Cardiovascular Marketing Question: Should You Have Restaurant Food In Your Cafeteria?

Branding cafeteria food as “restaurant fare” seems to be a trendy marketing ploy.

Unfortunately, I just returned from visiting my brother-in-law, who is currently a patient at our city’s newest heart institute.

While I was certainly sorry to visit under these circumstances, I was curious to see it. This place has been getting a lot of buzz, and media releases have been touting its state-of-the-art amenities. As long as I was there, I decided I should do a little competitive mystery shopping – starting with eating lunch in the cafeteria.

I was immediately struck by the spacious, restaurant-like facility with hip colors. The place certainly looked inviting. The next thing I noticed was the “branded” restaurant fare. Backlit signage tempted diners with well-known local restaurant names – an Asian bistro, a pizza joint and an upscale seafood place. Hmmm.   Curious to see what this was all about, I did a little tour.

Indeed, there were stations with reasonable likenesses of the food served in these restaurants: a pepperoni pizza, a Szechuan beef stir-fry dish, a noodle bowl with chicken and vegetables, and the seafood offering — a roasted pork loin. (Huh?)

I chose the noodle bowl. It was pretty good, although the process of watching the cafeteria worker making it was definitely not as appetizing as having it magically appear at my table in the restaurant.

As I observed the other diners, I really started to ponder the pros and cons of this strategy. The marketer in me appreciates the fresh approach. The association with well-known dining brands certainly added a panache that almost made me forget I was having lunch in a hospital cafeteria. It’s an interesting consumer-centric idea.

However, the healthy eater in me that drives my real interest in cardiovascular marketing had to wonder if this new facility had missed the mark. With articles like this continuing to surface about the lack of healthy food in hospital cafeterias, I wondered why this well-respected health system had not chosen to be a leader in providing healthy food instead of “restaurant” food.

“As health professionals, we understand the connection between healthy eating and good health, and our hospitals should be role models in this regard,” said Dr. Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program in the Department of Family Medicine, David Geffen School of Medicine at UCLA.

I agree with Dr. Lesser. I would have been really impressed if this hospital had chosen to design a new, improved dining experience that revolved around healthy, yet tasty food. But I understand that it must have been a business dilemma.

Is the real truth that American consumers won’t buy into a healthy food concept? To try to gain a competitive advantage, did the people at the new heart institute feel they had to give patients, visitors and staff food they want vs. food they need? It’s a conundrum. What do you think?

Cardiovascular Marketing and Your Cafeteria as an Extension of Your Brand

While Julie is on vacation, Susan Levy, Publisher of wellfedheart.com and dedicated reader of The Main Artery, will contribute as a guest blogger.

Does your cafeteria reflect a heart-healthy marketing message?

Not long ago I visited a “top 100 hospital” and went to the cafeteria. The special that day had creamy gravy over a biscuit and not wanting any of this cardiac center’s specials, I turned to the packaged foods. I didn’t know whether to laugh or cry when I spotted the bag of fried “chittlins”.

Leadership in healthy choices

You’re branding the XYZ medical center as the best place for cardiovascular care, diabetes, or cancer. You create strategies and tactics for external marketing opportunities. However, the best strategy could be within your own building. The cafeteria is the single biggest gathering place in a hospital. It’s where you nourish your employees on a daily basis. And, don’t patients and their families need the best foods when they are at their most vulnerable? I would argue that the cafeteria can become a centerpiece for any institution’s commitment to healthy living, and thus an extension of your brand. So, why is it that only the rare institution actually showcases its cafeteria as a place of thoughtful eating choices with good health and nourishment?

Where marketing meets dietary

Like all lasting initiatives, this one takes teamwork and a long-term commitment. One of my favorite examples began almost a decade ago at Providence Health System in Oregon. Dietary services were already distributing the NW Guide to Heart-Healthy Living booklet in cafeterias, classes and discharge packets. Then, the marketers and dietitians got together and asked themselves how they could integrate the messages in the booklet into their culture. That question began the process of integrating heart-healthy food messages with actual available choices.

Here are three elements in their ongoing success:

Get consensus. 

