that people automatically assume reputation management, ''Oh, it just has to do with your reputation.'' Your reviews is the first thing that comes to mind. However, that expands way beyond just our third-party review. So for example, are we getting found online? Are we showing up in a local Google search? Are we ranking the top three? And a lot of that is fueled by the work that we do with review management, ensuring that our listings are accurate with accurate data. There's so many times where we go to search for healthcare services and hours aren't updated, or an address isn't updated, or we're not sure what type of services that organization even provides. So something is granular that I think people might overlook, unfortunately, is just making sure that you're even getting found.

And then furthermore, the review management piece, really the reputation piece. A lot of times when we work with larger systems, and this was in my prior role, we knew that we were providing great care to our patients, our patients were telling us all the time through our letters, contact us forms, all of these great resources. However, when we went on Google or any search engine or any social media site, that reputation was not being reflected in those avenues of how our patients are choosing their care. And that was a really big gap. It was an area of friction for us. So we said, ''How can we make sure that our reputation is reflective of the care?'' And I know we're going to get into that in the different methodologies and initiatives that you can have in place for your organization to make sure that happens.

But then the last piece of that too, is okay, you're getting found, you're getting great reviews. However, are we leveraging all of this chatter in the universe, this feedback in the wild, are we leveraging that to really implement effective change in our organizations? And maybe that's positive, maybe it's leveraging the positive more, but are we using what people are saying? And listening to that, not just providing that lip service of a review response, but are we really listening and changing? So I know that's a lot, but I always think about it in getting found, making sure that we get chosen and then we get better.

Laila:

That's fantastic. And what I love too about that is that it doesn't just touch the surface. It gets at the root of why this is such an important piece of the puzzle for healthcare marketing. And it's becoming just more and more important. We know that... I don't even know, I'm sure you have the number in your head of the number of Google searches for healthcare related questions that happen on a daily basis, it's in the billions for sure. And this really is becoming a huge part of how people are making their decisions. And so I think for healthcare marketers, they know it's important, but how can they really convince their leadership and their providers to switch gears from just reacting to these situations where it's a review, ''Oh my gosh, what are we going to do,'' to making it proactive, an actual management function where we're saying, ''We can be in charge of this as opposed to a victim of it.'' So how do they go about that? How do they get that support?

Celine:

That is the golden question, especially in healthcare, because we've always traditionally as an industry been a little bit behind when it comes to innovation, or how we approach our digital campaigns, or efforts I should say. So a lot of times, like you said, we react more than we are being proactive. However, the past couple of years, especially throughout the pandemic, we've noticed that we need to start mimicking these other industries, such as hospitality, such as retail. So our patients, they're expecting, or our consumers, they're expecting this retail-like experience. They're no longer having that brand loyalty per se, but more say they're shopping for healthcare, just like the way that we shop for a pair of shoes. So in order to get that buy-in from the larger group, especially our leadership, our C-suite, and not just our marketers, to your point, who already understand the importance, is really showcasing that we are losing our consumers if we are not showing up in the way that they want to digest that information.

So for example, it's very traditional, we had billboards that when people were driving down the road, they looked at a billboard. Or we relied very heavily on feedback sources such as our CAHPS surveys. However, today, as we know, people aren't driving down the road, looking at a billboard and says, ''Hmm, next time I have a heart attack, maybe I should check out this local hospital for cardio services.'' No, they are looking for that care in that moment when they need those services, and that's happening on Google, we all know that. So if we're not there, it's a missed opportunity.

And then furthermore, using that and all of the, again, that chatter, that feedback in the wild, as low hanging fruit. There's so many times where we would, prior to building this reputation management program, and a lot of our clients are this way, they would see maybe one or two negative reviews, it would spiral, become this big PR issue. And they would react to it, rather than saying, ''Oof, maybe this is an opportunity to really address this, before it spirals into a bigger issue.'' And that's where we start to see that buy-in, is once you have that one really horrible experience, then all of a sudden leadership's like, ''Maybe we should listen to this a little bit more. Maybe this feedback is very valuable.''

Laila:

Yeah. That is really helpful. And I think our listeners are going to be able to use that as an example, maybe as they advocate for really making an investment in this. Because truly the time that gets spent chasing or trying to figure out how to respond, even internally, let alone externally, when these situations come up is it can be all-consuming. And there's so many other proactive volume building, reputation building activities that they could be doing if they could put a system in place to really deal with this. And as you said, yeah it starts on Google.

