Hospitals and Hotels

Yesterday I came across a piece in The Hindustan Times, which talked about the 'luxury' that a hospital now offers. The piece had snaps of fancy chefs offering a choice of cuisine to patients, nurses 'requesting' young patients, mostly kids to have their medication and the smiling front office staff making 'guests' welcome.

This made me remember my grandmother, who is all of 104 years old narrating to me her escapades in hospitals run by the British in colonial India. She had great admiration for the no nonsense English doctors, the stern nurses, who followed orders and paid little attention to patient grievances. She remembers these episodes with a mixture of nostalgia and respect for the efficiency that this system stood for. The food was always what the doctor ordered, the medicines were given like clockwork and chores like sponging were a must-the patient had little choice in the matter.

In today's age of the service economy, the patient has become a guest (air passengers too have become guests) to be treated and pampered. Hospitals try their best to provide a luxurious stay, with patients allowed to exercise choice in almost everything except perhaps medical treatment.

While this is great for patients and their attendants, to compare a hospital with a hotel is futile. No one except crooks wishing to evade imminent arrest go to a hospital of their own volition. Illnesses, which drive people to hospitals are universally considered a period of misfortune. Howsoever luxurious the hospital might be, one still wishes to recover and step out of it as soon as possible. The fact is that I am yet to meet anyone, who really wishes to spend  a few nights in the luxury of a 5 star hospital!

The unfortunate part is that a story, which highlights these peripheral services in a hospital tends to trivialise the core services of the hospital, which essentially revolve around medical care. Somehow the patients feel that these hospitals have little substance and a lot of style, which amounts to very little. This perception though (in many cases) unjustified is usually strong and hard to shake off.

The hospitals featured in this story included Indraprastha Apollo Hospitals and Max Hospitals amongst others. As the head of marketing communications of any of these hospitals, I would be very wary of  a story like this.

I have nothing against hospitals treating patients as guests. However, they must remember that talking too much about these is never a good idea. It would be a lot better for customers to spread the word around, about the great experience they had in the hospital. 

It would really serve the hospital a lot better.

Healthcare Advertising on Radio

Now that I work for a radio station I have been applying some time figuring out the feasibility of healthcare advertisements on Radio Stations.  In India the private FM radio stations are only allowed to play music and things like News, Sports, General Entertainment are not allowed. Most stations thus offer a mix of music interspersed with Jock Talk, audience bites, station sweepers, contest promos and of course advertising.    

The packaging of the stations is also slick, fun oriented and the jocks portray an on air imagery of being cool and connected to the young hip hop affluent city slickers. 

Hospitals, diseases and illnesses just do not gel with a Radio Station. This is at least what I thought, when I was on the other side of the table working for hospitals. The advertising media mix for my hospitals had plenty of Outdoors advertising (OOH in today's parlance!), print advertising, which included both English and the vernacular (Hindi and Punjabi) and sometimes advertisements on the cable networks. I spurned radio sales guys because of my belief that the medium and the on air content of the stations was just not suitable.

Now that I am closely involved with Radio advertising I noticed advertisements of Fortis Hospitals, Moolchand Hospital and Centre for Sight (CFS). Out of these Fortis and Centre for Sight advertised on Fever 104, which is the station I work for.

Out of sheer curiosity I decided to have a closer look and chose CFS. CFS is a chain of eyecare hospitals established by Dr. Mahipal Sachdev, a well known ophthalmologist. Dr. Sachdev used to work earlier at Apollo Hospitals and than founded CFS, which has now grown to multiple units. CFS has recently introduced the bladeless lasik surgery (the Intralease machine) and their target audience include the youngsters, who want to get rid of their glasses. CFS decided to advertise on Fever 104 with radio spots designed to appeal to this audience.

A three week campaign is presently underway. The response mechanism is a short message, which the radio station forwards to CFS and their sales team than contacts the prospect to try and sell the 'bladeless' surgery. 

When I met Dr. Sachdev before the start of the campaign I must confess I was a little apprehensive about the whole thing. However, we felt that the Radio station can add value in connecting with the right audience. Dr. Sachdev agreed and we did the spots and put them on air.

