Innovation as Community Connector:
A Proposed Digital Strategy for the
Boston Children’s Hospital
By Charlotte Rowe
TUFTS Certificate Program
Final Paper
Digital Strategies for Health Communication
Prof. Lisa Gualtieri
August 2014
1
Executive Summary
The “Innovators’ Showcase” sponsored by the Boston Children’s Hospital earlier this
year featured more than 30 new services, all developed by the hospital’s own
clinicians and technology experts. Information about the showcase or the hospital’s
in-house innovation team was dated or buried on the website of the Boston
Children’s Hospital, leading to comments like one by Dr. Michael Docktor, of Hacking
Pediatrics, who attended the showcase and told MedTech Boston that he “had no
idea Boston Children’s housed so much innovation under one roof.” The Boston
Children’s Hospital leads the nation in pediatric care; it has a longstanding mission of
advancing pediatric research; and it is in the midst of redefining the very nature of
innovation, its process of development, and its forms of application. There is a
disconnect between the hospital’s innovation presence and its digital presence. In
this paper, I examine why this disconnect exists and how and why it can be
addressed.
I analyzed the digital footprint of the institution, uncovering a wealth of fascinating
content that lacked seamless connections and context. I interviewed a member of
the hospital’s innovation team, gaining a fuller understanding of why the
advancement of pediatric care is viewed as a central institutional value – one that
could naturally serve as a thematic unifier for BCH online. I developed a set of
personas to imagine potential users of the BCH website. Each of their different
scenarios revealed the same stressed, hurried public with desperate needs for health
information accessible through personalized, preferred devices and gateways. And I
conducted a competitive analysis that featured children’s hospitals from across the
country – Nationwide Children’s in Columbus, Ohio; Texas Children’s in Houston; and
Children’s Hospital Colorado in Aurora – that are not only clinical leaders but also
leaders in innovative web design and digital technology.
Given its tradition, prominence, and internal innovation commitment, the Boston
Children’s Hospital should not just be listed in this group but should be the standard
bearer in the use of digital strategies to reach patients, their families, and well
children in search of healthy living advice. A stated commitment to innovation and
even producing dozens of new solutions is not enough to solidify a reputation for
leadership in the digital age. You must show you are innovative by being innovative.
Recommended initiatives involve the website’s navigation and integration with other
BCH digital properties, prioritizing of content, interactivity with children and families,
and the projection of an overall sense of “innovation,” whether in terms of clinical
practice and process or engagement and user experience. For the Boston Children’s
Hospital, a cohesive, deliberate digital presence designed around its innovative spirit
can both distinguish it from competitors and serve its mission to improve the lives of
children and their families.
Innovation as Lynchpin Value at The Boston Children’s Hospital
The Boston Children’s Hospital (BCH), founded in 1869, is both a clinical and research
leader in pediatric healthcare. Located in Boston’s Longwood Medical and Academic
Area, BCH is a 395-bed comprehensive center for pediatric healthcare and serves as
a Harvard Medical School Teaching Hospital. It is one of the largest and most highly
regarded children’s medical centers in the nation, offering a range of services for
children, from birth through age 21. Each year, according to its website, BCH has some
25,000 inpatient admissions and its 200+ specialized clinical programs schedule
557,000 visits. The 2014-15 edition of “Best Children's Hospitals” by U.S. News &
2
World Report ranks BCH as #1 in eight of the 10 evaluated specialties. In addition to
its clinical expertise, BCH is renowned for hosting the world's largest research
enterprise based at a pediatric hospital, with more than 1,100 participating scientists.
The Vision of BCH is best captured in its motto: “Until every child is well.”
In recent years, the hospital has nurtured a hotbed of in-house innovation for solutions
that go beyond its medical lab research into software and patient engagement tools
that improve lives by improving processes. This emphasis on advancement is reflected
in the stated Mission of BCH to:




