May 29, 2019
Chief Marketing Officer Jim Nuckols’ mission is to consumer-ize Sharp Healthcare; to find out exactly what customers want and need, instead of just assuming. In Part Two of our interview with Nuckols, we discuss the crucial consumer initiative and how it’s changing the way clinicians and hospital operations deliver care.
Host: Hi, it’s Michelle Torr again, Account Director at Orange Label. In our last episode of The 19: Healthcare, Part One with Sharp Healthcare’s Chief Marketing Officer Jim Nuckols talked about how the Sharp Experience guides the health system’s marketing strategy from media to messaging to measurement. Today on Part Two, we’re going one level deeper beyond marketing to the philosophy and practical application of healthcare consumerism. Jim’s extensive background in consumer products and software has propelled Sharp to be a pioneer in this very space. Hi Jim, thank you so much for joining us on The 19 Part Two.
Jim: Great to be here! I love talking about healthcare and marketing together.
Host: Well let’s start by telling us a little about your background. How did you get into the healthcare space?
Jim: I actually started my career in consumer marketing. I was at General Mills, I ran the Wheaties brand for a number of years. Actually signed Michael Jordan to Wheaties.
Jim: I made Michael Jordan.
Host: That is so cool!
Jim: And ran the Nature Valley brand, and then after about eight years I ended up in the medical equipment business with a company called Hill-Rom, who does 90% of the hospital beds in the US and ran strategy and ended up acquiring a French company that was in our industry to grow. I ended up spending five years in France, all in medical devices with Cardinal Health, Apexus, a lot of things around drug management, drug control, Alaris, which are infusion pumps, and even spent some time in the entrepreneurial world, helped introduce a new drug product and then came to the provider side, joined Sharp about seven years ago. So, when I sit at Sharp, when I first got to Sharp, I realized everything I had marketed in my past was now at Sharp: Hill-Rom beds, Apexus medication management, Alaris pumps and even Nature Valley granola bars were in the cafeteria. I guess it was all leading to Sharp.
Host: Yeah, everything came full circle for you.
Jim: But now I love running the provider side of healthcare. It’s a little bit different because you’re really now delivering care and making a difference for patients and also it’s a nonprofit. It’s just a different ethos than being on the corporate side.
Host: It is, but I think what’s interesting about your background especially now with the buzz around healthcare consumerism and the shift to a more consumer-focused delivery of care, your background in consumer packaged goods and retail in a sense probably lends a lot of value to the retail space.
Jim: I actually feel like my mission at Sharp is to consumerize Sharp and so that has been a lot of my focus. Sharp is a really brand and presence in San Diego, but as you mentioned you know making health care much more consumer friendly is crucial and that’s my background and that’s my interest and so everything we can do to make Sharp more relevant, more convenient, more consumer-focused is kind of where I’ve put my emphasis and so even changing the way we organize, the way we approach it, it’s actually been somewhat of a shock to the system at Sharp. I mean, I’m just kind of a different beast, I didn’t grow up on the provider side of healthcare, which most marketers in this industry have, including most of my staff. So, I think I do bring a very different perspective.
Host: What would you say are some of your top or your favorite or your most exciting initiatives where you’ve been able to push that consumer focus into the Sharp organization?
Jim: So, very early on, before this was common, I’d just said, “How do we make this more convenient? What are the consumer pain points?” And one of the most annoying things when you are sick is to think that you have to go and wait five hours in the emergency room. So we played around about six years ago with actually scheduling your E.D. visit and that was such a foreign idea to our operations and clinical people… “What do you mean schedule your E.D. visit?” And actually, we ran into some roadblocks with our larger hospitals and there were some capacity issues, but we did implement it in one of our smaller hospitals, for example, and we had people coming from all around the county to Coronado Island, which is pretty isolated, because they can schedule their E.D. visit. You wait at home instead of waiting in the E.D. with all the sick people. But, I think it’s a good example of just putting a consumer lens on instead of a hospital operations lens, a clinical lens, which is important right in delivering care, but it’s not the perspective that you need to make this friendly for consumers.
Host: Well I would imagine there are still some surplus benefits for the operational side. In terms of being able to schedule appointments or any of the things that you’re doing, how have you seen the impact on the operations and the bottom line?
