Don't forget about Gen X when you're planning your next hospital marketing campaign.

What about the Xers? So much of the healthcare marketing we see now is geared towards the Boomers. Boomer this, Boomer that—Boomers even have their own health conditions named for them, like “Boomeritis.”  How old do the members of the Breakfast Club have to be before they become a target audience for your hospital service lines?

Here’s a tip if you are going to start messaging to Generation X, leave the Boomer-speak at the door, a whole other language is required. And those services you were hoping the Boomers would use? Guess what? Xers are already using them.

According to research conducted by Thomson Reuters Healthcare, Generation X is the “Educate Me” generation. While other generations seek engagement or connection, the Xer wants to be sure you know what you are talking about.  Here are some highlights from their study:

• An interest in being engaged and educated characterizes Generation X.

• Relatively healthy as compared to older generations, they are notably curious and actively seek information.

• They assume physicians and staff are knowledgeable and have a strong interest in amenities.

• Consumers in this generation are more likely to switch physicians and hospitals based on their most recent experience, rather than their overall past experience.

• This group has more in common with the Millennial adults than with the Boomers.

• When Generation X thinks about medical professionals, their definition is broad and includes nurse practitioners, physician assistants, insurance companies, and pharmacies.

Generation X comprised the highest volume of callers to hospital call centers. Although they initially seek information online, they follow-up with call centers to determine expertise and seek additional information. Consider your services. What are you offering that speak to this generation?

The important of audience clusters.

A while ago, my friend Eric and his family came for a visit. When he pulled into our driveway, he asked, “Hey, Shari, does every homeowner get a Subaru Outback with the house?” I looked around the cul de sac and up the street. As far as the eye could see, driveways hosted different-colored Subaru Outbacks.

If you work in this industry, you know that clusters are not just for breakfast anymore. Clusters are segments of people who have so much in common, even their similar consumer-purchase habits are similar.

Understanding these clusters is important in everything from budgeting to positioning and messaging. Know your audience — in all their idiosyncratic glory. But don’t be fooled into thinking clusters are just demographics. Clusters are people who make decisions in similar ways based on similar needs. Understanding clusters means understanding how target audiences make decisions for themselves and their families.

Segmentation is about far more than where we live, but we shouldn’t discount the importance of geography. There are a number of segmentation systems out there. When I looked up my zip code at Neilson’s You Are Where You Live, here is what I learned about myself: I learned that I might belong to one of these clusters.

Which am I? I have to click through to read more. I can tell you right now, I am not an empty-nester or a gray power.

Pools and Patios? Maybe. I mean, we do have a patio. How did they know? And when you click on the link, you can learn more about the media preferences or buying habits of this cluster. Amazing how they know I really do watch Frasier.

You may not fit perfectly into one of these segments, but it gives me more data to work with. I need to know who I am talking to so I can send them the right message. You Are Where You Live helps me figure out where to find them. Check it out. Are you where you live?

Determining the all-important why.

My six-year-old son asks a lot of questions. More questions than I ever knew one human could possibly ask. If I am lucky, I can answer maybe a third of them. Sometimes the questions are about Star Wars or subjects he learned in school, but there is always one common thread with his questions that requires both my husband and I to think quickly — he wants to know the motive.

“Why did Obi Wan die so they could get on their plane?”
“Why did Anakin go to the dark side?”
“Why did Jack’s mom get so mad that he sold his cow for the magic beans?”
“Why is Dopey so dopey?”

He rarely asks how, who or when, but always why. And my question is, why is he so focused on the why? It's my job to study consumer behavior and analyze the motives that may influence a customer to use or not use a product or service. I spend days obsessed with the who and the why — the how and when comes later.

Is my son a budding market researcher? Is this quest for motive genetic? If so, it’s finally evidence that my DNA is in fact in my tall, blonde-haired, green-eyed child who looks like the result leaving my husband in the dryer.

When it comes to my son’s motive questions, I have a few tricks up my sleeve (read: stall tactics). But when it comes to consumer motive, I have to be a bit more strategic and thorough. Motivational research helps us determine the all-important why.

The goal of motivational research is to peel away the layers to reveal basic consumer needs and uncover hidden associations with products and services. It also is used to inform a company about how their product is utilized, and how brand perception is both affected and enhanced.

You may be thinking that you already engage in this type of research, and perhaps you do. But the more surveys I see, the more people are only being asked what it would take to buy or do more — not why do they buy at all.

There are three types:

Ethnographic Observation — This gives us the chance to be anthropologists. Watching the customer interact with the product in their own home or office. Do you remember the job they gave Tom Hanks at the toy company in the movie Big?

Focus Groups —  Online or in person, group discussions with a guide who probes attitudes more than solicits feedback about a product.

In-depth Interviews — These take a bit longer, but the interviewee gets to feel like they are on the Barbara Walters special and the client gets to learn a ton. These interviews are guided discussions with more broad questions and audiovisual cues to determine top of mind.