And it used to be, I think maybe even a few years ago, certainly pre-pandemic, that there was a lot of attention being paid to where do we show up in the rankings and thinking of search just as a locator, but now you cannot get that location without the associated reviews in your face. And so there is no escaping the importance of this. So let's start talking about those reviews. And particularly, you mentioned that bad review and you get it and the whole world feels like it's in crisis mode. Certainly not the kind of crisis that we've dealt with the past two years, but certainly for the provider involved, it becomes a really big issue. But also like you said, it starts to pique the interest of like, ''Oh, well how do we deal with this?'' So now what, you get a bad review, well, how do you manage that?

Celine:

I chuckled earlier when you said a lot of physicians or leadership, they're like, ''Oh, can you just delete the review?'' It's like, ''Don't you think all businesses and all hospitals and all physicians would have five stars, if you could delete a review?'' It's not a capability. And it's something that we constantly have to reiterate. We can flag or review if it violates guidelines. However, my biggest piece of feedback is that this is an opportunity for us to listen and get better. So instead of wanting to just shove it under the rug and not worry about it, what can we do with this to not only showcase to that specific consumer that, ''Hey, we are listening, we want to change this. We want to make it better.''. But also to all of those potential consumers that are looking at that review, seeing the negative comments and then seeing, ''Oh wow, this organization really cares about their feedback. It looks like they're actually listening. It looks like they care. '' So they're less likely to view that negative review with maybe as much weight as they would if we were quiet about that review.

Now, in terms of, how do we manage that and grow that at scale, that's where it becomes tricky. Because we all say it, we have very limited bandwidth in healthcare. It's going to be a constant problem. So, who owns this initiative, I think is the question we get very often. Is it something that sits with the marketing department, because they naturally have more ownership over maybe SEO efforts, or your business listings, or your social media initiatives, et cetera. Or does this sit with patient experience, since they're already handling all of that feedback that you get? Or does it maybe sit with risk, because they're handling the grievances?

So I think the first step is really determining that ownership. And it doesn't mean that one group has to own that solely. It can be a collaboration. So for example, in my previous role, I sat within a marketing and advertising agency and built the ORM team, however, I worked very closely with patient experience and risk and we handled in tandem. We would handle every piece of feedback together. We considered every feedback to be a grievance, so that would then go into our risk system, but then patient experience would be the ones to close that loop on the service recovery. So really determine that ownership. Create that workflow. I think that's something that's probably the hardest, is to say, ''Okay, every time a review comes in, how quickly do we want to respond to that review?'' We set a standard of 24 hours, because we wanted to make sure that we were well within that grievance timeline, but that might change depending on your organization and your needs and your goals.

But then also once you figure all that out, what do you say in your review responses? I always joke, there's so many times that I wish I could be Wendy's on Twitter, the way that they respond to all of the chatter, but we know, you know, that we can't respond that way in healthcare unfortunately. Because we want to be respectful and sensitive to HIPAA, PHI, et cetera. So making sure that our responses are compliant, but not robotic, that we're still a human that's behind the keyboard.

And then also, when to engage, when do you want to respond? When do you not want to respond? We wanted to respond to 100% of reviews. However, there's always going to be a handful that you don't want to engage with, for maybe a legal reason, maybe it's a troll, maybe it's an ongoing PR issue where we have a statement, but we don't want to publicly engage. So make sure there are those standards of these are the times when it's okay and it's appropriate, or these are the times where we need to escalate it before we decide to publicly put a comment out there. Because you and I know, things get screenshotted, it goes viral, and then all of a sudden it becomes a story, just out of something where we were trying to do something good, but it ended up not being great. So-

Laila:

And the pre-planning on this.

Celine:

There's a lot happening.

Laila:

Yeah, I think the pre-planning on this is also a real opportunity to really think through, maybe it's even a worst-case scenario and say, ''Well, who would get involved in that case? And let's get those folks all around the table and start talking this through.'' So that it isn't happening in real time where there are challenges or, ''Oh my gosh. I didn't even think about the fact that there might be a legal issue.'' So getting legal, getting service recovery, getting patient experience, getting risk, getting quality, where does it live in your organization? You really have to stop and think that through. And it's much better to do that before you're faced with an actual situation, so that you're not throwing everybody off of their game and diverting all of those resources to deal with this one issue. There's a system in place. There's a process. That's such great advice, such great advice.

Celine:

And that's a good point too Laila, is not just reacting to every review as they come, but being a little bit more prepared. There's so many scenarios, natural disasters or more unfortunate ones, where we have to plan ahead. And a lot of these require pre-approved statements from maybe public relations.

Laila:

Comms, yeah, the comms team.

Celine:

And if you can come up with a playbook ahead of time that says, ''Hey, these are the top 10 scenarios that hopefully, fingers crossed, they never happen, but these are top 10 scenarios that could happen and let's have pre-approved responses ready to go.'' So that if it happens, we can immediately respond, we are prepared and we're not waiting, going up the chain of command to figure out, ''Okay, can we use this or not?'' So it's also a way to really just be prepared for that crisis communication as well.