Jim: The bottom line is, for example in Coronado, where we’re scheduling E.D. visits, they’re bringing more patients to Coronado and 80% of your admissions in a hospital are coming through the E.D. so to a degree, you’re increasing E.D. visits, you’re increasing your hospital volume. And for Coronado, a smaller hospital, that was very crucial. That remains very crucial. That’s a very tangible ROI that you can attach to one of these consumer initiatives and that’s been sort of the jumping point for us to look at a lot of things. A lot of people are doing that now, not as much with E.D.’s but urgent care and doing online scheduling is almost becoming table stakes in healthcare, but it’s an indication of how much more consumer oriented it’s becoming.
Host: Yeah, well I think it may be coming more prevalent in some progressive markets. In many areas of the country that has not yet been adopted. I’m curious, what was the timeframe for you like between the idea being sparked and the implementation? How long did that take?
Jim: To implement in one hospital, that took about nine months, so not really that long. But, still it’s been now six years and we’re not fully implemented with online physician scheduling, online urgent care and other places where we need to do it. That’s a huge focus of mine right now to make that happen. And I think that there’s been a little bit of a seat change, even in management at Sharp and in most hospitals realizing, “Okay, this isn’t just a little gizmo, I mean this is going to be crucial to our survival.” So, I see the rate of change accelerating and a much greater openness on the part of clinicians and hospital operations, people will say, “Oh yeah, this consumer really does matter.” We pride ourselves on the Sharp Experience, Sharp is known in San Diego for the Sharp Experience and it’s an amazing level of care and caring. But, I think there’s a realization that that experience needs to start the minute someone Googles for care. You know, it doesn’t start when you enter the hospital doors. It starts with, “I’m not feeling well, what should I do?”
Host: That’s one of the things I’ve seen in my experience working with hospitals where there has been a disconnect. You know, the patient experience once you walk into the walls is a huge area of focus for any healthcare organization I’ve worked with. And yet, on the digital marketing side or the website experience or social media or Google or online wayfinding or whatever it may be, in the past they’ve been viewed almost as two entirely separate things and not interconnected, so that’s an amazing vision that you’ve brought to bring those two things together.
Jim: It’s making a difference. And I think that idea of “The Sharp Experience begins when you Google for care” has resonated with people and even though there’s still barriers to get over and there’s some logistical things that are tough to manage, but I think there is an impetus to really make this happen and I see the rate of change accelerating a lot. And we’re working on a lot of projects to make that happen. Interestingly, when you talk about driving things for consumers one of the things I took for granted in my prior lives is the whole product management discipline. For a product manager, you know you own kind of the consumer, the consumer need, understanding what they need and really defining that and then leading into product development. Well that job does not exist in a provider healthcare organization, but it’s really needed. So that’s been my latest fight is to get a product management discipline to marketing or even outside of marketing, but in the hospital provider side. And there’s almost this, “Wait, product management? What does that do?” So, people don’t really understand it, so we’ve made some real great progress in doing that and then also putting in a product development process. Something that is just very standard in where I’ve been before, either in consumer products or even in the healthcare technologies side, I mean you’re developing products with product managers running those products, understanding the key needs and I think the organization is starting to catch on on why that is so important. So, I think that’s going to be a real key step for us in transforming the way we’re able to transform the consumer experience.
Host: What are some of the roadblocks that you’ve faced in this process?
Jim: You know it gets to be as simple as things, “Well no, a manager to get compensated like a manager and be on bonus, you have to be managing at least five or six people.” Well, that’s the paradigm when you’re in a nursing organization or an organization that’s delivering healthcare, but that’s not how an industry or product management works, those are usually highly compensated, very professional people, might be on an incentive bonus and may have one report or none, but they’re doing a very important job. So, even getting the job scoped into our organization has taken some work. But then also showing people how it actually happens. We’ve got a recent experience right now with our urgent cares, where you can post wait times and schedule it and do everything online. We assigned one of these new product managers we’ve trained up and she did an amazing piece of work of really finding out what customers wanted and needed, not just what we are supposing. And as we presented that back, the research, some qualitative, some quantitative and provided some really terrific consumer insight to the people that were operating the urgent cares, it was, “Ah ha. Oh I get it.” So now we’re going to build what they really need, not what we think they want. For example, the supposition was in our urgent cares that scheduling your urgent care visit would be great. Turns out, in our urgent cares, the wait times are never more than about 20 minutes and they’re really happy with them. So, we would be kind of wasting our effort there. But what people really would want to know is which urgent care has the shortest wait time. And actually, at our urgent cares, we do rounding when people are waiting and say, “It’s going to be about 15 minutes, is there anything I can do for you?” People love that a lot more even than doing it online. So, as we looked at that, it completely changed the way we were approaching the project. And the people seeing this are saying, “Oh, I get it.” And we actually try to understand what the consumer needs before we buy something from a vendor or develop something that may or may not meet the need. So, that’s actually very gratifying to see this happening.
