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LINGUISTICA ANTVERPIENSIA, 2021 Issue-3
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The healthcare sector: A development of digital marketing
methods
Worakamol Wisetsri1, Dr. Nupur Soni2, Raghvendra Kumar Singh3, Dr. Pawan Kumar
Chaurasia4, Shashi Kant Gupta5
1Associate Professor, Department of Manufacturing and Service Industry Management,
Faculty of Business and Industrial Management, King Mongkut’s University of Technology
North Bangkok, Thailand
2Associate Professor, School of Computer Applications, BBD University, Lucknow, UP,
India
3Assistant Professor, School of Management Studies, Reva University, Bangalore, India
4Associate Professor and Head, Department of Computer Science and Information
Technology, Mahatma Gandhi Central University, Motihari, Bihar
5Researcher, Integral University, Lucknow, UP, India
raj2008enator@gmail.com
Issue Details
Issue Title: Issue 3
Received: 08 February, 2021
Accepted: 19 March, 2021
Published: 22 May, 2021
Pages: - 2602 - 2621
Copyright © 2020 by author(s) and
Linguistica Antverpiensia
Abstract
The study aims to examine why healthcare firms are lagging behind other digital
marketing sectors. This was achieved using an abductive approach, while a literary
assessment was undertaken early in the research, and the literature review was completed
following the evaluation of the empirical data collection and analysis. The study is
carried out in case study by a clinical research organization. Qualitative and quantitative
techniques were used by interviews with SEO experts and interviews with business
developers of healthcare companies. The quantitative section involves two data
collecting activities, a survey of SEO specialists and workers from different firms and
data collection of top volume and traffic keywords from branch colleagues. The result is
that inadequate work is being conducted for healthcare companies and businesses in
general inside digital marketing. Another inference was that, when it comes to digital
marketing, the healthcare sector is lagging behind other sectors.
Keywords: Digital Marketing, B2B Marketing, Clinical Research Organizations, Healthcare
Industry, Marketing Strategies.
1. Introduction
Since the healthcare industry is considered as falling behind in the field of digital
marketing in comparison to other industries (Grbic et al., 2019), this thesis work is
performed to understand the healthcare industry and investigate whether digital
marketing is a suitable marketing practice. To solve this, by studying and discovering
the possibilities of a specific company´s digital marketing strategy. However, since
both the Medtech and the healthcare industry are strictly regulated regarding
marketing towards consumers, it is harder to understand the consumer's preferences
since the companies are not allowed to advertise in the same way (SKR, 2019). Since
the increasing activity within B2B marketing, it is of high relevance to examine the
possibilities of digital marketing from a B2B perspective in the healthcare industry.
The aim is therefore to analyse the digital marketing possibilities towards other
companies, to analyse the underlying factors in their competitors´ success when
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pursuing digital marketing and to understand the industry, the respective company,
and its customers. Furthermore, the main task is to understand the need of Search
Engine Optimization (SEO) in field of Medtech and to analyse the company’s and
their competitors’ current choice of keywords, which are essential components when
searching for specific search queries such as products or solutions through a search
engine (Moz, 2020a). Furthermore, it is also to investigate underlying factors that
generate success in terms of a high volume, traffic, and web page properties such as
page speed and adaptability (Moz, 2020b). Finally, the research will hopefully clarify
the importance of digital marketing, nonetheless SEO within this industry, and
discover the possibilities of this new way of optimizing and marketing companies´
products or services.
The limitation is the relatively small sampling size of the qualitative method, which
is not representing the population of the whole healthcare industry and not the usage
of digital marketing. There is no absolute number of sampling size, however, the
more respondents, the higher validity. However, it is important to interview people
with knowledge of the digital marketing and financials of the companies they operate
in, receive as valid results possible.
Furthermore, on a macro-level, the handling of data needs to be taken care of seriously
due to strict government regulations such as the General Data Protection Regulation
(Datainspektionen, 2020). This is since an essential aspect of digital marketing
consists of getting acquainted with the customers the company wants to find, meaning
it could collect personal information such as gender, background, civil status, and
consumer behavior (Chaffey & Ellis-Chadwick, 2016).
The worldwide outbreak of the Coronavirus disease COVID-19 occurred during the
period of this research, which led to many governments, companies, organizations,
and civilians to take security precautions against the further spread of the disease
(European Centre for Disease Prevention and Control, 2020; World Health
Organization, 2019). This influenced the research in the way that meetings,
interviews, and planned seminars were instead of face-to-face meetings performed
over the phone or through video like Skype or Zoom. Since multiple companies had
forced their employees to stay at home to prevent further outbreak had also influenced
their willingness to help the authors with questions, interviews, and other contacts
due to a shortage of personnel and resources for pro bono interviews with the
researchers.
Another limitation is that the thesis reflects a small percentage of the Medtech
industry, namely clinical research organizations. Stating that the Medtech industry is
an element of the merely more significant healthcare industry; hence the conducted
research can be beneficial for the field of digital marketing and the healthcare industry
since it combines them. It is, therefore, a contribution to the unknown field of digital
marketing within the healthcare industry.
Finally, one of the research methods consists of qualitative interviews that can
facilitate insights into the Medtech industry and how companies operate in these
kinds of marketing decisions. However, one must acknowledge that some results
could be misleading and that some information could be hidden and not entirely
transparent, especially when interviewing companies that can be considered as
competitors to the chosen case company.
