Michael RothMichael Roth

Having worked in the communication industry for more than 20 years, I’ve never witnessed a term in greater need of re-examination than “integrated.” On its face, “integrated” sounds like a win-win, and an agency really has nothing to lose by adding the term to its name or offering. “Integrated” is a signal to a client prospect that your agency offers a broad marketing-communication mix and integrates them into a single strategic plan, an approach that may include social, digital, content development and lead gen, in addition to traditional public relations tactics.

The truth is, marketing and communications integration has become table stakes for most mid-size and large agencies. As a result, it’s no longer a core differentiator. Market integration is now simply the norm, our new business model.

O'Dwyer's May 2017 PR Firm Rankings MagazineThis article is featured in O'Dwyer's May '17 PR Firm Rankings Magazine

The kind of integration our clients most desperately need has more to do with an agency’s diverse and deep bench of executives than its marketing tools. The competitive business landscape and its targets are shifting so quickly, clients are looking for a team that will help them keep pace with changing market dynamics and customer expectations. Clients need subject matter experts from sectors outside of our own that will work together to help create better programs, stronger narratives and real results.

Perhaps the best question a client prospect should ask: Will the way you “integrate” your agency employees help our company achieve its strategic business goals?

The evolution of “integrated”

The term “integrated” didn’t begin in the PR industry at all, but by advertising agencies in the late 1980s and early 1990s. They began to recognize the value of comprehensive marketing plans that included a mix of communication disciplines including advertising, PR, personal selling and sales promotion. The term started to gain serious traction with PR agencies at the turn of the century, to acknowledge that digital and social media was a capability that could also be offered alongside traditional media relations.

Some PR agencies (including ours) started to use the term “integrated” as part of their name because it demonstrated that they put social and digital into the mix, but also wanted their clients to know that they could effectively integrate other atypical PR services like content production and lead generation strategy. The word was incorporated into the name just as much for the client as the agency themselves: it was a signal both internally and externally that the integrated model was evolving quickly, in parallel with the rapid pace of technology development and the industry.

So, if most big and mid-sized agencies offer marketing integration today, why do we bother using the term “integrated” at all? And what is its function?

Integrated subject matter expertise

A core principle that has driven the service business model is that an agency’s offerings must evolve to meet the business needs of its customer. And we must understand not only what it is that our client needs to be successful, but help them shape those messages. You can be literally everywhere in the media yet generate no sales without alignment between a client’s evolving business objectives and its media program or content distribution.

While there are great examples of the need for integrated subject matter expertise across financial, professional, technology and consumer PR practices, the example that comes to mind as most illustrative of this shift is in modern healthcare agency practices.

From life sciences to business of health

In the last twenty-five years, most healthcare/life science agency executives had to be firmly entrenched in the fundamentals of the pharmaceutical, biotechnology, medical device and diagnostics industries. They had to be conversant in the latest clinical developments in core therapeutic areas like oncology, neurology and cardiology, while mastering FDA guidelines on promotion, Sunshine laws, social and digital media guidelines and best practices, crisis techniques, and physician and patient education. They had to assess viability of clinical abstracts, speak to top researchers with authority and decipher relevance in a competitive and increasingly difficult media environment. And often, they had clients with clinical backgrounds without a sophisticated level of understanding of healthcare communications, or the value of what we do. That is a broad and impressive skill set, and there was a great deal of seasoned professionals who were quite good at it. But the entire game gradually started to change.

Something curious started to happen in client healthcare marketing meetings. Their internal insurance reimbursement and “value” experts started to wield increasing power at the marketing table. It was no longer enough to differentiate your products for the medical community. A product could not be successful in the post-ACA healthcare economy if it didn’t demonstrate value to the value committees at insurance companies and hospitals. Even a top surgeon could not unilaterally pick his or her instrument of choice anymore. Physicians could make a request to the value committee, but the product first needs to be vetted for its “value” vis-a-vis its competitors because of how the hospital or provider was now being reimbursed for care.

So, in the post-ACA age, our clients are increasingly targeting these value committees and looking for more examples in their armamentarium of “value.” It could mean evidence of fewer days in the hospital, fewer return visits to the physician, fewer days away from work or even a shift to home healthcare vs. hospital care.

Integration in modern healthcare

Today, it is mission-critical to find an agency that is built for the new healthcare economy and has a deep and fundamental understanding of the business of health. The transition is not so easy for a group historically steeped only in life sciences, and some may not be equipped to venture into these technical waters regarding value-based care. But unfortunately, it is no longer an option not to pursue this expertise in the same way it is not an option for agencies to be unfamiliar with social/digital communications or lead generation. Outcomes is the name of the game, and the targets have changed. Your agency staff needs to know how to speak in this new language.

A strong healthcare agency team can no longer be built in a pyramid structure with the Alpha Dog or all-knowing account leader with his or her minions below, who learn from the teachings of that leader. Rather, teams need to have diverse capabilities, divergent backgrounds, and operate more like a jazz band: a scrappy and passionate group of experts all moving toward the same objective, but with differing perspectives and knowledge pools.

For example, the rhythm section holds down the beat: these are the bioscience employees who are fluid in the fundamentals of healthcare, understand the product, its differentiators, milestones, and the product market. Then you need the soloists: the strategic leads who understand the insurance business, Medicare Advantage, Medicaid, reimbursement and value based outcomes business. These employees are all about communicating evidence, outcomes and providing analytics that tell the story of a best-in-class product.

The new “integrated” agency

I do think this next phase of subject matter or expertise “integration” will eventually become table stakes, just like social and digital integration is today. But for now, it is important for our clients to understand what we mean by this new frontier of integrated communications. Do we have B2B insurance experts on our teams? Do we have technology and analytics wonks? Are we able to draw out a narrative, messaging and communications tactics that work for new targets? If agencies choose not to rest on their laurels as integrated marketing experts, and fully embrace the rapid and unprecedented business challenges that our clients are facing, our industry will be able to add more value to our clients than ever before.


Michael Roth is a Partner and Healthcare Practice Leader at Bliss Integrated Communication.