(One caveat: I am not a healthcare attorney: I am a healthcare marketer. If you have a legal question, consult your corporate attorney. This post contains my interpretation of the implication of HIPAA regulations impacting business associates [photographers, videographers, ad agencies] that a hospital may employ. I am offering common sense advice, not legal expertise.)

The Health Information Portability and Accountability Act (HIPAA), defines a business associate as any organization or person working in association with or providing services to a covered entity who handles or discloses Personal Health Information (PHI) or Personal Health Records (PHR). For those of use working in healthcare marketing and communications, that includes videographers, photographers, media companies, advertising agencies and marketing firms, among others. There are special measures these organizations must take to ensure the security of private health information that they may gather as they work with their healthcare clients. All of us need to be aware of these and remain vigilant.

Updates made to the HIPAA regulation by the HITECH Act require business associates to comply with HIPAA mandates regarding the handling and use of PHI. As of February 18, 2010, the Department of Health and Human Services can audit business associates for HIPAA compliance.

IMG_9735Any company working with private health information should conduct a thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information held by that entity. Risk assessments should be conducted at regular intervals, and documented. Policies should be updated periodically as well.

If, as a hospital marketing professional, you allow a vendor to leave your facility with private health information, you need to know that they have systems in place for properly safeguarding that information. It is not enough for them to tell you that they will “blur out the patient’s information” from the finished video or photograph. Trust me, I hear this all the time. It does not satisfy the requirements for the safeguarding of private health information under HIPAA.

Here’s a very real scenario:

A video crew is shooting a monitor in your hospital’s cath lab. They promise to blur out the patient’s information in the finished video. You allow them to leave with the patient’s private health information recorded on digital video. Even if they blur out the patient’s information in the final product, what happens to the raw digital files? How are those safeguarded? How are they protected from a potential security breach, if at all? These are the things you need to know.

My preference would be that you not allow business associates or vendors to capture private patient health information at all. If you’re shooting monitors, use black tape to cover up any information that may identify the patient. Why even risk having private health information exposed unnecessarily? That is far different from photographing and videotaping patients that have signed a HIPAA release. (Remember, a standard photographer’s release is not sufficient when dealing with patients.)

Things you should know:

You should also know if your vendor has assigned a Security Official to oversee the development, implementation, monitoring, and communication of security policies and procedures within the organization.  How are digital files stored to maintain security? When employees of the firm access files that contain private information, is each point of access logged properly? What are the firm’s policies and procedures for granting access to electronic protected health information; for example, through access to a workstation, transaction, program, process, or other mechanism? Has the organization implemented a security awareness and training program for all members of its workforce (including management)? There should be procedures in place for  guarding against, detecting, and reporting malicious software; monitoring log-in attempts and reporting discrepancies; creating, changing, and safeguarding passwords.

If you’d like to learn more, I recommend checking out the HHS Audit Protocol.


I considered a number of potential titles for this post:

RFPs: The Bane of My Existence

The Dreaded RFP

Think Before You RFP

Issue an RFP with Care

The Request for Proposals (RFP)

The truth is, companies like mine want to receive RFPs for marketing services. It is one of the ways we win the opportunity to work with new clients. Crafting a thoughtful response takes a ton of time, but that’s just part of the process. It is expected. e are happy to do it.

Here’s the Catch

What is also expected is that the issuer of the RFP is going to do their homework before sending out the RFP.  At least once each year my firm will participate in an extensive RFP process only find that, in the end, the organization has decided that they don’t have the budget (or board approval) to move ahead with the marketing initiative. This news comes after my firm has spent an unimaginable amount of time digging in, doing research, drafting plans and timelines, and presenting to various groups.

