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D E B A T E Open Access
Integrated marketing communications: a
strategic priority in health and medicine
James K. Elrod
1
and John L. Fortenberry Jr.
1,2*
Abstract
Background: Healthcare establishments portray themselves to their patient populations using many communicative
mechanisms. Perhaps the first avenues that come to mind are the outward conveyances of the marketing
communications mix, including advertising, personal selling, sales promotion, public relations, and direct marketing. But
other prominent communicators also exist, including the people employed by healthcare institutions, the places in
which services are delivered, and the brands that represent given establishments. This wide variety of communicative
mechanisms is somewhat of a mixed blessing, affording myriad options, but also necessitating extra care and attention
in developing associated marketing communications.
Discussion: Now more than ever, health and medical establishments have at their disposal communications options
capable of addressing most any conveyance want or need. The marketing communications mix, once somewhat
limited due to industry tradition, is now fully accessible and widely used in the health services industry, providing
immense opportunities to connect with patients. Options for signage, building designs, servicescape amenities,
employee uniforms, and the like also are teeming, providing myriad avenues for making positive impressions. But
burgeoning options while beneficial also intensify obligations for ensuring that marketing communications are
properly integrated, with this particular article describing this imperative need and its implications for communicative
success in the healthcare industry.
Conclusions: By integrating marketing communications, health and medical providers are able to create synergies
between and among selected conveyance mechanisms, amplifying performance and increasing the likelihood of
reaching communicative goals. Achieving such cohesion requires devoted planning in an effort to coordinate verbal
and visual manifestations to express desired imagery and appeals to target audiences. As extensive benefits are derived
from integrated marketing communications, healthcare establishments should consider associated pursuits to be a
strategic priority.
Keywords: Integrated marketing communications, Promotion, Advertising, Hospitals, Healthcare
Background
Communicating successfully with current and prospective
patients represents an essential and ongoing task for
health and medical establishments [1–3]. Excellence on
this front is vital for many reasons, with perhaps the most
notable being that effective communications inform and
enlighten audiences, generating interest and attention,
prerequisites for attracting patients and acquiring market
share [2,4–6]. Communications, of course, must be ap-
pealing to target markets, necessitating steps to ensure
positive portrayals at every opportunity, with healthcare
establishments turning to many promotional mechanisms
to engage desired patient populations. In such pursuits,
perhaps the first avenues that come to mind are the out-
ward conveyances of advertising, public relations, sales
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* Correspondence: john.fortenberry@lsus.edu
1
Willis-Knighton Health System, 2600 Greenwood Road, Shreveport, LA
71103, USA
2
LSU Shreveport, 1 University Place, Shreveport, LA 71115, USA
Elrod and Fortenberry BMC Health Services Research 2020, 20(Suppl 1):825
https://doi.org/10.1186/s12913-020-05606-7
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
promotion, and other components of the traditional mar-
keting communications mix, with these pathways being
traversed extensively by health and medical organizations
in bids to connect with audiences [2,4,7,8].
Indeed, the components of the marketing communica-
tions mix are tried and true methods for engaging pa-
tient populations, but they are not the only avenues
available for doing so. Other prominent communicators
also exist, including the people employed by healthcare
institutions, the places in which services are delivered,
and the brands that represent given establishments,
affording extended means for informing and enlighten-
ing customer groups [2,4,7,9–12]. This wide variety of
communicative mechanisms, however, is somewhat of a
mixed blessing. While the burgeoning array of options
affords tremendous utility, healthcare providers must
direct extra care and attention when assembling associ-
ated conveyances to ensure cohesion between and
among promotional elements. Such cohesion yields inte-
grated marketing communications which should be a
strategic priority for health and medical establishments.
This particular article shares a range of insights on inte-
grated marketing communications, providing useful
guidance for healthcare organizations seeking to bolster
their patient engagement efforts.