Provide the highest quality healthcare
Be the leading source of research and discovery
Educate the next generation of leaders in child health
Enhance the health and well-being of the children and families in our local
community
The Mission is enhanced by an extended Values statement that highlights the central
importance of Excellence, Sensitivity, Leadership, and Community. The value of
Leadership emphasizes the importance of “fostering an environment of innovation and
discovery, and of individual and team contributions to advancing pediatrics in all areas
of our mission.” While the Community value states a dedication to “fostering
community, both within the hospital and in the neighborhoods around us.”
These themes of Excellence, Sensitivity, Leadership, and Community were emphasized
in a conversation with Alexandra Pelletier, a manager in the BCH Innovation Program,
who provided perspective on how research and innovation fit into the BCH vision. She
explained that while BCH has a long history of research and ground-breaking
discoveries, “innovation is a tricky term.”
Pelletier says she is finding that the definition of research and the understanding of its
applications is changing as the healthcare industry undergoes rapid shifts in care,
costs, and tools. The traditional view of research as lab-based bench science is
broadening to encompass innovations that improve day-to-day clinical processes
through new digital tools, making the patient experience better and allowing clinicians
more time to spend with patients. “Innovation is taking on new flavors,” she says.
“We’re looking at how we can solve problems more broadly and how we can transform
the industry, all toward the same goal, which is best-of-breed care for our kids and
our families.”
While some healthcare providers have pursued technological advances by partnering
with external app makers and other vendors, BCH has committed to creating from
within by building out its own innovation arm. Earlier this year, the 2014 Boston
Children’s Hospital Innovators’ Showcase highlighted advances in patient care and
engagement developed by the hospital’s researchers and clinicians. Highlights of the
more than 30 innovations included the Integrated Clinical Information Sharing System
(ICISS) to help clinicians assess in real-time how a patient is doing before they return
for a follow-up appointment; a platform to make the patient discharge follow-up
process more efficient; and the Children’s at Home service to provide a secure social
media outlet for children with certain diseases. Chief Innovation Officer Naomi Fried
told Clinical Innovation + Technology: “It’s really the tip of the iceberg—there are
three or four times as many projects going on. We’re so proud and delighted with the
culture we’ve been able to build.” This fall BCH will host the 2014 Global Pediatric
Innovation Summit + Awards “to address unmet needs, solve problems, and seize
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opportunities in pediatric health care.” This event is promoted on its own website,
separate from the main BCH website, with a completely different look and feel. (See
Figure 1 for a full SWOT Analysis.)
Pelletier cited another example of the hospital’s homegrown solutions: the
“MyPassport” iPad app. The hospital’s Diversity and Cultural Competency Council
identified a need to help patients and their families patients better understand the
medical information they were receiving, as well as who was part of their care team,
and how best to communicate with them. The council received an internal FastTrack
Innovation in Technology award from the Innovation Acceleration Program and worked
with Pelletier and her team of software programmers for rapid development. The app
automatically pulls patient data from electronic medical records in Epic and Power
Chart, and displays it in a way that’s meaningful to patients and families. It helps
patients engage with their care teams and feel more prepared to leave the hospital,
armed with home-care instructions.
Such a DIY approach to innovation, explains Pelletier, allows primarily for optimal
speed, resources, quality control, and meeting the exact needs of BCH and those whom
it serves. She adds, “the value of this approach for me, and I assume for others, is we
want to help the lives of our kids and families. We’re not doctors, but we can help with
technology and help make every child as well as they can be.”
Nurturing Legacy in a Changing World
Given Boston Children’s ingrained and growing dedication to discovery, a digital
presence designed to both reflect and promote this value would be a positive
investment. Moreover, the need to establish a user-friendly digital presence integrated
across platforms and social media channels is fast-becoming an imperative in U.S.
healthcare for three main reasons: 1) Americans are stressed and in a hurry; 2) More
and more and younger and younger Americans are getting wired and going mobile; 3)
Healthcare reform and market pressures are putting an emphasis on wellness and
prevention, requiring providers to pursue new methods of patient engagement and
population health management.
Americans are stressed out these days, especially over healthcare concerns, and the
last thing they need to encounter when surfing the web are sites that lack hierarchy
and straight shots to the information that they need. In March and early April of this
year, National Public Radio, the Robert Wood Johnson Foundation, and the Harvard
School of Public Health conducted a nationwide poll to measure stress levels. According
to their report “The Burden of Stress in America,” about half the sample of 2,505
respondents (49%) reported they had had a major stressful event or experience in the
past year. These respondents were then asked to describe the most stressful event or
experience had been. Over four in ten (43%) reported stressful events or experiences
related to health. While the report did not specifically address the stress levels
associated with having an ill child, my own development of personas for this analysis
pointed to a common theme of stress and lack of time in four very different lives: a
child and his grandmother using time-restricted library computers; a teenager surfing
on the school bus ride; a single mother of a sick child; and a multitasking founder of
a Silicon Valley startup.
Online and mobile access to information has been widely adopted and will to continue
to grow in popularity among consumers in all industries, including healthcare.
According to a report from the Pew Research Center “The Web at 25 in the U.S.,” 87%
4
of American adults now use the internet, with near-saturation usage among those
living in households earning $75,000 or more (99%), young adults ages 18-29 (97%),
and those with college degrees (97%). Fully 68% of adults connect to the internet with
mobile devices. Pew also noted adult ownership of cell phones has risen to 90% from
53% in 2000. Moreover, Pew researchers said respondents “made clear those
technologies feel increasingly essential.”
Initially, healthcare providers did not feel the same pressure from consumers for digital
connectivity as other industries such as entertainment and retail. That is no longer the
case. This was made clear in a report by web consultancy Evolve Digital Labs, “Aligning
Patient Needs With Online Capabilities: What Healthcare Reform Means for Your
Hospital Website.” The report outlines several common problems with healthcare
provider websites, including outdated content, lack of consistent branding, and the
need for integrated marketing. According to the report, improving online
communications is essential to the effectiveness of hospitals in meeting the postreform era’s emphasis on wellness and population health management. “A visit to the
hospital is now far more than just treating an immediate health problem,” noted
Evolve. “Healthcare providers must advise the patient about lifestyle changes that
could reduce future health risks and diseases. The right digital tools will allow
healthcare organizations to more easily adapt to new requirements in population
health.” Evolve further found that “most hospitals have upgraded to in-house systems
that make patient management simpler, but have not yet advanced to the same level
in online interaction and access for their patients.”
A Closer Look at BCH Online
Figure 1 – SWOT analysis
Strengths




Weaknesses
Clinical excellence & leadership:
Boston Children's Hospital is ranked
higher by US News & World Report in
more specialties than any other
children's hospital; affiliated teaching
hospital of Harvard Medical School;
supports world's largest research
enterprise based at a pediatric hospital
& in-house innovation team
Offers a number of entry points for
different users to access content on
the home page
A
wealth
of
groundbreaking,
newsmaking content to draw from
Rich
content
&
strong
visual
presentations on separate platforms:
o Vector, the science and clinical
innovation
blog
at
http://vectorblog.org/
o Twitter account dedicated to
pediatric healthcare innovation
news & linked to Vector blog at
@BCH_Innovation
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






Website not always fresh
Hard to distinguish priority of
messaging on home page
Design of home page feels dated & too
busy
Website gives options for users in
“Research + Innovation” to “organize
by” their own selected criteria such as
“A-Z” or “Featured” when might be
better
served
by
organization
prioritizing message
The design and style of the
presentation of the innovation stories
does not reflect the excitement of the
discoveries or their import
Timely events such as the “Innovation
Summit 2014” and an interesting
“Newsroom” feed are buried within the
site
Missed opportunities to connect with
children
and
teens
themselves
whether in regard to innovative
o
o
o
o
o
o
o
Official
Twitter
@BostonChildrens is connected
to
website
newsroom
childrenshospital.org/newsroo
m/
Thriving blog has relevant,
emotive
content
at
http://childrenshospitalblog.or
g/
Dynamically designed, of-themoment
Summit
site
at
http://bostonchildrensinnovati
onsummit.org/
Facebook does nice job of
telling
patient
stories
https://www.facebook.com/Bo
stonChildrensHospital/timeline
Center for Young Women’s
Health is an award-winning
teen girls' site with health
guides, quizzes, chats, & more
http://www.youngwomensheal
th.org/
Center on Media & Child Health
has
lots
of
engagement
opportunities
http://www.cmch.tv/
Suite of custom apps available
to share and promote




discoveries or engagement tools for all
ages
The first sentence under Innovation
Acceleration
Program
reads
“Innovation is at the core of Boston
Children’s Hospital” but this theme of
innovation is not used as a connector
through social channels
Home page is a weak link among
various platforms; sum not reflecting
whole of its parts; continuity lacking
Website organization too hierarchical,
perhaps
reflecting
institutional
organization rather than consumer
needs
Key innovations and engagement
tools buried and not consolidated
Opportunities
Threats