Create an annual meeting of all the hospital chefs and managers to discuss consumer food trends and ideas on how to extend their NW Guide to Heart Healthy Living beyond distribution in the cafeteria. Annually, recipes are picked that work in the home kitchen, and at least half are featured in the cafeteria food line as well. One of the most popular is salmon cakes.

Toss out conventional wisdom.

Dietary began with just one breakfast item. Conventional thinking was that if people didn’t buy it in the past, they wouldn’t buy it now. New thinking prevailed: let’s try again. Today the yogurt parfait is a mainstay as a breakfast/to-go snack.

Highlight healthy options.

Place pictures from the booklet above the healthy item in the steam line. Post the nutritional labels and information for healthy options.

So my question is this:  “Do your dining facilities deliver on the promise of your heart-healthy brand?”

Susan develops strategies and marketing tactics for health care organizations. With more than 20 million in print, her customized heart-healthy booklet of recipes has been used by cardiovascular centers in more than 35 states. Due to its success, and at the suggestion of hospital chefs and dietitians, The Well-Fed Heart online library was created. Susan’s blog, In My Experience, links current news in health care, research, and trends to her life as a baby boomer.

Should You Add A Chief Experience Officer to Your Cardiovascular Marketing Mix?

 Making the patient experience a top priority is more critical than ever.

As marketers, we spend a lot of time and resources developing our brand promises.  But how many of our organizations are as deliberate as they should be in making sure the patient experience delivers on the brand promise we tout in marketing?

Current research indicates that patience experience is at the top of CEOs’ priority lists.  But, how is it working?

I came across an excellent post from consultant Anthony Cirillo, who recently spoke at Cleveland Clinic’s Patient Experience Summit.

His main point is that only with a Chief Experience Officer (CXO) at the top of an organization can you assure the patient experience is consistent and integrated with marketing efforts, especially as delivery mechanisms continue to change.

He recognizes there is a financial implication, particularly in the context of value-based purchasing.

Here’s an example from Cirillo:

The average hospital has $180 million in revenue. Say 50 percent is Medicare. That is $90 million. By 2017 you will have to hold back two percent of your Medicare revenue for a bonus pool. So you are starting almost two million in the hole. And what would you have to charge to net two? And what happens when other payers follow suit? Do you really want to leave patient experience to chance?

Given these circumstances, Cirillo asserts there are three roles the CXO should assume to enhance patient experience:

1.   Chief Promise Keeper

The CXO must ensure patient experiences are consistent across the organization and consistent with the promise set forth by marketing.  Cirillo points out the importance of storytelling in making sure the patient experience matches the expectation.

2.   Chief Healing Officer

Cirillo asserts that healthcare workers often take the emotions of work home with them, which can have consequences that lead to quality issues.  As Chief Healing Officer, the CXO is an advocate for employee assistance programs that include benefits such as pastoral care.

3.   Chief Context Setter

The CXO should serve as a organizational leader who “infuses the patient experience into the culture” through employee orientation, training and other areas as appropriate, helping employees understand their ultimate role as healers.

I think this is great stuff.  One of my favorite parts of working with clients is to help them articulate their brand promises.  It’s even better when the promise is consistently delivered through the patient experience.

Can Your Cardiovascular Marketing Program Save Lives Through Social Media?

In addition to being a great tool for sharing information, Twitter can truly impact patient care.

One of the most rewarding experiences in my career involved a situation in which a woman sought quick treatment at a client’s hospital after hearing our radio spot for its stroke center.  We tell that story with pride, using it as a proof point that the much-maligned advertising industry can actually make life better.

I imagine the folks at Emory Healthcare are swelling with a similar pride these days.  According to a great case study on its website, Twitter recently played a vital role in expediting patient care.

Here are some excerpts:

At 11:06 am on April 25, we received a tweet from Matthew Browning, who was playing a critical role in helping his wife and family in getting through a crisis situation. The tweet read as follows, “@emoryhealthcare NEED HELP NOW!! Grandma w/ RUPTURED AORTA needs Card Surgeon/OR ASAP, STAT! Can you accept LifeFlight NOW!!?”

What would you do if you received a tweet like that?  Even if your staff is usually responsive to social media posts, could you mobilize to formulate the type of immediate response this message requires?

At Emory, they immediately threw out their process flowcharts and shifted into high gear, contacting a variety of departments as quickly as possible.

