Customer Advisory GroupsAnother way to listen to the marketplace

William (Bill) R. Gombeski Jr, MPH, MBADirector Strategic Marketing

UK HealthCare859-257-2296 bill.gombeski@uky.edu

Jason Britt, MBASenior Manager, Market Research

UK HealthCare859-257-5563 jason.britt@uky.edu

Christy HarrisonAdministrator of Oncology Service LineTallahassee Memorial HealthCare, Inc.

850-431-5038 christy.harrison@tmh.org

07-21-09

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Definition

Customer Advisory Groups are formal groups

of customers who meet regularly to share

their ideas and to provide feedback to proposed

or existing clinical, operation or marketing

strategies, programs and activities.

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Why CAGs?

• Marketers, clinicians and administrators are always looking for ways to listen better to customers and potential customers

• CAGs have been around a long time in other industries

• Survey of 550 CMOs across all industries showed 25% used CAGs (CMO Marketing Council 2006 Study)

• Began in health care with use of family advisory groups within Children’s Hospitals

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Possible Customer Advisory Groups

• Referring physicians• Patients• Health insurance brokers• Consumers/prospects• Tobacco users• Employees• Owned physicians• Neighbors

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Major Advantages of CAGs

• Through the education of a consistent group of customers and by building their trust with the organization, over a period of time, deep and more honest conversations are possible and more insightful opportunities can be identified.

• Brings customers into the marketing or clinical operations meeting room so that better customer-friendly and customer-focused strategies are developed.

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Objectives Today

Familiarize you with Customer Advisory Groups and a

disease specific Patient Family Council

Learn the advantages and disadvantages of CAGs

compared to other customer feedback/input techniques

Understand how to recruit, operate, manage and use

CAGs to improve your marketing, customer experience

and your organization

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Have Regular Marketing-Sponsored Advisory Groups?

87%

13%

1. Doctor Advisory Group (3)2. COO, Dean, Hospital Director3. Internal Advisory Group4. Website Advisory Group

No Yes (5)

n=39

Source: Feedback from 39 CMOs, July – September 2007 from Academic Medical Centers

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n

• Patient Advisory Groups (Children’s Hospital, Cancer, etc.) 7

• Community Advisory Groups 5

• Fund Raising Advisory Groups 2

• Business Leaders Advisory Groups 2

• Employee Advisory Groups 1

Other Common Approaches toObtaining “Customer” Input and Feedback

Source: Survey of 39 AMC/CMOs

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• Not enough time

• Advisory groups can micromanage marketing’s

efforts,

• Hard to keep attendance up/members motivated,

• Groups got off tract/not that helpful,

• Need new members to maintain freshness.

Reasons Offered for Marketing not Having CAGs

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Internal• PR/Fund Development/Marketing Council• Website Committee – 3 Board and 3 Physicians• Trustee Marketing/PR Committee• Recruitment Committee (Marketing, Human Resources, Nursing)

External• Legislative Advisory Group• Use Hospital Auxiliary• Business Leaders Advisory Group• Civic Leaders Advisory Group• Annual Meeting with Brokers/Insurance Agents• Annual Meeting with Employers• Annual Interviews with 25 Physicians, 25 Patients, 25 Payers and 25

Employees• Editorial Board for High-end Publication• Sensing of Paramedics• Survivor Groups

Interesting Approaches

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UK HealthCare

• Clinical arm of University of Kentucky• Major Referral Center for Kentucky/West Virginia/Tennessee/Ohio• One of Two Trauma Centers in State• One of Two Children’s Hospital in State

UK HealthCare

Clinical Colleges of Health Bluegrass Area• Two hospitals – 700 beds Professions • 750,000 Primary

Market• 900 Physicians/dentists Medicine • Bluegrass Music• 8,000 employees Nursing • Horse Industry• 33,000 admissions annually Dentistry • UK Basketball• 500,000 Kentucky Clinic Visits Pharmacy • Bourbon• 72,000+ Emergency Room Visits Health Sciences

