University of Pittsburgh Medical Center is a healthcare provider and insurer that employs more than 90,000 employees and is the largest non-governmental employer in the state of Pennsylvania. UPMC encompasses 40 hospitals in Pennsylvania, New York and Maryland, as well as hospitals in Ireland and Italy. UPMC is affiliated with the University of Pittsburgh Schools of Health Sciences.

THE PROBLEM

In 2014, UPMC had five major websites that varied widely in functionality, sophistication and design – resulting in a complicated, inefficient and cumbersome end-user experience. Over the years, each of these websites originated in different ways from an assortment of groups within the organization. The online presence was essentially a patchwork of loosely connected websites.

"Furthermore, each website was built on a different platform, which was a maintenance nightmare," said Susan A. Hill, senior digital marketing manager at UPMC. "The websites needed to be consolidated, or at least made more cohesive. Additionally, UPMC had identified the ability to implement a robust personalization strategy as a key marketing goal. We needed a solution that would also allow us to move aggressively forward with this initiative."

PROPOSAL

After the evaluation of numerous content management systems (CMSs), Sitecore stood out to UPMC staff due to its ability to deliver a full digital experience, its ability to provide the level of customization staff desired and the ability to implement a robust personalization strategy, Hill explained.

"They quickly became the clear and obvious choice for us," she said. "In 2014, we kicked off a large-scale, multiyear project to consolidate our five major websites into a single, comprehensive CMS. In December 2015, the UPMC Children's Hospital site was our first site to launch using Sitecore, followed by our Community Pediatrics site, Hillman Cancer Center site, Physicians Resources site, and, finally, our flagship site, UPMC.com, launched in 2018."

MEETING THE CHALLENGE

So personalization was a key marketing goal for UPMC. From the launch of the very first Sitecore website, staff toyed with personalization.

"Initially, we were focused on simple, rules-based personalization – changing content and images based on number of visits, campaign entry, GEO IP address and goal completion," Hill noted. "However, we were aware that we were only scratching the surface of what was possible. We also weren't fully taking into consideration the reporting or future optimizations that could be learned from a well-thought-out approach to personalization."

Additionally, staff faced a challenge that is particularly unique to the healthcare industry – finding the perfect balancing point between effective personalization and over-personalization, she added. Staff knew where they wanted to be but were struggling to chart a clear path.

"We have been able to consolidate maintenance and updates of all sites under one team. In addition to the somewhat obvious advantages of this, there have been a number of unanticipated benefits. For example, because our content authors now only need to work in one CMS, this has allowed them to develop a much higher level of technological expertise than previously when their work was split across multiple systems."

Susan A. Hill, UPMC

"It probably goes without saying that both HIPAA and GDPR must be taken into account when considering personalization on a healthcare website," Hill remarked. "Because there are restrictions on access to site visitors' personal information, every site visitor is essentially anonymous and able to be profiled by site behavior only.

"Also, we are keenly aware that when it comes to healthcare, people are especially concerned about privacy," she continued. "The level of personalization commonly found, and these days often expected, on e-commerce sites and entertainment streaming sites would be completely inappropriate for a healthcare website. While we want to provide our site visitors with an experience tailored to their interests and perceived needs, we never, under any circumstance, want them to feel uncomfortable."

With these two challenges always at the front of staff members' minds, they knew that putting in place the truly robust personalization strategy that they envisioned would take detailed planning to address the unique situation.

UPMC shared its challenges and goals with Sitecore and decided that working with the company's Sitecore Business Optimization Strategies (SBOS) team was the best first step toward accelerating personalization efforts.

"The SBOS team held a two-day, onsite workshop with UPMC in December of 2019 to start identifying and building out our digital goals," Hill recalled. "The workshop included members from all areas of the UPMC digital marketing team. Bringing together individuals from across the team was important because a successful personalization strategy requires both understanding and contribution from various areas of expertise."

With the SBOS team's guidance, UPMC staff came to a consensus on the key elements needed to move their strategy forward and realize their goal of building a truly personal experience for their website visitors.

"We came out of the workshop with a clear personalization strategy that everyone understood and, equally important, that everyone agreed on," Hill said. "Our development team built custom goals into our Sitecore solution to properly track digital conversion points. Building out the Sitecore marketing control panel and defining our digital goals made personalization efforts easier and more scalable."

Additionally, staff now had a concrete way of reporting and proving the effectiveness of their personalization efforts.

"Today at UPMC, we are personalizing pages on our sites with adaptive personalization using user patterns and profiles," Hill explained. "This has made our optimization more audience-based. We continuously test our personalization efforts to improve the effectiveness and lift of our personalization initiatives.

"While in the past, we sometimes struggled to get our clients to buy into some of our personalization ideas and suggestions, they now reach out to us to add personalization to support their campaigns," she continued. "Overall, UPMC has embraced and adapted to a more nuanced personalization and optimization approach."

None of this would have been possible, Hill added, without the involvement of people across the entire digital marketing team, including Marketing Technologist Sean Tubridy and the development team headed by Rich Collier.

Then came 2020 and COVID-19.

"To say that 2020 found us all living in unprecedented times feels like an understatement," Hill said. "Across the globe, individuals and businesses saw their world upended by the pandemic. Everyone felt the need to provide current and accurate information to their audience, but none more so than those in the healthcare industry. For us, it became potentially lifesaving.

"As a business, how do you connect during a pandemic? How do you reach people when you need to social distance? How do you have a conversation when everyone is observing stay-at-home restrictions? These were the questions most businesses were likely asking themselves. To us, it was at this moment when we knew that digital channels unquestionably would become the primary way to communicate."