Within minutes, we tweeted back to Matthew: “@MatthewBrowning Matthew, please either call 911 or have your grandma’s doctor call our transfer service to get immediate help: 404-686-8334.”

They gave Matthew critical information he could act on within Twitter’s 140-character limit.

 Four minutes later, at 11:21 am, Matthew responded, “@emoryhealthcare We are doing that! She is in small South Georgia hosp right now- but needs MAJOR help- We are calling, thanks!”

We responded: “@MatthewBrowning keep us posted & please let us know if there is anything else we can do to help. We’re keeping you both in our thoughts.”

Matthew sent a tweet one minute later, “@hospitalpolicygrp @emoryhealthcare Thank you for your help!”

Followed by “@emoryhealthcare Look for STAT Transfer from South Georgia, accept her if able and we’ll see you soon. Thanks!”

16 minutes later, at 11:41 am Matthew’s wife’s grandmother was on a lifeflight to Emory. “@emoryhealthcare Thank you for accepting her- She is on the LifeFlight to you now- Bless you all and Thank you!!”

What an intense exchange! This is the best example I’ve seen of harnessing the power of social media to affect patient treatment.   With a diagnosis of a ruptured aorta or something similar, minutes can literally make a difference.

Clearly Matthew is a savvy health care consumer.  He is a registered nurse and founder of Your Nurse is On, a health care staffing application.  Apparently, in this situation, he was using Twitter, email and LinkedIn simultaneously within his broad circle of health care contacts.  Using social media technology, he was able to make more contacts in minutes than anyone could in hours with traditional technologies.

At the same time, phone calls were being made from the hospital trying to find a hospital to transfer his wife’s grandmother to.  “We got lots of nos,” Matthew said.

Thankfully, when he reached out to Emory Healthcare, its team had the ability and capacity to help. “We group-sourced something to people with a common interest and achieved a medical miracle,” Matthew said.

I love this story.  It represents all of the best reasons to work in healthcare marketing and communications.  I have to admit it also scares me a little.

Stories like this get a lot of press.  Patients and their families get desperate in urgent situations.  And more and more mainstream consumers are becoming just as savvy as Matthew Browning.  While this case turned out well, similar situations also have the potential for disaster if the hospital receiving the tweets doesn’t have a plan in place to act quickly.

I’m encouraging our clients to use this case as a wake-up call.  Now is a good time to examine your processes and policies and to formulate an “emergency” social media plan if necessary.  I encourage you to read the complete two-part case history from Emory Healthcare as well:

http://advancingyourhealth.org/highlights/2011/04/27/can-twitter-help-save-lives-a-health-care-social-media-case-study-part-i/

http://advancingyourhealth.org/highlights/2011/05/04/can-twitter-help-save-lives-a-health-care-social-media-case-study-part-ii/

ACO Vocabulary Words for Cardiovascular Marketers

Figuring out what the long-awaited accountable care organization (ACO) guidelines really mean may require some study.

The federal government finally delivered its much- anticipated guidelines for ACOs.  Even though the program is voluntary and will be limited to only about five million Medicare beneficiaries when it opens next year, many healthcare experts have a sense that things have changed forever.

The guideline document is huge – 429 pages and 116,000 words, accompanied by an 8,700-word statement on the proposed ACO anti-trust enforcement policy.

Even for people who’ve been anticipating and researching ACOs for a while now, this could be overwhelming. It seems we all need to familiarize ourselves with a host of new terminology and acronyms.  I came across a great article in HealthLeaders Media that outlines “13 Hot ACO Buzzwords” we should all know.  Here’s a quick summary, but read the article for full definitions.

