Ethical Voices

Ethical Issues in Healthcare PR and the Challenges of Data Permanence – Erica Sniad Morgenstern

Joining me on this week’s episode is Erica Sniad Morgenstern, the vice president of marketing communications of Welltok. She is a savvy senior healthcare communications executive, with success in executing effective and creative communications programs for public and private companies to increase awareness and stimulate action. I have the pleasure of working with Erica 15 years ago to launch the first medical app for the iPhone, among other activities.

In this interview, Erica discusses:

Why don’t you tell me a little bit about yourself and your career?

I am one of those rare breeds that I knew very early on that I actually wanted to do public relations. A lot of people are like, “How did you even know about public relations in high school?” But I did, because one of my very first jobs was with a department store and they had what they called a team board, that was run by a PR professional to get more visibility for the department store. And I thought that was so creative and neat and her days were never the same. And so, when I went into college, I started right out the gate saying I want to be in communications and public relations.

I went to the University of Florida (Go Gators), which is very well known for journalism and I got involved in the Public Relations Student Society of America. I was a board member and did all the right things, participated in Bateman Competition and we won (Again, Go Gators!) A lot of the advice that I was given was to start an agency. I made the great migration out of college and started at a PR agency, where I had a wonderful experience.

But I always felt that I wanted to go a little bit deeper within an organization. And so, I started working at company called Epocrates as a PR associate. It was really great career journey because I quickly discovered along the way the power of the pen, that we are telling stories and that’s what people are drawn to.

And as I created more content, my role started to expand and my career ballooned from there. So it was, we’re going to an event, what is the messaging? What is the creative tie to it? And so, I’d have a hand in that. I had a long, very productive fun journey at Epocrates and we launched the first medical app. We are onstage with Steve Jobs.

It was a great ride. We had a beloved brand that we created and physicians love the application. We created an advisory board with the doctors. We’d been used for media and for other speaking opportunities. There was never a shortage of news. There was always something to talk about and share and promote with the company.

And then when the company was acquired by athenahealth, which is another great organization, it was just the right transition point for me to look for something new. And one of my colleagues, Michelle Snyder, who a lot of people know and love in the healthcare IT industry, was starting to join a company called Welltok, which is where I am now. So, I joined her and we’re doing it again together.

Over your career journey, what is the most difficult ethical challenge you ever confronted at work?

As the communicator for the organization, you always want to put out the right message. But sometimes that can be challenged by the people that you’re asking to provide that message. I had a situation at one of the organizations that I was at with a very senior executive who was a spokesperson for the company.

He had expertise, but when I would set him up for interviews, regardless of how much prep I did for him (having it typed out, key messages, etc.) he would go off the rails. He would talk about himself; he would self-promote. And in some cases that actually conflicted with the company messaging. Because he’d have an opinion about something that didn’t really represent the organization.

And so, I confronted him. I said, “If you cannot follow this, if you cannot communicate these messages, then we’re not going to use you. There are other folks in the organization that I can tap and there’s other means to do this.”

Basically, I cut him off. And for someone that’s in a senior position that is obviously full of himself. It wasn’t well received as you can imagine. Not too much later he was let go from the organization. And he said, “You are one of the reasons why I was terminated. You did not let me fulfill a part of my job. I was supposed to be a public figure, a thought leader for the organization and you cut off my communication channel.” That that’s hard to handle.

Obviously, I wasn’t the sole reason, but my ethics were being attacked. I was being attacked for a judgment call I made in representing the organization.

What’s the lesson you learned from that situation? Is there anything you would’ve done differently?

I have reflected on that quite a bit. Should I have gotten other folks involved? I think it’s really all of the above. However it was a toxic situation regardless. And I actually think I did the right thing and I’d probably do that again.

Did that make you change the way you did things in terms of documenting? Because once you’ve been sued once or blamed for something once. I say it always kind of opens your eyes to recordkeeping.

Yes, that is true. I could have had better documentation and probably put it in writing that due to X, Y and Z, you are no longer a spokesperson for the company – and have that stamped and approved by the CEO. To some degree I did feel like I was alone in that decision and the execution of it.

We all make the call and we all get attacked for making the call at some point. Did you then have to enlist champions?

I didn’t have to enlist Champions. I did get some support that agreed he was a hothead and had some ego tendencies and that led to this. I don’t feel that I necessarily was on an island, but I do feel that when I was making the decision and pulling back opportunities, I was taking sole responsibility, which isn’t necessary. The organization is there to support you and I could have tapped into that some more.

Beyond that case, what are you seeing as some of the key ethics challenges for the industry?

The media has changed and things are even more permanent. Before if an article appeared in a newspaper, you read it and you threw it away. If you missed an article you would have to spend $50 to find an archived piece of newspaper and go to the library.