Discussion
Now more than ever, health and medical establishments
have at their disposal communications options capable of
addressing most any conveyance want or need. Today,
healthcare institutions routinely make use of the full mar-
keting communications mix, calling upon its five compo-
nents of advertising, personal selling, sales promotion,
public relations, and direct marketing as desired to reach
their target audiences [2,4,13]. This starkly contrasts with
prevailing healthcare industry mindsets of the not-so-
distant past (ca. 1980s and earlier) which frowned on
using the full power of the marketing communications
mix. Notably, advertising was viewed to be beneath the
dignity of medical providers and potentially detrimental to
established patient referral patterns. But associated resist-
ance ended in the 1980s, aided notably by governmental
scrutiny of the American Medical Association’s ban on its
members’use of advertising, paving the way for advertis-
ing to flourish, making the marketing communications
mix fully accessible and acceptable for use in the health
services industry [1,5,7,9].
Beyond the components of the marketing communica-
tions mix, foundational elements—people, places, and
things that communicate on behalf of healthcare institu-
tions—also present more opportunities than ever to make
positive, enduring impressions. Cutting edge training pro-
grams, stylish uniforms, and the like have the potential to
dramatically elevate the actions and appearances of
healthcare personnel; modern exterior and interior sign-
age options, especially digital variants, are capable of cap-
turing attention like never before; and contemporary
servicescape designs and associated amenities have the
power to greatly impress and inspire target audiences.
These and similar elements convey volumes of informa-
tion to others, arguably projecting details as robustly as
anything within the traditional marketing communica-
tions mix, crucially impacting the perspectives of current
and prospective patients and presenting immense oppor-
tunities to influence associated patronage decisions [2,4,
7,9–12].
But burgeoning communicative options, while benefi-
cial, also intensify obligations for ensuring that marketing
communications deployed by given healthcare institutions
are properly integrated to present a cohesive picture to
target audiences. Integrated marketing communications
(IMC) happens to be a formal term in the discipline of
marketing. It is defined as “the coordination of all of the
marketing communications efforts of an organization for
the purpose of ensuring the consistent presentation of
promotional messages to target audiences”[2], p. 286.
Essentially, achieving integrated marketing communica-
tions yields a highly-desired communicative state where
all conveyances telegraphed by an establishment over a
given period of time are linked together. This typically is
realized through the use of a defined collection of verbal
and visual manifestations (e.g., logos, slogans, color
schemes, themes), leading audiences to view each commu-
nication to be part of a comprehensive body of work pre-
senting the establishment clearly and cohesively.
Integration effectively creates synergies between and
among all of the promotional elements deployed by an
organization, amplifying the impact potential of commu-
nicative efforts [2,4,14–16].
In the absence of such integration, communicative ele-
ments lack effective linkages. Imagine, for example, a
scenario where a healthcare establishment, on adopting
a new slogan, updates its advertising to feature the new
expression, but neglects to revise its other promotional
materials, accordingly. Similarly, consider a situation
where corporate colors have been updated, but some
marketing communications continue to make use of the
former color array. Given different creative treatments,
communicative synergies cannot be leveraged, diminish-
ing impact that otherwise would be possible via proper
communicative integration. Indeed, the necessity for in-
tegrating marketing communications is so pronounced
that entire textbooks have been written on the topic
(e.g., [17–21]), demonstrating its associated value and
importance.
Achieving a marketing communications presence that
would be considered to be integrated requires extensive
attention to detail. As various forms of promotion are
Elrod and Fortenberry BMC Health Services Research 2020, 20(Suppl 1):825 Page 2 of 5
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
developed, efforts must be directed toward ensuring that
they work in harmony together, creating a cohesive, in-
terrelated body of work [2,4]. As content which portrays
healthcare establishments (e.g., signage, advertisements,
sales promotions, websites, stationery, direct mail) usu-
ally is produced over time, the need for vigilance is quite
obvious, as without such, incongruence can appear in
the verbal and visual artifacts representing institutions,
undermining efforts to achieve and maintain integration
between and among components. Such incongruence
can range from subtle (e.g., an updated font for use on
business cards and letterhead is introduced, but
stationery featuring the old font continues to be circu-
lated) to very obvious (e.g., a logo is revised, but signage
continues to display the former identity), with such in-
consistencies, regardless of magnitude, undermining
communicative power and potential [4].