And the results, we have so far generated almost 300 queries in almost 3 weeks.  CFS is delighted and so am I. We are now planning on taking the campaign forward to the next level with programing integrations, testimonials and the works.

Similarly Moolchand Hospital has been successfully advertising their Emergency services on the radio and Fortis has been talking about the Maternity services at the Fortis La Femme.

Thus lessons for me the Healthcare Marketer are that no medium should be ruled out. Apparently it is the service line, the target audience and the message, which should determine the choice of the medium of communication. cancer or cardiac services will not go well on a fun filled radio station but cosmetic surgery, preventive health along with maternity services, emergency services etc. can be advertised on a Radio station.

I am happy to have been disabused of my preconcieved notions about Radio stations and healthcare advertising.

Healthcare Loyalty Programs

I must confess that without making any serious effort I have become a member of various loyalty programs and I bet this will be the case with most of you. I earn reward points whenever I use my credit cards, shop at my favourite store, fly my preferred airline or buy books at the corner bookstore chain. I was recently offered membership of another 'club', when I opted to purchase medicines for my mother at the local pharmacy, which seems to have suddenly gone a little high tech and dare I suggest become more customer friendly. Loyalty programs are suddenly everywhere.

I believe time has come for healthcare services to embrace the concept of rewarding loyal 'customers'.

What is a loyalty program?
A loyalty program involves identifying and rewarding 'loyal' customers, who keep coming back. Now I know this sounds a little weird in the context of a hospital, where at one level the objective is to ensure that the patient never comes back again. While no hospital wants to see patients coming back, the fact of life is that everyone needs care at different points in our lives.

Why should hospitals devise a loyalty program?
The most important reason for hospitals to consider introducing a loyalty program is to try and maximise its share of healthcare rupee spent by a customer. It is so much easier to retain a customer, who has walked into the hospital than to try and get a new one to walk in. Moreover, hospitals can cross sell services by ensuring that points earned during one episode are consumed on other services during subsequent episodes. The points can also float over family members thus ensuring new customer acquisition. A loyalty program also allows hospitals to stay in touch, with their most valuable customers by frequently communicating with them. The communication can be customised to make it relevant to the users and hospitals can make offers, which the customers will find meaningful. Loyalty Programs can also serve as brand differentiators there by generating favourable brand recall and creating customer pull.

How will a typical program work?
Here is an example, which illustrates my point. My mother underwent a bypass surgery last year. She subsequently suffered from a debilitating chest infection, which prolonged her hospital stay. We spent close to half a million rupees on her surgery and were indeed very happy to get out of the hospital.
Now wouldn't it be wonderful if the hospital at the time of her discharge gave us a percentage (let us say 5%) of the total bill back as points that we could redeem on using the services of the hospital in the future. Moreover, it can stipulate that these points can be used by any member of our family across any hospital of the chain. The hospital can also keep sending me patient information material regarding my mother's post operative care, precautions she needs to take, a regular reminder on when she needs to see her cardiologist and offers on let us say Preventive Checks for me. (Family history is an important risk factor in heart disease). This would ensure that the hospital remains in my consideration set and in all likelihood, should the need arise, I would be happy to visit the same hospital again.

How can a loyalty program be established?
Technology today allows hospitals to customise these programs. A smart IT solution is required to function as the backbone of the program. The system must be able to identify patients, calculate points, generate point statements and track redemptions. Trained individuals must run the program with a great deal of common sense, thoughtfulness and attention to detail.

The Business Case
A business case can easily be made for a loyalty program. I have worked on these and know from experience that the numbers look impressive. Once the basic program takes off, layers can be added, which allow for better returns.

The Caveats
While it is great to have a loyalty program underway, it can only succeed if it is taken up as a hospital/organisation wide initiative with buy in and active support from all concerned. A cross-functional team lead by a senior executive must be formed and enough resources must be allocated for the program to be rolled out.

The program must have clearly defined goals and performance of the program must be zealously tracked. Customer feedback must be taken regularly and these inputs should be used to add greater value to the program.

