by Hilary Weber

Operating in a highly regulated industry, healthcare marketing comes with inherent challenges, especially when it’s carried out online. The dawn of Web 2.0 brings additional challenges – along with some tempting opportunities.

Blogs provide an easy way to engage in a direct dialogue with patients, health seekers, and others, which can potentially enhance your organization’s brand, increase its goodwill in the community, and improve search engine rankings. But do these benefits outweigh the risks? Is there a way to make blogs work for healthcare?

The blogosphere has its own protocol, and “marketing speak” is openly frowned upon. Even worse than that is an organization operating a “flog” or fake blog. Who can forget the widespread negative publicity Wal-Mart sustained when the media revealed that a blog seemingly written by loyal Wal-Mart customers was actually sponsored by Wal-Mart and written by its public relations firm? Organizations that have made missteps with their blogs would have undoubtedly been better off if they had never started a blog at all.

Do your research
Known as a leader in technology and innovation, Kaiser Permanente had an estimated 75 internal blogs up and running before even considering blogging with external audiences. These internal blogs served as both practical communication tools and as pilots, and it quickly became clear there were many issues to consider when deciding whether to join the external blogosphere conversation.

To begin the decision-making process, Kaiser Permanente’s media relations team monitored and analyzed all external Kaiser Permanente-related blog postings on a weekly basis. The research reinforced suspicions that the brand was already being discussed online, most often without Kaiser Permanente’s input. Although many of the postings were positive or neutral, some were negative. In addition, some of the unfavorable postings from a few tech-savvy individuals were consistently ranked very well by search engines.

Be strategic
Blogging became an attractive option to improve desirable rankings and displace some of the negative listings on the search results page. Search engine optimization of the main Web site, www.kaiserpermanente.org, with its particular architectural design and a variety of technical complexities, had proved to be difficult. The site was designed primarily so that members could readily access the multiple features of Kaiser Permanente’s robust electronic medical record system, known as “My Health Manager.” With more than 1.4 million active members who have access to My Health Manager, it is the largest known active electronic medical record system in existence.

The idea of having direct dialogue online with its members was not new to Kaiser Permanente. For several years, the organization had hosted moderated message boards on multiple health topics on its main Web site. The message boards had a relatively small, loyal following, but they came with their own unique challenges. Although nearly all participating members followed the rules of engagement outlined on the message boards, there were occasions when a member would communicate about a critical, real-time medical situation. On such occasions, emergency care, such as dispatching an ambulance, would be required. Since patient safety is paramount and such a model was not sustainable for online interaction with members, the message boards were discontinued. Ensuring patient safety would be a major factor in Kaiser Permanente’s blogging strategy.

Ask for advice
Interested in learning more about Web 2.0, the media relations team formed a cross-functional team to begin conversations among various departments within the organization, including the Internet marketing department. One of the learning opportunities that arose was a meeting with an interactive marketing team from a major bank in San Francisco that had already started blogging. The bank had similar challenges, being in a highly regulated industry and dealing with some disparaging bloggers that ranked well on search engines. Meeting with the bank’s team was like the proverbial “light bulb going on” for Kaiser Permanente’s team. The bank team’s chief advice was to start with a “safe” topic instead of a topic more central to an organization’s core focus. The team had chosen to blog about the history of the bank, a topic inherently non-controversial (and likely to mitigate the risk of negative posts) yet substantial enough to be engaging and brand-building.

Another key realization was that successful bloggers possess real passion for their topics. The blogger’s enthusiasm for and commitment to the selected topic helps make the content rich and genuine. Blogs also need “regular care and feeding” (with the recommended frequency of posting at least once a week) to attract repeat visitors. The job ideally becomes more of a “labor of love” on the blogger’s part than just another task on a long list of work-related duties.

Make a safe choice
As Kaiser Permanente’s team started to consider safe topics for blogging efforts, it knew that the topic would need to align well with the organization’s brand positioning. Kaiser Permanente’s brand positioning is Total Health. Rather than focusing on “sick care” and only making people well after they need medical attention, the organization promotes proactive wellness and self-care among its members and the community at large. Some of Kaiser Permanente’s most passionate brand advocates are its physicians.