2. Literature review
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The literature review consists of gathering relevant theory. The theory is about
marketing, mainly business to business marketing, marketing within the healthcare
sector, the evolvement of marketing from traditional marketing to marketing today,
both business to business and business to consumer marketing. The literature review
will be presented below.
2.1 marketing background
There are numerous ways to describe a market, hence the different amount of
definitions of how a market looks like. While some scholars state that it is mainly
homogeneous such as an equilibrium between supply and demand, others explain a
market as rather heterogeneous, a more complex network with more actors that are
somehow connected. For instance, suppliers, retailers, consumers, manufacturers, to
mention a few. (Wagrell, 2018).
Furthermore, there are mainly two different perspectives regarding views, the
traditional view, and the network view. The traditional one is developed by the
famous marketing scholar Kotler (2018), and the second is developed and discussed
by the authors Håkansson and Snehota (1995). However, in this study, the traditional
view is the only one being discussed.
Briefly said, the traditional view describes a market as impersonal with clear
boundaries, it is also described as a space in where two actors are independent and
exchange a product with each other (Wagrell, 2018). Whereas as from a network
point of view, the actors are interdependent and a part of a larger whole (Håkansson
& Shenota, 1995). A more in- depth explanation can be found below.
Traditional View
From the traditional view of marketing, there is an expression that was coined in the
’60s named marketing mix. The marketing mix consists of the Product, Price, Place,
and Promotion. These four things are what are known as the 4P’s of marketing. The
product represents the actual product the company wishes to sell to the customer or a
contrary perspective, what the customer wants from the company. The price is the
amount of money that the customer is willing to pay for the product. Promotion is
like the marketing
of the product, display that the company can provide to its customers (Philip Kotler,
Hermawan Kartajaya, 2017; Yi, 2018). A newer version of the 4P’s is a more
extensive one named the 7P’s. There are the same four (product, price, place, and
promotion) as the 4P’s but besides there are People, Process and Physical evidence
as to the remaining three P’s. Whereas the people represent the person providing the
product or also the person receiving the product, the people are strongly connected
with how the product will be satisfying the customer. The process is how the product
is being provided to the customer of the product. Lastly, the physical evidence is the
environment in which the product is being handed over (Yi, 2018). A newer model
called 7P’s+1G where the 1G stands for Green Marketing. This last version, 7P’s and
1G, is relatively new and towards marketing online (Pistol & Ţoniş Bucea-Manea,
2017).
2.2 B2B marketing
Marketing is often referred to as either Business to Consumer marketing or Business
to Business marketing. Business to consumer is marketing where the company or
organization aims directly to the consumer of the product or service (Chaffey & Ellis-
Chadwick, 2016, p. 21). Business to business is, as mentioned earlier in the research,
when the trade is being made between organizations or companies (Chaffey & Ellis-
Chadwick, 2016, p. 21). Some correlations between B2C and B2B marketing will be
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made in this review to easier make a comparison of the two. When comparing B2B
and B2C digital marketing, it is seen that B2C often makes transactions while the
customer is at the website, compared to B2B, where there are not often transactions
being made through the website but rather through a transaction between persons.
Generating B2B Customers
There are four other concepts of generating customers in B2B marketing, citation
from Chaffey & Ellis-Chadwick (2016, p. 629) “Stage 1. Inbound marketing focusing
on search, online PR and display advertising used to attract website visits. Stage 2.
Engagement devices such as video, white papers or other forms of market education
material is used to encourage the visitor to interact with site and share information
via social media. Stage 3. Offering access to permission-based content valuable to
the visitor is used to generate leads via encouraging the visitor to register on the site,
supplying an e-mail address and profile information or sharing the content via social
networks. Stage 4. Leads are followed up through personalized e-mail sequences or
where appropriate outbound phone calls where leads are qualified as valuable.”
(Chaffey & Ellis-Chadwick, 2016, p. 629). The four stages are examples of a
“permission-based” marketing approach, also known in B2B marketing as content
marketing or inbound marketing (Chaffey & Ellis-Chadwick, 2016, p. 629).
The Transformation of B2B Marketing
Digital marketing has a lot of names, e.g., Internet marketing, E-marketing, and web
marketing. However, in most articles, it is referred to as digital marketing, which will
also be the name reference in this thesis. The marketing strategy originates from the
uprising of digital media, which is a term that includes several digital platforms such
as interactive TV, Web, mobile phone, and the Internet (Chaffey & Ellis-Chadwick,
2016).
The digital marketing came from when the World Wide Web and the following
websites were publicly available in 1991, and it was the start of an area that would
later change traditional marketing. With more than 3 billion people globally using the
internet today, digital marketing has become an essential tool for companies to
position themselves to connect with the right customers (Chaffey & Ellis-Chadwick,
2016). Digital marketing can be defined as “Achieving marketing objectives through
applying digital technologies and media.” (Chaffey & Ellis-Chadwick, 2016).
According to digital advertisement reports (Silverman, 2012, 2019), the total media
revenue in the US as of 2018 is $273.949 billion, where $107.487 billion is from
internet advertising, making up a total of 39% of the total US media revenue. Internet
advertising is the largest category, followed by TV advertising which has a 26%
market share. In the third place is B2B with a 9.5% market share. Other categories
are magazines, radio, newspapers, and other categories (Silverman, 2019). Internet
advertisement is becoming more through mobile rather than desktop; in 2010, the
market share for mobile was 3% of the total US market, and in 2018 the mobile
market share increased to 65.1% of the internet advertising revenue market share
(Silverman, 2012, 2019).
