Blurred Lines: Marketing and Ethics in the Brave New World, Part 2

March 1, 2019

// By Daniel Fell //

Danny FellThe following article is Part 2 of a 2-part series. (Read Part 1 here). The series was adapted from the panel presentation Blurred Lines: Marketing and Ethics in the Brave New World held at the 2018 Healthcare Internet Conference (HCIC) in Scottsdale, Arizona. Panel members include Karen Corrigan, founder and CEO of Corrigan Consulting; David Feinberg, chief marketing officer at Mount Sinai Health System in New York City; and Greg Green, chief data and analytics officer of Valassis.

Daniel Fell, president and CEO of ndp, moderated the panel. Part 1 touched on some of the broad ethical issues in using digital marketing in healthcare today and some of the current practices in our industry. Part 2 addresses some of the emerging challenges as both technology and our industry evolve, and what marketers can do to better prepare themselves and their organizations.

FELL: The lines between hospital, insurance company, and retail setting are beginning to blur with new mergers between pharmacy chains and insurance companies and tech giants like Amazon getting into healthcare. How does that impact the way we use data?

David Feinberg, chief marketing officer at Mount Sinai Health System

David Feinberg, chief marketing officer at Mount Sinai Health System

FEINBERG: I don’t know that any of us really know where it’s all going to end, but the effect that the insurance companies and drugstores will have all of our information, and be able to use it, I think is fraught with issues and there is a lot of concern about how they will use that data.

CORRIGAN: You know from the early days of healthcare marketing, there were a lot of questions about how and why we were spending money to advertise this or that. I remember having a conversation with someone about early breast cancer detection. If we have some sort of a screening and we pick up four or five women who need to advance to the next level of care, is that marketing or is that healthcare? And the answer is — it’s a little bit of both. I think some of the same things apply when we think about the access to data that we have today.

Karen Corrigan, founder and CEO of Corrigan Consulting

Karen Corrigan, founder and CEO of Corrigan Consulting

If you go into a grocery store or CVS or Target, you swipe your loyalty number and you enter your phone number. Everything about what you purchased as an individual and a household is going into a data warehouse somewhere. We can predict with good accuracy what the healthcare issues in that household might be based on your grocery spending, based on your drugstore spending, based on your Target spending, whatever that might be.

So, if you have a household that’s buying stuff that indicates they might have a health problem, and you get a hold of data like that to target that household because you have solutions that might help them, is there an ethical line there? It’s a very complex question.

GREEN: Let’s take an obvious example. Let’s say you have a household buying a lot of sugary soft drinks, right, and you find other things as well. So, this is a household that that might be a target in a propensity model for diabetes. Is it ethical to take that data and promote, “Hey, come in for a general health screening,” whether you tie that to diabetes or not? Where do you draw that line?

FELL: So, let’s say that you as a marketer can purchase a list of consumers who have bought antacids on a frequent basis within a 30-mile radius. Do you use that list to target them for a G.I. screening perhaps, knowing that you’re probably going to catch some people who have issues that could possibly save their life? And is purchasing that data within the realm of what we think we should be doing as marketers?

Greg Green, chief data and analytics officer of Valassis

Greg Green, chief data and analytics officer of Valassis

GREEN: I’ve heard the word “creepy” at this conference more than I’ve heard it anywhere lately. From my perspective, as an analytics person trying to make things work better, what I tell people is that it needs to have the potential to be a little creepy or it’s not going to work well from an analytics perspective. But then how do I protect privacy and how do I not make you — the consumer — feel creepy? And how do I not do something that’s creepy and wrong? And when do you think about it from a public health perspective?

CORRIGAN: There is a very similar conversation, a parallel conversation to the one we’re having here, going on in our health systems today, down the hall in the population health office. Because they are also talking about our patients and all of this data on our patients. How do we employ that to help the population health agenda?

At some point, these two agendas are really interconnected. I don’t think we’ve worked hard enough to strengthen that connection to date. It’s challenging, but that conversation is already going on, and that’s about the deep data we as health systems are collecting that’s not even interfacing with the data that we could buy externally to see how that could impact either population health or marketing. So again, it’s complex but critically important to get on top of all this.

FELL: It strikes me that the term “permission-based marketing” is an important part of what we are talking about here. Greg used the term opt-in earlier. Are we getting to that level versus the other side of marketing, which has traditionally been more about acquisition?

CORRIGAN: It’s an interesting thought, because on the one hand as marketers, our job is to figure out how we create demand — how we identify and target customers and stimulate their interest in our products and services. We offer solutions for their needs and we move them through the decision funnel. But I find we talk more about acquisition than when we do retention in a lot of our marketing in healthcare.

GREEN: I think the more of a dialogue you have with your customers, and your patients, and your prospective patients, the better. It’s “relationship” marketing and a lot of technology goes into supporting that today. But the other thing I tend to think about is context. If I’m bothering somebody with information they don’t want, they’re never going to respond.

FELL: As marketing leaders, what thoughts about privacy and ethics do you have around IoT or the Internet of Things — where everything from your car to your home to your refrigerator is connected? And what about voice-enabled tools like Alexa and Google Home that are “always on” in our homes and record every interaction?

GREEN: If you look at the data points on voice, it’s crazy. Millennials are not the heavy users of care, but they are the heavy users of voice. So, if you’re not looking at it in five to ten years, you’re going to be behind others out there who are using it.

CORRIGAN: I do think this is again where we’re bumping back into population health. There is a lot of investment going into the idea of these interconnected devices in the home around chronic disease management, or elder care or things of that sort, where we shift care to the home, but we do it with this array of devices that work together and in working together, deliver different kinds of services, or provide certain kinds of protection or monitoring of an older individual or someone who is chronically ill.

But all of that is also collecting data. So, data is being collected, data is being aggregated somewhere. And again, it’s how we build the right framework around the proper use of that data going forward. On the other hand, the ability for that kind of technology to make people’s lives better in the homes where they live is incredible.

FELL: This is clearly a very timely subject with a lot of nuances for marketers to deal with. What final thoughts do you have and what can marketers take away from this conversation to help them in their everyday jobs?

CORRIGAN: I think the most important thing right now is that you have a dialogue going on, that it becomes an issue that needs to be discussed and inside of the organization as a whole, and certainly within the marketing department as part of that overall thinking for the organization. So, I would say, make it a priority to get the dialogue started so that as an organization you can come to agreement on the framework for how you think not only about security but also about privacy, but then I think privacy becomes a discussion about ethics. So, it’s the sort of thinking about that is the framework for how to move forward with this.

GREEN: I would just say engage patients in these questions and don’t have all the conversations inside your organization. Include a variety of people outside the organization. When it becomes insular, everyone tends to agree with one another and that’s when we can get into trouble. Regulations like Europe’s GDPR (the General Data Protection Regulation) are coming to the U.S. so we need to both prepare and be proactive in influencing these policies to the extent we can and that will take a collaborative approach by our industry.

FEINBERG: We think of this as managing risk, but there’s also a big opportunity. I think if you can be on the forefront and have that dialogue and be a place where I can go because I know you’re going to use my data appropriately there’s an upside here. Maybe there’s a way to take this and flip it in a way that makes you, the institution — and even the industry — stand out as people who really care about this in the right way.

FELL: I would like to thank each of you for contributing your voice and your insights to this very important topic.

Daniel Fell is president and CEO of ndp, a full-service marketing communications agency in Richmond, Virginia. He is a frequent speaker and writer on healthcare marketing topics and is a member of the eHealthcare Strategy & Trends Editorial Advisory Board. Reach him at or 423-752-4687 ext. 300.