I am not sure any parent can be ready for any question, and I think I have some time before the questions get more sophisticated. But one question in particular stumped me the other day:

“Why are Shaggy and Scooby always hungry all the time?’

It’s not that I didn’t know the answer. It’s that I didn’t want to introduce the concept of that motive to my kindergartner.

How much time are you spending online?

There was a very interesting study released by Harris Interactive showing that web users are online an average of 13 hours per week. This is a slight dip from the same observed period in 2008 where they saw average users online for 14 hours per week. The major change? In 2008, 43% of users were online at work. In 2009, that dipped to 40%.

Harris tracks use at home, at work and at what they list as “other location.” Online at Home and Online at Work have both seen Year-Over-Year growth since the study began in 1995, with this being the first year they have seen a dip for the Online at Work category. A simple explanation may be that there are fewer people at work this year then there were last year.

Beyond that, the study is a very interesting look at the growth within the last two years in the amount of time users spend online. In 2006, that number was 9 hours. 2007 saw 11 hours. 2008 and 2009 saw an average of 13.5 hours spent online per week. Even more interesting is the fact that this time does not include time spent on email.

Another interesting takeaway from the study is subject audience itself. Harris Poll culled this data from 2,029 men and women aged 18 and over through phone surveys. It would be very interesting to know if these were randomly selected phone numbers, since landline use across the globe has been dramatically decreasing. Nielsen reported in September 2008 that nearly 20% of all households in the US do not even have a landline, effectively removing them from Harris Poll’s eligible subject group. This group also scores high for broadband web use, pointing to a population of web users that have been potentially ignored by the Harris Polls study.

Things have really changed in the online world.

I’ve become a big fan of the publication Mediaweek, despite the fact that I’ve never planned nor bought any media — ever. Yet, for some reason, I’m sent a copy of this magazine every week, so who am I not to read it? It’s funny how certain publications find their way to your mailbox. For example, I also look forward to my weekly dose of Modern Manicurist. There’s nothing quite like an article centered on the finer points of nail sculpture.

But getting back to Mediaweek, their recent “Best of the Decade” issue offers some interesting statistics about online-related trends over the last ten years. I love interesting statistics. (Perhaps Mediaweek realizes this and that’s why they’re sending me their magazine.) Here’s the first online fact: “Americans who said they used the Internet in 2000-01: 53%. Americans who use it today: 75%.” That’s three people out of every four. Not totally surprising. How about, “Total daily time Americans spent online in 2000: Less than 30 minutes. Time they spend on the web each day now: 4 hours.” No wonder we’re all so chunky! What were we doing with the extra 3? hours not spent online in 2000, power-walking? And perhaps the most astounding online statistic of all, “Number of text messages sent in 2005: 5.4 billion. Estimated number of text messages sent in 2008: 1+ trillion. That’s “trillion” with a “tr.”

Next up: I offer some hot tips on the do-it-yourself reverse French manicure.

The power of celebrity.

Celebrity is potent. We’ve seen the power of celebrity recently with the death of a certain music icon — how it takes over the news and, in his case, a city budget.

The power comes from celebrities’ ability to generate awareness — whether it’s fashion, diet or a cause, if they are affiliated with it, attention will be paid. Sometimes the attention comes about unintentionally, as with the awareness now surrounding prescription drug overdose.

This is the second public figure in two years to die from suspected prescription drug abuse. Too many pills from too many different people. Many contraindications. Is the problem that celebrities have too much access to whatever they want? Or is the problem that we have a healthcare system that enables someone to fill multiple prescriptions from different physicians? Will the deaths of Heath Ledger and Michael Jackson prompt real action on this issue or will it simply raise awareness?

Consider what can happen when a celebrity purposely supports a cause to generate awareness. After the country watched Katie Couric get a colonoscopy on The Today Show, a national study published in the Annals of Internal Medicine reported a monthly increase in colonoscopies from 15 to 18.1, with a hike in the percentages of women perceiving themselves at risk and being screened. Michael J. Fox not only educated the public about early Parkinson’s diagnoses, but then went on to raise close to 150 million dollars strictly for Parkinson’s research. The power of celebrity can launch foundations, research initiatives and important public discussion.

But what happens when the celebrity raises the awareness of an important cause with the wrong facts?

On the 1997 April cover of Ebony Magazine, Cookie Johnson claimed “God Cured Magic!” Those in the AIDS community knew what this meant — his treatment had been so successful that his viral load was deemed undetectable. Did the Ebony readers know this? Did they know enough about the disease to even comprehend this? Cookie’s celebrity could have helped spread valuable information — but instead, it fueled rumors and myths that the AIDS virus could be cured by prayer. The readers never learned that Magic had to take 900 pills a month and those pills came with their own brand of side effects that required their own clinical management. The readers never learned that an undetectable viral load goes right back up to highly detectable if all of these medications are not taken precisely according to protocol. All the readers learned was that God had cured Magic Johnson — imagine how disappointed they felt to later learn it was not true, or even possible.

