Category Archives: marketing

Population Health: The “Make or Break” Behavior Change Promise

A key promise of the population health phenomenon, so important to payors, providers, and suppliers is this: We need the public to get healthier. That requires participation. If payors pay, people will take advantage of free preventive services to get healthy.

Here’s how the Kaiser Family Foundation put it in their recent Health Reform overview (see bold): A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective. However, costs do prevent some individuals from obtaining preventive services. The coverage requirement aims to remove cost barriers.

The reality is that while cost is a barrier for some people, it’s not the only barrier. It may not even be the main barrier. Now you might be thinking, if preventive services have been proven to improve health and save lives, why would people NOT make use of them, especially when they’re free? What other barriers might there be?

In my two decades of experience working with CDC, CMS, FDA, and many public health efforts, behavior change is the holy grail. And maybe the hardest to achieve. The main barrier I believe is not money, but motivation. People will find all kinds of reasons (beyond costs) to NOT sign up for free preventive services, including: 1) I’m not sick, 2) I don’t need whatever those services are, 3) I’ll do it later.

Prevention has alway been a tough sell. The fundamental benefit promised is that something bad (illness) will not happen down the road. Many people don’t see that as compelling or personal relevant in a life with so many demands in the here and now.

The solution requires: 1) increasing immediate personal relevance, 2) making it simple to do. As my friend and colleague Peter Mitchell, head of Salter Mitchell’s MarketingForChange practice, says, make it fun, easy, and popular. Building on that, I like the FEFE acronym- Fun, Easy, Fast, Effective.

Research trends in the science of persuasion, behavioral economics and decision-making, social psychology, and marketing science, provide convergent evidence that motivating health behavior change and utilization of preventive services is no simple task, and requires far more than data, information, and logic.

Bottom line, population health players need to employ multiple approaches to motivate behavior change, and to not assume that a logical (and free) offer will do the job.

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FYI, here are a few more resources on motivating health behavior change:

Motivating Health Behavior Change: Three Dangerous Assumptions to Avoid

Getting People to Do What You Want: Two Paths to Persuasion

Ability-Motivation-Opportunity: Marketing’s Winning Trifecta

Behavior Change: It’s NOT Just the Person!

 

Great Technology, Or Are You Drinking Your Own Koolaid?

kool-aidSandy, a senior marketing manager at a med device company recently confided: “We’re so convinced our new technology platform is the greatest thing since sliced bread. It’s like we’re drinking our own Koolaid!” She was greatly concerned that her team had lost perspective and any sense of objectivity. They had become so enamored of their platform that they were no longer thinking of what customers might want or value. Were they building something that no one would want, use or buy?

I’ve heard this same concern from savvy marketing and product managers at health insurance companies, health IT companies, and health innovation labs. It’s what happens when people, however well-meaning, spend years developing a product, program, or idea,  and become so immersed in what they’re building, that they lose sight of its appeal and value to customers. They’re so close to the product or service that they can’t even see the question. They’re drunk, on their own Koolaid.

If this sounds like your team or company… well, from one perspective, it’s not your fault. It’s human nature to believe deeply in what you make or market. Why wouldn’t you? It can actually be unifying and inspiring to drink your own Koolaid!

On the other hand, drinking your own Koolaid can be deceiving. You start believing your own “propaganda” without healthy questioning. The resultant deception can blind you to disparities between how you want things to be and how things are, to differences between your company’s desires and the market reality.

Bottom line, it is your team’s responsibility to raise your heads and verify your assumptions, check out how customers think and feel about the benefits your product promises, and assess its usability. Inevitably, your solution has morphed over time, and what it is now may or may not meet market needs. In short, you need to be sure you’re still solving a meaningful problem and developing a unique solution customers will use and pay for.

Can you stop drinking your own Koolaid? It takes courage because you have a lot of sunk costs – and not just money, but effort and professional reputation as well. But as any investor knows, sunk costs alone do not justify spending more time and money. That’s called a money pit. It takes strength too, because once you have momentum in a certain direction, it’s tough to put on the brakes, or even pivot. But again, going further in the wrong direction helps no one.

So, set egos aside, ask the tough questions, get customer feedback, and make smart decisions. And quit drinking your own Koolaid!

