Google’s April 21 Algorithm Release and the Impact on Mobile Search for Hospital Websites: An Interview with Chris Boyer

July 22, 2015

// By Jane Weber Brubaker //

Chris Boyer, Senior Vice President, Digital at ReviveHealth

Chris Boyer, Senior Vice President, Digital at ReviveHealth

On April 21, Google’s new algorithm was released. Mobile-friendly websites will now be preferred for mobile searches. Was this the beginning of Mobilegeddon? Are non-mobile-friendly sites getting punished? We asked Chris Boyer, Senior Vice President, Digital at ReviveHealth (former AVP, Digital Strategy at North Shore LIJ) to weigh in on how the change is playing out. Read on for our in-depth interview with Chris, where we discuss the impact of Google’s algorithm on branded vs. non-branded searches, why responsive design alone is not enough, trends in mobile advertising, and more.

eHST: When Google announced and subsequently released its new algorithm on April 21 favoring mobile-friendly websites for mobile searches, was there a mad dash to update sites to be responsive?

CB: Many of the hospital and healthcare system websites that are being developed, or have been developed in the last two years, have been developed responsively. In terms of people scrambling to make the Google date, I haven’t heard of anyone speeding up their website development just to make that April 21 date. Certainly they probably are feeling the impact of their site not being responsive since that release. But some of the aftereffects of Google “Mobilegeddon” are that sites that aren’t mobile-friendly did have a drop in organic traffic. But I think it’s nominal, because a lot of the traffic that comes to the hospital websites is branded traffic. People are searching hospital names, and those branded searches are not negatively impacted in any measurable way.

eHST: So there was really no impact?

CB: Well, there certainly was an impact for those searches that are not branded searches, searches for conditions and treatments or the word “hospital” or “health care system.” If they don’t mention a particular branded name, Google now prefers mobile-responsive sites above the non-mobile-friendly sites. BrightEdge did some research that found a significant drop in the rankings on Google [“Non-Mobile-Friendly Share of SERPs Decreases 21% with April 21 Mobile Algorithm Change,” 4/28/15]. But in my experience with hospitals and healthcare systems, the majority of the searches are around branded terms that bring people through search engines to those websites.

eHST: Are there any stats about what percentage of hospitals have responsive sites?

CB: I’ve done some research and haven’t really found anything that actually states that. Anecdotally, I would say we’ve probably got about 50-50 right now. I would say by the end of the year that number will move up, but again that’s anecdotal.

eHST: What are the considerations for SEO in a mobile-friendly world?

CB: Having a mobile-friendly site is going to be preferred. It does drive higher search results. But I think that with SEO, there are some other very technical things that are going to be an influence, for example, page speed. One of the offshoots of this is that if you have a responsive site, that means your page speed, your page load time, will be much quicker. That’s going to be something that the algorithm looks at, and it does prefer sites that respond quicker.

In terms of all the nontechnical SEO, it’s still about good content, rich content, content that addresses what people are searching for on any device, be it a mobile device or a laptop, and making sure that the search experience is that much more meaningful. Those are really the big takeaways here. More and more people are using mobile devices to access websites, so organizations that are building websites need to really address that by committing to mobile-first design, mobile-first information architecture, mobile-first usability. That’s really the biggest result.

eHST: Are the websites you’ve seen doing a good job of reorganizing the information for mobile?

CB: That’s a very challenging thing to do. My answer in short would be no. Some do it well and others are not doing it so well. Information architecture, UX and UI all are very important in designing for mobile-first. It takes a lot of skill and time to do this. Many of the companies that are creating new websites for hospitals, or the hospitals that build their own, are finding it challenging to take a deep look at how the content is architected on the site. Ironically, that’s the most important thing you need to do. Simply implementing responsive design templates but leaving the information architecture the same is a big mistake.

Don’t get me wrong—it’s very difficult to completely redo an entire website’s information architecture across a large healthcare system. The one health system that I was at (North Shore LIJ) had 25,000 pages. We had to completely review and address each page, if it was the right content, if it was in the right place. That’s a huge undertaking. It’s much easier to just implement a responsive design site and leave your content structure the same. But organizations that are really leading the way are taking a serious look at how to simplify the way their content is presented.

eHST: Do you have some examples that are standouts?

CB: Of course I prefer North Shore LIJ as an example of that. El Camino Hospital just launched a site that is actually very nice. You can even look at hospitals like Sharp Healthcare who’ve done a pretty good job of simplifying the information architecture. It fundamentally changes the design of your site. It’s what we call a flattened architecture and a lot of emphasis is placed now on the on-site search capabilities. That really enhances the power of search. It’s no longer content in these silos that goes way down a navigation tree. Now we have flattened architecture where you’re using on-site search to navigate to the right areas and get to that content much quicker, doing it from whatever device you’re using.

eHST: So the menus are not as deep?

CB: Yes, they’re not two, three, or four layers. Many of the good sites are at most two layers of navigation deep, driving a heavier reliance on searching for content and using taxonomy to deliver that content in a robust and dynamic way.

eHST: Explain what you mean by taxonomy.

CB: Taxonomy is being able to categorize the content on your site by topics, and even more so, by how people would potentially interact with the content on the site. Taxonomy also can impact how content is presented dynamically to users.

eHST: How do hospitals actually do that with their websites? Is it through the content management system?

