In the midst of health care reform and institutional consolidation, local hospitals and clinics are touting new facilities and programs in an effort to keep themselves current and comprehensive in the eyes of consumers. Undaunted, ELIZABETH M. ECONOMOU sifts through all the messages and provides the perspective to keep your blood pressure in check.

In North Seattle recently, just off Aurora Avenue and across the street from Kmart, a towering Group Health Cooperative billboard advised: the doctor will see you now, or when you say so. The message couldn’t be clearer. As a Group Health patient, you’re in charge. Not the doctor. Not the institution.

At every turn—and by every form of media—hospitals are marketing to consumers the way all consumer-oriented businesses do, jostling for position, trying to get their messages seen and remembered. Where one hospital may extol the merits of a new hyperbaric wound center, another will boast about state-of-the-art robotics, and yet another will tout the easy online access patients have to its doctors. While insurance companies usually dictate where patients go for treatment and services, choosy consumers are doing painstaking research and often going outside their own networks of providers when they can.

When they do, they’re likely to find a dizzying array of messages. “Hospital marketing helps people know what’s available,” says Cassie Sauer, vice president of public affairs for the Washington State Hospital Association. People newly diagnosed with a certain type of cancer can research top-tier oncologists, she says, while a woman having a baby can think about what’s most important to her when she delivers.

Indeed, Annika Andrews, senior vice president and chief operating officer at Northwest Hospital and Medical Center, now a part of University of Washington (UW) Medicine, says consumers are more empowered today than ever before to choose where and how they receive health care. In the Seattle market, Andrews says, hospital marketing helps ensure that people in the community are familiar with the various institutions and with the services they offer. To the surprise of many, though, not all hospitals offer precisely what consumers need.

“Smaller hospitals are unlikely to have the full array of services that the larger medical centers have,” says John Gallagher, director of communication and development for Puget Sound Health Alliance, a regional partnership of employers, physicians, hospitals, patients and health plans committed to improving health care quality and affordability in the region.

“In the case of an emergency, such as a trauma or a heart attack,” Gallagher says, “it is important to get to the nearest hospital [with adequate facilities] as quickly as possible, as time is of the essence.” Sauer adds: “In most emergency situations, the patient is triaged by the emergency medical responders to the closest hospital that can take the case.”

Dr. John Milne, president of the Washington chapter of the American College of Emergency Physicians, says: “Even in the Seattle metro area, most hospitals do not provide every possible service a patient might need….The key is for every hospital to have a fully equipped emergency department where a patient can be rapidly diagnosed, treatment initiated, and the patient transferred to the appropriate location for further care. Sometimes that location is home, sometimes that location is another part of the hospital, and often that location is another hospital.”

At a minimum, says Andrews, all hospitals should offer these services: emergency care; critical care, including an intensive care unit (ICU) and a coronary care unit (CCU); primary care; general surgery; childbirth services; and pulmonary medicine. To let consumers know who has what, hospitals are vigorously touting their specialties and accommodating patients by introducing many new conveniences, such as same-day appointments and electronic health records.

“Health care as we have known it is changing, and hospitals are positioning themselves in the marketplace as any business would—[dealing] with changing times and a need to remain viable,” says Dr. Dale Reisner, a maternal fetal specialist who practices at Swedish Medical Center and Valley Medical Center and is secretary-treasurer of the Washington State Medical Association (WSMA).

Health care reform and the drive to be more consumer oriented are feeding the frenzy, says Lin MacMaster, vice president of marketing at Group Health Cooperative. “Seattle is a very competitive marketplace,” she says. “Hospitals are trying to differentiate on the quality of their doctors. People want the best care for the ‘what if’ moment in their life.”

Swedish, the largest regional nonprofit health care provider in the greater Seattle area, has taken branding via new media to unprecedented heights. Late last summer, a kidney transplant patient, a team of doctors from Swedish and several advocacy-group leaders set out to raise awareness of organ donations by Web streaming from Mount Rainier. Using social media and a profusion of high-tech gear, including a satellite phone, a laptop computer and a solar-powered Web camera, the climbing team conducted an hourlong live video chat to point out that the challenge of climbing a mountain is nothing compared to the daily battle a person waiting for an organ faces.  A few months earlier, a social media team at Swedish reported via Twitter a robot-assisted surgery to promote kidney health awareness. “Our efforts are there to remind people that we’re here,” says Swedish communications director Melissa Tizon.