The power of celebrity can be a phenomenal force. It can generate awareness, inspire action and create change. And apparently this is the case in life or death.

Are hospitals turning away patients?

Ten years ago a hospital system in New York City opened several public diabetes clinics to help people better manage their disease. From insulin injection assistance to nutrition education, diabetic consumers could gain the knowledge they needed to change their behaviors. Within seven years, these clinics closed. Did the public need the clinics? Of course. Were they underutilized? Not at all. The hospital was forced to close the clinics because the services did not increase patient volume for treatment procedures due to diabetic complications. The issue here was not the execution, but the intention.

The hospital administration wanted heads in the beds and when that wasn’t happening soon enough, the clinic was considered a fiscal failure. People who were benefitting from the onsite assistance to live healthier lives were left with limited resources. The American healthcare system has spent years rewarding those who fix problems when presented—be it in surgical procedures or pharmaceutical prescriptions—as opposed to those who help prevent the problems in the first place. Fortunately there is a new trend in hospital services that are paved with much healthier intentions.

The recent health issue of Time magazine focuses on preventative care in the hospital setting. The issue features hospitals such as the Cleveland Clinic that have adopted prevention-based models of care focusing on wellness, not sickness. Their intention is to keep the heads out of the beds.

Since the diabetes clinics had to close throughout Manhattan, one must wonder, what’s in it for hospitals that adopts such a model?

1. Hospitals can keep people from getting sicker- and sicker means they pay more in the long run.

If a health system were dedicated to providing assistance for behavior modification— such as nutrition classes, cooking classes, spinning classes, tobacco cessation meetings—and the physicians focused on helping patients find the motivation to use these services, there would be a phenomenal opportunity to prevent chronic disease.

Let’s take Joe Public. He’s 47 years old and 30 pounds overweight. When hospitals and health systems help Joe lose weight and maintain a healthy Body Mass Index, they may be helping Joe control other risk factors such as high blood pressure and cholesterol. However if they do not help Joe lose weight, then the risk factors associated with being overweight could lead to heart disease and diabetes.

By the time Joe presents with a TIA or cardiac event in the emergency department, he’s not just sick, he is sicker than he was back when he could have used help achieving a healthy weight.

Hospitals around the country are now beginning to connect the dots between prevention and ROI. The Cleveland Clinic learned directly from their own employees how prevention services benefit their bottom dollar. Employees are encouraged to take advantage of Clinic offerings such as the Lifestyle 180 program, designed to reverse the effects of chronic disease by focusing on nutrition, exercise, stress management and the Tobacco Treatment Center’s cessation services.

As a result of employee participation and lifestyle changes, the Clinic’s HR director anticipates that employee premiums will not increase in 2010. Since employees are leading healthier lives, the prevention efforts save the clinic “between $5,000 and $10,000 a year per patient on claims they would have otherwise filed for treatments such as dialysis, angioplasty or bypass.”

By providing these prevention services to consumers in their communities, hospitals can also avoid future expenses due to patients who need the dialysis or bypass but who have limited insurance coverage.

2. Hospitals can become a comprehensive health home.

Hospitals are businesses, and every business has a brand. What good is a brand if customers are not loyal to it? Healthcare consumers want to be loyal to a brand but they need to feel a hospital is worthy of that affinity.

By providing communities with a spectrum of services that focus on keeping consumers healthy, hospitals can build trust. Healthcare consumers who have been empowered by these services are far more likely to turn to the hospital when treatment is needed.

Joe Public, who lost weight through the Lifestyle 180 program and quit smoking with the Tobacco Treatment Center’s support, will likely choose the Cleveland Clinic for future care and treatment if necessary. Three factors ensure this—relationships have been formed between the Joe and the hospital, he has witnessed the effectiveness of previous services and, as a result, trust has been established between Joe and the institution. It is this trust that actualizes the hospital brand and builds loyalty and, eventually, a return on the hospital’s investment in prevention.

One has to wonder how loyal diabetic consumers in NYC feel toward the hospital that cut off its resources because they were actually learning to live healthier lives.

Social networking vs. Social marketing

People, please. You are breaking my heart.

I spend hours on Facebook. Hours. I do it so I can reconnect with people I purposely lost touch with years ago. I do it so I can poke Scott Bille and not get sued. I do it so I can see pictures of people from my past.

Facebook is social networking. It’s networking on social sites.
When I am chatting with colleagues on Jabber, or posting a hot topic to a marketing listserv, that’s social media. It’s interacting with people via boards and communication devices. It’s using media to socialize.
Now let’s say I was addicted to all of this social media use and social networking. Let’s say I could not stop. I was less productive at work, not paying enough attention to my family and completely unaware of where the hours of the day go because of this addiction.

People would want to help me, right? They would want to help change my behavior. Admit my addiction. Link me to resources that will help me decrease my time spent online. They will want to find ways to educate me on other things I could be doing that are less harmful. They will want to create messages I will feel are relevant to my situation and will make me seek help. That would be social marketing.