The latest example of this just happened. This particular healthcare organization was looking for an agency to guide them through a complete rebranding process. Within the RFP we had to give them a detailed account of our rebranding methodology and process, a timeline for each of the three phases of the process, and a budget that gave numbers for each element. Our team spent 78 hours preparing the RFP response and presenting to the organization’s leadership team. (Imagine – this is the equivalent of me dedicating one employee to this assignment for two straight weeks.) On my own, I spent an entire weekend, two ten-hour days, writing the initial draft of the RFP response. I did it because I knew that our team and experience made us the perfect match for this rebranding assignment. (Now imagine that at least two other marketing firms went through the same process – dedicating a similar level of resources.)

Last week we received an email (not a phone call), letting us know that the organization’s board of directors had determined, after reviewing the proposals of the three finalists, that they did not have the budget to take on this project over the next year. So the project is postponed until August 2016. No one was awarded the contract.

If this was the first time something like this had happened, I wouldn’t be writing about it. Sadly, this is not an uncommon occurrence. With that in mind, here are some tips for anyone considering issuing an RFP:

  • Have a firm budget in mind and share it with the agencies that are submitting responses. Please don’t make them create an imaginary budget out of thin air; that’s not how the real world works. You have financial realities that you operate within. Challenge the agencies to do exceptional work within those constraints! One mark of a good marketing firm is that they can do great work with a limited budget. It takes creativity and strategic thinking, two qualities I’m sure most of us would like to find in a marketing partner.
  • Make sure the budget is approved by all of the powers that be.
  • Make sure that your leadership is in support of this specific marketing initiative. Don’t use the RFP process to try to sway the thinking of your leadership. If you fail, you will have wasted the time of several marketing firms. This is another pitfall that I’ve run into on many occasions.
  • Don’t require the agencies to develop speculative creative, unless you are willing to pay them for their time. Why? First of all, the spec creative will be meaningless because they haven’t had an opportunity to do a true deep dive into your business. Second, our time is our only asset at an agency. To require us to give you creative concept for no charge is absurd.
  • Don’t ask the agencies to draft a strategy and a plan within their responses. Our thinking and creativity are our primary assets. To give that away in a proposal is a very bad business decision. The company issuing the RFP should be hiring us to access our thinking.

RFPs are tricky business. In my line of work, you love them and you hate them. I am forever grateful to those professionals who craft thoughtful RFPs and are considerate of the firms participating in the process.


I love it when small hospitals win! My business partner (Paige Zinn) and I have made a commitment to not let our agency get to the point where we can no longer work with small hospital clients. Community and critical access hospitals need good marketing as much as big academic medical centers; maybe more. That’s why I am so excited that a couple of our smaller hospital clients have done really well in this year’s Healthcare Advertising Awards and Aster Awards – both national competitions.

The Outer Banks Hospital (21 beds) won awards in both competitions for its Urgent Care radio spot. It is so rewarding to have this small community hospital in Nags Head, NC win this level of recognition.

3331_300x250_banner_SWTAnother winner in the small hospital category was Brattleboro Memorial Hospital (BMH), a 61-bed, not-for-profit community hospital located in southeastern Vermont. It serves a rural population of about 55,000 people in 22 towns in Vermont, New Hampshire and Massachusetts. BMH’s emergency services campaign won a Gold Aster Award and a Gold Healthcare Advertising Award. It also won Silver Awards for radio and print elements of the campaign. My congratulations go out to BMH, its marketing team, and its CEO who gave us the go ahead for this campaign. Thanks Steve!

Here’s some of the work from the winning BMH emergency services campaign. The graphics are simple, yet iconic – and extremely low cost. (I’m just showing the print element in this post, but this was an integrated campaign that included digital and traditional components.) Enjoy!

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An incredible lineup of national speakers, all healthcare marketing thought leaders, will be presenting at the Annual Conference of the New England Society for Healthcare Communications, May 20-22 in Boston. The content will be out of this world. (As a bonus, Erica Ayotte of Hootsuite is doing a special workshop on Wednesday afternoon, May 20, on the nuts and bolts of social media. I am a big Hootsuite fan, and can’t wait to participate in the workshop.)

