Chapter 10. Marketing
Early on, coalitions need to develop a
communication and marketing plan that presents a consistent image of the
coalition and uses clear and appropriate communications. This plan serves two
purposes:
- Internally,
it is essential for building and maintaining trust among stakeholders. Apparent
unresponsiveness, muddled messages, and ill-defined goals can quickly damage
the coalition's reputation.
- Externally,
it shapes how the media and the public understand the role of the coalition and
how to use performance data.
Among
Stakeholders
Define Your Terms
Misperceptions among participants can be an
issue when forming a coalition. Confusion can occur on the scale of the project
and in the way participants understand the terms being discussed. The Wisconsin
Collaborative for Healthcare Quality stressed the importance of defining terms
to ensure precise language among the participants. In its experience, confusion
and tension were at times caused by the different ways participants understood
the terms "provider," "cooperation," and "collaboration." In Wisconsin,
physicians define themselves as clinicians, but health care systems define them
as providers. Cooperation can denote a more informal relationship than
collaboration, which requires a more durable, intentional agreement between two
organizations to work together under a commonly defined mission and structure.
It is crucial, therefore, to be clear in communicating objectives and defining
terms with stakeholders.
Develop Communication Objectives for
Each Stakeholder
The overall communication approach with
stakeholders should be proactive, not reactive. It is important to develop
particular messages for each core constituency and institute processes for
regularly communicating with them.
Stakeholder audiences and key messages include:
- Employers, who look to provide employees information on where to
get the best care. The also they want to purchase value—the best quality care
at the lowest cost.
- Consumers, who look for information to make care decisions about
a provider or practitioner who fits their care needs.
Methods for Communication
Minnesota Community Measurement publishes a
newsletter five to six times a year for the provider community. At open
enrollment time, the coalition routinely connects with large employers in its
market to offer information for employees and refreshes data annually posted to
the Minnesota coalition's Web site. Additionally, the Minnesota coalition has a
regular news media release that communicates annual results through a live Web
cast to the provider community and consumers and encourages them to visit the
coalition's Web site.
It is also important to engage stakeholders,
particularly those being reported on, in a collaborative process that allows
for open debate and generates buy-in on how data will be reported and framed,
what the cut points should be, what labels should be used, and so forth.
The Indiana Health Information Exchange follows
an extensive internal review process that determines what larger messages are
developed for the public. The process involves conducting Administrative
Committee meetings, Measures Committee meetings, and Measure Subcommittee
meetings monthly and Action Team meetings biweekly. The Administrative
Committee involves high-level employer, hospital, and physicians groups and is
weighted heavily toward payers and employers. Among other functions, it reviews
program status, discusses directional issues, and reviews budget
recommendations. The Action Team is a lower-level, smaller team that represents
the types of organizations represented on the Administrative Committee. The
Action Team reviews, studies, and formulates recommendations around issues
before they go to the Administrative Committee. The Measures Committee consists
primarily of physicians and medical directors and discusses clinical issues,
measures, physician issues, and so forth. The subcommittees (Quality Health
First, General Measures, Cardiology, and Orthopedics) study details concerning
specifications, impacts, and so forth, before taking information to the larger
committee. The Indiana coalition's public relations staff works with local news
agencies to communicate high-level progress and initiatives derived from this
process to the general public. Additionally, the Quality Health First
subcommittee conducts monthly program overview presentations with any
interested constituencies.
The California Cooperative Healthcare Reporting
Initiative conducts regular Project Committee conference calls. The committee
is composed of project stakeholders and is charged with making project-specific
recommendations to the Executive Committee. In addition, the California
coalition conducts a monthly "all participant" conference call to provide
stakeholders updates on each project. Stakeholder-specific calls are scheduled
as the need arises.
Facilitate Frank and Open Discussion
Among Participants
As part of the startup process, provide regular
forums where members can discuss and debate strategies and concerns. Regular
meetings of coalition leaders and stakeholders are a good way to keep everyone
on task, update one another on progress, and determine what needs to be done by
whom.