Laila:

Exactly. I think involving the comms team is really a critical piece of this and I just think so much pain could be potentially avoided. It's still not fun to deal with the bad review, but at least it's not that problem solving on the fly.

Celine:

Exactly.

Laila:

And worrying about, have you really thought that through? That's really great advice. So that's the bad review and we know that those are going to happen, and so we've talked a little bit about how to plan for that as opposed to just react to it. But on the flip side, I know I've heard you all present at several conferences and webinars and just, like I said, you all have great resources and great information that you share. And one of the things that I think is a new way of thinking about reviews is actually asking for positive reviews and using that.

Because one of the answers that we used to say is, that bad review, whether it's accurate or not, it's an opportunity, like you said, to listen. And we used to kid internally in the marketing team to say, ''Well, the way to get rid of the bad review is to have so many good reviews that the bad review really becomes an afterthought, or it drops out of sight and it's overwhelmed by the good reviews. So talk a little bit about that, because I know that's something that you all help with and really believe in, in terms of requesting those positive reviews.

Celine:

I could talk about this all day until I turn blue in my face. It's something that I get so passionate about, is review requesting or review solicitation. And admittedly, when I was on the provider side as a client, I was very hesitant, very skeptical of asking for reviews, because, again, I was, at the time, a one person team, I thought it was counterintuitive. Why would I ask for more reviews? I don't want to have this slew of negative feedback that's coming in. But as we stepped back, we noticed we were making huge budget decisions based off of one source of feedback, specifically CAHPS. And our completion rate for CAHPS is traditionally lower, when we look at our entire patient population. And because we were seeing that our online reputation was so poor, naturally it was, ''Okay, maybe we do need to ask for more feedback.''.

And we noticed, and this is across all of our clients, that when you ask the silent majority of people, the people that come in, they receive the care that they expected to receive, if you don't ask them to leave you feedback, they are not going to do it. But the people that had a negative experience, they're going to leave you a review, whether you ask for it or not. So we started this review requesting initiative, and it's what a lot of our clients do, is where they roll it out in phases. So it's not, let's throw spaghetti at the wall and see what sticks, we make sure that we're strategic with it and say, ''Okay, let's not boil the ocean. Let's maybe pick a service line, or maybe we pick a handful of physicians that are hand raisers, or maybe it's one rooftop location, or maybe one market, let's start with them and figure out, okay do we want to do this through email? Do we want to do this through SMS?'' Which naturally, SMS has a much higher completion rate, ''But let's start asking for feedback.''

And we tested all of these different theories of timing, making sure that we're not overserving, because we want to be very respectful of all of the different types of feedback that we're asking for and all these touch points. And once we start review requesting and we launch that and grow that at scale, it's phenomenal how much our review volume not only increased, but the positive sentiment increased and just exploded. And that's where you start to see your feedback be more statistically significant and more in line with the care that you know that you're providing, which then, we all love it, it then further fuels SEO. Then you rank higher, then you're more likely to get chosen. So in the end of the day, review requesting, it's not only about the feedback that you're garnering, but it's more about how you're now showing up in this plethora of options now with healthcare.

Laila:

And once you see the data, it just becomes like, ''Oh my gosh, of course we should do this.''

Celine:

It's a no-brainer, yeah.

Laila:

It's a no-brainer. It's like, ''Of course we should do this.'' And of course, if you're not providing great care, that's a whole... But typically, health systems are providing wonderful care for their patients. And you're exactly right. They may take the moment, while they're in the hospital or right after the hospital, to provide that feed... We know, I know, we used to distribute the positive comments to leadership to share with the teams, because it's so fulfilling to hear these wonderful comments. But again, that's part of the typical patient satisfaction type of surveying. It doesn't necessarily show up or translate. And that's why I think there's been this disconnect at leadership, because they know, they've seen the patient satisfaction surveys and the comments, but then they look at that and they don't want to believe it. It's because it's being left to chance, it's being left to those people who are so inspired and that tends to be those disgruntled folks.

So when you do that active, positive review request, you're just requesting reviews, but the positives will come out and a hundred percent, it really just benefits all the things, so that's fantastic. And again, great counsel. And I know Reputation has a study that they put out. We'll talk about that at the end and we'll point people to that. So people can really see that data and use it, again, as a proof point, if needed, to advocate for the support to really make these investments of time and energy and resources and support to get this work done. So the last question I have, I think, is how do you operationalize this? How do you make this now part of the day-to-day and not this one-off effort? How do you recommend that healthcare organizations go about doing this?