1. The Paperwork Reduction Act of 1980 (PRA) – Bottom line, it won’t apply to ACOs because of more patient “opt-in” provisions vs. “opt-out” and the resulting new paperwork that will follow.
2. Safety Zone – This is promise that federal anti-trust agencies won’t challenge ACOs if provider participants have a combined share of 30 percent or less of each common service in an ACO participant’s primary service area. Of course, exceptions apply.
3. Primary Service Area (PSA) – the lowest number of contiguous postal zip codes from which the ACO participant draws at least 75 percent of its patients for that service.
4. Retrospective Assignment – Each ACO will retrospectively be assigned groups of 5,000 beneficiaries to prevent them from picking only the healthiest, easiest-to-manage patients.
5. Procompetitive – The Department of Justice and Federal Trace Commission are more likely to approve, and less likely to scrutinize, ACOs deemed to be “procompetitive” vs. “anticompetitive.”
6. Rule of Reason – The guidelines that will be used to ensure procompetitiveness.  Pure price-fixing is clearly out, but joint price agreements among competing health providers that are deemed “reasonably necessary to accomplish the procompetitive benefits of integration” may be okay.
7. Taxpayer Identification Number (TIN) – Each ACO will use this number to signify who would be paid shared savings.
8. Dominant Provider Limitation – This would apply “to any ACO that includes a participant with a greater than 50 percent share in its PSA of any service that no other ACO participant provides to patients in that PSA. Under these conditions, the ACO participant (a “dominant provider”) must be non-exclusive to the ACO to fall within the safety zone.
9. Mandatory Antitrust Review – Most ACOs will be subjected to mandatory federal scrutiny if its share exceeds 50 percent for any common service that two or more independent ACO participants provide to patients in the same PSA.  Of course, again, exceptions apply.
10. Group Practice Reporting Option (GPRO) – the proposed method to calculate results for the first year of the program.  Beneficiaries’ lab results and other clinical information will be reported using this tool to determine shared savings.
11. Domain – categories for the 65 quality metrics that will be the basis for determining shared savings.  There are five domains: patient or caregiver experience, care coordination, patient safety, preventive health and at-risk population/frail elderly health.
12. ACO Professional – Physicians, osteopaths, physician assistants, nurse practitioners and clinical nurse specialists, not limited to primary care.
13. Eligibility – The proposed rule says that the following groups are eligible to participate in an ACO:

• ACO professionals in group practice arrangements.
• Networks of individual practices of ACO professionals.
• Partnerships or joint venture arrangements between hospitals and ACO professionals.
• Hospitals employing ACO professionals.
• Other groups of providers determined to be appropriate by the Secretary of Health and Human Services.

Wow.  I’m definitely not ready for the quiz yet, but you can bet I’ll be figuring out how to use GPRO in a sentence soon.  Good luck.

Why Your Biggest Cardiovascular Marketing Competitor May Not Be Another Hospital

Retailers are putting the squeeze on hospitals and health systems when it comes to leading the charge in wellness, prevention and education.

Take this example:

Walgreens is launching Walk With Walgreens, a program that will sponsor 5,000 community walking events around the country.

Program participants can earn prizes from national brands like Unilever, Coke, Johnson & Johnson, Lifetime Fitness and Famous Footwear through logging their steps on a dedicated website that offers a host of digital tools.  Those who walk in live events will also get a pedometer and logbook.

The program also includes forums, videos and social-networking opportunities.  In addition, Walgreens is investing in a major media blitz with outlets like Dr. Oz, the “Today Show” and “Good Morning America.”   And, they have Biggest Loser host Ali Sweeney pounding the pavement as an ambassador.

“Walgreens’ brand purpose is to inspire wellness… we’re not just saying we stand for wellness in an ad, we’re getting out into local communities and proving it,” said Leslie Meredith of the marketing services firm that created the program.

This sounds like a good program, so why am I concerned?  I think it’s a real wake-up call for traditional cardiovascular marketers.  Wellness education and prevention have long been important ways to engage patients and prospective patients.  “Inspiring wellness” has been part of our brand purposes.   We’ve been the ones “getting out into local communities” and proving that we care about people’s health.  In fact, more than one of my clients has sponsored a walking program over the years to “prove it.”

Clearly, Walgreens and other retailers are recognizing that these strategies work in gaining share of mind (and share of wallet) with consumers.

Walgreens says five million people shop in its stores every day.  In addition to the walking program, Walgreens, both through its pharmacies and its Take Care Clinics, has been intensifying its wellness commitment in recent months, including free screenings, $35 sports checkups for kids, and a $100 million commitment to testing and preventative health care in its communities.  If these are successful, it’s a sure bet they’ll expand the screenings to include more in the area of cardiovascular health.