Public Health12

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Strategic Marketing

Bill Gombeski

Communications& Advertising

Call Center

Service Line

Management

Physician/Hospital Liaison

Customer Service

Marketing Department Structure

Market Research & Database Marketing

Jan Taylor

Jason Britt

Wanda Adkins, RN

SuzanneSpringate

Tanya Wray

Karen Riggs, RN

Bill Gombeski

Strategic Marketing Director

Marketing Department

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UK HealthCareMarketing Review Process

CEO/COO

Customer Service

Executive GroupSenior Administrative Group

UKHC Executive Committee

MarketingDepartment

Physician AdvisoryGroup

Final Decision

Review and Approval

Input and Consensus

Recommendations andImplementation

Input/Advice/Coordination

Employee MarketingAdvisory Group

Medicare Patient Advisory Group

Consumer AdvisoryGroup

Email Advisory Group

Referring PhysicianRoundtable

Main CampusEmployee Advisory Group

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Tobacco FreeAdvisory Group

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Physician Marketing Advisory Group

• 15 physicians• Chaired by senior physician/Co-chaired by Director of

Marketing• Two year commitment• COO has joined as permanent member• Third Monday evening from 5:00 – 6:30pm• Have had CEO, VP Health Operations and Chief

Medical Officer attend

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Examples of Physician Marketing Advisory Group Agenda Topics

• Improving patient satisfaction with UK physicians• Physician behavior expectations• Market share discussion• Growing internal familiarity with all UK docs• Review of publications aimed at referring physicians• Advertising concepts and campaign direction• Improving service to referring physicians• Clinical annual reports as a direct mail piece to referring physicians• Review of dress code• Influencing patient/referring physician decision-making• Increasing referring physician satisfaction with UK doctors• Growing numbers of medicare patients• Developing patient satisfaction tips for UK physicians

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Key Accomplishments• Physician section to Standards of Behavior• Testing of patient satisfaction quarterly report format• Patient Access standards set• Reports to referring physicians decreased from 30 days to

10 days• “Killed” marketing message to local physicians• Helped select key ad campaign theme• Input into Clinical Annual Reports• US News & World Report Analysis• Physician/Employee Feedback• Patient Satisfaction Cause for Physicians• Professional Appearance Policy

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Referring Physician Roundtable• Object of monthly meetings were to discuss issues of importance to

the referring physician with pediatricians and surgeons at Kentucky Children’s Hospital.

• Physician champion at Kentucky Children’s Hospital and physician liaison support were keys to success.

• First meeting consisted of five community physicians, physician champion and two physician liaisons as facilitators. Roundtable participants stayed fairly consistent from month to month.

• One or two UK faculty physicians were invited to the table by our physician champion. Invited faculty were made aware of community physician concerns before the meeting.

• Concerns identified during discussions were researched before the next meeting. Participants were notified of university hospital’s ability to correct or mitigate the issue before or during the next meeting.

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• Criteria for discharge from NICU to home• Hospitalists role with inpatient pediatric patients• Evaluation and treatment for congenital malformations of the heart• Advanced radiology service available• When to refer diabetic children• New surgical capabilities• Improving communication regarding referred patients• Access to laboratory and radiology test results

Examples of Physician Roundtable Agendas

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Key Accomplishments• First year of meetings focused on referring physician concerns.

During the second year meetings focused on new specialty services or process improvement.

• Day of discharge fax form which includes, diagnosis, medications, lab results and follow up needs. Copy of form given to caretaker and faxed to referring provider.

• Improved discharge process for NICU patients. • Access to laboratory and discharge summaries made available to

referring pediatricians through new web portal. • Created “Community Pediatric Division”, led by a community

pediatrician who participated in roundtable discussions. • Improved relationship between pediatricians , KCH physicians and

physician liaisons. • Pediatrician who would often send patients out of area increased

referrals to university hospital. • Referrals to new pediatric subspecialist increased.