Celine:

That's the end goal, is now we have a great review management process in place or feedback management process in place, whether that's your first-party or your third-party reviews. And then you're now asking for all of this feedback, but now that you have it all, what do you do with all of that feedback? And the way that I like to look at that is three different buckets. So the first, and the one that I think we more traditionally think about, is patient experience, that operations bucket. So looking at this feedback, looking at the distribution between your positive, your negative, your neutral sentiments, and where that lies within different parts of your organization.

So at Reputation, we have an NLP and an AI, so artificial intelligence and natural language processor, that will take all of your comments and tag a bunch of different categories. So you can start looking and drilling down to, maybe it's a service line. Maybe you want to look at maternity and seeing what people are saying and what common themes are happening within your maternity service line. Or maybe you want to look at it high level. What markets within your organization are doing really well. Or are there poor performers? Or where can we maybe mimic some of the positive? So really taking a look at those themes, so that you can really identify your areas of opportunity and where you really need to make some changes.

We have some great case studies of healthcare organizations, both smaller and larger, that were able to holistically look at this feedback and immediately see, ''Okay, we have an issue with bedside manner.'' And clearly, bedside manner is translating to the way that our patients are experiencing their care. And we can really drill down and say, ''Okay, it's at this location, with this department, is where we're having bedside manner issues.'' And then when we work with that local organization, we determine, ''Oh, well we're having bedside manner issues, because the shift turnover is horrible.'' And that's turning to poor communication. And then it's just this spiral. So we're able to really identify where we need to make those changes.

Now, the second bucket, the one that I think people don't think about as often, but is something that I get really excited about, is marketing and communications. So it's not just the patient experience team that can glean from these insights, it's marketing as well. For example, if there's a really big initiative or a really big campaign that we're throwing a bunch of budget towards, let's say it's ER, you can use the reputation insights, or your reputation management insights, and see exactly, ''Okay, what's being said about ER, is it favorable? Is it not?'' And maybe, depending on those insights, you can make better decisions of how you want to move forward with that marketing campaign.

Maybe we notice, ''Okay, the service line's not really doing too hot. Maybe we don't want to spend all of this money touting this way. However, we notice that people love the staff in the ER. So maybe we want to focus on the staff and make them the focal point of this campaign so it resonates more.'' I think that's something that is very underutilized. It's something that I used at my previous organization where I could really say, ''Hey, use me as consult, anytime we're doing large marketing campaigns.'' And we really did. We were able to avoid some really big mishaps or have some campaigns just not be very well received, because we had these insights ahead of time.

And then the third one, and I'll keep this one more brief, is public relations. So how do we uncover issues? How do we make sure, to your point earlier, how are we being proactive rather than reactive? Anytime we have a large issue come up or something that goes viral, how can we get ahead of that? How can we make sure that we are really listening to what's going on in the online space. And that doesn't have to just be through reviews. Social listening is a really big part of that as well. Seeing what people are saying about your brand, but also about the industry. Especially today, there's a lot of chatter about healthcare.

Laila:

A hundred percent, there absolutely is. And that really ties in I think with the way we talk with our clients about not starting without listening first. And so thinking about this as a listening opportunity I think is another, like you said, underutilized and great opportunity for marketing teams to hear, without necessarily additional investment. There's always other ways obviously, to go out and listen to consumers and to patients and various perspectives, but it's all right there for the taking. There's all this information. And thinking about how to analyze that and feed that back to the things that people are bothering to take a minute to talk about, that's a piece of insight I think that could be really beneficial, so that's great. Thanks Celine. So is there anything else that you'd like us to share with our listeners today? Anything else that you can think of that is really important, as they're considering reputation management for their organization?

Celine:

I think we went over a lot of information. It can be very, very daunting. And knowing from firsthand experience that it's not as scary as people make it out to be sometimes. And really just think about the basics. What are your goals? What are your objectives? Where do you have the bandwidth to allocate some resources to this? And start small, you don't have to go at it full force, you don't have to tackle everything at once, it can be a phased approach. And then celebrate those small wins. And then every milestone you achieve. That's where you can grow your program at scale. And then there's always people like myself at organizations, that are excited and happy to help and consult on some of these and answer some of these questions.

Laila:

Well, that's fantastic. And I do urge all of our listeners to check out reputation.com. And there's all sorts of great information there. And you can reach Celine, I'm sure there's a way to find you on that website as well.

Celine:

Absolutely.

Laila:

Yep. So thank you so much again for joining us and for sharing your insights and your experience with us. It's been a great conversation.

Celine:

Thank you so much for having me Laila. It's been great.

Laila:

Yes! So a reminder to our listeners to please subscribe to the Core Exchange on Apple Podcasts and sign up for our newsletter at corecreative.health.