I fervently believe that in this age of innovation hospital loyalty programs if implemented properly can do wonders and add tremendous value to patients and provide better returns to investors.

The Hi Tech Story

I recently came across an intriguing piece of news on  the online WSJ about the efficacy of the 64 Slice CT  Scanner. I am familiar with this piece of high tech  gadgetry because I was tasked with marketing the  benefits of CT Angiograms, when Max Hospital had installed it at the Max Devki Devi Heart and Vascular Institute. I recall we were in a race with Apollo Hospitals, who had also bought  a similar machine and both of us wanted to claim that we were the first to offer CT Angios in the city of Delhi.

The WSJ piece titled 'Doubts grow over High Tech CT Scans of the Heart' refers to a study published in the Journal of American College of Cardiology and concludes that 'in more than 50% of the subjects, CT angiography 'detected' coronary obstructions that simply were not there'. The study was  funded by the Dutch government and used CT scanners made by Siemens, Philips and Toshiba.  

Researchers enrolled patients with chest pain who were planning to undergo conventional angiograms and offered them a CT Angiogram as well. On comparing the results it was found that the CT's were very good in identify blockages, where they existed, however alarmingly they also indicated blockages in many patients, where none existed.

These findings also corroborate the findings of another study led by John Hopkins researchers published in the New England Journal of Medicine last month, which also concluded that 'CT Angiography can not replace conventional angiography at present'.

This report made me go back in not too distant a past, when we had started marketing CT Angio's in Delhi offering a complete and reliable heart scan in less than 8 secs. Our rivals at Apollo Hospitals went a step further by branding the scan a 'instascan' and offering it to lay public as a preventive heart scan.

What are the dynamics of these high tech acquisitions in a hospital and how all this really works?

Hospitals are always looking at opportunities to differentiate. A new machine allows them an edge over everybody else (or at least till someone else acquires it as well). They get an opportunity to position themselves as 'the most modern/advanced hospital in town'. The referring doctors are sent glossy kits explaining the benefits and virtues of the new equipment, a 'launch' function is organised, CME's are held, and advertisements released to ensure hype and thereby business.

The sellers of these machines are keen to oblige with great deals involving deferred payments, credits and deep discounts, research tie ups and marketing support. Once the first machine is sold, the other hospitals as well as the new upcoming ones, willy nilly go for the them because they can not be seen without one! These in the hospital world are the ultimate status symbols.

What is also of great importance is that these machines allow a wanna be hospital to attract top notch talent from its downtown rivals. Thus Max attracted Dr. Ashok Seth and his team from an older and well established hospital like Escorts as well as Dr. Ajeya Jha (a neuro surgeon) from Apollo on the promise of the 64 slice scanner and flat panel cath labs and an intra op MRI called the Brain Suite respectively.  Artemis too did a Max and hired Dr. Devlina Chakravorty a well known radiologist (from Max ) offering her toys like a 3T MRI, a 64 Slice CT Angio, PACS, 4D Ultrasounds and a PET-CT Scanner and a promise of directing medical research using them. Artemis also hired a team of oncologists from Rajiv Gandhi Hospital by tom tomming the IGRT capable Linear accelrator and a PET CT scanner.

This is not to blame the doctors for falling pray to the lure of smarter technology. At the end of the day, all of them do believe that the use of these will help in faster diagnosis, enhance their medical outcomes and provide superior  and better care. Hospitals too believe that they will be able to attract better doctors and more patients, which in itself is a legitimate goal.

I believe all this is fine as long as the equipment has a scientifically proven benefit, contributes someway in the enhancement of care (early diagnosis, reduces risk, cuts hospital stay) and delivers all that it promises. If that does not come to pass and subsequent research negates these benefits, than I believe that the manufacturers of these machines are taking everyone for a ride and must be stopped. There should be sufficient evidence of the benefits of these machines before ordinary people like me are put through tests on them.

http://blogs.wsj.com/health/2008/12/16doubts-grow-over-high-tech-ct-scans-of-heart/