CB: In part, yes. It’s through a good content management system, good search engine technology, and using dynamic content on the site. For example, on NorthShoreLIJ.com, there’s a search engine field right on the front page. If you type in “breast cancer” and hit search, it brings up an onsite search results page. But also “related news” and “videos,” dynamically populated on the right-hand side, are all related to breast cancer. If you click on the “breast cancer” link on the search results page, you go to the breast cancer page. All of the content on that page is also related to breast cancer, and it is dynamically populated through taxonomy and content mapping. It is not static content.

eHST: What content management system were you using to do that?

CB: North Shore-LIJ is using Drupal—which speaks to a bit of a trend. Many hospitals and health systems are moving to an open source content management system like Drupal because they feature capabilities like taxonomy and personalization that are being used in other industries. Some content management systems that are created specifically for healthcare may not have, or are only just now implementing those capabilities.

eHST: Can healthcare organizations count on only organic search for traffic, or do they have to use paid search as well?

CB: Every healthcare organization should be investing in pay-per-click or paid search. If they are trying to market or promote themselves in any way, there should be a paid search component. When I say paid search, I mean not only Google ads, but also display ads, contextual-based ads, and social media ads. Organizations should be investing in not only volume growth advertising, but also branded activities to keep themselves at the top of search engines. There is heavy competition through search engines, and having an online advertising campaign is becoming one way to ensure that you’re remaining at or near the top of the search engines. Most search engines are providing paid search premium real estate at the top of search engines. So, in order to fight for that space in organic search, paid search can help. My recommendation is for healthcare organizations to dedicate at least 15 percent of their marketing budgets towards online advertising, across multiple campaigns, branded, volume-growth and otherwise.

eHST: So are you saying paid search will influence the organic search results?

CB: Google has a preference towards online advertising. More and more of the valuable real estate on the screen is going to be taken over by advertisements, particularly on smaller mobile devices. And the ads look more like organic results. Google and other search engines will dedicate valuable space on any search results page towards paid opportunities.

eHST: What are the considerations for planning digital advertising campaigns in a mobile world?

CB: In terms of planning for advertising on a mobile screen or creating mobile sites, it’s important to realize mobile devices are being used in different ways. The nature of a mobile device clearly is people use them on the go. When I’m out and about in a city and trying to find a place near me, a mobile phone is my turn-to device. That means mobile advertising is a great way to promote geo-specific information, such as where is the closest urgent care center, for example.

It’s also important to realize that mobile is being used as a second screen, and not in a “mobile” sense, for example, using a mobile device when watching TV, which is the very opposite of being mobile. You might see a news story about a particular medical service and you wonder if your local hospital provides it. You search on your mobile device. Marketers should look at mobile advertising as a way to make it easier for people to find you when searching this way.

eHST: When you are doing paid search, can you specify that it’s for mobile searches?

CB: You can. But you want to use analytics to see what device people are using to visit your site. I’ll give you an example. My previous work at a health system involved advertising minimally invasive orthopedic services to people that were taking the subway. Those people saw an advertisement on the subway, and they may not have remembered the very clever, short URL that we created. They may not even have taken the picture of the QR code we placed on the ad—in fact they didn’t. Instead, they went to their phones and they searched for it. And they did it after they left the subway.

eHST: What did they search for?

CB: They searched for the hospital name and minimally invasive options, or the headline they saw in the subway ad—from their phones. When we started tracking that behavior and realized this, we adjusted our advertisements to heavy up on mobile and the particular keywords they were searching, specifically on a mobile device.

The thing about digital is you can measure absolutely everything. You want to spend time not only measuring, but going back and reviewing and using that information to feed into what you do moving forward. Even though Google may release these algorithms for mobile, does it impact your sites? I don’t know. Measure it. See if it does, and if it does, how do you respond to that? That’s really kind the answer to this. The hard part is taking the time out to stop and think about it and going back and actually applying what you’ve learned to it, because we’re so busy.

eHST: What opportunities for mobile search should healthcare marketers be aware of?

CB: There are now more and more opportunities for mobile advertising. Clearly we know of display advertising within apps. Companies are creating free applications that have an advertising component built into the experience, like Pandora or Spotify. Advertising is going to become more natively involved in the mobile space. I just read today that the New York Times is now starting promoting news through WhatsApp, which is a text-based application. They are using it now as a content platform.

eHST: Pandora has ads that are very personalized.

CB: You brought up something very interesting—the amount of information about you that is fed through your phone, your preferences, what you like, what you download, what you interact with—all done through your phone. My iPhone is synced up with my Apple ID so it knows everything that I buy through the Apple Store. But it also has my Google ID. My phone in my pocket knows probably more about me because it knows where I am at all times. Combine that with the data that Google and Apple know about me. What you are talking about now is a new level of personalized communications. Imagine using something like the Apple Watch and the data it can track. The Internet of Things is providing a huge landscape for advertisers in the future.

The good news for healthcare systems is they can use these platforms not only to advertise, but also to talk about population health and deliver relevant patient education information. Think about the impact you can have on value-based care delivery in the future. It’s monumental.

eHST: But how far is this in the future?

CB: The future is there. We just need to work with health systems to get there. My saying is, think revolutionary but act evolutionary. So knowing what is in the future, what can you do today to move there? You’re developing a relationship with people through their devices. The nice outcome of the Google algorithm change on April 21 is that mobile search, the way people use mobile to search, is more like the way we interact with our lives. People are searching through mobile differently than they are on the desktop and are using mobile more frequently than they are the desktop. All of these changes that Google put forth in the new search algorithm are really to align with the way we are living our lives.

Jane Weber Brubaker is Editor of eHealthcare Strategy & Trends.