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Procedia Economics and Finance 26 (2015) 1020 – 1025

4th World Conference on Business, Economics and Management, WCBEM

Uncovering the Online Marketing Mix Communication

for Health Care Services
Victor Lorin Purcareaa, Iuliana-Raluca Gheorghea*, Consuela-Madalina Gheorghea
a
“Carol Davila” University of Medicine and Pharmacy, Marketing, Medical Technology, Medical Informatics, Biostatistics,
Bucharest, Romania

Abstract

Any marketplace, nowadays, is made out of a crowded environment of businesses which provide almost the same services. New
organizations enter the market on a daily basis without knowing they will survive. The help for organizations to distinguish their
services from the ones offered by their competition comes in the shape of one “P”, marketing communications. Communication
is the most visible and audible component of the marketing mix, which used wisely, may bring many advantages. Further,
organizations include descriptive elements in their communication messages such as the nature of their activities, the benefits
consumers would have and other elements which help consumers “tangibilize” the services provided. Many businesses moved
from the offline environment to the online, becoming more consumer oriented. For an organization to both succeed and survive,
it is essential to find the balance, the ideal mix between the services it offers in the real world and its online communications. For
example, in health care services consumers are “hooked” by traditional communication tools, experience the service and
afterwards use the internet to deliver indirect feedback on their lived experiences. The aim of this paper is to shed light upon the
online marketing communications mix applied in health care services.
© 2015
2015 The
TheAuthors.
Authors.Published
PublishedbybyElsevier
ElsevierB.V.
B.V.This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of Academic World Research and Education Center.
Peer-review under responsibility of Academic World Research and Education Center
Keywords: health care marketing; integrated marketing communications; marketing health care services

1. Health Care Marketing Communications

Kotler (2008) described marketing communications as organizational actions in the shape of messages which
target both internal and external audiences, with the objective of influencing peoples’ attitudes and behaviours.
In a service setting, Lovelock and Wirtz (2007), stated that marketing communications have several functions, as
follows:
™ Marketing communications help organizations add value through their content, meaning that
communication may inform prospective consumers about the service options, where and when these

* Raluca Gheorghe. Tel:+4-345-543-45

E-mail address: raluca.gheorghe@umf.ro

2212-5671 © 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of Academic World Research and Education Center
doi:10.1016/S2212-5671(15)00925-9
 Victor Lorin Purcarea et al. / Procedia Economics and Finance 26 (2015) 1020 – 1025 1021

services are available, what are the specific features, functions and benefits. Moreover, organizations do not
use marketing communications only for prospects but also in establishing relationships with their current
consumers through tailored messages. For example, in health services, physicians may remind their patients
of their next annual check-up.
™ Overcoming the problems of intangibility suggests that since services are considered processes or
performances, their benefits are difficult to be expressed. Therefore, organizations have to communicate
clear messages, emphasizing the attributes of their services as well as the resulted benefits after the service
experience. For instance, if a health care organization highlights the attribute of healing as main benefit for
their service experience, they should conceive messages which “picture” the healing stage as well as other
benefits such as feelings of calmness, distress etc.
™ Using metaphors to communicate value indicates that organizations attempt to “tangibilize” their services
using metaphorical words in order to express benefits. For example, in health care services, the slogan and
the images used to support the slogan are very helpful.
™ Marketing communications facilitate the consumer involvement in the production and the delivery process
of the service. Most of times, in services, consumers are viewed as co-producers so an organization should
train their clients similar to their employees. For example, in health care organizations, animated displays
or videos are used to show to their patients certain procedures.
™ Marketing communications help consumers evaluate service offerings and distinguish between the
providers’ offers. As consequence, in health care services, marketers may highlight in their messages,
service attributes related to quality and performance such as highly skilled personnel and the physicians’
qualifications.
™ Marketing communications stimulate or dampen the match capacity which suggests that organizations
implement time specific promotions which depend on the period of the demand fluctuations. For example,
in health care services, marketers may wish to advertise sales promotions like vaccination programs. In
Romania, every autumn, many health care organizations offer vaccination services against flu and,
accordingly, implement sales promotions as well.
™ Marketing communications promote the contribution of service personnel. In high-contact services, such as
health care, physicians are the core individuals in the service delivery. Hence, most of times, health care
organizations advertise their services with the help of physicians and the description of the service
encounter.
Most experts claim that it is not enough to have knowledge only of the marketing communication functions and
to, independently, apply communication strategies. Moreover, on today’s markets, in order to be successful, it is
recommended to adopt an integrated marketing communication approach.