B2B marketing can also have a contrary view as well on digital marketing since the
online and offline activities can follow hand in hand means Popovici et al. (2018).
Popovici et al. (2018) further conclude that B2C marketing benefits a whole lot more
from the available research compared to B2B marketing since it is a shortage of B2B
digital marketing research. It is concluded that some practitioners benefit fully from
digital marketing, while some practitioners are performing both traditional and digital
marketing (Popovici et al., 2018).
2.3 The environment of company marketing and education
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Since the evolvement during the past decades with digitalization, schools, and
companies need to stay competitive in the field and adjust to the trend of digital
marketing (Langan et al., 2019; Rohm et al., 2019). This becomes clear when
studying the Fortune 500 companies, where companies are overall underperforming
in digital marketing, which in return, affects their financial performance. The adverse
effects on the Fortune 500 companies are shown by more than 50% of the companies
listed there have either gone out of business or similar between the year 2000 and
2018. The downfall of the Fortune 500 companies who have disappeared, directly
correlates to them not following the trend of digitalization within marketing (Rohm
et al., 2019).
The Fortune 500 companies come from the magazine Fortune, which was founded in
1929 by Henry Robinson, who also was the co-founder of Time Magazine. The
magazine makes an annual list of 500 companies that fulfils several requirements to
attend the list. These requirements are among other revenue, profit, employees. The
company is required to be registered in the US. Examples of companies on the
Fortune 500 list as of 2019 are Walmart, ExxonMobil, and Berkshire Hathaway. The
Fortune 500 companies have almost 30 million employees and revenues exceeding
13 trillion USD combined (Fortune Media, 2020).
As mentioned in the previous section, that companies fall behind within digitalized
marketing is no exception for healthcare companies (Grbic et al., 2019). The
healthcare sector is currently in a time of transition from traditional marketing and is
going more towards digital marketing. This is because the customers are doing more
of the work themselves to allocate the aid they need since they are becoming more
engaged in the process through search engines, websites, and apps. Anderson,
Rayburn, & Sierra (2019) states that customers who demand a higher level of service
are increasing (Anderson et al., 2019). Conclusions from the ongoing transition are
that healthcare organizations are falling behind on digital marketing. (Grbic et al.,
2019). Also, Anderson, Rayburn, & Sierra (2019) have concluded that future survival
within the healthcare industry will be through well-functioned marketing (Anderson
et al., 2019).
Furthermore, Rohm (2019) writes about Loyola Marymount University (LMU), who
has concluded that there is a gap between the marketing educations at universities
and work life. LMU has then started a new program to eliminate and close the
knowledge gap between education and work-life within marketing, the education is
known as M-School and was launched 2012 as a result of the increasing knowledge
gap (Rohm et al., 2019). Gummesson & Polese (2009) agree in this approach with
the statement, “Marketing scholars more often seem to conceptualize and record what
role model enterprises already practice, thus being historians more than futurists”
(Gummesson & Polese, 2009). Gummesson & Polese (2009) concludes that
textbooks in marketing education often are too general and do not follow the latest
evolvements within the marketing field. Marketing courses are standardized in some
sense and can inhibit the learning experience for the student who follows the often
not updated textbook examples (Gummesson & Polese, 2009).
2.4 Sponsored Search
Sponsored search or paid search as it is often called, is when the company pays for
getting their links on the top of the first results page at the search engine, e.g., Google.
The paid searches are listed above the organic searches on the first page of the search
engine (Arnold et al., 2018). The cost for keywords varies in price depending on how
high the keyword is ranked by the search engine. Some essential tools in sponsored
searches are Cost per click (CPC) that indicates how much it costs for a company
every time they get a click on their ad or website through keywords. CPC is an
example of paid media (Chaffey & Ellis-Chadwick, 2016; Grbic et al., 2019). CPC,
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through Google’s program AdSense can vary between 0.1 GBP up and beyond 20
GBP, but most often not higher than 4 GBP. The company’s website itself is an
example of owned media (Chaffey & Ellis-Chadwick, 2016). Cost per action or cost
per acquisition (CPA) is similar to CPC, but instead of a cost for every click, it only
costs for the company which is acquiring the ad when an action is being made because
of the click, example of action can be a registration or a purchase. Examples, when
this occurs, is where a third party website links to the company’s website and the
customer makes an action, like a registration or a purchase (Chaffey & Ellis-
Chadwick, 2016; Zhou et al., 2019). Cost per sale (CPS) is like CPA, but here the
company only pays the advertiser when a customer makes a purchase. Other than the
cost when a customer makes an action there is also a monthly fee (Chaffey & Ellis-
Chadwick, 2016; Zhou et al., 2019).
Comparing the three to each other for what is most suitable to use can depend on
different factors. Since all of them can be used for gaining the same result in some
cases, however, one can be better than the other from the marketing spending’s point
of view. If the company have good knowledge of their relevant keywords, the CPC
method could be a suitable alternative. If the company had excellent customer
knowledge and insights, it would render in attracting purchasing customers to the
webpage. If they manage to perform this, they will then have a high click-through
rate which is the ratio between how many times the ad is shown compared with the
number of times it is clicked on, e.g., 1000 exposures and 16 clicks give a click-
through rate of 1.6% (Chaffey & Ellis-Chadwick, 2016; Rutz et al., 2019).