Does Your Company Win at Caring? Take the “Who Cares” Quiz

who_cares“People want to know how much you care before they care how much you know.”

You work in the healthcare space. Whether you’re a product manager, a marketing specialist, a software engineer, or an executive, you are in an industry that exists to provide care. It’s not just evident in the industry name (healthcare), it’s the core purpose of the industry.

If any industry should be able to live up to the axiom above*, it’s healthcare.  And by caring first, business improves.

How does your company rate at first showing you care, and reaping the rewards? Take this quick quiz to find out. Give your company, then yourself, an honest rating. (Scale: 0= Not at all, 1=A little, 2=Somewhat,  3=A great deal)

The Official “Who Cares” Quiz

COMPANY QUESTIONS

  1. My company genuinely cares about the well-being of our customers.
  2. My company demonstrates caring, before showing how much we know.
  3. My company is aware of customer perceptions about our caring.
  4. My company gets better results because of how we care.

“YOU” QUESTIONS

  1. I genuinely care about the well-being of our customers.
  2. I demonstrate caring, before showing how much I know.
  3. I am aware of customer perceptions about our caring.
  4. I get better results because of how I care.

Scores: Add up your scores on each set of four questions. This will give you a company score between 0 and 12, and a personal score between 0 and 12.

Making Sense of Your Score

The four questions represent a sequence – feeling, doing, knowing, and winning.

Question 1 is about what you feel toward customers; how much you care about their well-being (not just their money!). If you fall short here (a score of 1 or 2), the remedy is culture change so you become more customer-centric and less product-centric. That’s a big job.

Question 2 is about what you do; the extent to which you communicate that caring first. A low score here means your actions do not match your intent. Fixing this requires improved and more strategic communications and organizational behavior change to support right action.

Question 3 is about what you know (rather than assume) about how much customers perceive your caring. This requires customer research to meaningfully score. A low score means your actions are not being recognized. The solution is better understanding customers and what actions they perceive as caring.

Question 4 is about what you win as a result of your caring. This refers to achieving revenue and other business objectives. A low score here means you’re falling short on one or more of the three other metrics, or you’re not leveraging your caring into other business outcomes. The fix is developing specific strategies to translate your caring into better products, improved experiences, and more effective marketing.

Conclusion

If your company scored at least 3 on each question, you’re in decent shape. However, for many med tech companies, and health care payers and providers, that’s not the case. When companies lose sight of their core purpose and instead focus solely on hitting their numbers, caring about customers gets squeezed out of the picture. The same holds true about your personal scores.

If your scores were low, consider the fixes described above. Ideally, your relationship-building, the customer experiences you create, your marketing campaigns, and your on-the ground sales reps should consistently emphasize caring – before knowledge. That way, you get “on purpose” and generate lasting emotional connections with customers that can translate into long-term loyalty and increased sales.

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* This popular axiom from James Hind was cited in a post by Jim Guiffre, reminiscing how dear colleague and friend Gene Drabinski, who recently died in a tragic car accident, didn’t just frequently share this quote, but fully lived it. Gene was a nurse, Vietnam vet, and former president of Healthwise; and a good, good man that freely showed how much he cared. More reminisces about Gene  here.

Better Med Tech Marketing Campaigns: The “Donald Trump” Lesson

MTMUnlike the most controversial presidential hopeful Donald Trump, med tech marketing campaigns often shy away from saying what they really mean. Call it political correctness, fear of failure, legal restrictions, or CYA. But regardless of what is driving the ambiguity, the result is watered down messages and poorer results. Say what you believe as explicitly as you can – at least in your brainstorming and creative strategy development. Then (also unlike Donald!) tame it in your message execution if you have to.

In the 1990 movie Crazy People, Dudley Moore was an advertising exec turned mental patient who got his fellow patients to create wildly successful campaigns. Their gift was honesty – unvarnished, blunt, explicit honesty. For example, their Jaguar car campaign targeting men showed a scantily clad woman next to a shiny new Jag with the line “Buy a Jaguar. Get Laid.” Now most of us may not be able to get away with that degree of explicitness in our ads, but we can in our creative thinking.