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Employee Marketing Advisory Group

• 15 employees• Chaired by Director of Communication and Manager

of Internal Communication• Two year commitment• Noon to 1:30 monthly

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Examples of Agenda Topics with the Employee Marketing Group

• Advertising concept review• Marketing overview and suggestions• Employee appreciation day feedback• Feedback on Medicare patient records binder• 100 Top Hospital campaign idea feedback• Ways to capitalize on county extension agents• Employee shuttle bus communication • Physician liaison program feedback• Advertising plan review• Marketing outcomes• Internal and external communications regarding new parking options• Tobacco Free campus implementation• Feedback on promotional items• Market research findings and what they mean

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Key Accomplishments

• Fine-tuning communications and marketing plans

• Improvement of social media policies that apply to internal users

• Better insight into the needs of employees not located in main campus facilities

• Increase in accurate word-of-mouth communications via members

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Main Campus Employee Advisory Group

• 12 employees not affiliated with UK HealthCare

• Chaired by Senior Manager of Marketing research

• 12 month commitment

• 11:30 to 1:00 on the last Tuesday of every month

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Agenda Topics

• Employee medical guide

• New patient care facility communication

• Perceptions of UK HealthCare and Anthem Blue Cross Blue Shield negotiations

• Online advertising concepts

• Website usability testing

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Key Accomplishments

• Employee medical guide refinement

• Radiosurgery icon

• Kentucky.com web site ads

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Tobacco Free Advisory Group

• Chaired by Director of Marketing/co-chaired by Director of Communication

• 11 current/recently quit tobacco users• Represented most facilities and grade levels• Met biweekly for six months and monthly for a year• Met Fridays noon-1pm at Chandler Hospital

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Agenda Topics

• Awareness of coming Tobacco Free Campus• Concerns• How best to communicate to employees, visitors• Tobacco Cessation and Management• Enforcement• Patient issues

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Key Accomplishments

• Changed focus of campaign from smoke-free to tobacco free to be more inclusive/less inflammatory

• Helped create more compassionate messaging• Created tobacco-etiquette for smokers/non smokers• Selected les offensive no tobacco sign• Influenced leaving campus policy discussions• Influenced decision to only have managers

responsible for policy enforcement• Avoided using of guilt in messaging

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Medicare Patient Advisory Group

• 15 patients 65 to 81 years• Chaired by Director of customer Service/co-chaired

Director of Marketing• Meets 4th Thursday of each month 12-2pm at

Malone’s restaurant • Two Year Commitment

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Examples of Patient Advisory

Group Agendas

• HCAHPS awareness, use• Quality measures patients would like to see• What makes a good volunteer experience• Issues/frustrations patients face with healthcare• Tobacco-free campus initiative• Use of UK Website• Medical Binders – How to improve• Has consumer/patient power changed• How to capitalize on World Equestrian Games Sponsorship• Emergency Department patient guide – How to improve

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Key Accomplishments• Helped sell patient infection prevention campaign to

senior leaders• Helped hospital nurses rework Family Assisted

Activated Response hotline material to be clearer• Helped with decision to produce consumer Medical

Guide catalog• Helped pick more appropriate radio surgery ICON• Provided early insight into social media• Provided input into proposed new hospital patient

rooms• Improved on-call waiting messages• Improved patient daily feedback form

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Consumer Advisory Group

• 29 Consumers

• Chaired by Senior Manager of Marketing Research

• Meets as needed, averaging once every 2 months, in the Marketing conference room from 5:30 to 7:30

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Examples of Consumer Advisory

Group Agendas• Newspaper banner advertisement assessments• Yellow pages usage• Creative/copy testing• Web site usability testing• Health care purchase habits• Tag line feedback• Advertising concepts• Organizational outreach clinics• Health lectures• Attributes of a good or bad physician• Familiarity with Hospital Consumer Assessment of Health Providers

and Systems • (HCAHPS) and likelihood of use.

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Key Accomplishments

• Input into brand advertising campaign

• Input into surgery advertising campaign

• Usage of online resources for hospital and physician comparisons

• Fine-tune tobacco free communication for patients and families

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• Approximately five to six times a year specific topic questions are identified and sent out to a growing population of 2,000+ members.