Check out some of the speakers. These are my friends and people I hold in high esteem as healthcare marketers.

  • Screen Shot 2015-04-30 at 9.39.33 AMChris Bevolo – Author of Joe Public Doesn’t Care About Your Hospital, and his latest book, Embracing the New Paradigm: A Strategic Guide to Digital and Content Marketing for Hospitals and Health Systems. I’ve known Chris for years and think he’s one of the smartest and most grounded people in healthcare marketing. Some of you may know Chris from his the Arrogant Healthcare Marketing Bastards podcast. I’ve been fortunate to be his guest on the podcast in the past. Chris is best known for helping healthcare organizations re-envision what their marketing could be, re-energizing management and inspiring staff to think bigger and act differently.
  • Screen Shot 2015-04-30 at 9.38.11 AMJamie Verkamp, Managing Partner and Chief Speaking Officer at (e)Merge – Jamie is an expert in helping physician practices and hospitals improve the patient experience and create measurable growth in customer service, referral volumes and bottom lines. I’m met Jamie years ago at the Mayo Clinic and have considered her a friend ever since. You can expect her presentation to be right on point! You’ll leave her presentation ready to put her ideas into action at your organization.
  • Screen Shot 2015-04-30 at 9.36.30 AMAhava Leibtag, AHA Media Group – Ahava will be talking about content strategy and developing winning content for your organization. She is the author of The Digital Crown: Winning at Content on the Web. When people contact me looking for a content development specialist in healthcare and its a project my firm can’t handle due to a client conflict, I usually refer them to Ahava.

The conference will also feature several speakers from hospitals and health systems across New England. (They are even letting me present, if you can believe that!) Below are a few of my favorites!

  • Jeff Steblea, Market Street Research
  • John Bidwell, Baystate Health
  • Michael Esordi, Care New England Health System
  • Julia Sorensen, Cooley Dickinson Health Care
  • Laura Pierce, Tufts Medical Center
  • Brooke Hynes, Tufts Medical Center

I hope to see you at the conference. Here’s the link for conference information and registration.

Screen Shot 2015-04-27 at 1.09.58 PMAs a healthcare consumer, there is no official organization out there protecting me from bad health information; that applies to information I gather online and through my consumption of mass media. (The FDA does try to protect me from exaggerated or false claims from pharma companies, but their reach is limited.) Let’s face it, health information and misinformation is flying at us from all directions. And none of it comes with the healthcare equivalent of the Good Housekeeping Seal of Approval. That includes information that I gather from media-anointed celebrity physicians like Dr. Oz – a man who has caused quite a stir in medical circles of late.

Last week I read a terrific op-ed piece in The New York Times (online) by Frank Bruni, titled “Hollywood Trumps Harvard.” To some extent, it is a piece about the cult of celebrity.

About midway through the article, Bruni takes on Dr. Oz. He does so in a beautiful and compelling manner. Here’s a very brief excerpt from his commentary (you’ll want to read the whole thing for yourself):

“Oz has morphed not just willingly but exuberantly into a carnival barker. He’s a one-man morality play about the temptations of mammon and the seduction of applause, a Faustian parable with a stethoscope.” (Source: NYT online, “Hollywood Trumps Harvard,” April 22, 2015.)

Wow! Bruni’s article comes at a time when physicians (with questionable motives) are petitioning Columbia University to cut ties with Dr. Oz for his supposed quackery. For years I have listened to physicians with the best of motives complain about the bad advise that Dr. Oz dishes out. My only hope is that this recent criticism doesn’t further fuel the legend of Dr. Oz and embolden his efforts.

Of course, others have jumped on the “hating of Oz” bandwagon. Most everyone will recall Senator Claire McCaskill calling out Dr. Oz when he testified before a Senate Subcommittee nearly a year ago. He’s also fair game for the media. Here’s a link to a story about John Oliver’s recent take down of Dr. Oz. CNN gives their take on the situation in an April 27, 2015 story titled “Who’s Really Harmed by Dr. Oz?