I recently saw a billboard for a mortgage firm that boldly proclaimed “your loan sucks.” Which is more typically the unspoken claim. As always with bold messaging, you need to weigh the attention-getting effect against the turn-off effect.  Check out our “Think/Feel/Do” messaging framework here, for more guidance.

So, in extremely plain language, answer this: What is it that are you not saying, but you want customers to think? Then do your customer messaging research to see just how explicit you can be, while improving your reputation and increasing sales.

Med Tech Marketing: From TMI to JEI

“Wait until you hear about our amazing new technology!” the CEO exclaimed to a group of potential hospital executives. With great enthusiasm he spewed out more jargon-laden technical details than anyone cared to hear. Deep inside, the CEO sadly wondered why his audience is less than totally entranced.TMI

This unfortunately happens a lot. Really smart people make this mistake. Why? They let their passion blind them. They get carried away with their own stuff, lose sight of the customer perspective, and give way too much information (TMI). And they somehow convince themselves that their audience needs to know all about the technology in order to appreciate it.

Maybe it’s the CEO of a biotech start-up who spent years developing her ideas and designing prototypes. She really truly believes her technology is super-amazing. And maybe it is. Or perhaps it’s the product manager enamored of all the specs and product requirements his engineers are diligently working on to bring their next gen device to life. Or it may be the marketing person who is expected to give customers ALL the data her team thinks is important.

Note that the issue is NOT whether your technology or device or software really is amazing. It doesn’t matter. What does matter is that your customers care about your product. That requires you to give them just enough information (JEI) so they know what it is they are caring about and why. Remember JEI: Just Enough Information.

One challenge in shifting from TMI to JEI is what Noble Prize-winning economist Daniel Kahneman calls the “illusion of validity.” That is, when people hold onto their judgment even in the face of contradictory evidence.

How does this play out? Let’s say you’re pitching your product and go overboard with TMI. You know customers and investors are tuning out. You’ll come up with all kinds of reasons why that happened. But they won’t include TMI. You’ll manage to “protect” your belief that others need to know all about the technology.

It’s not logical. Somewhere inside you, you know better. But it’s a tough to surrender that yearning to tell the world all about the technology you care so deeply about and know so well.

The good news is you can redirect that passion into more productive marketing that meets your customers where they are at. And you don’t have to let go of your tech patter forever. There is a time and place for the technical details, the facts and figures, the product specs, and the empirical evidence. But it’s not first. And it’s not all at once.

First is enabling customers to make an emotional connection – not with your technology, but with the problem you’re solving. To do that, tell people what inspired you or your company to build the new technology. Talk about what problem you saw and why it was not acceptable. Only after people connect with the unacceptability of the problem, will they appreciate the need for a solution, and then eventually for your solution.

In short, to avoid TMI and embrace JEI, start by being human.

Better ROI from Your Marketing Research Investments: The Deep-Wide-Long Approach

Med device and health IT companies are constantly investing in new ideas, hoping to discover and bring to market the next game-changing product or service. That requires lots of market intelligence and customer research to get it right and avoid relying on risky guesswork and hunches.

A problem we see, especially with the larger companies that sell hundreds of products into numerous care areas in hospitals, is fragmentation. Even within a care unit, many research projects involving the same target audience and addressing similar needs are not coordinated and not taking advantage of cross-investigation.

For example, a company offering a range of cardiology products may have one business unit doing discovery research for new product ideas for stents and catheters, another BU validating value propositions for their special ECG monitor, and yet another BU getting reactions to messaging for a groundbreaking ultrasound device. Or all three BUs may be simultaneously doing research to answer the same business question, e.g. how to position their particular line of new cardiology products for launch. In either case, it’s likely – unfortunately – that none of the BUs are talking to one another.

The good news is that there are good strategic opportunities for collaboration that would benefit all the BUs, the company, and the customers they serve. Here is a framework we developed to help med tech companies leverage their investment in any and every customer research project for a better ROI. We call it Deep-Wide-Long.

Typically, a customer research project will go deep on the main topic, whether it’s understanding a specific set of problems customers are facing, getting reactions to new product concepts, or shaping marketing messages. With careful planning, the project can also go wide by investigating adjacent areas. And it can go long, by strategically reinforcing within the company the benefit of taking a customer-centric approach to product innovation and marketing. The incremental cost of doing so is small compared to the knowledge gain and its value.