• Response rates vary based on topic but are between 9.4 percent and 12.5 percent.

• No more than three questions are sent at any one time. • Questions are usually open ended.• Chaired/managed by Senior Manager of Market Research

Email Advisory Group

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Agenda Topics

• Medical campus terminology: academic medical center vs. regional referral center

• Advertising concept evaluation• Web site usage habits• Awareness of and suggested uses for children’s

hospital mascot• New Hospital construction and traffic issues• Consumer driven health care• Difference between ambulatory and outpatient

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Key Accomplishments

• Refined icon for the Radiosurgery department

• Initial reaction to brand campaign concepts

• Awareness, understanding, and usage of KY Children’s hospital mascot, Stitches

• Web usage behavior for health care information

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1.Provide an employee perspective and ideas for marketing strategies, programs and tactics

•UK HealthCare Merchandise

2.Provide feedback on organizational communications, decisions and initiatives affecting employees. and HR policies and communications

•Lunch

3.Enhance internal awareness of UK HealthCare marketing efforts among UKHC employees

1.Evaluate current and proposed marketing initiatives

•UK HealthCare Merchandise

2.Provide context to consumer perceptions •Dinner

•$10 gift card

1.Evaluate current and proposed customer service programs

•UK HealthCare Merchandise

2.Identify opportunities to provide an improved patient, family and visitor experience

•Lunch

Community Internet Panel

1.Evaluate current and proposed UK HealthCare programs and initiatives

2.Provide context to consumer perceptions

1.Discuss issues of concern with community pediatricians and UK faculty physicians

2.Provide information that will improve the referral experience

Main Campus

Employee

On main campus faculty club

12 2 years 1. Main campus employee perspective 2.Feedback on strategies to increase image and utilization

Director Market Research

Lunch UK HealthCare merchandise

Tobacco Every 2 weeks 11 2 years 1. Insight on how best to roll out to 20% of employees who smoke

Director Marketing &

Lunch merchandise

•Dinner

Monthly / E-mail 4,000 + None •Manager, Marketing Research

•None

Referring Physician

Roundtable

Monthly / Variable 9 None •Director, Physician Line Marketing

Consumer Advisory Group

Bimonthly / Marketing Office

30 None •Manager, Marketing Research

Patient Advisory Group

Monthly / Malone's Restaurant

13 2 Years •Director, Customer Service

Employee Advisory Council

Monthly / Medical Campus

15 2 Years •Director, Communications & Advertising

Advisory Group Information

Patient and Family Advisory Councils (PFAC)

•Christy Harrison, RN, MS

•Administrator•Tallahassee Memorial Cancer Center•Tallahassee, Fl

Patient and Family Advisory Councils (PFAC)

•Why a PFAC?•Structure•Maintaining Participation•Development as Faculty•Tips for Success

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Patient Councils

Past patients are passionate about the care they receive. Using these patients in advocacy committees brings with it great ideas and a sense of urgency that only those using the service can bring. Tallahassee Memorial Hospital’s Cancer Center established an advisory group made up totally of past patients. Their insight has provided TMH with understanding how to better meet the needs of cancer patients.

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So You Want to Create/Operate a Customer Advisory Group?

• Recruitment

• Orientation

• Process Management

• Participation/Retention

• Issues

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Recruiting Observations

• Diversity vs opinionated/knowledgeable• Interested/motivated• Scheduling• Chair/VP/Director/Supervisor Blessing• Replacement• Link to Decision-Making Group• Trial Opportunity

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Sources of Recruits

* Patient Satisfaction/Employee Surveys

* Name in newspaper

* Complainers

* Attendees at lectures/events

* Word-of-mouth referrals from current members

* Organizations

* Marketing employees

* Current members

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Orientation

• Short overview of UK’s marketing plans/objectives

• Takes about three meetings before a group begins to become comfortable

• Small breakout groups encourages interaction

• Do some group building exercises

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Process Management

What Doesn’t• Just show and tell• Topics outside area of

expertise or interest• Loose/unstructured

topics

What Works• Link activity to actual

decision making• Group development• Minutes• Homework• Orientation• Appropriate agendas• Bring senior leaders