Here’s my take: Anyone who takes advantage of people who are desperate for “miracle cures” is lower than low. Of all people, a physician ought to understand just how desperate an individual can be when dealing with chronic illness and poor health. To play on the hopes of these individuals, and to pander to the public’s desire for a quick fix to health and wellness challenges, undermines the efforts of legitimate healthcare and public health professionals. From my perspective, there’s enough bad information out there; we don’t need celebrity physicians contributing to the confusion and misinformation.

I don’t know about you, but I get health scams emailed to me everyday. Here are a couple that I receive regularly. They may look familiar. My point in sharing these is that the public is bombarded with bad health information from disreputable parties. On top of this, we don’t need physicians who work for reputable organizations like Columbia University and New York Presbyterian Hospital adding to the morass.  (Remember, the examples below are scams. I’m confident that CBS News, Dr. Sanjay Gupta, CNN, AccentHealth and others mentioned in these email messages are not involved in the production, distribution or sponsorship of these bogus messages. But this is what consumers have to sort through on a daily basis.)

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Recently I found a great article on StakeHolderHealth.org where Dr. Denise Koo of the CDC is interviewed about the soon to be launched Community Health Improvement Navigator Website. I have the pleasure of working with Dr. Koo on a project (she’s on the steering committee for A Practical Playbook; I serve on the marketing communications subcommittee), and have a great deal of respect for her. From my perspective, her vision of what is necessary to create population health improvement is spot on. According to Dr. Koo:

“Health is affected by more than just healthcare. Where we work, live, study and play has a greater effect on our health than does the short time we spend in the healthcare system. We need a multipronged, multi-partner approach. We recognize the complexity of tackling health (not solely healthcare) and want to support hospitals and their partners in solving this problem together.” (Stakeholderhealth.org interview)

As I’ve said many times of late, we’re not going to solve population health challenges in the physician’s office alone. Hospitals, health systems and clinicians are part of the solution. But to battle the prevalence of chronic disease in our communities, we need a collaborative approach that brings together clinicians, public health professionals, and community organizations. Yes, I drank the Kool-Aid.

As the CDC prepare to launch its Community Health Improvement Navigator website, it has created an Infographic that provides the What, Who, Where, and How of community health improvement. For many of us who work on the hospital/health system side of things, it is important to acknowledge that the answer to creating healthier communities lies outside the walls of our hospitals and outpatient facilities. We’ve got to work collaboratively with groups in our communities to address the social determinants of health within the region.

Check out the CDC’s infographic below. (click on the infographic below to see an enlarged version.)


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Yesterday I attended a panel discussion at Duke University Medical Center: “Population Health: An Informal Conversation with National Leaders.” The panel was made up of steering committee members from A Practical Playbook – a joint initiative of the CDC, de Beaumont Foundation and Duke Community & Family Medicine. A Practical Playbook encourages and facilitates collaboration between primary care, public health and community organizations for improved health outcomes.

Here’s my main takeaway from the discussion: population health challenges will not be solved, and healthy communities will not be created, in the doctor’s office. It is only through collaboration between healthcare providers, public health practitioners and community organizations that we’ll truly take on chronic disease. Together, we need to address the social determinants of health in order to create healthy communities.

The Practical Playbook Team curated the Tweets from the population health panel discussion and they are available on Storify @ sfy.co/r0LdW.

Below is a list of the distinguished professionals who served on the population health panel. These are all leaders on the national scene.

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By my judgment, the event was a success. We ended up with a highly engaged audience and terrific activity on Twitter. Over the course of the hour we had 212 Tweets for a total of 345,156 potential impressions.

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The metrics for the hashtag for the entire day are even more impressive (267 posts, 30 unique accounts Tweeting, 30,836 reach, and 436,134 impressions):

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Here are some of my favorite Tweets from the panel discussion. (For the full experience, please visit the Storify for this event.

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