How do you build your brand in digital health?

I talked to comms pros from the likes of Livongo, Athenahealth and Ginger

When I first started covering digital health in 2011, it was considered a niche industry. Now, it’s wildly trendy and is attracting hundreds of millions of dollars in venture investment. 

So with all this competition in the marketplace, how do start-ups stand out from the pack? It’s a question I hear very often from founders in my new role in venture, given that I spent so many years in health-tech journalism. I’ll share some of my own experiences, but stress that I had my own way of doing things that might not be a reflection of how other reporters work. 

To get a broader perspective, I chatted this week with comms pros who have helped build the brands of some of the biggest companies in digital health. That includes Livongo, Verily, Ginger and Athenahealth. Those on the agency side are getting inundated right now, given how many start-ups are raising. So they’re picking and choosing their clients carefully. 

The questions I posed below are drawn from founders in my network. I summarized what the PR experts had to say - and interspersed my own thoughts throughout. 

PR can be an expensive line item. So when’s the right time to bring in the cavalry? And what’s better: An agency or in-house hire?

John Hallock, senior VP of communications at Transcarent, suggests bringing in an in-house comms expert first to cultivate relationships and develop a strategy. I’ve known Hallock for years, as he’s worked with digital health powerhouses like Livongo, Crossover and Athenahealth. 

“Build in house capabilities that can naturally be closer to the creation of a corporate narrative and augment with outside support as needed,” he suggests. Hallock said that founders should make sure that the person they bring in can really execute as “powerpoints are nice, but results are better.”

From my perspective, expecting an outside team to take on the job of telling the story on their own is a mistake. Founders have something really special that is truly differentiated. That’s their passion, the reason for doing what they’re doing. Just in the same way that you take the time to talk to investors, cultivate personal relationships with the media early on. It’s always best to start off by asking how you can be helpful and not the other way around. 

Should every digital health founder get a Substack and a Clubhouse account?

Short answer: Probably. These are new mediums and so there’s still a lot of experimentation going on. And not everyone has the time. That said, “it can’t hurt to have a presence,” said Hallock. 

“I love when founders are willing to get out there early on with a strong point of view,” added Victoria Barnes, the head of corporate marketing and comms at Ginger. 

On the subject of Substack, my only feedback to folks is that it’s worth doing if you know you’ll stick with it with some regularity. If you have something to say as a one-off, there’s other mediums out there, like LinkedIn. Ginger’s founder Karan Singh recently wrote a super honest three-part series on LinkedIn about his company’s journey, including its big pivot. On another note, that kind of vulnerability can be very effective. If you’re only willing to talk publicly about how successful you are, it can be off-putting. Very few companies and teams face zero challenges - and if you’re in health care, it’s invariably going to be an uphill battle.

To founders, their companies can be like their babies. So how do you determine what’s actually noteworthy?

That’s what a comms pro is for.

Erik Milster, a long-time digital health comms exec, said that he prefers to work with founding teams that respect his expertise. So he can push back when he doesn’t feel that there’s a strong news angle. In other words, if you’re hiring a PR pro, make sure you bring on someone you respect and are willing to listen to what they have to say. Otherwise, don’t recruit them at all.

“Founders should embrace a communications pro / team that won’t always say ‘sure we can do that’ because they are afraid of losing the business,” Milster said.

100%. And another thing to avoid: Pressuring a PR team to call up a journalist to push them to change a story so it’s closer to the internal messaging. Journalists are not going to do that. They will certainly make a change if there’s a factual inaccuracy, but not to meet a personal preference. And if you ask a PR team to do that, you’re hurting their relationship with the press.

Should founders have their own relationships with the media?

All four of the comms folks I spoke with said yes, they’d support it. But they would prefer to be in the loop if possible. Reporters get dozens, if not hundreds of pitches a day, so it’s essential to have personal relationships.

That said, if you’re developing media contacts, you’ve got to be prepared to answer tough questions. Here’s how PR pro Dan Budwick puts it: “If you're gonna talk to the media when things are good, there will be an expectation that you're gonna talk when things are bad. I don't think many folks understand that.”