Connect blogs, Twitter, other social
accounts & related websites more
prominently to BCH website so easier
to access and clearly branded under
trusted BCH name
Create a seamless design & branding
statement between website, blogs,
and other sites
Analyze fresh content appearing on
blogs and newsroom pages and see
where repurposing makes sense v.
new creation
Can simplify user interface on home
page to make experience more
straightforward,
targeted,
and
relevant
“Innovation” as a theme can apply
across user groups & to a variety of
topics
Curated apps section of recommended
online tools & applications for healthy
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






Many competing “best practices” to
highlight
Different core needs of user groups &
states of mind that users approach site
with (i.e. some looking for care, others
research,
others
business
opportunities)
Tension between fresh content and
evergreen information
Quickly changing nature of social
platforms
Doctor-Patient privacy
May be strong investments in existing
website
architecture/interface
&
design
Strong adherence to/appreciation for
institution’s hierarchy
Departments and resources are
targeting vastly different audiences
and health needs

children focused on wellness & for
inpatients and outpatients of the
hospital
Explore more ways to connect directly
with children as a trusted voice of
health & wellness advice
Primary Goals & Measures of Success
Planning Horizon: 12 months
Goal 1: Establish innovation and its practical implications as a theme throughout the
site and linked properties. This will help ensure that all sites and channels share the
same contextual touchstone and work together to enforce a timeless message.
Measure of success 1: BCH homepage looks visibly less “busy” and key stakeholders
more quickly identify their paths to click for information.
Goal 2: Create a section of recommended, curated apps and websites. This will further
leverage the existing products and services that BCH innovators have created and
establish BCH as a leading advisor of new tools.
Measure of success 2: Parents and children are aware they can download a BCHinspired app within one or two clicks off homepage.
Goal 3: Simplify navigation with messages clearly prioritized to guide users through
the site more calmly and efficiently. BCH will not only help users understand better
where to find their information but it will better enforce its own messages.
Measure of success 3: Content is consciously repurposed or created new, with
awareness of what is happening on all platforms, and innovative spirit is reflected in
both design of site and content featured.
Goal 4: Identify a seamless design style for all BCH digital properties so that BCH
brand isn’t diluted and is instead strengthened by association with modern voices and
tools geared toward children’s wellness and healing. This will create a more pleasing
design look and users will always know the source of their information.
Measure of success 4: All BCH digital properties look like they have the same branding
approach and design style and priorities/themes.
Personas
The development of “personas” creates an opportunity to conduct a theoretical user
study without commissioning a formal focus group. Turning the concept of a website
“user” into sketches of imagined “real” individuals allows strategists to dive deeper
into who might actually be using the site. The personas are then walked through
“scenarios” providing windows into the possible “triggers” for how different people
reach the website and then how they feel and what they do once they get there. (See
Figure 2 for the full BCH Personas & Scenarios.)
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Figure 2 – Four Personas & Scenarios
Persona &
Scenario 1
Sam &
Margaret
Sam is an 8-year-old second-grader at a Boston public elementary school. His
parents both work outside the home, and Sam spends a lot of time with his
grandparents Margaret and Bob who live nearby and are both in their 70s, having
retired from their jobs in sales. Sam is healthy and active. He was an early reader
and is very inquisitive and empathetic. He likes to think of himself as the “helper” in
his classroom and with his grandparents. Sam spends most afternoons at the library
after school with his grandparents where they will use the public computers (which
often have lines because of 20-minute limits) and then let Sam play educational
games on them. Sam often goes rogue online when they are occupied with their
crossword puzzles and newspapers. They are like many families in this afternoon
ritual: Key takeaways from Pew Internet’s Libraries Research include that a top
driver of visiting the local library is that grandparents’ enjoy taking their
grandchildren, and more than 77% of those surveyed said free access to computers
and the internet “is a very important service.”
One afternoon when he is at the library with his grandparents, Sam asks his
grandmother for help on the computer. He found out during school earlier that day
that his classmate Jessica had to go to the “big children’s hospital” and she is staying
there now. “What is asma, Grandma?” he asks. “What is wrong with Jessica? I want
to help her. I want to send her a message.” Margaret assumes that Jessica has been
taken to Boston Children’s Hospital and goes to its website. There she searches for
“asthma” and finds the basic clinical information to give Sam. She also searches for
“contact a patient” but when she reaches this page, the email link is broken. Sam is
frustrated at the seriousness of the information – it is not geared to him in
presentation - and that he can’t immediately express his concern for his friend or
understand exactly what kind of environment she is in. He and Margaret decide that
he will suggest to his teacher that they organize his classmates to make paper getwell cards and deliver them in person to the hospital.
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Persona &
Scenario 2
Caroline
Caroline is a 12-year-old suburban New York middle schooler. She is an active and
very social “tween.” She plays soccer for her school team and participates in a
community after-school drama program. Her social life revolves in large part around
sharing photos and videos with friends on Instagram and YouTube. She also likes to
go to the mall for fun and is caught between listening to her mom and her peers for
support and advice. Because she takes athletics and acting very seriously, she is
very attuned to her looks and fitness level and often finds herself feeling selfconscious about her changing body. One morning she gets ready for school and
grabs a granola bar for breakfast to eat on the bus. She spends the bus ride
Instagramming and YouTubing with friends on her smartphone, which was originally
intended “only for emergencies” and when she is babysitting. She gets upset when
she sees that a friend has posted photos from a slumber party over the weekend
that she wasn’t invited to, leaving her feeling down and left out. She doesn’t end up
eating the granola bar because she thinks she wasn’t invited to the party because
she isn’t pretty enough.
Later on the bus ride home, she happens to catch a funny shared video of “Outtakes”
from the Young Women’s Health Center at the Boston Children’s Hospital. She clicks
on the link and is taken to the center’s site, which is full of fun, accessible information
including an anonymous Q&A option. She bookmarks it and refers to the site again
to help her make a healthy lunch. She also enjoys reading about the older teen girls
and role models who are featured on the site. She doesn’t quite make the connection
that the site is part of the Boston Children’s Hospital network or become aware of
the hospital’s other resources that might benefit her.
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Persona &
Scenario 3
Linda