Keywords
According to Li & Yang (2020), advertisers in sponsored search advertisements are
making important decisions regarding keywords. This is since these are the
components that are the link between search engines, search users, and advertisers.
Thus, leading that keywords that are organized well contribute with more traffic and
revenues since it pairs up the right ads with the right customers. The challenge for
search advertisers is to decide on selection, grouping, keyword generation, and
adjustment (H. Li & Yang, 2020).
According to Chaffey & Ellis-Chadwick (2016), there can be in particular, niche
markets low volumes of searching. Hence this led to a higher competition of the
keywords with the CPC increasing (Chaffey & Ellis-Chadwick, 2016, p. 627).
Ad Groups
By organizing advertising campaigns to achieve a goal, ad groups are defined to be
able to convert searchers into potential consumers. This is a set of several keywords
along with ad copies that together make up an “Ad group”. For instance, if a potential
customer searches for “soda”, the results from the ad group could consist of “Coca-
Cola”, “Sprite” or “Bud light” (Google, 2020). For instance, if a potential customer
searches for “soda”, the results from the ad group could consist of “Coca-Cola”,
“Sprite” or “Bud light”. (Google, 2020). Since the word beverages are so broad,
consisting of multiple beverages, ad groups make it possible to reach out to a more
significant population. However, the set-up of ad groups is vital to reach out to a
target population. It is also more convenient for advertisers to optimize the
performance of several ad groups rather than focusing on specific keywords. One
must acknowledge that several factors are contributing to conversation rates for the
consumer; for instance, the article describes it by stating that many keywords matter
for advertisers (H. Li & Yang, 2020).
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Furthermore, Li & Yang (2020) states that a budget increase in the keyword grouping
decisions does not necessarily render in a decrease in marginal profits. However, the
authors pinpoint the importance of optimizing the keywords and ad groups to achieve
a higher conversion rate and profits, rather than just increasing the number of
keywords and increasing the budget (H. Li & Yang, 2020).
Bidding and Ranking Strategy
According to Liu and Chen (2006), significant differences were depending on the
search engine that the companies chose. The two main search engines that the authors
compare are namely Google and Yahoo!. Stating that they differ in the so-called Unit-
Price- Contract (UPC), it is not only the highest bidder that wins, its previous task
performance is also taken into consideration. According to the authors, the advertisers
using Google ads, gain a high ranking not solely on the bidding but also if they have
a high CTR performance previously. This allows companies that have a history of
high CTR to have a high rank. Yahoo! on the other hand, ranks the advertisers solely
on the highest bidders making it possible for new actors to compete for the high
rankings on the search engine (Liu & Chen, 2006).
2.5 Digital advertisement methods
To more straightforward divide different digital advertisement methods have the
Internet Advertisement Bureau divided the US internet market of 2018 into four
different categories, namely, Search that is the most extensive section of 45% of the
market and consists of things like search engine advertisement, keywords. On the
second largest market share with 31% is the Banner category. The banner category
consists of rich media (i.e., interactive media), sponsorships, and banner ads. The
third category with 15% of the market is Video, and lastly, the fourth category is
named Other, and in that category, there is audio and lead generation among others
(Silverman, 2019).
Internet advertisement revenues are increasing at a steady yearly pace from $26.4
billion in 2010 (Silverman, 2012) to $107.5 billion in 2019 (Silverman, 2019), an
increase of 307% (Silverman, 2012, 2019). Out of the $26.4 billion in 2010 was 45%
from search advertisement through keywords (Silverman, 2012) and for the full year
2018 it was still at a 45% market share (Silverman, 2019) but the Search category
market har grown bigger, from $11.7 billion in 2010 (Silverman, 2012) to $48.4
billion in 2018 (Silverman, 2019).
Focusing more on sponsored search, which also is known as search engine
advertisement through keywords (J. Li et al., 2013; Silverman, 2019). When a
company, for instance, wants to advertise a specific service or product or themselves,
they can locate keywords that seem suitable for them and then put a bid on that
keyword. The bid is then compared to other advertisers’ bids. The bids get then
ranked with the highest rank on the top of the results page (J. Li et al., 2013).
3. Methods
3.1 Research Method
Research Design
This research will be carried out in the form of a case study. That is, after thorough
consideration, the authors find that a case study would be the most suited research
design. To answer the research questions whereas the authors can focus and gain in-
depth knowledge within one specific organization; therefore, a case study is most
suited for this research. The findings in this study are hopefully valuable for other
sectors in the healthcare industry and not only the specific sector of Clinical Research
Organizations (CRO) within the healthcare industry that this study is focusing on.
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The generalization can hopefully provide knowledge to other cases in the future
(Bryman & Bell, 2011).
The ideal company for a case study is one who does not market themselves digitally
but is going to start and market themselves digitally. The selected company fulfils
these requirements since they have a webpage but have not optimized themselves yet
in terms of the search engine- or webpage optimization.
According to Bryman and Bell (2011), there are three primary criteria for managing
research, namely reliability, replication, and validity. Furthermore, the chosen
research design which consists of a framework for collecting and analysing the data
will be in the form of a case study since the authors describe a case study that is taking
place at one specific organization; therefore this is the chosen research design for this
research (Bryman & Bell, 2011).