And Walgreens certainly has a hefty marketing budget to raise awareness of these services.   Sounds a little like it’s trying to sneak in on our territory – both from a patient relationship and revenue standpoint.

What do you think?  How are you dealing with increased retailer involvement?  Are you fighting them or partnering with them?   What about referrals?  Some of the people who receive screenings in a retail environment will certainly need referrals.  What are you doing to make sure those referrals go to your physicians?  Thoughts please.

Feel-Good Cardiovascular Marketing Story of the Year

We all know that delivering an excellent, customized patient experience can go a long way in promoting our hospitals.

Check out this story about Anne Arundel Medical Center in Annapolis, Maryland.

Kudos to the staff, who clearly went above and beyond to host a wedding under some very unusual circumstances.

I’m jealous.  This is a great story, and I hope they get tons of mileage from it.

A Toast to Cardiovascular Marketing?

Serving alcohol to patients in the hospital may be a new differentiation strategy.

What? Really?  I enjoy a glass of wine in the evening as much as the next person.  And we all know red wine, especially, can have some heart-healthy benefits.

But, I have to say I was kind of taken aback by a recent NPR story reporting that some hospitals are trying to spice up their menus by adding cocktails.

Parkview Ortho Hospital in Fort Wayne, Ind., allows patients or family members to bring alcohol into the hospital if doctors have approved it. As first reported in The Journal Gazette, the hospital also indulges patients’ fancies by serving steak dinners as a final meal before being discharged.

And they’re not alone.  According to the Association for Healthcare Foodservice “many other healthcare facilities” stock beer, wine and even liquor to dispense to patients with their physician’s blessing.

The American Hospital Association doesn’t track alcohol policies among its members, but spokeswoman Elizabeth Lietz says the AHA defers to physicians’ own clinical expertise.

I’m not 100 percent sure what I think about this practice.  Regular readers of this blog know that I’m a huge proponent of making the patient experience a meaningful competitive differentiation strategy.

But does serving alcohol go to far?   At its best, it seems a little odd.   At worst, it seems risky and hard to regulate.

What about medication interactions?  How do you keep roommates from sharing with patients who are not approved to drink?

Or am I being paranoid?  Is this a good strategy for improving patient satisfaction?   With the right policies, does it seem fine?

Weigh in, please.  I’m really curious to see what others think.

Are You Including This New Specialty in Your Cardiovascular Marketing Efforts?

Promoting CardiOncology, expertise in treating cancer patients with cardiac problems, could be a solid differentiation strategy for your hospital or health system.

A lack of evidence-based treatment guidelines has historically meant cancer patients who also have heart issues might not be treated as aggressively as they could.

The International CardiOncology Society started in January 2009 to close the knowledge and treatment gaps in this patient population.

Because cancer patients are living longer and are increasingly presenting with cardiac diseases, Daniel J. Lenihana, MD, Vanderbilt University in Nashville, Tenn., with colleagues from the University of Milan in Italy, wrote in the September/October issue of Progress in Cardiovascular Diseases:

“An emphasis on ‘personalized’ therapy will continue to make collaboration between cardiologists and oncologists important.”

Some examples include:

• Oncologists want to stymie vascular endothelial growth factor (VEGF) in cancer patients to limit tumor growth. Yet, VEGF can have beneficial effects for ischemic myocardium.
• Stem cell therapy is another overlapping area of intense research.
• Cardiologists have added to the understanding of cardiac toxicity associated with anti-cancer drugs that have helped refine breast cancer treatment.
• Input from cardiologists has also helped manage cardiac problems associated with anthracyclines.

“There is burgeoning evidence that cardiovascular risk factors may have a substantial impact on the cardiac toxicity of cancer chemotherapeutic agents and the preventive treatment of cardiovascular-related comorbid conditions can have a significant benefit on all-cause mortality and cardiac-related outcomes.”

The International CardiOncology Society has multiple goals, including eliminating cardiac disease as a barrier to cancer therapy and preventing the development of heart failure.

The group also hopes to establish a database and to develop web-based educational tools, as well as disseminating multidisciplinary guidelines.

“All this represents a big challenge and stimulating incentive for both the cardiologist and the oncologist,” Lenihana and colleagues concluded.

I think it represents an interesting opportunity for marketers too.