Linda is the 38-year-old single mother of 2-year-old Matthew. She is a bank teller
in Atlanta and adopted Matthew at birth. She is close emotionally with her extended
family but they all live in different states. Linda is highly organized and determined.
She uses a laptop at home that she repurposed from work and also depends on a
smartphone for keeping in touch with family and with the daycare center where she
drops off Matthew each morning on the way to the bank. She usually picks him up
around 5:15 p.m. to head home for dinner, bath, and bedtime. Last week, she
noticed that Matthew was unusually thirsty and brought him in to see the
pediatrician who referred her to a community hospital for tests. Early results show
that Matthew may have early-onset diabetes.
During the waiting period before a definitive diagnosis could be made, Linda
experiences a panic attack and frantically begins conducting Google searches on the
medical terms and conditions mentioned in the initial visits with the pediatrician and
by hospital lab workers, particularly focusing on their theories about diabetes. Her
searches lead her several times to Boston Children’s Hospital, which is ranked #1 in
diabetes care by U.S. News & World Report. She concludes that she needs to bring
her child here to receive the best specialty care. While the layers of navigation on
the BCH homepage do not reduce the stress of Linda as she is searching, the
information she eventually uncovers in her determined search convinces her that
BCH is the right place to bring her child for further treatment.
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Persona &
Scenario 4
Luke
Luke is a 28-year-old Stanford graduate living a fast-paced, high-stakes life
revolving around his San Francisco-based startup incubator focused on digital health
applications. He is highly wired as is his fiancée, Kate, who works in media. They
both use smartphones, iPads, and laptops for professional and personal use. They
also both wear Fitbit activity trackers that are synced with their smartphones. He
personally is coping with fatigue and stress but exercises regularly and is a healthy
eater of farm-to-table foods. Luke is an early riser and checks his email on his phone
as he prepares breakfast smoothies for himself and Kate as they rush out their door.
One morning he’s on a conference call with New York investors while driving to his
office in Silicon Valley. The call puts pressure on Luke to come up with new ideas
and avenues of opportunity. When he’s later checking his email on his laptop at his
desk, he reads an email blast of upcoming hackathons and innovation challenge
opportunities. One of them is the Boston Children’s Hospital Global Pediatric
Innovation Summit scheduled for October. This sparks the the idea that his firm
should be exploring more apps and digital tools focused on children’s health needs.
He books a ticket to Boston and assigns an intern the task of finding out more about
what’s going on at BCH – he doesn’t have time to dig through the site.
I gained several guiding conclusions from the Personas exercise. First, the BCH
navigation and content prioritization does not reassure and calmly guide its stressed
and hurried users through its information as well as it could. Second, BCH has some
amazing resources but they are not all integrated into the main site and are too easily
reached and visited without making a connection to the larger organization. And finally,
external influencers such as schools, referring doctors, and professional interests can
affect site traffic.
Competitive Analysis
A disciplined competitive analysis can reveal ideas for your own site by teasing out
techniques and approaches that you might want to borrow and customize – or avoid.
The analysis can further spark ideas or validate existing strengths that are worth
maximizing through further investment.
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The institutions chosen for the Boston Children’s Hospital competitive analysis were
the Nationwide Children’s Hospital of Columbus, Ohio, the Texas Children’s Hospital of
Houston, Texas, and the Children’s Hospital Colorado of Aurora, Colorado. These
hospitals were chosen for comparison based on three major criteria: 1) High national
ranking for clinical excellence 2) Citations for website and health information
technology excellence 3) Geographic diversity. (See Figure 3 for full competitive
analysis.)
A high national ranking for clinical excellence is important because Boston Children’s
Hospital is the standard bearer in the field. Like BCH, all of the comparative hospitals
were ranked in the top 10 of the U.S. News & World Report Best Children's Hospitals
2014-15: Honor Roll. Boston Children’s Hospital tied for #1 overall with the Children’s
Hospital of Philadelphia; Texas Children’s Hospital ranked #4; Children’s Hospital
Colorado ranked #6; and Nationwide Children’s Hospital ranked #7.
However, this strategic comparison does not center on questions of clinical excellence;
it is focused on digital excellence. Hospitals that are on the forefront of pediatric care
that have also been recognized for their digital strategies represent a respectable
subgroup that can offer lessons for a category leader like Boston Children’s. In 2012
Nationwide Children’s in Columbus received a Silver eHealthcare Leadership Award for
Best Overall Internet Site (Hospital 400+ beds). The annual award is presented by
Strategic Health Care Communications and factors considered include delivery of
strong health content, interactivity, medical care support, integration with the
organization's operations, and strength of web design and ease of navigation. For the
second year in a row, Children’s Hospital Colorado was named a 2014 "Most Wired"
hospital by Hospitals & Health Networks magazine. The award recognizes hospitals
and health systems for having excellent IT capabilities in a variety of areas, such as
the routine use of electronic health systems and digital clinical imaging. Interestingly,
both Children’s Hospital Colorado and Texas Children’s Hospital were cited in the blog
post “Best Responsive Websites in Healthcare” by the web consultancy Massachusetts
Technology Corporation. The author wrote:
As I was researching for this article I noticed that Responsive Web Design was
not really incorporated in the Healthcare field. Most websites I came across were
information based and purely functional. However, there were some healthcare
websites that were designed for all screens and had some features that we
enjoyed….The Texas Children’s Hospital website has great responsive features.
The menu bar shrinks down into an easily accessible and fully functioning drop
down menu. It is very user friendly when it is pulled up in mobile and you can
still scroll through the highlights while browsing on your phone….Children’s
Hospital Colorado has a highly informative website that is also well designed.
Our favorite thing about this website is that even though they have multiple
separate menus on the homepage, all of these menus are fully accessible in
mobile. The icons shift in such a unique way you can tell that a lot of thought
was put into each different interface.
Finally, geographic diversity makes the point that no matter where you are located,
you can expand the local, national, and globalreach of your mission by strengthening
your digital footprint.
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Figure 3 – Competitive analysis
Purpose
“Provide the highest quality health care; Be the leading
source of research and discovery; Educate the next
generation of leaders in child health; Enhance the health
and well-being of the children and families in our local
community”
“To fulfill our promise that ‘When your child needs a
hospital, everything matters.’”
“To create a healthier future for children and women
throughout our global community by leading in patient
care, education and research.”