To this end, Minnesota Community Measurement has
set up two formal advisory groups. The Reporting Advisory Committee sets
reporting policy, and the Data Planning Committee establishes the details
around measurement. The Reporting Advisory Committee is composed of crucial
stakeholders, including medical groups and health plans, and makes
recommendations to the Minnesota coalition's board on what measures Minnesota
Community Measurement will report and how it will display the quality
information. The Data Planning Committee comprises all the health plans in Minnesota that submit data to the coalition and advises on data collection and aggregation.
Types
of Communication
Internet/Intranet
Establishing an Internet presence is important
for creating and promoting your coalition's public identity. The coalition's
Web site often will be the first place people will go to learn about its
mission and activities. Each Better Quality Information site has a Web site
that includes an overview of the coalition, its partners, governance structure,
and contact information. Some also include press releases of significant
developments, guidelines, performance reports, tools, publications (for
example, reports), and links. Links to the Web sites follow.
Coalitions establishing an Internet presence
should work with an information technology partner that is engaged with the
coalition and sensitive to the needs of the health care community and a
collaborative project.
Once the Web site is available, tracking traffic
to the site is useful in understanding what constituencies are visiting and how
often. Placing links to your site on stakeholder Web sites is an effective way
to track visitors from that particular group.
A key tool for coalitions is a reliable and
effective Intranet. The Wisconsin Collaborative for Healthcare Quality, for
example, uses its Intranet for providers to review data before reporting it
publicly on its Web site.
Newsletters and Presentations
An effective way to promote coalition activities
is to publish an E-newsletter. For example, Minnesota Community Measurement's
E-newsletter is The Measurement Minute. (For an example, go to http://mnhealthcare.org/News/2006-05/MNCM_eNewsletter_2006-05.html.)
It may be challenging to produce content and
manage a subscriber list; however, additional cost-effective ways to promote
the coalition exist. These include contributing articles about coalition
activities to stakeholder newsletters and giving presentations at stakeholder conferences.
Create a "Genesis Story"
Develop a narrative that tells what your
coalition is, what it does, how it began, and what its early processes and
successes were. This method is excellent for introducing the coalition to the
media, legislators, stakeholders, and the public.
Public
Relations and News Media
Establishing a coalition entails marketing what
the coalition does. Working with the media can be an effective avenue for
promoting positive news about the coalition and attracting potential collaborators
and partners. In the formative stages, many Better Quality Information sites
deliberately chose to maintain low profiles because they did not want "the hype
to get ahead of reality." They wanted all aspects of the coalition to be on
solid ground before developing marketing and public relations strategies.
Still, developing an effective public relations
approach early on is crucial to maintaining a regional coalition, particularly
when dealing with the news media. One approach is to cultivate relationships
with health writers and reporters in the local media and provide them with
background on the data and what the data mean. This will ensure providers are
not misrepresented in the press.
Potential negative outcomes can contribute to
providers' reluctance to participating in public reporting. Coalitions need to
be sensitive to the effect release of data will have on the public. If not
framed correctly and understandably, data can damage public perception of
providers, even if the physicians are doing a good job.
Positive Influence
Massachusetts Health Quality Partners has
established relationships with local media to ensure accurate accounting of the
complex issues behind public reporting of data. In one instance, a newspaper
was going to publish an article about the Massachusetts coalition's patient
experience reporting that misleadingly expanded cut points from three to seven.
Because of the relationship between the newspaper and Massachusetts Health
Quality Partners, the editor showed the coalition what it intended to print
before publishing the article. The coalition explained why the established cut
points were crucial for accuracy, and this was reflected in the published
article.
Tips:
- If your budget allows, work with communications experts (including
public relations professionals from stakeholder organizations) to develop ways
to educate the press and identify key words and messages that everyone in the
coalition can use when communicating with the press and the public.
- It is not easy to explain to members of the media and the public
where data come from and what they ultimately mean. Take time to develop a
clear, understandable message.
- Before a new launch of data, develop and provide talking points
to stakeholders that help them explain results to the news media.
- When stakeholders join the coalition, make certain they know that
part of their responsibility as members includes promoting the coalition.
- An important part of branding the coalition involves having a
high-profile executive director who participates in face-to-face meetings with
constituents to drum up interest and recognition.
- To ensure a consistent message, establish a policy that requires
all documents containing data produced by stakeholders be reviewed and approved
by the coalition before submission.
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