Question: Health system communications have had to pivot numerous times during recent months. How have the needs of organizations you work with changed over the course of the pandemic?
Dan Miers: Early in March, our clients started to get a sense that something big was about to happen, but they were unsure what to do and in what order. Our team created a five-step strategic framework based on an epidemiological curve to map out how communications would need to change across time:
- In the beginning, the message was "we're prepared and we'll work together to defeat this unknown threat." At that point, the virus wasn't in most of our clients' markets.
- When the virus started to appear, the message shifted to "we're responding." Communications shifted to tales of heroism among frontline staff and to stories of real-time inventiveness used to get PPE and other necessary supplies.
- As markets reached their peak, the conversation shifted to resilience and a message that "we are being pushed to our limit, but we are winning and if you need to see us, we are open and you can get to us." Our clients highlighted how they were meeting the needs of the community despite being stretched on an inpatient basis.
- Now, as we get past the peak in many of our markets, the conversation turns to safety and how you can trust providers to come back for care. Messages outline the steps taken to protect people and reduce risk of exposure to the virus.
- Finally, we're beginning to outline the next phase where the pandemic is a near constant backdrop. The stories we prepared before the pandemic will need to change given sensitivities that remain post-Covid.
Q: When did you recommend to your clients that they pivot their communications to the next phase in messaging?
Miers: The clients actually dictated the pace. They came to us and said, "We think we have the next 48 hours covered, but we need you to cover the next 2-6 weeks." We developed the safety message as they put out the resilience message in the market that we developed two weeks prior. We would load up the messages and creative artillery, and they as an organization would pull the trigger when they thought it was right, based on observations on the ground.
Q: In the peak phase, the main message was one of resilience, but also about trying to reach people with care disruptions and reassure them that they can still get essential care. That seems like a hard balance to strike. Do you feel most organizations were successful?
Miers: Those that stood up a telehealth platform and were aggressive about getting people onto the platform found that consumer willingness to use telehealth was very good. One thing that was thrust upon us was competitors—outpatient centers and specialized hospitals—pushing the envelope with a message that said, "we're open and we don't have Covid patients." Our clients needed some help combatting that by getting out their own message that they were still open as well.
Q: Do you see a lot of variability among your clients in their ability to recover volumes?
Miers: We think that in more densely populated urban centers, the fear of coming back is higher. We worked with one large urban health system in the South that had experience treating Ebola patients. At the time, people did not want to come to the health system because Ebola patients were there. They had to work hard to get the "here's how we are protecting you" message out. With Covid-19, they were proactive about dedicating a hospital to treat Covid-19 patients and communicating that the health system will only take care of Covid-19 patients in those designated facilities. The system got ahead of that message to try and reduce the fear, but the amount of cases was very high in the area, so there was still a struggle.
Another client in the Midwest is located in a less densely populated area where the number of cases was never very high. The client never felt a capacity challenge and was aggressive about treating patients who tested positive remotely through telehealth. This client has seen a very rapid return to volumes, because very few in the area know anyone who got the disease. In areas where people know others who have been to the hospital or clinic with the disease, there is more of a hesitancy to return. In our consumer sentiment and social listening work, we hear rural markets say, "What is all the fuss about, can we get on with things?" We're seeing that the willingness to return will be linearly coordinated with how overrun the population was with the disease.
Q: How do you expect that communications will need to change as Covid-19 becomes a persistent backdrop in our lives?
Miers: I think of three different versions of communications. First, hospitals have to tell people how they will manage Covid-19 on a day-to-day basis—how they're changing waiting rooms, appointment registration, and care processes. This makes me think about post 9/11. Within a fairly short period of time, we had to take off our shoes, put liquids in bags, and stand in a scanner. This was a huge disruption at first, but then people got used to it. Now that system has evolved to have TSA pre-check to make the process less burdensome.
Similarly, for a short period of time, we will have to communicate with people about process of care changes. Then, changes will be part of our normal routine and alternatives like telehealth will make the process less burdensome. We'll have to teach people how to go through these new processes at first, but then get on with it, and focus messages on the importance of your health and the importance of seeking care.
Second, hospitals should prepare their communities for the possibility of disease flare-ups. Hospitals need to communicate how they are prepared if there is a second wave in the fall.
The third version relates to the scientific uncertainty of how the virus works. How does it impact treatment? Does it become a complicated addition to someone's primary diagnosis? How do you use your expertise in science and best practices and multidisciplinary teams as a way to tell people that you are adjusting your care strategy for these patients? It is part of this conversation around how you're using your brand to demonstrate that you deserve the trust people have given you right now.
Q: Now that some organizations have new brand capital, what kinds of opportunities does that open for health systems?
Miers: Prior to this crisis, health systems were getting slaughtered in the news. Prices are too high, they were being forced to put charges online, disclose negotiated rates, etc. Health systems were seen as predatory and taking advantage of people. Then Covid-19 happened. From a consumer research standpoint, we're seeing that confidence in health systems and frontline workers is now high. This confidence is an opportunity to take ownership of the conversation, and not let the problems from before come back.
Health systems should be using this capital, not just to say it is safe to come in, but also to talk about other issues such as value and affordability. Right now, people are worried about the virus, but changes in employment and insurance status are going to bring the question of affordability right back to the forefront. Health systems can get ahead of that. That's just one example of how this crisis could provide an opportunity to lead in the conversation instead of reacting to it.
Q: What additional trends do you see unfolding that will influence communications strategy?
Miers: There are a few other areas I'm watching. First, organizations are talking more competitively than they have in a long time. Competition drives progress in many ways so I think this is good, but if organizations don't move smartly around regaining confidence and trust in their community, they will lose ground.
Second, we are closely watching the impact of Covid-19 on independent organizations and consolidation in the market. Some might decide that they can't weather a storm like this again.
Third, this is a great time for disruptive competitors such as concierge medicine practices to say, "We will come to your house and do everything, or talk virtually, and you will never have to go to a hospital again."
Fourth, I see an opportunity to highlight the value of the patient experience and to customize the patient's experience to what makes them feel comfortable. This will be an intriguing opportunity for health systems to communicate about innovations beyond science.
Finally, we're watching the flexibility and speed of media strategies. Organizations will need a campaign for the next eight weeks and then will need a new one after that. At the end of the day, the ultimate organizational trait is the ability to be strategically flexible, nimble, and quick.
SPM is a member of the Health Care Industry Committee. We thank them for advising our work.
How to communicate with patients amid Covid-19
Consumers are eager for credible information about Covid-19, when and how to seek various types of health care services, and what to expect if they do require in-person care.
The attached guide includes details to consider when crafting messages for consumers, example communications from health care providers and companies in other industries, and insight into what makes a message effective.