“To improve the health of children through the provision of
high-quality, coordinated programs of patient care,
education, research and advocacy.”
Potential: Patients, doctors, researchers, kids, parents
Looks aimed toward: Parents, clinicians
Users
Potential: Patients, doctors, researchers, kids, parents
Looks aimed toward: Parents
Potential: Patients, doctors, researchers, kids, parents
Looks aimed toward: Parents
Potential: Patients, doctors, researchers, kids, parents
Looks aimed toward: Parents, kids, patients
Isn’t consistent across digital properties; social channels
more aligned than different websites and blogs
Branding
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Same butterfly logo or riff on this logo w/ girl with butterfly
in her hair across properties
Same logo and simple clean design used across channels
w/ recurring photos of kids w/ cowboy hats and purple
flowers
Useful social media channel aggregator on homepage that
keeps them all in same design; “When I Grow Up…” photo
campaign carried across channels
Harvard Medical School Teaching Hospital
External
affiliations
Ohio State University Medical Center
Baylor College of Medicine
University of Colorado School of Medicine
Too busy & too much hierarchy, messaging not prioritized,
feels dated & not fresh in style or substance
Design
Clean design w/ fresh stories in changing news carousel,
organized for user action especially w/ section titled “i want
to…” followed by key user information choices such as “Get
Directions” & “Prepare for a Visit”
Extremely clean & simple design lacking in expected
warmth, has been recognized for its responsive design,
very modern look, photo of kids with cowboy hats really
connects them to community
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Nice combination of modern clean design with playful
elements such as colourful animal drawings that add the
warmth that you’d expect at an institution caring for kids
Section
organization
“How Can We Help You?” box in center is a nice feature that
keeps user goals on track; other sections have an overload
of information, type is too small throughout & there is a
lack of message prioritizing
Organize sections along lines of information about research
& services, practical information and timely news & advice
information like that provided on their blogs
Sections organized very practically: top sections are
defined by user action – “Locate” “Learn” “Plan” “Refer”
“Donate” and others focused on latest news
Sections are organized around practical needs such as
directions and accessing information such as research.
There is some overlap in categories such as “Patient Safety”
and “Wellness & Safety” that may create confusion
Layout and
navigation
There are 3 main navigation options on the homepage and
similarly used throughout site: top nav bar, a “How We Can
Help You?” box, and nav bar that asks users to organize
their information by Featured, Newsroom, Parents’ Corner,
Ways to Help, Video. This customizable bar risks creating
confusion for visitors in terms of what is the main message
and main source for getting answers to their questions.
Having to choose different ways to organize the information
may create time hassles for users.
The website makes use of several features that help the
site stay focused on the user’s needs. For example, on the
home page and carried throughout other pages is the “i
want to” organization tool introduced on the homepage as
well as a “quick links” option used on subsequent pages to
help users find their information quickly.
The initial navigation could not be much simpler. Each of
the “Locate” “Learn” etc. tabs does widen into a broader
menu that loses some of that simplicity, though each of the
pages under each subject do stay tied to the nav tab
15
topically. They could add just one more simple tab, for
example, to break up the complexity in the menus.
While the design, look, and feel of the site is appealing for
both parents and children, there seems to be a little too
much going on. There are several types of navigation
options, from the top nav bar which has dropdowns to a
quick info box in the center, plus a rotating carousel of
stories and images, a newsfeed and social media feeds. In
addition there is a conditions search box, more location
finders, and options for virtual tours and making donations.
The fun design helps move all this along but the many
choices create opportunities for key messages and
information to get lost.
Research
Section
The one hospital to feature “Innovation” and not just
“Research.” Clearly a theme that is important to the
institution and one that presents a clear path to
differentiation. The landing page for the Research +
Innovation section again asks users to prioritize. I would
argue that this is different than making the site responsive
to user needs. It’s necessary for the institution to exercise
judgment over what and how to feature the resources. Too
much of the “cool” and exciting work is buried in the sidebar
navigation, when it could be more richly featured in the
main body of the page. The page does feature great work
but in a way that may not grab users’ attention. Too much
of the work is buried in blogs that don’t directly tie in
branding or navigation to central website.
From its Research page, it is clear that the hospital
approaches research through “12 Centers of Emphasis” and
while institutional hierarchy may not always be the best
way to organize the website, here I think it makes sense as
a navigational method. They list the 12 centers in the main
text area and then each has its own landing page and
spinoff information that has same look and feel as the rest
of the site.
The Research Studies section naturally flows from the main
nav tab “Learn”. On the main research page, their studies
and various centers are presented with same simplicity and
clean design that characterizes the rest of the site.
Research tab is clearly featured in top nav. They do a nice
job of driving home the relevancy of why the hospital
conducts research with two main text sections on the
Research page: “Finding cures faster with child health
research” and “Our research process: from the hospital to
the lab”.
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Research
section
currency
The first item on the Research + Innovation page is dated
8/15/2013.
The first item in the “latest news” section of the Research
page is dated 10/21/2013 & in a different section on same
page 7/24/2014.
Latest blog post promoted on home page August 1, 2014.
The first “Related News” item is dated 06/05/2014.
Health
literacy
&
readability
Writing is authoritative and accessible. The amount of
information and how it is organized makes reading through
the site difficult.
Their “700 Children’s” blog is featured prominently on their
homepage and directs parents to a fun, accessible, relevant
resource written by hospital experts.
The information appears to be up to date, but it is difficult
to find an indication of exactly when the content was
published, aside from the copyright logo.
They have some great examples of ways to provide health
information clearly and in an interactive way, such as their
interactive child symptom checker, their virtual tour
campus map, and “Calm a Crying Baby” resource link.
English
Language
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English
Spanish site a clear option
English
None apparent
Usergenerated
content
Replies may be left on blog; really thoughtful option
accessible on homepage to “Send a Greeting Card” to a
patient.
The latest comments are featured on the blog.
Social media channel content displayed on homepage
through unique aggregator tool.
Web Site User Privacy Rights
Policies
HIPAA Privacy Notice
Notice of Privacy
Responsibilities
18
Practices,
Patient
Rights
and
Website Terms of Use & Privacy Policy
Registration
&
purchasing
“Sign up for a MyChildren's account. Manage appointments,
