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Sleep Center
Marketing Plan

  August 3, 1998
Sleep Center
                                                  Marketing Plan
                                                  Table of Contents

  Market Analysis........................................................................................................... 3
   Our Mission................................................................................................................ 3
   Services Offered ......................................................................................................... 3
   Market Definition....................................................................................................... 4
   Strengths..................................................................................................................... 5
   Weaknesses ................................................................................................................ 6
   Opportunities.............................................................................................................. 6
   Unexplored Opportunities .......................................................................................... 7
   Threats........................................................................................................................ 7
   Customer Profile ........................................................................................................ 7
   Target Market ............................................................................................................. 7
   Competition................................................................................................................ 8
   Competitive Roundup ................................................................................................ 9
   Observations and Conclusions ................................................................................... 9
  Marketing Goals ........................................................................................................ 10
   History...................................................................................................................... 10
   Graph—Average Monthly Sleep Studies per Fiscal Year........................................ 11
   Two-Year Goals ....................................................................................................... 12
   Graph—Average Monthly Sleep Studies per Fiscal Year Through FY 2000 .......... 13
   Financial Projections ................................................................................................ 14
  Communicating with Our Market ........................................................................... 15
   Marketing Strategy ................................................................................................... 15
  Exhibits ....................................................................................................................... 19
   A. Map—Sleep Center Service Area
   B. Marketing Action Plan




Sleep CenterMarketing Plan                                                                                              Page 2 of 23
Prepared by Bruce Mulkey                                                                                                   08/03/98
Market Analysis
According to the Report of the National Commission on Sleep Disorder Research, sleep
disorders affect millions of Americans. In fact, nearly half of all Americans suffer from
some type of sleep-related problem. Additional findings include:

•   Forty million Americans suffer from sleep disorders. Eighteen million of these suffer
    from obstructive sleep apnea, while 250,000 to 375,000 suffer from narcolepsy.
•   Sixty million Americans, one-third of all adults, suffer from chronic insomnia.
•   Twenty to 30 million Americans experience intermittent sleep-related problems.
•   Twenty five percent of children between ages one to five experience some type of
    sleep disturbance.
•   Over half of the 19 million people now over 65 experience some disruption of sleep.
•   Millions more Americans obtain inadequate sleep because of their work schedules or
    their lifestyle.
•   Fewer than five percent of Americans who suffer from sleep-related problems are
    diagnosed and receiving appropriate care at accredited sleep centers.

Since advancing age is an important risk factor for many sleep problems, the sleep
problems facing the United States may become even more prevalent as our population
ages as expected in the coming decades.

Our Mission
Our mission at Sleep Center is to provide high quality, affordable sleep medicine services
to all patients in need and to improve the level of awareness of sleep medicine in the
professional community as well as the public. We provide diagnosis and treatment for a
broad range of sleep disorders, including sleep apnea, narcolepsy, insomnia, parasomnias,
and circadian rhythm disturbances for adult and pediatric patients.

Services Offered
Sleep Center provides the following services to patients with sleep-related problems who
reside in Western North Carolina:

•   Physician evaluation, including history and physical for adults and children (adult
    evaluations also available at satellite sites in Angel Community Hospital in Franklin
    and Spruce Pine Community Hospital in Spruce Pine)
•   Polysomnography, usually referred to as sleep study (adult studies also available at
    satellite sites at Angel Community Hospital in Franklin and Spruce Pine Community
    Hospital in Spruce Pine)
•   Multiple Sleep Latency Testing
•   Maintenance of Wakefulness Testing
•   Insomnia specific evaluation and treatment
•   Community education programs, including talks to various groups and participation
    in area health/wellness fairs


Sleep CenterMarketing Plan                                                       Page 3 of 23
Prepared by Bruce Mulkey                                                            08/03/98
Market Definition
The market for our services consists of the populations of the following Western North
Carolina counties:


                             Sleep Center Service Area

              County                                     1998 Population*
Primary Service Area
Buncombe                                                      188,385
                                 Subtotal                     188,385
Secondary Service Area
Haywood                                                        48,400
Henderson                                                      78,262
Madison                                                        17,335
McDowell                                                       36,385
Yancey                                                         15,990
                                 Subtotal                     196,372
Tertiary Service Area
Cherokee                                                       21,342
Clay                                                           7,515
Graham                                                         7,263
Jackson                                                        28,191
Macon                                                          26,368
Mitchell                                                       14,472
Swain                                                          11,927
Transylvania                                                   27,259
                                  Subtotal                    144,338
      Total of 14-County Service Area                         529,095
Other Service Areas
Alexander                                                      29,899
Alleghany                                                      9,772
Ashe                                                           22,392
Avery                                                          15,105
Burke                                                          79,051
Caldwell                                                       73,522
Catawba                                                       129,710
Polk                                                           15,829
Rutherford                                                     59,956
Watauga                                                        40,119
Wilkes                                                         60,644
                                  Subtotal                    535,999
  Total population entire service area                       1,065,094
* Projected population, Land of the Sky Regional Council, 2/6/95


Sleep CenterMarketing Plan                                                     Page 4 of 23
Prepared by Bruce Mulkey                                                          08/03/98
We conservatively estimate that 20 percent of the total population of the 14-county
primary, secondary, and tertiary service areas served by Sleep Center has serious sleep-
related problems. Since the total population of these service areas is 529,095, we can
assume that the market for our services is 105,819 individuals in these counties (20% x
529,095 = 105,819). As this population grows and ages, an even larger market can be
assumed. It should be noted, however, that the majority of our patients come from
Buncombe County at this time.