For example, if we’re interviewing cardiologists to mainly gain insights into what they want ultrasound devices to do for them (deep), we can secondarily allow time to also investigate their use of ECG monitors as well as their reactions to new ideas for device integration (wide). Plus we can engage the other relevant BUs to understand their information needs as we shape the project, and then facilitate integration of the results across BUs (long).

The bottom line of Deep-Wide-Long is improving the bottom line by getting as much mileage as possible from every marketing research project, in a way that strengthens the company’s commitment to put the customer first.

Motivating Health Behavior Change: Three Dangerous Assumptions To Avoid

Behavior change is becoming more and more important to device manufacturers, health IT companies, pharma, and life science firms, as they expand their offerings into disease prevention. Whether aiming to get people to eat healthier, exercise more, participate in screenings, take meds as prescribed, monitor insulin levels, or conduct self-exams, successfully motivating behavior change isn’t easy.

The good news is that health behavior change has been a major focus in public health for decades, and there are a lot of lessons that health care businesses can apply.

One key lesson is recognizing and correcting the fundamental assumptions that derail most efforts to motivate health behavior change. Here are three of the most pervasive and insidious assumptions.

  1. Assuming people don’t know better: Many companies wrongly assume that the barrier to behavior change is lack of awareness. Therefore the thinking goes, if we just give people logical reasons for why people should change their behaviors, they will see the light and mend their ways. Typically these logical reasons center on reducing risks of morbidity and mortality (does that sound exciting or what!?). The reality is that more often than not, people are already well aware that certain behaviors are bad for them. Ask any smoker or obese person; they recognize their habits are harmful, and they know they should quit smoking or cut calories. Lack of awareness is usually not the problem. Therefore, behavior change campaigns aimed at increasing awareness will always fall short.
  1. Assuming people behave as they believe: Consider your own life. Do your actions consistently reflect your beliefs about what is and is not healthy? Or is there a disconnect? I gave a guest lecture today to a great group of grad students studying public health communication. To make the point that people’s behaviors don’t always match their beliefs – what psychologists call cognitive dissonance – I asked how many regularly sleep 8 hours a night, eat nutritiously, and exercise vigorously. Only a handful of the students raised their hands. While they all believe they should get good sleep, eat well, and work out, very few behave that way. (And these are young people making health promotion/disease prevention their profession. They really know this stuff!). Human nature is such that we don’t always do what we know we should do. We unfortunately have the ability to sustain high levels of belief-behavior inconsistency. Campaigns that are predicated on the idea that people’s health behaviors will align with their beliefs about health usually fail.
  1. Assuming big negatives trump little positives: It seems so obvious. If you sell CPAP devices, you may think: How can people possibly not use their CPAP machine?  They could stop breathing and die in the middle of the night! Similarly, if you work for an insurance company or hospital, you may think: How can people at high risk of heart disease possibly not choose low fat, low salt foods? They could die of a heart attack! Same with medication adherence. Same with breast self-exams. Clearly, stopping breathing or having a heart attack are big negatives. But they are only possibilities. The comfort of sleeping without a face mask and loud machine is a definite. A small positive but a definite one. Likewise, the definite pleasure of a rich dessert can eclipse the possibility of a heart attack. Never underestimate the allure of immediate pleasures.

All these mistaken assumptions are rooted in what I call “us” centered thinking. The solution is to adopt “them” centered thinking. Put your customers in the middle, not yourself. That’s the first step toward successfully motivating health behavior.

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More resources on health behavior change here:

Getting People to Do What You Want: Two Paths to Persuasion

Be Like Vegas!… and 6 Other Tips to Increase Wellness Program Participation

 

Earning Real Customer Loyalty: The Challenge for Med Tech Companies

When it comes to customer loyalty toward med tech companies, the most common story we hear from hospitals and clinicians goes like this:

“The sales reps give us a lot of attention when they want to sell us something. Once we buy, we rarely hear from them or their company. All they care about is making the sale. There is no relationship or partnership. All they are to us is another vendor.”