When the coronavirus began to spread, as the leading healthcare provider in its region, UPMC's need to communicate and stay connected with its communities became a moral imperative, not just a business need, she added.

"UPMC's leadership immediately recognized the need to provide the communities we serve with up-to-date information as quickly as possible, and they turned to the digital marketing team to make this happen," Hill said. "Leveraging the tools that Sitecore provides, we were able to rapidly set up a COVID-19 information hub on our flagship site, UPMC.com."

There, not only patients but the broader communities UPMC serves can find a wide range of up-to-the-moment information including:

• Preventative measures to contain the spread of the virus

• How to recognize symptoms and seek care

• Testing availability and locations

• New hospital protocols including visits to the ER and admissions

"With daily, sometimes hourly, updates and additions, the COVID-19 hub grew quickly," Hill said. "As soon as instructional videos were available, they were posted to the hub. We added live-streaming capabilities that allowed our audience to watch press conferences with our medical and research experts in real time.

"In under an hour, thanks to Sitecore forms and an integration with Salesforce Marketing Cloud, we were able to add a registration form to the hub that allowed users to sign up for informative emails," she continued. "In the past, this type of work would have required days, if not weeks. But with Sitecore's technology, we were able to add new tools and functionality as quickly as needed."

No request went unfulfilled, and as a result staff have been able to continuously serve their communities in the way they deserve during extraordinary times, she added.

"Normally, large projects have timelines that stretch out weeks if not months," Hill noted. "With the pandemic, we had to move at lightning speed because lives literally depended on it. We had the initial hub up within a couple of days, and we were adding new functionality to it before it even officially launched.

"Many things came together to allow us to move at such an accelerated pace – a dedicated digital marketing team, medical experts willing to carve out precious time in their frantic schedules, a patient experience team to help coordinate marketing and clinical efforts, and the expertise of our technical team that allowed us to leverage our platform in new and unanticipated ways."

The pandemic brought unimagined challenges and levels of anxiety never before shared by so many. UPMC has always put its patients' needs first, and, seeing the very real health risks facing its communities, it recognized right away the need for a trusted ally to help guide them through the unchartered waters, Hill said.

"Sitecore's technology allowed us to quickly respond to these needs of our patients, our neighbors and our friends, and establish an information hub for information where our community could get current, accurate and honest insight from trusted medical leaders in a quickly changing world," she said.

RESULTS

Initially, UPMC's primary goal was to unify the websites. It needed to ensure a consistent and optimal user experience for all visitors.

UPMC also wanted to streamline the maintenance of five major sites. Hill says she doesn't want to downplay the effort of rebuilding five large sites on a new platform, but the investment of time and resources has certainly paid off.

"We have been able to consolidate maintenance and updates of all sites under one team," Hill noted. "In addition to the somewhat obvious advantages of this, there have been a number of unanticipated benefits. For example, because our content authors now only need to work in one CMS, this has allowed them to develop a much higher level of technological expertise than previously when their work was split across multiple systems.

"From a development perspective, our tech team now has the ability to build new tools and functionality that can be used across multiple sites," she continued. "No longer does the addition of a new page component need to be built five times in order to be used on all the sites. 

"Even when a site requires a unique development approach, much of that work used can still be leveraged for use on the other sites," she added. "This has dramatically streamlined our overall development process and allowed us to be much more efficient and productive."

The same applies across all areas – user testing, site performance, accessibility improvements, SEO best practices, etc. While it may start on one site, it can then easily be applied across all the other sites, she added.

"In addition to consolidating our main websites, we also had started with the marketing goal of establishing a robust personalization strategy," Hill said. "Sitecore's ability in this area was certainly a driving factor in our platform decision. While the actual implementation of our envisioned strategy was much more nuanced than originally anticipated, we now have in place a solid foundation.

"Today, in addition to standard rules-based personalization, UPMC is using adaptive personalization based on user patterns and profiles on our sites," she continued. "This allows our personalization and optimization efforts to be more audience-based. In other words, rather than simply personalizing a page based on a geolocation or time of day or referring source, we can provide personalization more aligned with the users' interests and perceived goals. This provides our users with a much richer and tailored on-site experience."

ADVICE FOR OTHERS

First, Hill advises peers considering such a project to be thinking of the future.

"As we all know, the digital world seems to evolve at warp speed sometimes," she said. "New technology can often be a significant investment in both cost and resources. You want to make sure your investment will not only address your current needs but will evolve and grow with you. When evaluating technology providers, look at their history of upgrades and how those upgrades expanded the capabilities afforded by the technology.

"You want to choose a company that has consistently been forward-thinking and growing their product to keep pace with the needs of their customers," she continued. "Taking this into consideration will help reduce the risk of outgrowing the technology you've invested in."

Second, Hill strongly recommends being as inclusive as possible in the decision-making process, the implementation and the ongoing use of the technology.

"In our case, when we were evaluating new CMSs, representatives from across the organization were part of the process," she said. "This included IT, marketing and hospital leadership. Each group brought a unique and valuable perspective on their specific requirements as well as potential challenges that needed to be considered."

Taking this approach ensured not only that staff were choosing the right solution, but it also instilled a sense of ownership that ensured a commitment to success across many somewhat disparate groups, she added.

"We have continued to take this inclusive approach over the ensuing years, and as a result we have created a solid core of support for and understanding of the technology," she concluded. "An unforeseen bonus to this approach is that the cross team and department connections made have carried over to other projects and opened new channels of communications."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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