view portions of your child's health record, contact your
clinician directly or pay your bill online.”
“The info in our free Health e-Hints newsletter is
customized, so it grows with your child. It’s like having a
pediatrician in your inbox.” + “Nationwide Children’s
Hospital offers MyChart, an online resource for families, to
access medical information for your child. This tool is
available for both inpatients and outpatients.”
View medical records online, pay your bill online, sign up
for blog email newsletter, a “subscription center” for 6
newsletters and publications
“Children’s Hospital Colorado puts a variety of parentpopular resources and expert medical advice right at your
fingertips – so you can provide your family with the best
possible
care.
To
start
receiving
our
FREE
Shine eNewsletter and other expert advice on parenting,
please fill out the information below.”
Mobile
MyWay, a free mobile app with step-by-step directions to
help you get around many of our locations plus others but
not grouped together
The myChildren’s app puts Nationwide Children’s at your
fingertips anytime, anywhere. Find a Nationwide Children’s
doctor, program or service at the click of a button. Find the
tools you need to navigate through the hospital’s main
campus, set up appointment reminders and much more.
Not apparent
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Award-winning ChildrensMD Mobile App: Available for
Android, iPhone, and iPad Devices
Social media
Facebook: 738,420 likes; 23 hrs ago on West Nile virus
Twitter: 28.2K; 24 hrs ago on #stemcelltransplant study
YouTube: 2 dys ago on cardiac caregiver (122 views)
LinkedIn: 21K; 2 dys ago on drug research investment
Google+: 391; drug research investment
Instagram: 2,865; July 29 w/ Miss Mass. at blood center
Pinterest: 35 followers/no boards; not promoted
Blogs: Vector on innovation, Thriving on kids health topics,
Teen Speak on young adult health
 Strong updated content but not promoted enough,
not easily found through main website, & content
not shared/used enough through main website
Facebook: 168,844 likes; 2 hrs ago on research registry
Twitter: 11.1K; 20m on research & how can help
YouTube: 1 mth ago on ear tube surgery (1,497 views)
LinkedIn: 13,211; 5 dys ago on NCH NASCAR 200
Google+: 677; 2 hrs ago on research registry
Instagram: 2,494; Aug 1 on EKG testing
Pinterest: 1,914 followers/47 boards
Flickr: NCH NASCAR 200 photos
Podcasts: “PediaCasts” on child health (1M+ downloads)
Blogs: 700 Children’s news for those who “have a child –
or care for a child”, Health e-Hints newsletters
 Convenient listing on “Social Media at Nationwide”
page; newsletter & blog featured on homepage;
Instagram/LinkedIn icons missing at homepage
bottom; smart commitment to Pinterest which is
known for popularity w/ women (70M users/80%
women according to DMR) who are also known for
their healthcare decisionmaking role (85% choose
children’s doctor & make other key family health
decisions according to Health Grades)
 Raises question of what does hospital/any of the
hospitals know about the distinct audiences reached
by each channel and if there is overlap – could affect
whether all channels needed/whether repurposing
content is ok because different audiences reached
or whether this would risk redundancy of message
Facebook: 37, 588; Aug 1 on top July hospital news
Twitter:13K; Aug 1 on patient w/ celiac disease
YouTube: featured from 2 yrs ago w/ hospital CEO (8,709
views)
LinkedIn: Google+: 987; Aug 1 on top July hospital news
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Instagram: 780; July 31 on heatstroke prevention
Pinterest: NA
Email updates: Signup to receive news on patient stories,
medical breakthroughs, ways to get involved
Blogs: Texas Children’s Blog written by medical experts &
patients on pediatric health topics
 Content particularly relevant to the community from
where to go for a snake bite to heatstroke and an
epilepsy camp and patient families meeting &
becoming lasting friends
Facebook: 26, 856 likes; 21 hrs ago on family gift to
parents of preemies
Twitter: 13.9K; Aug 1 on new hospital commercial video
YouTube: featured from 3 mths ago on family w/ child w/
Down Syndrome (4,088 views)
LinkedIn: NA
Google+: NA
Instagram: NA
Pinterest: 695 followers/11 boards
Email newsletter: Shine for parents
Blogs: NA
 Platforms are well promoted through homepage &
well-integrated though may want to consider
expanding Pinterest & developing Instagram to
reach more women & kids & teens (see above for
stats on Pinterest + consider more than 200M users
monthly on Instagram – 23% of teens consider
Instagram their favorite social network - 42% of
teens surveyed use Instagram on mobile according
to DMR); also may want to consider transitioning
Shine into a blog format rather than newsletter
though could also have both & repurpose content
(i.e. newsletter would function as a roundup of blog
posts)
Overall
The Boston Children’s Hospital has no shortage of
compelling content. Nor is it lacking in a widespread digital
footprint as it covers all the major social media platforms
and provides updated content for each. However, by
comparison, the site navigation needs to be simplified,
content from the various social media channels and blogs
should be better promoted and featured on main website,
more interactive features should be explored to engage
parents and patients/well children alike, and a redesign
could “warm up” the tone and imagery of the site to better
relate to children and stressed families. BCH may also want
to consider developing its presence further on Pinterest,
given the channel’s popularity among women healthcare
decision makers (see above). None of the reviewed sites do
as well as they could promoting their in-house innovations
and tying these advancements to the real lives of patients,
well children, and families – presenting a real opportunity
21
for Boston Children’s to further advance its mission of
innovation through digital connections.
Of the four sites reviewed, Nationwide may offer the best
combination of user-directed navigation options with
inviting design and in-depth content. That said, the site can
feel too text heavy when viewed next to the Texas
Children’s site, for example. And it can feel less animated
and interactive when compared to the Children’s Hospital
Colorado site.
The Texas Children’s hospital site appears to be on the
forefront of website design simplicity and user responsive
design. Its navigation is a breath of fresh air within the
category of often information-overloaded healthcare sites.
It also has the right idea in mind to connect to and feature
its fresh blog and news content directly on its homepage,
where other practical user actions such as paying bills and
accessing medical charts are also readily available. If it
could just “warm up” its site a bit with more of those
fabulous, sense of place images like the kids with the
cowboy hats used throughout, it would be closest to
achieving a streamlined yet personality-infused user
experience.
The Children’s Hospital Colorado website is by far the most
relatable to its primary intended audience of parents and
children. Its colors and imagery are playful yet practical and
clearly establish the website and organization as a place for
children and families who need information. Their
integration of their social media channels into the
homepage is the best representation of the four in terms of
maintaining a unique personality while also offering an
efficient solution. They should promote more their
interactive features and do more of them. They should also
consider simplifying their navigation and homepage
content further to ensure that the institution’s key
messages as well as the key practical information being
sought are not buried within other topics or functions.
Instagram may be worth pursuing to expand its outreach
to kids and teens.
Borrow, Avoid, Distinguish
Borrow