Research Approach
Since the study goes back and forth in terms of theory and empirical findings, the
most appropriate approach will consist of a mixture of both deductive and inductive
approaches. Namely, the abductive approach which is a way theory and data have
interacted back and forth, the overall approach in this study is abductive which is
common, especially in qualitative research. (Brantnell, 2019). In this case, the
approach is suitable since it gives the research the best prediction regarding search
engine optimization for the case company by generating a hypothesis and questioning
the current theories of both digital marketing and the healthcare industry (Mirza et
al., 2014).
The initial idea of the applied research approach was the so-called deductive approach
which is a relationship between theory and research. Where theory is building
hypothesis which is inherently scrutinized empirically (Bryman & Bell, 2011). The
deductive approach is one of the most common approaches in quantitative researches
(Brantnell, 2019). Furthermore, the deductive approach was then followed by an
inductive approach since the field of Search Engine Optimization is relatively new
and in constant change.
The inductive approach is considered as the opposite of the deductive approach, in a
way that the empirical data is gathered and then compared to the theory. In this case,
the empirical data in terms of qualitative and quantitative data was contributing to the
relatively unknown field of digital marketing within the healthcare industry. This
could be aspects that were not covered in the theory and literature, therefore it is also
described that the inductive approach is often used in qualitative studies (Brantnell,
2019).
As the thesis is built on a theoretical framework yet validated through empirical data,
the abductive method is the most suitable choice.
Research Framework
Both qualitative and quantitative research methods were used in the thesis project.
The mentioned design methods used to answer and investigate the research question
was a mixture of both quantitative and qualitative data.
The quantitative method consisted of two different gatherings of data: The first type
of data being collected from a survey in which the authors conducted to get an
overview of what people thought was prioritized in search engine optimization. The
survey was created in Google Forms and was sent out through e-mail and in various
SEO groups on the platform LinkedIn. Personal messages with the google forms link
was sent to members of the SEO groups on LinkedIn to gain a higher response rate.
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The second type of data gathering was made by collecting keywords based on their
traffic and volume.
The keywords were gathered for all the companies in which was considered
competitive companies to the case company. These keywords were later analysed
based on their search intent, which was a method based on the literature and the
empirical data in terms of interviews and the survey.
The qualitative method consisted of interviews that were made to gather empirical
data and results in which the respondent could answer things that could necessarily
not be collected in a survey. The interviews assisted the authors to get the respondents
to answer more freely to the questions through semi-structured interviews. The
interviewees consisted mainly of two groups, the first one being personnel with key
roles within the case company but also several people with similar types of roles at
competing companies to the case company, these were later referred to Business
Developers. The second group that was interviewed consisted of SEO specialists that
contributed with qualitative input on the success factors for search engine
optimization for their companies or the companies they worked for.
The motivation for using these two groups was since they both represent their
respective field, namely the healthcare industry and the industry of digital marketing.
Since this thesis answers the questions in the merged field of both these industries,
the choice of choosing both business developers and SEO specialists was found as a
suitable choice. It was also since it was interesting to see as SEO specialists tend to
only focus on their field to gain as much traffic and volume as possible, whereas the
business developers have other priorities such as making a profit, attaining long-term
relationships, and staying aligned with the regulations. This method design was,
therefore, both empirically contributing to creating the survey and analysing the
search intent, but at the same time complementary since it was reliable and could
validate both the literature and the quantitative design.
The mixture of the three different data gatherings (interviews, keyword collection,
and survey) was considered as complementary to each other. Namely, some of the
interviews could be considered both as empirical data and as a tool to obtain specific
empirical data. For instance, one interview gave the authors insights which allowed
them to add specific questions that were later used in the survey. It also led to finding
the right program (Ahrefs) to use to take part in the competing company’s keywords
without having to ask for the keywords. This in turn led the authors of being able to
analyse the gathered data in terms of keywords and to ensure that the data was valid
and relevant by having qualitative interviews.
3.2 Literature Review Method
This literature review method has mainly been executed in two ways, one by google
Scholar, (scholar.google.com) and the other way through searches via Uppsala
University, Student portalen (www.studentportalen.uu.se) the search results have
primarily been limited down to papers, articles, journals, books, and reports to
receiving valid results from the searches, hence relevant results for the authors are
first-hand information. However, some aspects of SEO have not been academically
published. Therefore, other types of information, e.g., from webpages, where specific
guidelines and methods have been discussed that were relevant for the study has also
been included in the literature review. The searches in the library database were done
by using words, e.g., B2B, marketing, online, Search Engine, CRO, healthcare
marketing, digital marketing. The words were either by themselves or by
combinations of different words.
3.3 Competitor Analysis
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The competitors were divided into two different categories; the first category were
the competitors to the case company who were direct competitors that offered the
same services to the customers as the case company. The second category was branch
colleagues operating within the same industry, namely the healthcare industry.
Direct Competitors
The direct competitors were located through searching for clinical research
organizations that offered their customers the same services or products but not
necessarily through the same procedure. These companies were located through
google searches with the keywords in the searches being the same as the services or
the drug development assistance the case company offered, among other things;
immune profiling, cytokine release assay, in vitro haemolysis test, hemocompatibility
and more. The competitor analysis was decided to include at least one competitor for
every one of the services the case company offered since there was not any company
that offered the same services as the case company. A total of 15 companies were
located as direct competitors, where some of these companies were verified from the
case company to be direct competitors.