For some, that might mean limiting correspondence with the media. For others, it will mean leaning into it. It depends very much on the founder. 

To offer a personal example, I used to be very skeptical about the group of companies emerging in the direct-to-consumer health space. So I reached out to a bunch of founders to ask for an informal, unofficial chat. Some turned me down but a few agreed to talk to me one-on-one. One exec whose name I won't share here as the conversation was “on background” (skip to the bottom for a definition of what that means) suggested we go on a long walk. We talked for several hours. By the end, I still wasn’t totally sold on the business. But I gained a lot of respect for the founder. He wasn’t combative or defensive. He acknowledged my concerns and responded thoughtfully to my most hard-hitting questions. We went on to have a really great working relationship.

Bottom line here: Journalists don’t get up in the morning with to re-write your latest press release. You can’t control the message, and you will be frustrated if you try. Recognize that not all criticism is bad. In my experience, the hype cycle is very real and can do a lot of damage. When a company gets non-stop glowing coverage, there’s often an event or moment that changes things and suddenly what was once all good is now all bad. Just look at what happened to Facebook, a former golden child of Silicon Valley that could do no wrong. In my opinion, it’s better to embrace the nuance. Very few things are black and white, so wade into the grey. 

Do you believe in media lists and press releases anymore? Or are they going the way of the dinosaur?

It’s complicated. Milster thinks that press releases no longer need to be issued over the wire unless the company is publicly traded and/or a major entity. For start-ups, he thinks of a press release as more of a narrative. It’s an opportunity to get on the same page and articulate ‘the why.’ “It houses all the facts, the commentary, our partners' insights and more - a canvas of sorts that we collectively paint,” he said. 

All of the comms pros agreed that media lists should be updated regularly. Reporters tend to move around a lot more than they used to and change beats, given today’s media environment. So if you’re going to rely on a list, be very careful to ensure that it’s accurate. 

In my view, one of the problems with lists though is that it’s impersonal. I used to get hundreds of pitches a day via mail merge that had clearly been sent out to a spreadsheet of folks. I didn’t have time to respond to it all, especially when on deadline. So I’d suggest instead reaching out to a few people that you really want to get to know, and use databases to help find their contact information. Do your homework first to get a sense of what that reporter loves to write about.

As for how to best reach out to journalists, it depends. The vast majority don’t want to get a phone call out of the blue. Twitter DMs were always my preference. Or a thoughtful, personal email. Once I got to know someone, I typically shifted to text. In-person events are also great in a post pandemic world. One suggestion for those planning in-person events for media post-pandemic: How about breakfasts instead of dinners? My colleagues with kids could rarely attend the evening events, and if they could it meant paying for childcare. 

What’s better: Exclusives or embargoed pitches?

Milster is a big fan of exclusives. “The opportunity to collaborate exclusively is quite rewarding on all fronts,” he shared. “Being able to hyper-focus on building a single story via (often) multiple interview sessions frequently results in a more comprehensive article.”

Barnes is also a fan and has some specific advice: “Ask yourself the following questions before reaching out: ‘What’s the headline here?’ ‘Why would this be interesting to [publication]’s readers?’ ‘Has this been told before?’ ‘Who else outside of my organization can validate this story?’ ‘What type of research or data would help to back this up’?”

For his part, Budwick suggests that founders should read some of the articles that have been written by the reporter they’re talking to. I couldn’t agree more. It’ll give you a really good sense of what that writer cares about, so you can have a more balanced and relevant conversation. 

Budwick also points out that it also depends on the moment in time and type of story being pitched. He favors pitching more broadly in normal times, but that changed during Covid-19. Health teams were - and still are - swamped with the pandemic, so a start-up’s financing round might not be a priority. 

Any tips to build a ‘halo effect’ around your company/team?

