Hernando walks us through how he is growing NYP, one of the world’s premier medical institutions affiliated with the renowned medical schools of Columbia and Cornell, is a leader in medical education, groundbreaking research, and innovative, patient-centered clinical care.

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Announcer: Welcome to the Ignite Podcast, where we help marketers and CEOs learn the latest tips and tricks to help ignite growth in their business. This isn’t your typical marketing podcast. We push beyond platitudes to deliver you real-world stories from the trenches. Are you ready to learn? Are you ready to grow? Are you ready to have fun? Well then buckle up because you are about to enter the Ignite Podcast.

Alex: Hey, everybody, I could not be more excited. We have Hernando Ruiz-Jimenez, on the call today on Ignite. This guy is a heavyweight of medical marketing, of marketing, in general. He comes from marketing soft drinks to the drinks that make you feel good, has worked agency, client side, done just about everything in marketing. I could not be more thrilled to have him. He’s currently the CMO of NewYork-Presbyterian Hospital, often ranked one of the top five hospitals in the entire country. We are in for a treat today. Hernando, welcome to the show, give us a background. How did we end up in medical marketing, coming from agencies and soft drinks and everything in between?

Hernando Ruiz-Jimenez: Hi, Alex. Thanks for having me. Well, it’s actually as most path, it kind of took different routes and different corners. I started in CPG, started at PepsiCo, moved to alcoholic beverages with Diageo and then decided that I needed to get into the digital world. I always wanted to be an entrepreneur. For about six years, we built a company, sold these assets, took a detour into publishing, being a general manager for El Diario in New York, which is the oldest Spanish-speaking newspaper in the US. By accident, I was on a plane going to Puerto Rico and the new CEO of Triple-S, which is basically Blue Cross Blue Shield in the Caribbean, he just took over and he needed someone to help him with marketing, and while I started as being there six months trying to help a friend, ended up being three years.

Finally, I got into healthcare, fell in love with it and realized that this is an area where us marketeers can really make a difference. It’s not that we don’t make a difference in CPE and other industries, but there’s more of us that have been doing it for a long time. Healthcare, it’s right for marketing to come in and actually help drive the agenda and help drive growth and experience.

Alex: Yes, I love it. Thanks for the background. Let’s talk about the agenda and what’s on the docket in NewYork-Presbyterian. I couldn’t agree with you more, healthcare is right for marketing innovation, and it’s so fun to be on the cusp of it now. There’s a lot of people in CPG that have been doing advanced things for a long time. Let’s talk about NewYork-Presbyterian. You came in, was it two and a half, three years ago, I think, right? Two and a half years ago?

Hernando: Yes.

Alex: All right. You’ve gotten your feet under you. For a CMO, one of the best hospitals in the world, what do you go into 2020 thinking or worried about? What are your top priorities? How do you measure them? Talk to us about everything that matters most to you.

Hernando: When we look at the world, we’re trying to divide the world between what we call consideration and conversion, which basically is how do we drive the reputation of our brand and the relevance of our brand. Second is how do we attract growth, customer acquisition, and customer retention. The first one and the key focus is how do we continue building a differentiated brand in what is a crowded space? When you look at healthcare, there’s a lot of players, there’s a lot of money. People are spending a lot and it’s hard to break through with consumers.

One of the key things that we are working on and we try to is it’s how do we let consumers know that the obvious choice for them, it’s a hospital like NewYork-Presbyterian. I think the second piece is it goes back to customer acquisition. On that one, what we’re working on mainly is it’s on how do we create the infrastructure to really be able to drive that customer acquisition and retention in a way that it’s relevant for consumers and it’s cost-efficient.

Alex: What are some of the things that you put in place? Okay, so building the infrastructure so that you can increase patient acquisition, it’s first and foremost because it’s irrelevant if you run a bunch of advertising that works but you can’t handle it. What goes into building the framework so that you guys are able to focus then instead of the framework on acquisition? What are some of those groundwork things that you’ve been working on?