Turns out that for most med tech manufacturers, their healthcare customers either feel no loyalty, or place their loyalty with the rep. While hospitals and clinicians may have a brand preference, it is quite rare that they feel strong loyalty toward a manufacturer. In fact, surprisingly often, clinicians don’t remember the brand of the devices they use, even those they use day-in and day-out.

What’s causing this absence of loyalty to the companies that make and sell important and often life-saving equipment? I believe there are two factors at play.

  • The business model of many med tech companies puts short-terms sales over long-term relationships. Hitting quarterly numbers (even if it means greatly discounting prices) trumps maximizing the lifetime value for a customer. As a result, downstream marketing does not invest in sustaining long-term customer relationships. That clearly hurts customer loyalty.
  • Many med tech companies still think they’re in the business of selling boxes or software. Really, they’re in the business of improving healthcare. But when their focus is so product-centric, it’s hard to see the need to invest in building strong relationships. This sets up a dynamic in which customers choose between product A or B. The promise of partnering to help hospitals and clinicians provide better care over the long-term isn’t even on the table. This too takes away the opportunity to create customer loyalty.

That said, some reps are so good that they overcome these obstacles and are able to engender extremely strong loyalty from their customers, like in these two stories:

“It was almost midnight and we suddenly had a serious malfunction with our new ventilators. We called Sandy, the manufacturer’s rep, who happened to be 8 months pregnant. She immediately came by and with profuse apologies got us up and running. Then she came back the next day and provided a more permanent fix. When we need new vents, we buy from Sandy. Doesn’t matter what company she’s with. We trust her and whatever she recommends for us.”

“Dan advised us not to buy his company’s newest monitors yet. He said they were still working out some connectivity kinks and to wait until next year. He recommended we buy from his competitor if we really needed new monitors right away. That was a huge trust-builder. We’ll stick with Dan forever!”

These are true examples and the kind of thing we hear occasionally from clinicians when we’re doing research for our med device clients about how to generate customer loyalty. These reps are like gold and should be valued as such. You want these reps to stay committed to your company.

However, to get healthcare customers to be loyal not just to your reps but to your company is a big lift. It requires a long-term investment in what we call customer intimacy. It also requires a different business model and compensation structure. And it requires a cohesive strategy for prioritizing what customers want and need over what your solutions and technologies can do. Finally, it requires you to convincingly demonstrate to your customers how committing to buying from you over the long-term (i.e. loyalty) will measurably improve their situation.

In the always-changing healthcare space, I believe that the few med tech companies courageous and committed enough to fulfill these challenging requirements will be the big winners.

Overcoming the CEO Attitude: “We’re So Good We Don’t Need Marketing!”

I was talking with a friend recently who heads up business development for a small technology development company that specializes in solving really complex engineering problems.

She faces a big and not uncommon challenge: Her leadership team has the unfortunate belief that a) because the company’s problem solving skills are so unique, and b) because they’re so good within their specialization, they don’t need to invest in marketing. By extension, the supposition is that customers must inherently understand what the company does and know why they’re the right choice. Therefore, the logic goes, the company doesn’t need to work on their marketing strategy, or brand positioning, or what their value proposition is. (Feedback to the contrary and underwhelming sale figures be damned!).

From an inside-in perspective– that is, how people within the company think about the company– the reasoning is understandable. From an outside-in or customer perspective, it is clearly and dangerously flawed thinking.

What to do about it?

First, let’s dive into the underlying dynamic. We all know there’s often conflict between engineers and marketers at technology companies. Engineers want to push the limits of that can be done with technology, while marketers want to focus on what customers want and will buy. When well-managed, the tension between these two equally important and valid perspectives can be productive and lead to significant and highly desired innovation.

But when a technology-centric mindset invades how company leaders think and how business development happens, it becomes a big problem. When this occurs, company culture evolves within an often unspoken and rather insidious “if we build it, they will come” philosophy. This myopic perspective leads CEOs to denounce the need for marketing, or for that matter to reject investing anything to understand what customers think and want.