In that same vein, a team of cardiologists at Overlake Hospital Medical Center in Bellevue has launched a cardiac blog to educate patients about heart disease prevention. And at Seattle Children’s Hospital, Dr. Wendy Sue Swanson, aka Seattle Mama Doc, blogs about motherhood and medicine, and dishes about health tips, vaccine recommendations and hot-button issues, such as protecting children from firearms.

“Traditional advertising is one-dimensional, while social [media] allows us to be more personal, interact, listen, learn and adapt as the world is constantly changing around us,” says Group Health’s MacMaster. “I think there is a downside to not doing smart marketing. You have to look at who your audience is and how they want to be communicated to.”

MacMaster says more than 75 percent of consumers use the Internet when they have a medical question. “We are a society of Yelp,” she says. “We go to see what others have said…what they know that we need to know.” Thus, the Internet has become a mainstay of Group Health’s branding effort. The nonprofit cooperative was an early adopter of electronic medical data, and the Web is the patients’ portal to medical teams and health records. Group Health patients use the Internet to e-mail their doctors, get lab results and make appointments, empowering them to take an active role in their health care.

Still, without actual buildings and facilities, hospitals have very little sizzle to sell. In addition to three hospital campuses in Seattle (First Hill, Cherry Hill and Ballard) and one in Edmonds (Stevens Hospital recently joined the fold), Swedish is set to open a new hospital in the Issaquah Highlands this summer. Phase one will include retail shops and a 12,000-square-foot area called The Commons, where patients can gather and even meditate in “a warm, comforting environment emphasizing natural light, spectacular views and healing gardens.”

In addition to growing by consolidation and expansion, Swedish has an extensive network of primary and specialty care clinics throughout King County, as do UW Medicine, Virginia Mason Medical Center and Group Health. This continuing neighborhood presence, along with the convenience of same-day appointments and electronic access to medical records, is part of the effort to change the medical landscape to make health care more appealing and consumer friendly. But even that isn’t enough.

Locally, for example, Swedish is leading the way in establishing freestanding emergency rooms that aren’t situated inside hospital buildings. Designed to keep waiting times down and consumer appreciation up, these facilities allow patients to bypass the usual triage and registration process that can lead to long delays. Patients needing hospitalization are taken to one of Swedish’s medical facilities or to a nearby hospital. Swedish already has one freestanding ER in Issaquah and will soon open others in Mill Creek and Redmond.

Similarly, Kirkland-based Evergreen Medical Center this spring will open a new Redmond campus that features a freestanding 24-hour emergency department, as well as a new primary and urgent care center in Woodinville.

These efforts to engender customer loyalty are not so much new as they are evolving with the times. Just as bariatric—or weight loss—surgery in the 1990s signaled an acknowledgement by providers of medical care that treatment of obesity had created a new area of opportunity, with diabetes on the rise, hyperbaric healing is now emerging as a core specialty at local hospitals. The Wound Healing Center at Valley General Hospital in Monroe, which opened in 2009, has logged upward of 4,000 patient visits and more than 180,000 minutes of oxygen therapy for conditions such as diabetes-related foot ulcers, as well as carbon monoxide poisoning and tissue damage caused by radiation therapy, says Dr. Jonathan Borjeson, the center’s medical director. Hyperbaric therapy surrounds a patient with high doses of  oxygen, allowing red blood cells to pass more easily into the wound and encouraging healing from the inside out. Other facilities with hyperbaric wound centers include Northwest Hospital and Medical Center, Swedish/Edmonds and Virginia Mason Medical Center, which operates the oldest and largest hyperbaric facility in the region (as many as 18 patients can be treated in the chamber at the same time).

Another feature that hospitals have introduced in recent years is the concept of the medical spa—an extension of a medical center’s dermatology and plastic surgery departments. While most people may not think “hospital” when they think of facials and bikini waxing, the Medi Spa at Virginia Mason’s main campus touts the “clinical quality” of its aestheticians and services, and notes that caring for one’s skin is both an art and a science. Other hospitals with medi-spas in King County are UW Medicine, at its clinic in Shoreline, and Tacoma-based MultiCare, at its clinic in Covington. MultiCare’s spa, called Healthy Reflections, boasts “a fusion of innovative therapies based on medical research and soul-satisfying treatments that indulge you on your path to beauty and wellness.”

The bottom line, it would seem, is making sure consumers feel good about themselves—and their hospitals. As Northwest Hospital’s Andrews says: “It’s about patient benefit.”

