CMS Regional Offices
Are Hospital Websites
A Waste of Time and Money?
After a brief "surf" around a random sample of the 888-more-or-less hospital websites on the Internet, it is abundantly clear that most of these hospitals should have saved their time, effort, and money unless the only
thing they were constructed for was hospital ego-building - in which case, they are smashing
successes. The sad part is that most of them have valuable information that could help their
patients and improve the hospital's over-all image and performance if only the patients could find
that information.
Without getting overly technical, the collective wisdom of net-commentators is that 95% of the
websites online "suck" but almost 40% are making money - the lesson is that, at the moment, even
"bad sites" will produce positive results. As competition grows, however, the "good sites" really
begin to out-distance the "bad" ones and drive them out of business. The 60% that are bad and
failing then announce to the world that the "web does not work".
What hospitals need to understand about their websites is that this rule applies just as much to
them as it does a website that sells widgets, even though the hospital sees itself in the service
industry.
The hospital is selling a product - a perceived image of quality service and caring. |
The
web can and will work for hospitals, just as it works for Realtors, insurance sales, stock brokers,
lawyers, consultants, and dozens of other service industries. But to work, the hospital website
must follow the same rules as successful websites in retail or other service industries.
THREE SIMPLE RULES:
It is not difficult to create a good website - it takes just as much time, effort and money to create
a good site as it does to create a bad site. It's like anything else in the health care industry - you
can buy the best, most expensive piece of equipment, and if the staff cannot or will not use it
properly, you end up with financial or medical-legal problems. Fortunately, for websites the
worst case scenario doesn't involve legal problems in most cases, but it does involve loss of time
and money - and yes, even patients.
So what are the simple rules?
- The site must load FAST.
- The site must be user-oriented
- The site must be interesting and usable
Before you can achieve these three cardinal rules, however, the hospital creating the site has to
have two more critical rules firmly in mind.
- What is the purpose of the site?
- How will we know if the site is serving its purpose?
WHY DO WE WANT A SITE ANYWAY?
Websites can serve many purposes. They can even serve multiple purposes. But until you know
why it is being constructed, you cannot do a good job of it. It's like the old saying about if you
don't have a destination in mind, any road will do.
If you were to call a builder and tell them to construct a building on your property, you would
probably know what you were going to use the building for, and might even have the advance
work done to provide them a blue print of the building. You should not do any differently with a
website - but some people get intimidated or confused by all of the "techie" talk and web jargon
(like the bowl-game commercials over New Years 99/00). You should not abdicate the
construction supervision - you have a purpose for constructing your site, and it is the job of the
web design folks - either in house or out-sourced - to build the site to achieve your purpose.
The important thing about the website, however, is that it is not brick-and-mortar. It can and
should change as you add more ideas, create new purposes, and correct earlier ideas that did not
work quite as you planned them. Unlike the fixed building, supervising a website is a on-going
task that is constantly "remodeling" the site.
So, what do you want your site to do?
- Provide information to employees
- Be an impressive brochure or "annual report"
- Provide information to prospective employees
- Provide information to recruit physicians
- Provide valuable information to patients
- Market your services to insurance and managed care groups
- Improve patient satisfaction levels
- Automate some of your services
- Get feed-back from your patients
- Save printing costs
- Save other costs
- Public health education
The website is uniquely capable of doing everyone of these things - and if carefully developed, it
can do ALL of these things successfully. The important thing here is that you need to approach
this like a planned development of a Medical Center campus - you need to prioritize what areas
are most important, and build them individually. Only when they are up and functioning to your
satisfaction can you begin to add more functions - and even then, you must be certain that they
are not compromising your priority functions. That brings us to the next development issue...
HOW WILL YOU KNOW IT'S WORKING?
Unfortunately, in my consulting work with hospitals over the past 14 years, it is common to find
that no one knows whether a given program or service is working, partially working, or a total
failure. Typically, this results in sagging productivity or cash flow going unrecognized for extreme
periods of time. When the effects begin to be noticed, then we see in-fighting and "turf
protection" going on. Even internal cost-accounting systems are often set up with inherent biases
that result in the wrong conclusions from the data - a typical bias is to focus on cost alone,
without considering that a high-cost department may generate a lot more net revenue than a less
costly department. Cost in that case is not a valid decision criteria - reducing costs may also
reduce more revenue than the savings justify.
Let's assume that the website is intended to be used by patients and that it is the purpose of the
site to build a perception of quality and care. How are you going to measure that - it cannot be
left to a gut feeling that "our patients like us more." You need to know how you are going to
measure that so that your site is designed around getting the information, results, feed-back, or
whatever you need to measure your results. And by the way - "hits" are not a valid way of
measuring the success of your site unless you are simply going for the Guinness Book of World
Records.