Now anything that’s run is on the Internet forever. So, the degree that you have to fact check, proof, verify statistics, I mean it’s even more important now. Because of the permanency of that. And I don’t necessarily think that people take that as seriously as they should.

What should they be doing?

Number validation. When you’re putting the numbers in a press release or quoting a survey or sourcing something, verify it. Follow the trail of the source. I’ve actually seen that happen a couple of times where people would source an article. I’ll go to that article and then I’ll follow the link to the original study and they actually misquoted the data. Make sure that you’re following the thread of information because it’ll unravel at some point, if it’s not fully fact checked. Also, if you list target dates, like the press release we are excited to be partnering with Company X and we’re going to be live by Q1. That is out there now. If you’re not live by Q1, that is a credibility issue.

You made me cringe by saying “we are excited”. That to me is code for stop reading. So nobody would even know that it was in Q1. But I think that’s a good point. How do you deal with data that was accurate when you said it, but is now inaccurate?

That’s a really good question. I’ve had situations where you have a target date and you don’t hit it. The one thing you do not do is go on your website and delete that press release. That does not make the press release go away. And yes, that has been requested by me before.

To fix it, you could add an update line above it. Update, revised timing. Or if you have a reporter that’s like, let me know about this, reach out to them and say, “Hey, there’s going to be a delay. We’d love to give you a preview.” Or would you like the exclusive? That’s the beauty of messaging is that you can message anything as long as you are authentic about it.

In addition to that, are there new areas you’re concerned about regarding ethics?

A challenge for our profession in general is the decline of earned media and original reporting. You see it across the board, publications are scaling back less reporters. This means they have less time to do the in-depth reporting because I mean, some of the reporters I talked to, they’re like, “I have to have three blogs up a week, while I’m trying to do this investigative report.” They just don’t have time.

So much now is being sourced and sponsored or there’s a byline by this CEO. I’m sure the CEO has a lot to say, but how, back to the point before, how authentic is what he’s saying> Or for sponsored content of a study, who published the study? And did they have a hidden agenda? I feel like it’s not nearly as transparent and there’s no True North of who has the ethical responsibility of making sure this is fair, true, factual and doesn’t have a hidden agenda or bias to it.

Are there specific ethical challenges you see and come up as a healthcare technology company that you grapple with or you keep top of mind?

A big topic in the healthcare industry right now is data and transparency.  A lot of people are really concerned about the privacy of their information, how it’s being used, who’s using it, where it’s going. I’d say that would be in any aspect of your life, but with healthcare it’s so much more personal and so it’s definitely a challenge for us as a data-driven organization to help educate people about why it’s important that some of your data is used to serve you up better.

I’m willing to use Google Gmail for free and they’re collecting data on it and I might get a more relevant ad. Right, so why can’t that apply to healthcare? There are some valid concerns that people have. For example, I don’t want my company to know if I have X, Y and Z. Because they might treat me different. I totally understand that. I’m in the same boat as well, but to the same degree, there’s machine learning. People aren’t looking at the information, they’re collecting the data and applying it to serve you better. Who doesn’t want that?

It’s true with all. I think there’s cases, I mean I did PR for Ancestry.com for a number of years and I still wouldn’t give them my DNA, because that I don’t want a private company to have my DNA. When they stay private non-healthcare company to have my DNA. And I think some people are also concerned about some of the biases that you may be seeing in the use of AI and machine learning. I think there was a story about a month ago about how hospitals were treating African-American patients differently due to an unconscious bias in the machine learning of one of a major scheduling systems.

You just sent me up perfectly. Those situations, especially Ancestry.com, that’s a one-to-one situation. They are matching you with your DNA data, right? Whereas with a lot of these other organizations and what we do, it’s aggregated. And so it’s encrypted. It’s encoded. It’s not like all of a sudden my company is going to know that I have three kids and one of them has eczema. Right? That’s not information that they need to know, but my physician’s office, they should know that.

What is the best piece of ethics advice you were ever given?

Can I quote TSA? See something, say something.

As a communications person within an organization, you’re in a position of power, whether you have the title or not, you are the central soul, to some degree, of right and wrong. And when you see that information cross your desk and you’re like, “Oh, but did we really do that?” Or are these numbers accurate? Or we’re talking about registered users versus active users. There are all these questions that you should be asking. It’s your right to question them. If you see something. Say something.

Check out the full interview, with bonus content, here:

 

 

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Mark W. McClennan, APR, Fellow PRSA, is the general manager of C+C's Boston office. C+C is a communications agency all about the good and purpose-driven brands. He has more than 20 years of tech and fintech agency experience, served as the 2016 National Chair of PRSA, drove the creation of the PRSA Ethics App and is the host of EthicalVoices.com

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