HOW TO PICK A HOSPITAL
Living in a region where cutting-edge technology meshes seamlessly with top-notch medicine and where myriad choices abound, Seattleites are fortunate beyond measure. Still, John Gallagher of the Puget Sound Health Alliance (pugetsoundhealthalliance.org), a nonprofit organization dedicated to improving health care quality and affordability, cautions that, while many hospitals perform well by certain measures, no single hospital gets everything right. He suggests that patients consult the alliance’s Community Checkup (wacommunitycheckup.org), a report that consumers can view online and use to gauge hospital performance on a range of services, such as cardiac and surgical care.

“Hospitals look at these measures to see where they can improve, and many [hospitals] share information about promising practices so they can learn from each other,” Gallagher says.

Beyond that, hospital rating services such as HealthGrades (healthgrades.com), which allow consumers to assess and compare health care facilities, nursing homes and physicians, can come in handy. The U.S. Department of Health & Human Services operates a similar site, Hospital Compare (hospitalcompare.hhs.gov).

The Washington State Hospital Association (wsha.org) provides comparative data on the cost of hospital procedures. Listening to friends and neighbors is also worthwhile. “We can market all we want,” says Lin MacMaster of Group Health Cooperative, “but the best tool is word of mouth and making sure hospitals have an infrastructure set up so patients have the best experience possible.”

Additionally, hospital websites are a good source of information on any facility. For a complete list of websites for hospitals in the Puget Sound region, see page 134 or go to seattlemag.com and search “hospital websites.”

MEDICAL RESOURCES
A guide to websites for hospitals in the region, and major projects recently opened or soon to open.

Allenmore Hospital & Medical Center, Tacoma: multicare.org

Auburn Regional Medical Center, Auburn: auburnregional.com; newly expanded     
Regional Behavioral Health Center opened in 2010

Enumclaw Regional Hospital, Enumclaw: fhshealth.org (see St. Elizabeth’s Hospital)
Everett Clinic, Everett: everettclinic.com

Evergreen Hospital Medical Center, Kirkland: evergreenhealthcare.org; new Redmond and Woodinville facilities opening in 2011.

Fred Hutchinson Cancer Research Center: fhcrc.org

Good Samaritan Hospital, Puyallup: multicare.org

Group Health Cooperative: ghc.org

Harborview Medical Center: uwmedicine.washington.edu

Harrison Medical Center, Bremerton: harrisonmedical.org; new heart and vascular center opening in 2011.

Highline Medical Center, Burien: highlinemedicalcenter.org; new emergency department opened in 2010.

Kindred Hospital: kindredhospitalseattle.com

Mary Bridge Children’s Hospital & Health Center, Tacoma: multicare.org; new emergency department in Milgard Pavilion opened in 2010.

Minor & James Medical: minorandjames.com

Northwest Hospital & Medical Center: nwhospital.org; new Bone & Joint Center of Seattle opened in 2010.

Overlake Hospital Medical Center, Bellevue: overlakehospital.org; new medical clinic in downtown Bellevue opened in 2010.

Pacific Medical Centers: pacificmedicalcenters.org; new Canyon Park facility opened in Bothell in 2010.

The Polyclinic: polyclinic.com

Providence Regional Medical Center, Everett: www2.providence.org/northwest-washington; new building in north Everett opening in 2011.

St. Clare Hospital, Lakewood: fhshealth.org

St. Elizabeth Hospital, Enumclaw (formerly Enumclaw Regional Hospital): fhshealth.org; newly remodeled building opening in 2011.

St. Francis Hospital, Federal Way: fhshealth.org

St. Joseph Medical Center, Tacoma: fhshealth.org

Seattle Cancer Care Alliance: seattlecca.org

Seattle Children’s Hospital: seattlechildrens.org; new Bellevue clinic and surgery center opened in 2010.

Stevens Hospital (Swedish Edmonds campus): stevenshealthcare.org
Swedish Medical Center: swedish.org; new Ballard emergency department opened in 2010; new Issaquah hospital opening in 2011.

Tacoma General Hospital, Tacoma: multicare.org; new emergency department and MultiCare Regional Cancer Center opened in Milgard Pavilion in 2010.

University of Washington Medical Center: uwmedicine.washington.edu; new wing opening in 2011.

VA Puget Sound Healthcare System: www.pugetsound.va.gov; new Community Living Center opened in 2010 in Lakewood; new emergency department building opening in 2011 in Seattle.

Valley General Hospital, Monroe: valleygeneral.com

Valley Medical Center, Renton: valleymed.org; new Margarita Prentice Trauma Center opened in 2010.

Virginia Mason Medical Center: vmmc.org; Floyd & Delores Jones Pavilion opening in 2011.