User-directed middle navigation segmentation from Nationwide:
22

Send a greeting card interactive option from Nationwide (our Sam Persona
would have loved this! note: Sam’s persona was developed before this was
found!):

Social Media aggregation page from Nationwide:
23

Simple upper user-directed navigation from Texas Children’s:
24

Imagery that provides a sense of place from Texas Children’s:

Playful, efficient social media channel aggregator from Colorado (click on icon,
then box fills with that channel’s content):

Interactive, kid-friendly symptoms checker from Colorado:
25
Avoid + Distinguish
26
When you focus on how each of the four websites presents their research, lessons for
both “what to avoid” and “how to distinguish” emerge for Boston Children’s. BCH could
improve its access to is innovation arms with the listing approach taken by the other
sites. Children’s Hospital Colorado provides perhaps the best example, especially with
its clear, explanatory language:
Just a listing of related hyperlinks would stop short of the fuller vision of not just
improving access to information about BCH innovations but also expanding its story of
innovation to become a thematic link between the site and other digital channels, using
innovation news as a major source of featured content, and tying the innovations to
their practical implications for improving the lives of patients and their families. Boston
Children’s Hospital was the only one of the four to spotlight the concept of “Innovation”
not just “Research:”
Takeaways for Design, Content, & Technology
27
When viewing the Boston Children’s Hospital digital presence in the context of various
user personas and peer medical centers, its depth and reach of content is clear. But
its presentation and organization of the content could be improved in a redesign. The
navigation relies in large part on a navigation bar that appears in the middle of the
home page and on subsequent section landing pages. The bar is problematic. It does
not allow for smooth, efficient navigation of the site because it does not help users
prioritize what they are viewing. Yes, it allows them to choose how they want to group
the content, but this is different from prioritization of message. It also interferes with
the look and style of the content, stripping it of a context that creates a personality
and sense of warmth or playfulness, particularly evident on the Colorado site, that
would be appropriate for a site reaching out to children and families. The style also
feels clunky and dated – not the destination site of a modern, cutting-edge research
and innovation center. Consider a more streamlined approach like that of Texas
Children’s to better reflect the hospital’s leadership. While our persona Linda may care
more about the medical services available to her child, how she finds that information
and the environment she enters when searching for it, will affect her entire opinion of
her experience with Boston Children’s Hospital.
While BCH does have an impressive depth and range of content on its various sites
and channels, there may be some opportunities for repurposing that have not been
identified that could free up time to spend on maintenance and promotion. Key
differentiating news and stories are buried throughout the site and other digital
properties. It takes several clicks to find news on truly leading innovative research and
to find current articles and stories about patients and the institution. The institution
could exercise more news judgment in prioritizing its messages throughout the site,
and, like the competitor sites, find ways to integrate streaming content from its rich
blogs into the home page. Persona Caroline, for example, could be directed
immediately from the home page to a blog post on healthy lunches or to a “Just for
Kids” or “Just for Teens” section that offers a trove of (already developed) healthrelated games and advice for tweens.
A key differentiator for BCH is its large number of patient tools and services developed
in-house specifically for children and families. This same tech ingenuity can be applied
to the hospital’s digital presence by incorporating more interactive digital opportunities
for engaging with the site and institution. Our persona Sam would make an early
positive connection to BCH if it could reach him with some simple interactive games
and tools, like Nationwide’s greeting card sender or Colorado’s symptom checker. And
persona Luke would really appreciate cutting-edge user interface & responsive design
technologies. Combined with Boston Children’s solid reputation, this sort of attention
to tech would tip off Luke before he even read any more about BCH that it is a nimble,
user-oriented organization where he would be excited to brainstorm about new ideas
and future applications.
Recommended Initiatives
28

Simplify Boston Children’s Hospital site homepage navigation and content
promotion with innovation as a dominant theme. Write the story of innovation
at Boston and then reflect this story in digital design and featured content
throughout. A clearly prioritized, user-directed navigation system is essential
for meeting the needs of consumers who are increasingly stressed, particularly
over health concerns. According to the report “The Burden of Stress in
America,” about half the sample of 2,505 respondents (49%) reported they had
had a major stressful event or experience in the past year. Of these
respondents, over four in ten (43%) reported stressful events or experiences
related to health. Scenarios research also showed that consumers - whether
young children, grandmothers, tweens, middle-aged single mothers, or
twentysomethings – are pressed for time online and stressed about personal,
professional, and family matters.