To foster presentation of a consistent image across all
marketing communications, health and medical establish-
ments can benefit by developing a creative style guide, a
comprehensive marketing communications document
which presents depictions of approved verbal and visual
elements representing given institutions and supplies de-
tailed guidelines for their use. The exact composition of
such guides is dependent on the wants and needs of given
healthcare establishments, but typical areas that are ad-
dressed include (1) logos, noting their proper display, use,
and associated restrictions, (2) creative treatments, outlin-
ing approved typography, color schemes, and associated
stylistic elements, (3) messaging characteristics, noting
approved slogans, storylines, and related content, (4) audi-
ence profiles, indicating served markets, associated targets,
and demographic attributes, (5) communication avenues,
identifying components of the marketing communications
mix and any supplementary communications pathways
that are to be pursued, and (6) authorization processes,
outlining protocols for presenting assembled communica-
tions to institutional leaders for review and approval, per-
mitting dissemination.
The activity of developing these guides, in and of itself, is
helpful in that it forces institutional leaders to think deeply
on the verbal and visual manifestations which represent their
given organizations, providing an opportunity to examine
and potentially improve methods and manners of presenting
their establishments to target audiences. This also aids in
achieving communicative cohesion, as components are de-
veloped in an orderly fashion, something which avoids patch-
work assembly methods which inadvertently can foster
incongruity [2,4,10,22]. The all-important authorization
process is also addressed, further ensuring compliance with
designated standards. By adhering to defined creative proto-
cols, a clear identity emerges, essentially yielding consistent
creative signatures which amplify all marketing communica-
tions forwarded on behalf of healthcare institutions.
In the 1970s, a particularly formative time period for
the institution, Willis-Knighton Health System laid the
groundwork for enduring integrated marketing commu-
nications by focusing on creative treatments and applica-
tions, with one of the most essential being the
development of an appealing logo. Today, this logo is
Fig. 1 Several recent billboard advertisements promoting Willis-Knighton Health System
Elrod and Fortenberry BMC Health Services Research 2020, 20(Suppl 1):825 Page 3 of 5
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
one of the most widely recognized in the marketplace
and it anchors virtually every communication forwarded
by the institution [9,10]. Coupled with consistent color
schemes, slogans, and manners and methods of presen-
tation, Willis-Knighton Health System’s particular cre-
ative treatment, regardless of the service line to which it
is applied, builds communicative bridges between and
among each and every conveyance, naturally supplying
the critical linkages that afford integrated marketing
communications, as the sample billboard and newspaper
advertisements, provided in Figs. 1and 2, and the
sample television commercials, available at https://www.
wkhs.com/video/commercials, illustrate.
Applications of Willis-Knighton Health System’s cre-
ative style are not limited to conveyances of the trad-
itional marketing communications mix; they influence
decisions pertaining to anything which communicates
on behalf of the institution, guiding signage decisions,
employee uniform designs, and so on, yielding a univer-
sal creative portrayal of the institution to its audiences.
Such results stem from the devoted use of a creative
style guide which, once assembled and approved, directs
the development and dissemination of content, provid-
ing reasonable assurances that presentations and por-
trayals of given institutions will be consistent.
A healthcare establishment’s achievement of integrated
marketing communications is best ascertained by view-
ing the totality of communicative elements deployed by
the given institution. Interior and exterior signage,
stationery, employee uniforms, promotional brochures,
advertisements, direct mail pieces, website designs and
associated promotional content, and more should be ex-
amined comprehensively. If each element when viewed
individually appears to be part of the larger body of
work, then integration pursuits can be deemed to have
been successful. If not, corrective actions need to be
taken to bring noncompliant promotional elements into
compliance with the communicative aims expressed in
the associated creative style guide, affording harmony
between and among all conveyances.