Hernando: Funny enough, it goes to very simple stuff. When you look at marketing, marketing is about a lot of common sense and doing things in a disciplined way and that discipline starts with planning. How do you have plans that tightly link back to what the business needs are? It’s creating that discipline of planning, looking at what are we going to do next year? How are we going to do it? Then when you’re in the year, how do we follow up those plans and really do what we said we were going to do?

Second is how do we make sure that we have the martech stack that will allow us to do all these things. We’ve been doing lots of reviews on what are the tools that we have, what are the tools that we need, and making sure that we integrate all of them. Healthcare is very complex and the backend integration of all these tools is not as easy. Third, I think it has to do with people. It’s how do you drive the team to be more digitally literate in a sense and drive those competencies so you can keep growing in that area.

Alex: Let’s talk about you. You named a number of things. I can’t wait to get to the team competencies and how do you roll out the marketing initiatives. Let’s start with the tech stack. Everybody wants to know what everybody else is using. Do you guys have CRM? Are we tracking patient acquisition from campaign all the way through the EMR? Talk to us about what you guys are doing.

Hernando: We’re implementing our CRM strategy. We are, let’s say, early in the journey. We are actually in the process of linking all these pieces together. The hospital is going through a huge epic launch so that’s going to determine the way we actually are able to link all of our systems together. We just launched with Columbia this month, a couple of– I think it’s like 20 days ago. Over time, we’ll be integrating all the other pieces of the hospital.

Once we do have them all together is when we’ll be able to have a fully working system. That doesn’t mean that we’re not doing things today. We continued running our campaigns. Even though it’s not automatic, we try to track our ROIs the best way that we can. Again, I go back to the plans and try to link our campaigns to those things that matter most to the system.

Alex: I’m sure the system has certain focuses, whether it’s oncology, or PAEDS, or nephrology. I saw you guys were ranked top 10 in a number of specialties, so trying to integrate and show the ROI per campaign. Let’s talk about some of those campaigns and then we can talk about the ROI from them. Hospital’s a little different from a multi-location specialty clinic or a large dental group. You guys care about patient preference, branding, a lot more than some specialty clinics will, which are more can quick at patient acquisition type of things. Talk to us about the variety of campaigns that you guys run.

Hernando: I think you’re right. It starts with our brand campaigns and it starts by defining who we are. We are an institution that has been here for almost 250 years. Actually, next year, it’s our 250th anniversary. We have been here longer than the nation has. In that sense, we have to continue building our brand. Those are the first type of campaigns that we have. You probably have seen our ads, which are the patients’ stories. Most of them in black and white that you see from our patients about the amazing things that happen here at NewYork-Presbyterian.

We have a second type of campaigns, which are campaigns that I would call local retail marketing, which are the ones driving people and allowing people to know in which locations we are. We have grown a lot over the last couple of years, so we need to be able to inform people that they’re able to get the care of NewYork-Presbyterian right in their neighborhoods.

Alex: How do you get that message in front of them? Is it through the combination out-of-home, direct mail, digital? How are you doing that?

Hernando: I think you’re right. It’s about a mix of different media. It’s how do you become very relevant at a local level? Out-of-home is the obvious one. It’s simple way of finding. If I have an office in the corner of 5th and 31st, putting something there that says, “I’m here” makes a lot of sense. Direct mail really makes sense when you are opening something or for people who are moving new to the area. Digital tools if you’re searching, we have stepped up our game on search, and that’s the way people will find you. Those are the basic tools for that.

Alex: Very good. We’ve got a combination, out-of-home, direct mail, and search. Are we running any social advertising because it’s an event-based? We’ve got a doctor doing a seminar. What kind of brand building? We have the number one oncology center. My marketers out there, they’re running social ads, are running different kinds of advertising. They’d love to hear the tactical stuff you’re doing.