There are three likely outcomes in this kind of scenario when management puts technology ahead of customers: 1) The company keeps doing what they’re doing and may show incremental growth (usually in fits and starts), but clearly fails to meet expectations, 2) The company stagnates and dies without ever getting to root cause, 3) The company suffers from underperformance until investors or other power brokers demand new leadership and a more customer-centric mindset takes hold.

The other and much less likely outcome is for the company to get lucky, hit a home run with a new technology, and win success in spite of themselves. This fairy tale ending happens just enough, and is so seductive, that it can sustain a CEO’s self-deception that the company does not need to put customers first and does not need real marketing strategy. It’s kind of like the allure of slot machines – maybe the next pull will hit the jackpot!

The good news is that there is a way (besides deep pain!) to overcome a CEO’s dismissal of marketing as an unnecessary investment and the corresponding presumption (i.e. hope) that customers will just “get it.”

It stems from an often overlooked common ground: Both engineers and marketers fundamentally believe that with the right tools, any problem can be solved. The key is to leverage this powerful and shared worldview. This can be accomplished in several ways that I’ll cover in detail in a future post. One of the most compelling is to set up experiments in which management a) hypothesizes what customers know, and b) commits to taking corrective action if their hypotheses are proven wrong. Then you do the customer research to confirm or correct the hypotheses and bring the results back to the team. This approach seems to bypass egos and importantly, reframes the problem in a way that better matches the CEO’s more technical mindset.

Tell us. How have you seen the problem of company leadership denying the need for customer-centered marketing strategy successfully overcome?

How to Unseat the Market Leader: Hit the Right Emotional Chord with Customers

Here’s a tough situation med tech and health IT companies face in healthcare: The maker of a particular technology has more than 75% market share; they are the undisputed market leader.  unseat_pull_the_rug_from_underWhen their device or software was introduced 5 years ago, it was groundbreaking. Now, it’s the standard. But you have something better.

How do you effectively disrupt the market leader’s longstanding domination and win significant market share? The answer lies in the hearts and minds of the clinicians using the technology. You need to carefully and precisely determine which emotional chord will open customers’ minds in order for them to consider moving from the market leader’s technology (the “status quo”) to your new and presumably better innovation.

To reveal the right emotional chord, you must ask the right questions: Are they happy with the status quo? Do they perceive any problems? Can they envision a better state?  These kinds of questions will reveal the “set point,” i.e. where customers are before they know about your better device, service, or software.

In simple terms, there are four main set points based on the idea that customers are either satisfied or dissatisfied with the status quo technology, and they are or are not aware of a possible solution (or better state) a new technology might deliver. Once you know the set point, you need to identify the corresponding emotional chord, so that your messages will connect with customers and resonate at an emotional level. That resonance leads customers to feel understood, which will then open their minds to consider alternatives to the longstanding status quo.

Example: Let’s say customers are satisfied with the market leader’s status quo technology. They aren’t aware of any problems, so they certainly wouldn’t expect new solutions. Your job then is to identify the meaningful problem that: a) your customers will care about once they know about it, and b) your improved technology will solve. (And if no meaningful problem exists, then there’s really no need for your improvement, right? But that’s a different story!).

Once you determine the meaningful problem, be sure to verify customers do care about it enough to take action. Now you need to find the corresponding emotional chord. It could be frustration, as in “why didn’t I know about this problem for all these years!” Or it might be concern, as in “I hope this problem didn’t hurt our patient satisfaction scores!” Or embarrassment at not knowing about the problem. Or relief at knowing about it now. Or hope for a solution to the problem.

There are numerous possible emotional chords, and sometimes the difference between them is very nuanced, like frustration vs. concern in the example above. It’s really important to know with confidence precisely which emotional chord to tap into. Your message to tap into frustration will be quite different than messaging for concern or embarrassment or relief.

If you miss the mark on the emotional chord, then your customers will feel you just don’t get them. You will have missed your chance to open their minds to letting to of the market leader’s technology and to consider your innovation as a viable alternative. On the other hand, when you tap the right emotional chord, you may hear as we have, “Finally, someone understands what I deal with everyday!”  That deep connection is the magic that can unseat the dominant market leader and win you significant market share.

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More resources:

Why Selling New Technology into Hospitals is Hard: Overcoming the Status Quo Bias

The Emotional Hook: How to Win Your Customers’ Hearts