While the concept of integrated marketing communica-
tions might seem so obvious as to not warrant discussion,
environmental complexities, propensities to lose sight of
the bigger picture, routine distractions, and the like have
the potential to undermine and erode efforts to ensure co-
hesion between and among communicative components.
As noted earlier, if proper attention is not directed toward
the assembly and management of elements promoting
healthcare establishments, incongruence eventually will
emerge, diminishing the communicative power and poten-
tial of given expressions. The introduction and use of cre-
ative style guides, coupled with ongoing discussions
regarding the importance of integrated marketing com-
munications, will help healthcare establishments stay on
course for achieving harmony across all communications,
reaping associated benefits.
Conclusions
By integrating marketing communications, health and
medical providers are able to portray themselves clearly
and consistently to their audiences, something that is ab-
solutely essential for the best communicative outcomes.
Further, synergies will emerge between and among the de-
ployed conveyance mechanisms, amplifying performance
and increasing the likelihood of reaching communicative
Fig. 2 A recent newspaper advertisement promoting Willis-Knighton
Health System
Elrod and Fortenberry BMC Health Services Research 2020, 20(Suppl 1):825 Page 4 of 5
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
goals, ultimately improving the return on investment gen-
erated by the associated marketing communications.
Achieving such cohesion requires devoted planning in an
effort to coordinate verbal and visual manifestations to ex-
press desired imagery and appeals to target audiences,
with guiding protocols and reminders to maintain integra-
tion being essential as a defense against oversights and dis-
tractions which could lead to communications
incongruence. As extensive benefits are derived from inte-
grated marketing communications, healthcare establish-
ments should consider associated pursuits to be a
strategic priority.
Acknowledgments
A special note of thanks is extended to Marilyn Joiner, Darrell Rebouche, and
the greater Willis-Knighton Health System family for their helpful assistance
throughout the development and publication of this article.
About this supplement
This article has been published as part of BMC Health Services Research
Volume 20 Supplement 1, 2020: Marketing communications in health and
medicine: perspectives from Willis-Knighton Health System. The full contents
of the supplement are available online at http://bmchealthservres.biomed-
central.com/articles/supplements/volume-20-supplement-1.
Authors’contributions
The authors jointly developed the submitted manuscript, with each
performing critical roles from early conceptualization through to the
production of the full manuscript. The manuscript resulted from a
collaborative effort. Both authors read and approved the final manuscript.
Authors’information
JKE is President and Chief Executive Officer of Shreveport, Louisiana-based
Willis-Knighton Health System, the region’s largest provider of healthcare ser-
vices. With over 55 years of service at the helm of the institution, JKE is
America’s longest-tenured hospital administrator. A fellow in the American
College of Healthcare Executives and honoree as a Louisiana Legend by
Friends of Louisiana Public Broadcasting, he holds a bachelor’s degree in
business administration from Baylor University, a master’s degree in hospital
administration from Washington University School of Medicine, and an hon-
orary doctorate of science and humane letters from Northwestern State Uni-
versity of Louisiana. He is the author of Breadcrumbs to Cheesecake, a book
which chronicles the history of Willis-Knighton Health System.
JLF Jr. is Chair of the James K. Elrod Department of Health Administration,
James K. Elrod Professor of Health Administration, and Professor of Marketing
in the College of Business at LSU Shreveport where he teaches a variety of
courses in both health administration and marketing. He holds a BBA in
marketing from the University of Mississippi; an MBA from Mississippi
College; a PhD in public administration and public policy, with
concentrations in health administration, human resource management, and
organization theory, from Auburn University; and a PhD in business
administration, with a major in marketing, from the University of Manchester
in the United Kingdom. He is the author of six books, including Health Care
Marketing: Tools and Techniques, 3rd Edition, published by Jones and Bartlett
Learning. JLF Jr. also serves as Vice President of Marketing Strategy and
Planning at Willis-Knighton Health System.