So, let's move on to the site rules:
Your site must load FAST!!
In my little sample of hospital websites, pages loaded in 48 - 72 seconds on the home pages of
these sites. That is NOT fast. I was using a 56K modem, but the average patient is going to be
using a much slower modem, so the loading time is INFINITELY WORSE!!
The real shocker for hospitals is that people will not stick around to see your page load unless
they are truly committed to visiting you. The standard in the industry for effective business sites
is that you start losing visitors if the page does not load something of interest within 15 seconds,
and you have lost the majority of your visitors if the site takes 30 seconds. Very few people will
ever view your site if it takes 48 second or more to load.
Why are pages slow? Mostly because of HUGE graphics (pictures and designs) that take long
times to load. Reducing the size of graphics or using high compression programs that "shrink"
the electrical size of the graphic produces dramatic improvements in loading time. Simply taking
some of the graphics off of the page is usually an improvement in both speed and readability.
Graphics, animations, flashing things, spinning things, and all of the fancy things websites can do
are SELF DEFEATING on your hospital's home page. Contrary to the belief that these fancy
things are necessary to attract viewers to the page, they drive them away at the worst, and strain
their patience at the least.
If your purpose was to improve the perception of your services and caring, you have not
demonstrated it in the way you offered your patient the information on your first page - that is a
poor first impression.
THE SITE MUST BE USER-ORIENTED:
You will notice, I did not say user-friendly - that is in the next section. I am talking here about
presenting a home page that says to the user "We are understand what you want, and here it is."
There is no way to be gentle about this - the websites I looked at shouted "We are the important
medical center, and you should feel lucky to visit our site!" I have deleted the names and identifiers here because the hospitals are good facilities - their
websites just don't showcase that well. Let me quote from one in particular:
"_____ Health System is the largest vertically integrated health care delivery system serving
northern ___ and Southern ____. Located in ____, the system combines the resources of ___
Hospital, a 490-bed tertiary care hospital; ___ Clinic, more than 175 primary and specialty
doctors strong; ______ providing a full range of home health care services to people of all ages;
and __________ (health plans) offering a variety of managed care and insurance plans to meet the
needs of individuals and businesses."
Who is the user here?
Now, if this lead were on a page that is aimed at businesses purchasing health plans, maybe this
would be ok, but even then, this says nothing about how this helps the business. It's all about the
characteristics and services of the SELLER - the hospital. Not, about how this will help the
employer offer quality health plans to their employees at a reasonable cost - which is the only
reason an employer would come to a site like this. Bad plan.
The reality, however, is that almost all hospital websites at least purport to be aimed at
communicating with their patients and potential patients to create a positive perception of the
quality of services and the degree of care and concern they have for the patients. This opening
screams just the opposite - it is institutionally oriented and doesn't offer the patient anything in
the way of a demonstration of hospital concern for what they want and need. This is written like
an annual report to the investors rather than a warm, open invitation to the patient.
Think for a moment about the television commercials that basically say - "We are big, big, big so
shop with us!" If you are like most people, you are turned-off by the arrogance or the attitude
that they convey.
The patient who is savvy enough to look you up on the Internet is comparing your site with the
others they see routinely on the web. They know instantly those that are oriented to the user and
those that are not. Your site will be "clicked-off" in an instant. Let's look at that language again:
"_____ Health System is the largest vertically integrated health care delivery system
serving northern ___ and Southern ____. Located in ____, the system combines the
resources of ___ Hospital, a 490-bed tertiary care hospital; ___ Clinic, more than 175
primary and specialty doctors strong; ______ providing a full range of home health care
services to people of all ages; and __________ (health plans) offering a variety of
managed care and insurance plans to meet the needs of individuals and businesses."
The first turn-off is "largest vertically integrated health care delivery system" - this is pure
industry jargon that many in the industry could not properly define. It is a feature that the hospital
thinks is important, but doesn't relate it to what it means for the patient.
"Just a moment, that
may be on a later page," you may say - that is correct.
But what difference does it make if the
patient never finds that later page. And once again, we are talking about first impressions here -
this one is not warm and fuzzy nor does it convey a sense of quality or build confidence. It conveys a cold, institutional entity - which is not what was intended, I am sure. In today's
health market, cold institutions are exactly what the public HATES.
The rest of the paragraph does not help either - what's a tertiary care hospital? -- (and they are only staffing 300-400 of the beds according to the newspaper articles the public has seen). Again, this
is not a confidence-building feature. Actually, if anyone has been reading the papers about the
competition in health care in this particular community, the reference to more beds actually
appears like the hospital is trying to "con" the visitor. Not a good first impression.