Indirect Competitors
The indirect competitors were located at a later stage of the process as a complement
to gain sufficient data for the qualitative research. These organizations were also
found through google searches, the same as the direct competitors were located. A
total of 10 indirect companies were located. The essential factor in the indirect
competitors was to locate companies that were branch colleagues to the case
company. Companies that were found were working within different areas of the
healthcare industry, such as manufacturing, distribution, and marketing.
3.4 Survey
During the project, a survey was created to gather quantitative data about different
properties regarding the different ways of working with search engine optimization.
This was later used as both empirical data.
Finding Survey Respondents
The survey was spread out in several SEO groups on LinkedIn and through private
messages using the same platform. The people to contact through private messages
were randomly picked from the SEO groups on LinkedIn. From those groups were
more than 3000 profiles searched for the possibility to contact them through private
messages since there is not always the possibility to contact people that you are not
connected with on LinkedIn. From those 3000 profile searches, there were 147 that
could contact through private message without adding them as friends. This is a rate
of just below 5 %.
Survey Structure
The structure of the survey´s questions was based upon the literature review and one
of the early interviews. The survey was made through Google Survey and took an
estimated 1-2 minutes to complete. Since the research and the survey´s purpose was
to find the underlying success factors, the foremost content was aimed towards people
with little to a great experience of SEO. The survey consisted of questions to see in
what industry the respective respondent worked in and if their company prioritized
search engine optimization. Finally, the survey ended with a ranking question of how
the researched properties were ranked. This data could along with the qualitative data
be compared and analysed. However, since the risk of getting many respondents that
had no experience at all of SEO, the authors added alternatives that would address
this group. See Figure 1 for a schematic explanation of the survey structure.
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Figure 1. Structure of the google forms survey
Survey Sample Size
The sample size of the survey consisted of 51 respondents, which was a wide
sampling size that can be analysed further on. The authors created the survey and
spread it around various platforms and groups. For instance, the groups SEO expert
and Marketing Group SEO on LinkedIn. Furthermore, the authors spread the survey
out by mailing them out individually through private messages and by writing a
public post on LinkedIn. This was spread successfully and made it possible to achieve
51 answers within three weeks. The authors stopped collecting data at 51 respondents
due to theoretical saturation since there was showing significant repetitive answers in
the survey.
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The number of people that were privately reached out was 147 (note that the number
of people that the authors could not write private messages to was much higher), thus
leading to only a few of these answered the survey altogether. Especially when having
in mind that the public post itself had 923 views. Total answers of 51 from the 147
people contacted and the 923 who viewed the post on LinkedIn gave a response rate
of just below 5 % on the survey.
Coding the Survey
The survey was coded by different charts and diagrams by the Google survey tool.
Each question was categorized and portrayed by a chart, namely the number of people
and the percentage of a specific answer. This gives the authors a glimpse of how
many people that are working with SEO, in what industry they work in, how critical
specific properties are. Furthermore, the respondents were given a chance to answer
an open question regarding why they think SEO is prioritized at their company.
Besides, the authors can review the respondents' answers individually, for the
possibility to analyse them individually.
3.5 Keyword Data Gathering
The survey lets the authors use the answers to conclude what elements are necessary
when deciding on which keywords that are important for a specific company. The
survey showed that the most critical factors were traffic and volume. However, the
data from the interviews emphasized the importance of search intent, and therefore,
this was also taken into consideration.
Keywords Sample Size
From the competitor analysis, the authors had located the main competitors to the
case company, this was to have as similar companies to analyse. In the keyword
comparison, it was crucial to compare similar companies to the case companies to get
as valid results as possible.
Keywords Coding
Based on the parameters of the highest traffic and highest volume, the authors
proceeded to take out the top 15 organic keywords based on the highest traffic and
the top 15 organic keywords based on the highest volume. The total amount of
keywords that were analysed was 454 due to some companies having less than 15
keywords.
4. Analysis
There were namely four global themes that were conducted based on the interviews
with the business developers. These were: “Healthcare Industry”, “Traditional
Marketing”, “Healthcare Organizations” and “Digital Marketing”. As in the thematic
analysis above, the respective global theme will be analysed below.
Healthcare Industry
The business developers discuss the theme around the healthcare industry as highly
transparent, sober, and ethical, hence the organizing theme “Validity”. This along
with the industry being highly regulated with no direct marketing or selling towards
private customers, no comparisons between products and no gifts nor offers between
sellers and buyers. Besides the validity and regulation aspects, the industry is
described as capital intensive and diversified with high-profit margins. Therefore, the
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potential is high regarding the potential use of SEO, especially since the overall
impression of the healthcare industry is seen as lagging, niched and immature, this
statement is further discussed by Grbic et al. (2019) which was also the purpose of
why the thesis project was done.
Traditional Marketing
One of the main examples by the business developers regarding the use of traditional
marketing was the conferences, which the interviewees' mentions are a great way of
meeting potential customers and present recent discoveries. It was also described that
it was held between 4 to 5 times annually, and that was costly for the companies. This
could be considered as a weakness with traditional marketing, especially when a lot
of today’s communication can be performed online by the various communication
programs available. Although the interest in changing traditional marketing with
conferences does not seem like the industry have picked up on yet due to conferences
rather be cancelled or postponed than be performed as an online conference. This
became clear due to COVID- 19 hindered physical conferences and in that way can
be considered as a trial that online conferences were not of interest. (P3, 2020)
Although, it is described as personal and perceived as more trustworthy with physical
conferences. The literature is showing that digital marketing and communication
tools are more efficient since it is not as time- consuming and more flexible than
traditional practices.