Create a section of curated apps and websites and other online patient and
wellness engagement tools and resources that is clearly accessible from the
BCH homepage. BCH has a number of homegrown apps and digital tools such
as its MyPassport and its Children’s at Home service that provides a secure
social media outlet for children with certain diseases. These are in addition to
related online resources such as the Teen Speak blog of the Center for Young
Women’s Health. BCH should inventory what apps and websites (whether
internal or external) that they would recommend for health information and
support. Such a clearinghouse would establish BCH as a leader in the
advancement of new engagement tools in line with its mission and values. As
Evolve Digital Labs found in its research “most hospitals have upgraded to inhouse systems that make patient management simpler, but have not yet
advanced to the same level in online interaction and access for their patients.”
There is opportunity in this space for BCH to “show” that it is an innovator by
standing at the forefront of digital technology just as it is at the forefront of
clinical advances.

Identify a seamless design style for all BCH digital properties so that brand isn’t
diluted and is instead strengthened by association with modern voices and tools
geared toward children’s wellness and healing. Analyze content production and
flow to determine where content could be repurposed so that resources could
be diverted to efforts to update, integrate, and promote. The goal is give the
following disjointed digital properties a more cohesive look and to fill them with
content that works in sync with other channels. Currently, the brand risks
dilution by varied presentations online and by not promoting them in a broader
context on the main site. Here are four examples of sites all under the BCH
umbrella – note the varied designs:
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
Expand and develop presence on Pinterest and Instagram which are used by
many patients, children, and teens who could benefit from wellness messages
and health living advice. Currently, BCH does not have a presence on Pinterest
beyond setting up an initial page. According to Digital Marketing Ramblings,
Pinterest now has 70M users, 80% of whom are women. At the same time,
according to research reported by Health Grades, women choose their
children’s doctor 85% of the time and make other key family health decisions.
These two statistics together suggest that Pinterest would be a place to reach
an important audience of Boston Children’s Hospital. A similar logic follows with
Instagram, which, according to Digital Marketing Ramblings, has more than
200M users monthly and which a quarter of teens consider Instagram their
favorite social network. The BCH Instagram feed is currently targeted to a
broader audience, like a newsroom feed might be, but it could more
aggressively promote health messages that are geared to teens. It could also
be used to launch crowdsourced campaigns such as "#BCHPictureofHealth” that
would take advantage of the messaging services that make Instagram unique.

Wild Initiative - Create Wellness Portal for Kids & Teens promoted directly on
home page and featuring in-house engagement tools as well as those
developed through potential partnerships through organizations, such as Girl
Zone and the hospital’s own Center for Young Women’s Health. Many
population health measures are currently focused on the aging population and
specific groups of individuals with chronic diseases. But what are the initiatives
targeted toward children and wellness? How could the hospital work with
schools, libraries, pediatricians, and professional groups to reach this
30
population more effectively and with the tools that they prefer? The growing
need for curated wellness information is noted by Evolve:
A hospital can take advantage of the digital tools available to more
effectively interact, communicate, and provide critical health
information to patients….The focus on urging the public into a new and
better state of wellbeing through diet, exercise, and nutrition are all part
of the current approach to healthcare. Building a bridge of
communication between patient and healthcare facility with multiple
interactive functions makes the process of providing holistic healthcare
more effective.
Conclusion
The incentives are clear for all healthcare providers to take deliberate steps to improve
their online users’ experiences, invest in digital communication tools, and view online
engagement as a key ingredient in advancing burgeoning wellness and prevention
initiatives. Children’s hospitals, particularly a leader like Boston Children’s, are
uniquely positioned to take the most advantage of new digital advances to achieve the
population health, prevention, and wellness goals of post-reform healthcare. By
employing these digital advances creatively, they can reach children and teens before
they develop unhealthy habits and ensure their message and mission continue to
resonate well into the digital age. Therein lies the opportunity for a leader like Boston
Children’s Hospital: to “show” it is an innovation leader by sharing with ease news of
its innovations and by using the latest technology and knowledge about effective digital
design in its online outreach efforts.
References
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The Burden of Stress in America
The Web at 25 in the U.S.
Aligning Patient Needs With Online Capabilities: What Healthcare Reform Means
for Your Hospital Website
BCH: About Us
Clinical Innovation + Technology
MedTech Boston
Pew Internet’s Libraries Research
U.S. News & World Report Best Children's Hospitals 2014-15: Honor Roll
Silver eHealthcare Leadership Award
Strategic Health Care Communications
Best Responsive Websites in Healthcare
DMR Pinterest Stats
Health Grades
DMR Instagram Stats
Appendix A: What did you learn in the process of doing this research?
I learned that one user experience, in this case my own search for information on
innovations at Boston Children’s Hospital, can be a tip-of-the-iceberg moment in an
organization’s website redesign. I also learned that though people may come from
different backgrounds and situations, their experiences with technology can be similar
in many ways, particularly with respect to universal priorities like simple navigation
and prioritized messaging. And I learned that there is a tension between having your
31
website be a source of pure practical interactivity versus a repository of institutional
history and information. That can be the subject of the next paper!
Appendix B: About the Author
Charlotte is pursuing her graduate Certificate in Digital Health
Communication from Tufts University Medical School. Her
professional background is in print and digital media. After
earning a master's degree in journalism from Northwestern
University, she went on to report for Modern Healthcare, write
and edit features on research and campus news for the
University of Chicago Magazine, and launch multiple websites
as an online content manager. She is currently a marketing
coordinator for a New York-based healthcare consulting practice. Home is the Hudson
Valley where she serves on her local school board and enjoys spending time hiking
and hanging out with her family. Connect on Twitter @CharlotteSRowe.
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