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Participation/Retention

• Meaningful issues• Food • Gifts• Minutes• Final results shared with members• Visits from Senior Leadership• Feedback that participation is valued

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Issues to Avoid

• Negative/angry participant• Participants who have personal agendas• Trying to tackle world hunger topics• Time dominant individuals• Individuals who never contribute

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Strategic Uses of CAGs

• Used to instill a patient-centered philosophy• Especially good for emerging or transforming market

segments where organizations need to stay in touch with quickly changing dynamics of the marketplace

• To reach out to certain customer segments• From a strategic perspective CAGs allow marketers to test

ideas and draft programs so that how to package and sell ideas are carefully worded and organized to insure key internal stakeholder buy in.

• Recommendations from CAGs provide valuable input for senior management and a level of comfort that key customer groups have bought in.

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Other Uses

Uses of CAGs outside of marketing include input to • design new facilities• set hiring standards• interview job candidates• design clinical trials• evaluate hospital equipment• review medical safety measures• help train medical students• Improve clinical and operational processes

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Advantages of CAGs

• Insights generated are higher quality as there is more comfort disagreeing and sharing one’s position on a topic leading to more open discussion.

• Members often share delayed reactions and ideas leading to many more new and good ideas.

• New agendas/topics introduced that were not on the marketing department’s radar screen often surface eg. patient advisory group – financial;

• Identification of operational side effects both positive and negative from a proposed marketing recommendation.

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Advantages of CAGs• CAGs tell management that marketing is listening. • Having CAGs lets the public and community leaders know

that the organization is including community input into its efforts.

• Avenue to make sure marketing is included at the organization’s decision-making committees.

• A tactical benefit is the word-of-mouth marketing and communications that takes place between members and other similar customers

• Advisory groups can help you acquire resources • Help decisions happen more quickly.

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Super Advantage of CAGs

Testing of Ideas Across Different Advisory Groups• Advertising Campaign• Social Media Strategies• Medical Services Catalogue• Patient Satisfaction Ideas

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Tactical Benefits of CAGs

• Many new ideas leading to effectiveness and efficiency of UKHC marketing efforts

• Increased UK physician and employee awareness, understanding and support of marketing efforts

• Growth in number of referrals, transfers, new patients, image, market share

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Tips for Success

• Have senior leadership come

CEO

COO

VP for Medical Operations

CMO

VP for HR• Opportunity for managers and other marketing employees

to get feedback, presentation experience• Go around the room and ask each member to comment - -

allows less confident to get involved and more opinions

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Disadvantages

• Recruiting participants can be difficult and time consuming.

• Managing the groups requires time and resources.

• Groups often raise issues that require follow-up and significant effort.

• Because CAGs are usually comprised of current customers (patients, referring doctors, health insurance brokers), obtaining ideas on how to attract and acquire nonusers or prospects can be difficult.

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Lessons Learned

• First, get buy in and approval from management. Invite them to use

• Work CAGs into your marketing plans so that your organization understands their role and importance.

• Recruiting internal members is most effective when the members’ supervisor has approved and helped select the participant

• Reach out and include planning, HR, Operations, PR in your CAGs.

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Conclusions

• CAGs are now becoming more important as the growing consumer movement continues to empower health care consumers.

• CAGs are also becoming bigger and moving online and the “hawthorne effect” of being involved in an organization’s marketing can lead to significant positive word-of-mouth marketing.

• Physician/patient/family advisory councils should be part of a marketing strategy to understand customer needs.

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Conclusions• For marketers wanting to listen more closely to customers

and prospects, becoming more involved in CAGs is one way to get new insights.

• To generate a competitive advantage health care organizations need to bring their customers into the marketing conference room to develop the most customer-focused strategies.

• Having CAGs provides strong evidence to the organization that marketing management is providing market leadership.

• Sends signal to employees that customers are number 1• Eases management buy in when they know it has passed

the customer test.