The offerings with traditional marketing are according to the respondents a way
companies can provide services in terms of simulations, especially simulations of the
risks involved in early preclinical studies. Another aspect was the physical benefits
that the company could provide its clients, namely, to keep a large stock of drugs and
to publish content continuously. The benefits with traditional marketing were
according to the interviewees the fact that the companies could have a more
customized approach and meet potential customers and existing customers
individually, making the perception of a more personal way of doing business
(Popovici et al., 2018). Another advantage was also that they could have more
marketing in-house without having to outsource this section or hire consultants.
Healthcare Organisations
The interviewees described their respective organization, which was a part of the
healthcare industry, it was mentioned that the healthcare organizations had close ties
with universities and that the businesses were highly academical. Furthermore, they
pinpointed the need for publishing content, especially by producing digital content
and publishing it at a fast pace. This was done through different channels, that is
everything from traditional conferences to featuring in health magazines to digital
tools such as LinkedIn, Google,
and other social media. An important aspect that was highly connected with this was
the use of special sales channels that occur in the healthcare industry. Namely, the
use of special sellers in a tender market which was only allowed in sales if the
company was listed and thereby approved to use the tender market. (Maniadakis et
al., 2018) Moreover, since the companies were regulated in the aspect of channels,
some of the interviewees mentioned the need to hand out free samples, write
publications, and the need to influence the doctors.
Regarding customers, employees, and companies have mentioned that the market is
global and consists of both small, medium, and large organizations. Examples of
customer segments that were mentioned were hospitals, clinics, and pharmaceutical
companies. It seems by interpreting the business developer interviews that long-term
relationships are highly valued since it is a question regarding a highly regulated
industry, where the technology is usually of the unique kind, and the companies are
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often spin-offs from universities. The distribution of staff and resources differed
depending on the respondents, while some respondents mention that the amount of
time spent monthly on SEO was roughly 20 hours and that only 10% of the staff
worked within communication, while others state that their distribution was divided
70-30 between digital- and traditional marketing. Although some things were similar,
for instance, the companies used both in- house and outsourcing SEO personnel,
intending to have all staff in-house within digital marketing. However, the desired
goal was to hire full-time staff towards digital marketing which indicates that the
healthcare companies start to realize its purpose and the need for it. This goes hand
in hand with the research made by Grbic et al. (2019), where the statement “more and
more health organizations recognize the need for online presence and the use of
digital channels to attract new clients.” (Grbic et al., 2019) is used.
Digital Marketing
The respondents had more or less of a marketing strategy, some had focused more
than others, especially in digital marketing where some had 10 years of experience.
The motivation for implementing such a strategy was to create awareness, create
demand but also locate customers and make sure they find the company. This is
explained by Chaffey & Ellis-Chadwick (2016) where the benefits of digital
marketing are described as something that can influence many people faster and at a
larger scale (Langan et al., 2019) this is further backed up by Rohm et al. (2019) who
states that schools have picked up on
the need for organizations to create awareness towards the customers. The way to set
up a digital marketing strategy was according to the respondents an iterative process
that needed continuous improvements and it was mentioned that a trial and error
method was used to eliminate errors. Moreover, it is worth mentioning that the digital
strategy, as well as other marketing strategies, take time to implement and to develop,
one of the interviewees mentions that it took a year to set up such a strategy, mostly
due to creating compelling content. It is a long process that takes time since it is one
factor that can make a company differentiate from other companies, as well as it is a
way to target the desired customer segments more precisely, which is fundamental
according to marketing theories (Chaffey & Ellis-Chadwick, 2016). There was also
much effort in improving the website, presenting the company, but also to understand
why and how the customers find the company. (Chaffey & Ellis-Chadwick, 2016;
Moz, 2020b) The use of traditional marketing was complementary to the digital one
according to one respondent since it could help gain traffic and maintain existing
customers, this is in line with the blurred line description by Popovic (2018).
There is also a big trend since it is considered the right time to launch a digital
marketing strategy for future survival, which aligns with Anderson et al. (2019) and
Rohm et al. (2019) when referring to the effective sides of digital marketing.
Furthermore, the interviewees emphasize the trend in managing data and the fact that
companies can get more exposure, and it is considered more stable in the long term
if thinking of the scaling. The perception of digital was generally positive, and there
were no negative aspects in it according to some, the method seemed highly trusted
and seemed according to the respondents as a constant and iterative process in where
properties could be improved every day. The improvements could be to adjust and
deliver fresh content and keywords to gain more volume and traffic. However, there
was an awareness that it took multiple tries to get more sales and that larger
companies with more resources could outrun smaller companies, therefore it was
considered necessary to invest in it since it could be the reason why companies
succeed or fails. Anderson et al. (2019) theory that digital marketing is vital for
healthcare companies' survival. The perception that it takes multiple tries to gain more
sales and traffic can be that the companies are relatively new to the digital marketing
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and have not yet learned what is tangible aligns with stated by Langan et al. (2019)
that the digital marketing practices need to be further refined.
4.2 Analysis of Survey
Figure 2. Schematic explanation of survey dividing
The survey is structured with the intent to answer mainly three different questions
that were needed in the research. (1) Aim towards people that possesses knowledge
within SEO to answer what the relevant properties are when deciding on what
keywords to use.