Hernando: When we look at social, we’re trying actually– When you have such a large institution, it’s hard to control it, and if you start doing too much, you lose relevance. Right now, we’re going through a process of defining what is the right strategy for us to do? We want to make sure that the content that we provide is the best in class content that is relevant for our consumers. Also, when we look at social, I think it’s a mix of how do you affect both paid and organic, and that’s the other piece we’re looking closely into doing.

The other area, it’s very, very interesting for people to start really trying to figure out better, it’s geotargeting and geofencing. We’re doing some exercises, trying to figure out how much you control it, is the ROI really there, and you see they’re scalable.

Alex: Yes, tough because you’re running display ad campaigns and you don’t really know if the person that saw it, if that’s the reason they ended up coming in and being seen by a provider. Did they see the ad in the first place? Yes, that’s tricky. That leads back to your point of we’re tracking ROIs. Do you guys do it from a first touch? Are you trying to look at every touch you had with a patient? Are you just generally saying, “We spent 10K on ortho, we brought in three ACL repairs”? How granular are you able to get or do you want to get in the next few years?

Hernando: Attribution continues to be a problem for everyone. Ideally, and that’s where I would like to go and be able to look at the journey and try to see how our investment pays off. We have a view on first touch and some channels are easier than others to really get to understand where you are. Again, I go back to the problem of having the systems and you have to make sure that your systems are talking, especially with your financial system, so we can really go and look down at all the encounters and really attributed to those ads.

Those things take time. Right now, what I would say is we have something that gives us directional information of where the ROI is. We cannot pinpoint the exact ROI down to the dot, but I think it’s where everyone is. It’s in healthcare. It’s really, really hard to put all these things together.

Alex: Very, very hard. I’m just happy to hear that you guys are moving towards trying to solve it little by little, day by day. That’s really what we care about. It’s kind of justifying everything, but not every campaign can be justified. Sometimes we are just running branding. We have to hope patient preference increases in the area. There’s a balance. We are such data-driven marketers, especially here at Cardinal, but there’s also a balance to understand that Brand A doesn’t have a day to day effect on ROI, and we have to be okay with not measuring every little thing.

Hernando: You’re right on that. That’s critical because there’s certain ads that you don’t really– It’s not that you don’t care. You know that long-term, they’re going to drive that ROI, but when I put a patient story on TV, I’m not looking at driving a person to a phone or desktop to make an appointment. What I’m looking for is to drive sentiment and to drive awareness, and when in the future their needs arrive, we’re top of mind for them and we’re there to serve them.

Alex: That’s right. When they go to search engines and type in “New York oncologists” that they choose NewYork-Presbyterian over anybody else because they saw those ads earlier on. How do you stay up to date? You’re obviously following the latest trends. You’ve got an epic launch. You are working in CRM, ROI, attribution. Hernando, you’re obviously very astute in staying ahead of the trends. How do you do that? Do you attend conferences? Do you read? Do you listen to great podcasts like this one? How do you do it?

Hernando: I think that the secret is a mix of all of them. Going to conferences allows you to talk to other people and understand what other people are doing. I think talking to suppliers, it’s important because they will tell you what they do, and it’s interesting to figure out what they’re doing. The problem is we’re inundated every day with suppliers trying to sell us things. You cannot believe how many emails I get every day.

If you don’t have those type of meetings once in a while, you’re going to stay behind. Podcasts, meeting, they give you another perspective, and those are important too. For me, something that it’s critical. It’s being surrounded by people who really know a lot more about this than you do and are much more informed and can teach you and teach the team all these new trends and what’s going on.

Alex: Yes. They could be your vendors, partners, suppliers. What does your team look like? What do you have in-house and what do you source out?

Hernando: We’re actually building our team, so we are moving from a model where most things were sourced out. We are starting to define what are the pieces that we want to keep in-house. Our website, we manage internally. Although we’re going through some web design processes and we have some external partners helping us with that. CRM, we’re still defining where do we draw the line, what do we do in-house, and what do we take outside.