Host: I believe that. What are the steps that you and your team take to uncover that type of data and maybe define that need?
Jim: We’ve developed a set of quantitative skills, so we have an insight community that we’ve built here in San Diego, where we can tap into online. We can do qualitative surveys quickly. So there’s a quantitative basis for this. We’ve developed a user experience design group. So, we’re actually, especially when it has anything to do with web design, using a lot of user experience tools to literally measure what things work and what things don’t for people when they’re using the web. So, we get a really good sense for usability. And using some of the UX skills, we’ve been able to dramatically improve the performance of the web. But then also some of the qualitative tools, literally one-on-one interviews, but taking the time to do it. And you know, going out and doing it with competitors, doing it with our own customers. Things that are just really standard. Nothing new, right, in a consumer world, but on the provider side of healthcare it’s a little less usual. But, then doing that in a disciplined way, and as part of a disciplined development process where you have kind of idea management, you have a real concept phase. That is one of the key things, I think is having that product development process in place. So we have a concept phase, it’s the whole idea, “Go slow to go fast.” In other words, really understand what you want to design before you do it and that is really understanding what the customer needs and wants and after that concept phase moving to a planning phase and then we develop. I think healthcare development on the IT side has been much more reactionary or much more kind of just respond to clinician needs, it’s a different mindset than inventing something new for our consumer so trying to get that process in place is key.
Host: Sure. Well, you clearly bring a pretty bold leadership style to your organization and I’m sure along the way you’ve had some pushback. You’ve spoken to that already. What would you say to those who need to persevere in their space?
Jim: Persevere. You need to get some advocates on board and make it feel like it’s their idea. On the consumer initiative, specifically here at Sharp, at the end of the day, most of the consumer things we’re talking about impact primary care. Not as much, at least immediately, the hospital. And the threats of Amazon and all those things are more to primary care than they are to acute care. Amazon’s not going to do heart transplants, but they are doing all sorts of things on primary care. So, for us the consumer initiative had to come from our physician groups and our physician group leaders and the physicians, themselves. So, I basically started there and I gathered as much information as I could and just over time, kind of a steady drum beat, of the importance of having the consumer lens on and then actually make it their idea. I think I can say now, our medical groups, our physician groups and our physicians themselves are now starting to push this and drive it. But it had to be kind of their idea, too. It couldn’t be the “marketing guy” telling them that we’re going to do this consumer thing. And to the degree that they see some successes and they understand that we’re really listening on the clinical operations side because some of the roadblocks are just how do you manage it clinically and operationally? And make sure they’re really listening to that. That’s why this urgent care project was so crucial because we really listened to the consumers but also to the clinicians. In fact, some of the solutions were things they were already pushing, kind of with a few tweaks here and there. They hear that and go, “Oh yeah, we really could make a difference here and they’re really listening and this process could really work.”
Getting back to your initial question is get some allies. Make sure you get the right allies that really can make a difference and help it be their idea.
Host: Yeah, I mean two of the biggest allies I would imagine, one are the physicians and the other side would be the payers. How have you engaged the payers so far?
Jim: I’d say the payers on the consumer side honestly, I view more as competitors than cooperating. In fact, the payers have helped us in an indirect way in that some of the payers now, for example, are saying, “Well, we’re going to do online scheduling.” AETNA, DocASAP, which is an online scheduling tool basically said, “we want our members to be able to schedule their physician visit online.” And you know physicians have resisted online scheduling. They want to have the freedom of their schedule. They don’t realize that that’s just going to be table stakes. But, when AETNA comes and says, “We’re going to do it. If you’re not willing to come and let us do online scheduling, we’ll just do it with your competitors.” So, in that sense, that added some strong impetus for us to get our physicians on board with online scheduling. We have a massive project going on on that right now and in some ways, the urgency to do it has been pushed by the payers. But, I wouldn’t say the payers are helping us, other than motivating us.
Host: That’s interesting. This was amazing. Jim, thank you so much for joining us today on The 19.
Jim: Thanks, it’s been a pleasure.
Host: Thank you for listening to The 19: Healthcare Part Two with Jim Nuckols, Chief Marketing Officer of Sharp Healthcare. If you have additional thoughts on this topic, send us an email. You can send questions, comments and more to firstname.lastname@example.org. Be sure to subscribe to The 19 on iTunes and Google Play, and if you like what you heard today, leave us a review.
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