(2) The need to know how it is for people without SEO experience, to have
knowledge of the company they are operating in, and to know if they have a digital
marketing strategy.
(3) Give knowledge of how the overall perception is about digital marketing from
the respondents’ perspective if they are negative or positive towards it. These are the
main outcomes from the survey, but it provides the authors with more insights as
well. The survey is divided into three parts to analyse the data from the survey. The
dividing of the survey can be found in Figure 16 that explains how the dividing is
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made. Following the dividing in Figure 16 will the three parts be presented and
analysed. For the following parts, see Figures 2 and 3.
The dividing of the three parts as presented
Figure 3. Survey analysis 2
Figure 17 represents the dividing of the first part whereas the 51 first respondents
were attending. Then they were divided by the “Yes” or “No” question where 26
respondents continued to part 2, and the remaining 25 were directed to part 3. The
three parts that follow will be presented below, in order 1 to 3.
The % represents the share of the 51 respondents that were responding for each
answer
51 % have previous or current experience of working as an SEO expert, the high
amount of “Yes” should be considered with the background that the authors received
many answers from the SEO groups from LinkedIn where there were mainly SEO
experts operating in the groups. Relevant answers to receive to answer what
properties are important when setting up an SEO strategy and what to look for when
deciding on relevant keywords.
The weighted score is the average answer on the 1-10 scale of the 26 respondents in
this part
Keywords are considered very important with its 9.3 ranking. This increases the
validity of the SEO interviews since the survey was done with data from those
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interviews that keywords were of high importance, and the survey verifies that.
Backlinks and webpage properties are also of high importance with 8.7 and 9.3 score.
This information is very important when setting up a digital marketing strategy so the
developer that will optimize the webpage emphasizes that as well. But on the
contrary, it is only keywords and backlinks that other companies can investigate,
backlinks can be “taken” from companies, by a company competing company
contacts the website with the backlink are coming from and the competing company
gets them to change the backlink to their company´s website instead. But, from a
comparison point of view, it is relevant to compare keywords where traffic and
volume have the highest rankings with 29 % and 24 %, which is backed up by
interviews with the SEO specialists.
4.3 Analysis of the healthcare industry
After analysing the individual answers, the results from the survey showed that the 8
people responding belonged to the healthcare industry, and 4 out of 8 worked with
SEO. The rest were familiar with SEO and had some sort of SEO strategy at their
company. 75% of these belonged to a company that prioritized SEO, the one who did
not belong to a company stated that an SEO strategy would be beneficial for the
company.
After the analysis of the survey, it is non-dependent if the SEO specialist is working
towards healthcare or any other industry when selecting valid keywords. The
approach to select valid keywords is merely the same for all the industries when
reviewing the survey responses. It can be more valid to investigate the analysis of
keywords to find differences when establishing a digital marketing strategy within
healthcare.
4.4 Analysis of Keywords
See Figure 4 for the calculated shares of informational, navigational, commercial, and
transactional have in volume and traffic.
Figure 4. Compilation of calculated Ahrefs data for all competing companies
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This Figure represents the parts of informational, navigational, commercial, and
transactional. This is to represent the low parts of commercial and transactional.
In Figure 5, it is presented how the portions are divided between the categories, non-
dependent of if it is based on volume or traffic.
Figure 5. Calculated share, the difference between the four categories and volume
and traffic
The calculated difference between informational, navigational, commercial, and
transactional but non-dependent on if it is volume or traffic
Figure 6 is shown how volume and traffic are divided into the four categories,
dependent on if it is volume or traffic.
Volume
Traffic
70%
59%
80%
67%
60%
70%
50%
40%
30%
20%
60%
50%
40%
30%
20%
10%
10%
0%
0%
Figure 6. Calculated share, the difference between the four categories
The calculated difference between informational, navigational, commercial, and
transactional for volume and same calculation with the four categories for traffic
5. Conclusion
The prerequisites for healthcare companies when choosing SEO strategy is first to
define the need for it and have a positive attitude towards it, but also the willingness
to adapt to the circumstances and environment of the industry. In this case, it could
be concluded that digital marketing tools could be used in a complementary way to
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the existing traditional way of conferences and influencing healthcare research by
producing relevant to their customers. The underlying success factors shown
throughout this research is the way to understand its customer by analysing the search
intent. Based on the healthcare industry the results from this study show that the
customers should have a user-friendly website, fresh content to which is continuously
published, and with much emphasis on informational and navigational keywords. The
barriers that have hindered healthcare companies from using digital marketing is the
lack of knowledge, the dependency of traditional marketing methods, and the
pressure regarding regulations. The Healthcare industry itself consists of many
regulations regarding direct marketing towards customers. Therefore, the standard
ways of digital marketing today need adaption in terms of highlighting the content of
the research and publishing continuously.
future work could have in mind to gather data over a specific period instead of
collecting them one time, for instance, by looking at the keywords every week within
a given time. The keywords were collected at one date, but if more focus would be
on a smaller number of companies and instead perform data collections over a longer
period where the differences over time would be analysed. Another perspective could
be to consider more aspects than just search intent, volume, and traffic. Perhaps
having in mind about keyword difficulty, ranking, and backlinks. Another way of
analysing the keywords could be the idea of doing a type of regression analysis to the
case company in comparison to other companies in how they rank based on different
properties.
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