2. Health Care Integrated Marketing Communications

IMC is defined by the American Association of Advertising Agencies as being a “concept of marketing
communication planning that recognizes the added value of a comprehensive plan that evaluates disciplines, e.g.
general advertising, direct response, sales promotions and public relations- and combines these disciplines to
provide clarity, consistency and maximum communication impact” (Duncan, & Everett 1993).
In Gronroos’s (2007) view, the traditional marketing communication efforts, such as advertising and sales,
impact the expected service while the integrated marketing communication should impact the process of service
experience. In other words, IMC emerged as an approach to understand how other messages, not only the planned
ones launched by organizations, impact consumers and potential consumers.
The most important part of the communication process is the message and the elements it contains. According to
Duncan and Moriarty (1997), a message may be the outcome of several sources, so they elaborated a message
classification, as follows:
9 Planned messages are the result of planned marketing communication campaigns which are usually sent
through controlled channels such as printed advertising.
9 Services messages are the outcome of the service delivery process and are influenced by the conceived
service, the appearance, attitude and behaviour of the personnel, the equipment used, the servicescapes.
9 The unplanned messages are the result of the experience of consumers with the organization and have the
role of an indirect feedback, as the organization cannot control them. We think in health care services,
1022 Victor Lorin Purcarea et al. / Procedia Economics and Finance 26 (2015) 1020 – 1025

these are the most important ones. These type of messages are sent from one consumer to another, in the
form of word-of-mouth communication. In the case of unplanned messages, the sender will no longer be
the organization but another consumer as shown in figure 1 from the Annex.
9 The absence of communication (Calonius, 1989) takes place when the organization is not giving any
information to consumers or in the case of a scandal, no reaction is seen from its side. For example in
health care services, this is the case when a physician is accused of bad professional behaviour and the
organization is not reacting in any way.
Once the organization gets familiar with the communication process, the next step will be the integration of the
communication marketing mix components in the IMC strategy. The components of the communication marketing
mix are the channels through which a message is transmitted. In an integrated marketing mix there are more
channels which deliver the same message.
Gronroos and Lindberg-Repo (1998) organized the communication instruments under three statements: “what
the firm says”, “what others say and do” and “what the firm does”. The most important sources of communication,
as they are linked to credibility and trustworthiness, are the unplanned messages or “what others say and do”.
Actually, these type of messages are not included in a marketing communication plan and are frequently neglected,
because they are not easily controlled or monitored.
Following the communication classifications elaborated by Gronroos (2007), Lovelock and Wirtz (2007) and
Pelsmacker et al (2005), we have developed a services integrated marketing communication triangle, as illustrated in
figure 1.

3. Health Care Integrated Marketing Communications in the online environment

The online IMC is defined by the integration and coordination of a variety of multiple sources of information as
well as interpretations of the already given feedback. The voice of an organization is no longer the only one which
sends a message in the online and in the offline mosaic of marketing communication activities, but consumers’
feedbacks may be read by other peers and managers at a wider scale.
In order to effectively be applied, the objectives of the online integrated marketing communication, should focus
on (Grosseck, 2006):
¾ The integration of the online and offline communications in order to attract consumers or lead them to a
website where they collect more information;
¾ The usage of the online communication instruments to provide efficient messages;
¾ The integration of all communication channels into a strategic plan according to the marketing objectives.

The online marketing communications encompass the same components found in the offline communications but
only adapted to the requirements of the online environment. Hence, the planned integrated online marketing
communication mix is made out of online advertising, online sales promotions, direct marketing which keeps the
same name as used in the offline, online sales forces and online public relations (ePR) whereas the unplanned
integrated online marketing communication mix is made out of electronic word of mouth and online press
releases (figure 2).
 Victor Lorin Purcarea et al. / Procedia Economics and Finance 26 (2015) 1020 – 1025 1023

The firm says

(planned messages) The firm does
- advertising (service messages)
- direct - service processes
marketing - corporate design
- sales promotion - physical evidence
What the What the
- web sites firm says firm does
- public relations
- personal selling
- online marketing

What others say

and do
- news stories
- word of mouth
- blogs and online ratings
Fig. 1. The Services integrated Marketing Communication Triangle (Source Gheorghe, 2012)

Public
Relations

Sales Direct
promotions marketing

Consumer Legend:
Planned integrated online
Advertising marketing communication mix

Electronic Unplanned integrated online

word of mouth marketing communication mix
Sales
Media forces
News

Fig. 2. The Integrated Online Marketing Communication Mix in Health Care Services (Source Gheorghe, 2012)
1024 Victor Lorin Purcarea et al. / Procedia Economics and Finance 26 (2015) 1020 – 1025

Annex

Fig.3. The integration of planned and unplanned messages in the communication process (Source Gheorghe, 2012)

References

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