How US Health Systems Approach Digital Marketing

Working with US health systems teaches you quickly that the constraints on digital marketing have almost nothing to do with marketing. They are organisational, technical, and regulatory, and they compound on each other in ways that make the simplest-sounding task, updating a service page or adding a new physician, take weeks rather than hours.

This is what we learned from working across health systems in Pennsylvania, California, and Illinois, including the physician directory project we ran for Commonwealth Health.

The Enterprise CMS Problem

Health systems do not pick their CMS the way a business picks a CMS. The CMS is often inherited through a merger, selected by an IT department optimising for integration stability rather than editorial flexibility, or mandated by a parent organisation that runs dozens of facilities across multiple states.

Epic is the dominant electronic health record system in the US, and its patient portal, MyChart, becomes the front-end digital experience for millions of patients. What Epic does well is clinical workflow. What it does poorly is marketing. The patient portal is where patients book appointments, view test results, and message their care team. It is not built to be a conversion surface for new patient acquisition.

The health system website sits alongside Epic, not integrated with it in any meaningful marketing sense. A prospective patient searching for a cardiologist in Scranton, Pennsylvania finds a health system page, perhaps reads about the physician, and then has to log into MyChart separately to book. That handoff is a conversion leak that most health systems acknowledge and almost none have fixed. Fixing it requires IT governance approval, compliance review, and often a full budget cycle.

Gateway Health manages eight properties across Pennsylvania. Each has its own web presence, its own legacy content, and its own internal stakeholder who has opinions about what the site should say. Coordinating a content update across eight properties through a centralised IT function is a six-to-eight-week process for anything beyond a minor text edit.

The Physician Directory Problem

The physician directory is where health system digital marketing breaks down most visibly. A regional health system might have 400 physician profiles. A large system might have 4,000. Each profile needs to be accurate: the physician's name, credentials, specialties, locations, accepting new patients status, insurance affiliations, and a photo that is less than five years old.

Every one of those data points changes. Physicians join, leave, add locations, change their new patient status, and update their credentials. Keeping 800 profiles accurate manually is not a workflow problem. It is an impossibility dressed up as a workflow problem.

The data typically exists somewhere in the organisation. Credentialing systems hold the credentials. The EHR holds location and schedule data. HR holds the employment records. None of these systems talk to the website CMS in real time. The reconciliation between what the directory says and what is true in the organisation is done manually, periodically, and imperfectly.

We worked on a physician directory project for Commonwealth Health, a Pennsylvania-based health system. The brief involved extracting and structuring physician data at scale because manual data entry across hundreds of profiles was creating a backlog that the internal team could not clear. The AI-assisted extraction process we built reduced the reconciliation time substantially, but the underlying structural problem, disconnected data sources, remained a health system challenge, not a technology challenge we could solve in one project.

The patient-facing impact is significant. A patient searching for a specific specialist who finds an outdated profile listing incorrect locations or closed panel status does not call to check. They search again and find a competitor.

Compliance Review as a Marketing Bottleneck

Everything a US health system publishes carries legal and compliance exposure. Clinical content that overstates capabilities or implies outcomes creates liability. Content about services that are subject to federal regulation, reproductive health, substance use treatment, certain psychiatric services, requires legal sign-off before publication.

The compliance review process exists for good reasons. Health systems operate under HIPAA, state regulations, Medicare and Medicaid conditions of participation, and in some cases Joint Commission accreditation standards. Publishing inaccurate clinical content is not a marketing mistake. It is a regulatory risk.

The consequence for digital marketing is that the approval chain for a new landing page at a health system can involve marketing, legal, compliance, clinical leadership, and sometimes the C-suite. A campaign that a private practice could build and launch in a week takes three to four months at a health system.

This is not dysfunction. It is the appropriate level of caution for organisations of that size and regulatory exposure. But it means that digital marketing at a health system is fundamentally a program management challenge as much as a marketing challenge. You need to know how to work through the process, not just what good marketing looks like.

What Works in Health System Digital Marketing

The areas where health systems get real return from digital marketing are search-driven patient acquisition for high-value service lines and physician-specific search visibility.

Cardiology, orthopaedics, oncology, and neurology generate high patient lifetime value and patients actively search for these services. A well-structured Google Ads campaign targeting service-line keywords in a health system's geographic market, combined with strong physician directory pages, drives measurable new patient volume. The attribution is imperfect because the path from search to booked appointment runs through multiple systems, but the directional signal is clear.

Physician search visibility matters because a large share of new patient searches are physician-specific. Patients who have a referral search for the physician by name. Patients who research conditions search for specialists in those conditions. Physician profile pages that are current, complete, and optimised for search rank well because they satisfy specific informational intent.

The health systems that do digital marketing well have usually made one organisational decision that most have not: they have a digital team with some degree of autonomy from the general IT and compliance cycle. Not complete autonomy, but enough to move at a pace that makes campaigns viable.

The Lesson for Australian Healthcare Organisations

Australian public health systems face analogous constraints. State health departments, hospital networks, and community health organisations operate under governance structures that create similar bottlenecks. Private hospital groups in Australia often manage multiple sites with inconsistent digital presences and no centralised data infrastructure for physician or specialist directories.

The lesson is not that large health organisations cannot do effective digital marketing. The lesson is that effective digital marketing at that scale requires someone who understands the organisational reality, not just the channel mechanics.

If you work in healthcare marketing, whether in a practice or an institutional setting, we have worked at both scales. Get in touch to talk through what is actually achievable given your organisation's constraints.