Funding
Article processing charges were funded by Willis-Knighton Health System.
Availability of data and materials
Not applicable.
Ethics approval and consent to participate
Not applicable.
Consent for publication
Figures 1 and 2 are published with permission of Willis-Knighton Health Sys-
tem. All required approvals for publication were obtained.
Competing interests
JKE and JLF Jr. are both employed with Willis-Knighton Health System.
Published: 15 September 2020
References
1. Berkowitz E. Essentials of health care marketing. 4th ed. Burlington: Jones
and Bartlett; 2017.
2. Fortenberry JL Jr. Health care marketing: tools and techniques. 3rd ed.
Sudbury: Jones and Bartlett; 2010.
3. Elrod JK, Fortenberry JL Jr. Healthcare establishments as owner-operators of
digital billboards: making the most of excellent roadside visibility and high
traffic counts to better connect with patients. BMC Health Serv Res. 2018;
18(Suppl 3):928.
4. Fortenberry JL Jr. Cases in health care marketing. Sudbury: Jones and
Bartlett; 2011.
5. Thomas RK. Marketing health services. 3rd ed. Chicago: Health
Administration Press; 2014.
6. Kotler P, Shalowitz J, Stevens RJ. Strategic marketing for health care
organizations: building a customer-driven health system. San Francisco:
Jossey-Bass; 2008.
7. Elrod JK, Fortenberry JL Jr. Formulating productive marketing
communications strategy: a major health system’s experience. BMC Health
Serv Res. 2018;18(Suppl 3):926.
8. Elrod JK, Fortenberry JL Jr. Catalyzing marketing innovation and competitive
advantage in the healthcare industry: the value of thinking like an outsider.
BMC Health Serv Res. 2018;18(Suppl 3):922.
9. Elrod JK. Breadcrumbs to cheesecake. Shreveport: R&R Publishers; 2013.
10. Elrod JK, Fortenberry JL Jr. Driving brand equity in health services
organizations: the need for an expanded view of branding. BMC Health
Serv Res. 2018;18(Suppl 3):924.
11. Fortenberry JL Jr, McGoldrick PJ. Internal marketing: a pathway for
healthcare facilities to improve the patient experience. Int J Healthc Manag.
2016;9(1):28–33.
12. Elrod JK, Fortenberry JL Jr. Am I seeing things through the eyes of patients?
An exercise in bolstering patient attentiveness and empathy. BMC Health
Serv Res. 2018;18(Suppl 3):929.
13. Fortenberry JL Jr. Nonprofit marketing. Burlington: Jones and Bartlett; 2013.
14. Laurie S, Mortimer K. How to achieve true integration: the impact of
integrated marketing communication on the client/agency relationship. J
Mark Manag. 2019;35(3/4):231–52.
15. Keller KL. Unlocking the power of integrated marketing communications:
how integrated is your IMC program? J Advert. 2016;45(3):286–301.
16. Luxton S, Reid M, Mavondo F. Integrated marketing communication
capability and brand performance. J Advert. 2015;44(1):37–46.
17. Percy L. Strategic integrated marketing communications. 3rd ed. New York:
Routledge; 2018.
18. Juska JM. Integrated marketing communication: advertising and promotion
in a digital world. New York: Routledge; 2018.
19. Andrews JC, Shimp TA. Advertising, promotion, and other aspects of
integrated marketing communications. 10th ed. Boston: Cengage; 2018.
20. Clow KE, Baack D. Integrated advertising, promotion, and marketing
communications. 8th ed. New York: Pearson; 2018.
21. Moriarty S, Mitchell N, Wood C, Wells WD. Advertising and IMC: principles
and practice. 11th ed. New York: Pearson; 2019.
22. Calder BJ, Reagan SJ. Brand design. In: Iacobucci D, editor. Kellogg on
marketing. New York: Wiley; 2001.
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