I’ve worked a lot with Budwick, who runs an agency called 1AB. His advice is spot on. When you’re approaching a reporter, don’t talk about yourself or your company nonstop. Instead, share your thoughts on the broader landscape and how it’s evolving. “Talk democratically about your competitive landscape instead of pretending you're the only one there,” he said. “If reporters think they're talking to someone who's actually being real with them, they're more likely to want to connect with that person again and again, thus gaining that status of a go-to source of commentary.”

Yep! Imagine you’re hearing someone tell a self promotional story without context. You’d be inclined to react with skepticism. Reporters will too.

How should I talk about what I do in a way that’s compelling to a journalist?

Barnes from Ginger is nails it. Her advice is to speak in plain English. “Healthcare, and digital health specifically, suffers from an excessive use of jargon and lofty claims,” she said. 

10000000%. When I was reporting, I’d often walk away from conversations feeling like I had no idea what the founder was talking about because they used so many buzzwords. And I wasn’t new to the beat. My advice to readers is to explain what things in a way that a sixth-grader would understand. There’s power in simplicity. Attention spans are limited, so if you can’t get someone excited in the first few minutes, you’ve probably lost them. 

And here’s my list of words/terms to avoid wherever possible: Platform (unless you’re referring to a train), solution, breakthrough innovation, big data, revolutionary, empowerment. And acronyms in general. Be careful of AI, VR, AR. These terms are so overused to the point of being meaningless. Be specific even if you have a grand vision for where you want the company to go. It’s better to have a product that does something for a group of people than a “digital health platform” that isn’t about anything in particular. I still have a former editors’ words ringing in my ears: “What is it you’re writing about? Is it a website, an app? Both? Spell it out?”

Another tip: There’s a lot more about your company that might be newsworthy than funding rounds. “Other milestones to consider include new research and evidence or significant client additions or partnerships,” suggests Barnes. “A good journalist will likely pay attention to any of these milestones if you can prove significant value to the industry and for patients.” I’ll add here that patient/user stories are also really important. Many journalists will be looking for a first person “lede,” meaning an anecdote about how a human being benefited by a product or service. 

How do you talk about clinical evidence? 

This is particularly important for companies that have really invested in the studies/evidence, but compete against players that do not. How do you talk about your commitment to science without bashing the competition?

Here’s some advice from Barnes: “Peer reviewed research is great to put out via press release, highlight on your website, via social media, etc.,” she said. “I would also encourage founders not to underestimate the value of non-peer reviewed data science initiatives, too.” At Ginger, Barnes finds that the media is consistently interested in understanding the demand for the services compared to pre-COVID averages. And that data is easy enough to pull, she says.

I’d also add that it’s okay to talk about the competition. A policy of never talking about rivals has always seemed odd to me. Reporters will ask those questions to others in the space if founders sidestep them. It’s standard practice to map out the competitive landscape in stories. So assume it’ll happen regardless. 

A final piece of feedback: Know the difference between on record, off record and on background before engaging with the press. There’s slight variations of what these terms mean to different journalists, so it can’t hurt to ask. But I’ll share what they mean to me:

• On the record is always assumed when you’re talking to the press. That means you can be quoted directly or paraphrased. In other words, what you say can be attributed to you. Again, you are on the record unless you say otherwise - and it’s important to do so ahead of time, versus after the fact. 

• On background means the information can be used, but you will not be identified as the source of the information. When you read an article citing “people familiar with the matter,” or a “federal official with access to the information,” those are background sources. That tends to be negotiated between the reporter and the source. 

• Off record means that nothing from the conversation can be used for publication. It’s worth having a conversation upfront to agree on what that means on both sides. Oftentimes, the person being interviewed will really want to be on background. 

And a final comment because I can’t stress this enough.

Don’t assume reporters are different than everyone else in your network that you engage with. No one wants to get spammed or pitched at/to. Show who you are and what you care about. It’s obvious when someone you’ve spoken to rehearsed messaging and is intent on regurgitating talking points. My favorite folks in digital health were always the ones I could trust. It’s a cliche but it’s true: The best approach is to be yourself. 

Any questions? As always, you can reach me at @chrissyfarr on Twitter.