Other sites listed their "vision statements" and "mission statements" - these again are corporate
buzzwords that mean little to the patient until they are explained why they are a benefit for the
patient. Even the vaunted Mayo Clinic website opening page contains only one feature
"Frequently Asked Questions" that might be considered a user-oriented feature and the button
"Info For Journalists" is a clear PR button for the institution.
HOW TO MAKE A SITE USER-ORIENTED:
It is sometimes hard to describe the difference between "US" and "YOU" orientation, so I want
to offer a simple example. Let's take our previous example and demonstrate how the information could be written to achieve a more user-oriented impression:
| ORIGINAL
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REVISION
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"_____ Health System is the largest vertically
integrated health care delivery system serving
northern ___ and Southern ____. Located in
____, the system combines the resources of
___ Hospital, a 490-bed tertiary care hospital;
___ Clinic, more than 175 primary and
specialty doctors strong; ______ providing a
full range of home health care services to
people of all ages; and __________ (health
plans) offering a variety of managed care and
insurance plans to meet the needs of
individuals and businesses."
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"X" offers you and your loved ones the
advantages of a single health system, from
your family doctor, to specialists, the finest in a
full service hospital, all the way through to
home care to assure that you and your family gets all their medical needs met by a single quality team that cares about
you, your health, and all of your medical needs. If you cannot find
a physician, you can count on "X" to help you
find the right one for your personal needs without
having to worry about what health insurance
plan covers what doctors. Your insurance
probably includes services at "X" because our
reputation for quality has caused most
insurance plans in the two-state area to add
us to their approved lists. We even offer our
own health insurance programs, so that you have local people
helping you with your insurance issues and at the same time saving money for you and your employer. |
Now, I am not suggesting that this is the language is what you should have to kick off a website, but it certainly is
going to get more readership (especially if a good headline introduces it) than the institutional one
that is currently on that page. The goal here is to take what the institution views as its major assets and state them in a way that tells the public what it means to them.
In advertising, there is a phrase "WIIFM" -- no, its not a radio station, it stands for "What's In It For Me" and it means that the person viewing the commercial ( and, yes, that is what your website is) wants to know why this product is worth his or her time and money. They are not watching or viewing to help you -- they had a reason or need that brought them to your site, and it is not usually a burning desire to listen to self-agrandizing propaganda.
HOW DO YOU MAKE A SITE INTERESTING AND USABLE?
A site that is user-oriented is always more interesting than one that is not, but it takes more than
just user-oriented introductory material. It takes substance - things that are of interest to the user
and are likely to bring them back for more.
So, why would a patient or a member of the patient's family go to a website in the first place?
- They are shopping for a hospital
- They are shopping for a family doctor
- They are shopping for a specialist
- They want to learn more about a disease, condition, or surgery
- They are entering the hospital and want to know about where to go
- They are going to enter the hospital and want to know what to expect
- They want to know whether their insurance pays at this hospital
- They are looking for directions around the hospital or campus
- They have a problem with a bill
- They want to know how to contact someone
- They simply want to ask a question of someone, they aren't sure who
- Maybe you can think of some more
- Oh, yes...They want to complain about something
Now, these are a lot of potential issues - won't it be hard to engineer a site that is responsive to
all of these interests? The answer is: NO, it is not. That is merely a technical matter - if you have
decided to address these interests, the site design staff can make it happen through multiple
buttons or "window shade" lists that take up very little space, but offer a number of options.
You might want to include some ideas from this demo website page Click Here
Welcome back -- or if you haven't visited the sample site, please do, and then return.
OK -- now what should you notice about the sample site?
The simple elements:
- It loads fast
- It is ENTIRELY about what the patient might want to know
- It offers a FREE newsletter to the patient -- which will allow you to get their email address, get an idea of who is using your site, why, and get their feed-back. An it guarantees that you have an excuse to email them on a monthly or even weekly basis to promote Xyz Health System, community events, and build patient loyalty (with zero cost). You can even offer specialty letters to your specialty patients (but that's another topic for future discussion).
- It offers helpful advice and positions the health system as "big, capable, and caring"
- It invites communication -- even complaints. (It's better that you here the good and the bad, rather than the State licensure department.)
"But this site doesn't look as fancy and as formal as the other hospital in town," someone might say.
CORRECT!! You can add a little graphic here or a warm friendly photo there, and some of your interior pages can take a full minute to load if you have something REALLY important for the patient if you want.
But REMEMBER -- "big, fancy graphics, image maps, animations, or board-room formal" websites are like commemorative plagues or memorials -- they generally remind us of someone (or something) nice that is DEAD and GONE.
Now that you have seen how simple it is to create a fast-loading webpage, user-oriented and interesting and useful from the viewer's perspective, you need to know that this simple page took less than an hour to create -- with interruptions. Your or your web design folks can do a much better job than this because you are working with real information and experience with your hospital's patient needs and interests.
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