Search, we manage through outside agencies and we have our regular digital buying agencies, traditional media buying agencies, our agency of record that helps us with our advertising, designers that help us with day-to-day work that we need to do, so it’s a mix. I think the trend, unfortunately, is for things to be more outside than inside.

What I mean by “unfortunately” is the pressure on budgets and headcounts, and I don’t see it just by myself. I see it by talking to my colleagues. It has some advantages but also it has disadvantages as everything that you do.

Alex: Yes, let’s talk through that because obviously, I’m on one side of that, and that’s good news to me. It could be bad and why? Because you lose the people that are thinking about your brand, non-stop all day because you don’t have as big of an internal team. Tell me about what you’re losing by having to outsource so much?

Hernando: I think that there’s certain things that if they’re mission-critical, you have to try to have them as close to you as possible. That doesn’t necessarily means that you need to have a headcount to do it, but usually, it translates into that. An example, community management for social. That’s a function that traditionally you would have had in an agency, but you see, if you look at the bigger clients and when you look at people, basically, that community manager is your brand, talking to people. You probably want someone who is the brand doing that.

For me, that’d be an example of where do you make those calls and how do you say, “Do I keep this inside or do I take it out?” It’s not necessarily cost the major, your driver is. It’s how important is this for you doing what you’re trying to achieve.

Alex: You want to be able to make the right decision regardless of budget based on what’s the most important. Community management should never be with an agency. Sorry, the agencies that do that, but that’s never going to be relevant enough to do it on the outside. Yes, important to be able to do it how you need to. I wonder where that downward pressure on budgets is coming. I guess the payer influence and stuff like that. Okay. All right, very interesting.

Yes-no question, what’s the MBA? Hernando, everybody’s got an MBA from Stanford, is that right?

Hernando: Yes.

Alex: Was it worth it?

Hernando: It was fantastic.

Alex: What kind of food is better, American or Spanish?

Hernando: Spanish, of course.

Alex: Yes. What’s your favorite–

Hernando: You mentioned why you would find is American food because hamburgers are delicious.

Alex: [laughs] What’s your favorite Spanish food?

Hernando: I love tortilla, but that doesn’t [unintelligible 00:17:01]

Alex: Yes, there you go. All right, Hernando, that was incredibly helpful. We cannot thank you enough. Thank you for being on Ignite and sharing all of these insights with us. Hopefully one day, someone listening can pay it forward to you.

Alex: Fantastic.

Announcer: Thanks for listening to this episode of Ignite. If you liked what you heard, please leave us a rating and review. Before you go, please remember to subscribe to this podcast so you don’t miss the next episode. For more digital marketing tips, make sure you visit cardinaldigitalmarketing.com. Have a great rest of the day and don’t forget that the most important part of your job is to ignite growth.

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Hernando Ruiz

Hernando Ruiz-Jimenez, Chief Marketing Officer at New York Presbyterian Hospital

Alex Membrillo

CEO

Alex Membrillo is the CEO of Cardinal, a digital marketing agency focused on growing multi location companies. His work as CEO of Cardinal has recently earned him the honor of being selected as a member of the 2018 Top 40 Under 40 list by Georgia State University as well as 2015 and 2016 Top 20 Entrepreneur of metro Atlanta by TiE Atlanta, Atlanta Business Chronicle’s 2016 Small Business Person of the Year,and the Digital Marketer of the Year by Technology Association of Georgia (TAG).

Cardinal has experienced exponential growth under Membrillo’s leadership, being consecutively named on the Inc. 5000 list of fastest growing privately-held US companies for the last three years. Membrillo’s innovative approach to digital marketing has transformed the industry and delivered remarkable results to clients of all sizes and markets. He has been featured in leading national publications including The Business Journals, Entrepreneur, Search Engine Journal, and The Wall Street Journal. He has also served as an expert speaker for conferences including the American Marketing Association, SouthWired, and Vistage Executive Leaders, where he spoke on his unique approach to Millennial Management to over 400 CEOs.

Alex Membrillo Cardinal CEO