One physician in particular stood out as a natural candidate for the first blog. Preston Maring, MD, is known as the “father of farmers’ markets for Kaiser Permanente,” a distinction that started when he set up a single farmers’ market at an Oakland, CA, medical facility. There are now 25 farmers’ markets at Kaiser Permanente facilities across five states, with more in the works.

For the past several years, Maring has visited one of the farmers’ markets every week, selected produce in the peak of its season, customized a recipe that included one or more of the market’s fresh ingredients (sometimes testing the recipe several times during the week), and then shared his experiences in a weekly e-mail newsletter sent to more than 5,000 physicians and employees. And he manages all of that activity in the course of seeing patients and handling his hospital administrative duties!

Put it all together
Eventually, Kaiser Permanente’s Internet marketing team helped Maring convert his internal newsletter to an external e-mail format with a branded template so that members could also enjoy his weekly recipes and updates. His updates often included information about sustainable farming, news and other colorful details about individual farmers he had come to know, as well as health-conscious, easy, delicious recipes and related cooking tips. In essence, his existing e-mail content was already very “blog-like” in its tone and feel and was already being produced weekly. All it really took was for both the Internet marketing team and Maring to put the pieces together and consider pioneering a new channel – a blog – to showcase his topic in a new, expanded way.

An innovator himself, Maring was open to the idea from the start. As the team built the blog site with its outside vendor, it soon realized that there would be some additional benefits to switching from an e-mail format to a blog site. Maring could sort his recipes by type, making them searchable. He could archive his past recipes and updates. The team set up an RSS feed to make the content accessible to subscribers and search engines alike. Having a robust site made it possible to have an area for relevant links, including a “Meet Dr. Maring” section and a place for related food topics (e.g., Kaiser Permanente’s in-hospital locally grown food programs). As an added bonus, setting up and maintaining the blog site ended up reducing the cost dramatically compared with the previous e-mail blasts. The blog site investment was about one-twelfth the annual cost of sending weekly e-mails for Maring’s program.

The Kaiser Permanente team decided to launch the blog in two phases. The first phase enabled Maring to post his content at will, but site visitors could not yet post comments (although they could send an e-mail to Maring while on the site). The second phase, which was recently deployed, allows visitors to contribute comments that are moderated by Maring at his discretion. The blog policy allows Kaiser Permanente to define the boundaries of the conversation and to prevent it from wandering to unrelated subjects that would put the organization at risk. The organization’s legal team also provided a detailed disclaimer regarding posts about medical emergencies.

Even with an unpublicized launch, traffic numbers and RSS subscriptions to Maring’s blog – www.kp.org/farmersmarketrecipes – have been impressive, especially during the holiday season when food and recipe searches are very popular.

Takeaway lessons
Kaiser Permanente learned a few lessons about blogging, including:

1. Do your research. Monitor how your organization is being talked about in the blogosphere, and see if the benefits might outweigh the risks, given your situation.

2. Let strategy, not sizzle, drive your actions. Only pursue starting a blog if it fits into your organization’s overall goals.

3. Don’t feel that you need to go about it alone. Be open to reaching out and learning from others, both inside and outside your organization.

4. Consider starting with a safe topic, as long as it’s written by someone in the organization with a true passion for that topic and who will be able to produce at least weekly posts.

5. Don’t give up if it makes strategic sense. Just keep an open mind and an opportunity will likely fall into place.

Blogs can be a satisfying first taste of the Web 2.0 world. They also serve as a great showcase for your organization’s best and brightest, such as Maring, who says, “I get inspired by trying out recipes using fruits and vegetables that are in season at my hospital’s farmers’ market. My blog is a great way for me to share news and healthy ideas about simple, good food with our members and the community.”

Hilary Weber is director of Internet marketing services for Kaiser Permanente Foundation Health Plan.