While the estimated 105,819 Western North Carolinians suffering from sleep-related
problems is the market we must reach, the primary method of doing so is through the
referrals of physicians in the service areas. Therefore, we must target Western North
Carolina physicians, inform them about sleep disorders, and enroll them into the process
of referring their patients to us when sleep disorders are suspected. In addition, industries,
especially those where shift work takes place, provide a secondary target. The Mission St.
Joseph’s Health Plan now allows for only one sleep study per lifetime. In addition, no
sleep screening questions are asked during pre-employment physicals. Therefore, the
Mission St. Joseph’s Human Resources Department, the Health Plan Design Team, and
the Safety Officer must be lobbied to make changes in this regard and, thus, provide a
tertiary target.

Strengths
The strengths of Sleep Center include:

•   Accreditation as full-service sleep disorder center by the American Sleep Disorders
    Association—Distinguishes us from some other local sleep centers
•   Staff physicians with over 30 years combined experience in the evaluation and
    treatment of sleep disorders (One board-certified; one expected to attain certification
    in 1999)—Assures exceptional patient care
•   Pediatric sleep specialist—Effective treatment offered for children
•   Staff psychologist—Enables us to treat insomnia, usually with behavior modification
•   Four registered polysomnographic technologists, with two additional staff members
    completing their registration—The quantity and quality of these technologists assure
    attention to patient needs and high quality sleep studies
•   Sleep Sciences, Inc. in Atlanta provides services—Leading provider of sleep medicine
    services in U.S.
•   Positive treatment results—Success rate of approximately 60 to 80 percent in
    improving the quality of our patients’ sleep overall. Approximately 90 to 95 percent
    success rate in compliant patients
•   Home-like sleep facility with six private beds—Comfortable setting with substantial
    privacy
•   Convenient locations—Right off I-40 in Asheville and satellite sites at Angel
    Community Hospital in Franklin and Spruce Pine Community Hospital in Spruce
    Pine
•   Satellite sites (two locations currently with three other locations under
    consideration)—Patients near these programs can be seen without driving long
    distances, and referring physicians in outlying regions can retain care of their patients
Sleep CenterMarketing Plan                                                          Page 5 of 23
Prepared by Bruce Mulkey                                                               08/03/98
•   Flexible scheduling—Around-the-clock testing accommodates patients’ varying sleep
    schedules
•   Reasonable cost—The cost of evaluations and treatment is considerably lower than
    the Southeastern U.S. average
•   Affiliated with Mission St. Joseph’s Health System—System has strong regional
    presence and provides opportunities such as the capture of the sleep medicine portion
    of managed care contracts
•   Adjacent to hospital—Medical treatment is available in case of emergency
•   Support groups for patients with sleep apnea, restless legs, and narcolepsy—Free
    support groups offers sufferers of these disorders ongoing physical and emotional
    support

In marketing, our most powerful assets are:

•   The relationships built with local and regional physicians by our medical directors
•   Our affiliation with Mission St. Joseph’s Health System and its stellar reputation
•   The ability to offer everything that someone with a sleep-related problem might need,
    including sleep studies, therapy, and when required, continuing support
•   Our moderate pricing
•   Our technical expertise

Weaknesses
There are several apparent weaknesses in our services. They include:

•   Delays, especially in the evaluation of new patients, because of physicians’ schedules
•   Lack of interaction with specialists in related fields, including ENTs, pulmonologists,
    cardiologists, neurologists, pediatricians, and clinical psychologists.
•   Lack of feedback from referring physicians regarding collaboration on patient
    treatment plans
•   Lack of data on compliance and outcomes from referring physicians and patients
•   Lack of patient follow-up

The issue of physician scheduling must be addressed in the weeks to come. The
interaction between the Center staff and other physicians, especially specialists in related
fields will be addressed in the marketing strategy portion of this plan. An effective
method for obtaining feedback from physicians and patients will also be addressed.

Opportunities
The opportunities to market our services that have been explored include:

•   Obtaining patient referrals from physicians
•   Yellow page display ad in Physicians section in the Asheville telephone book
•   Talks to wellness groups, community organizations, and support groups
•   Participation in health and wellness fairs
•   Alumni group

Sleep CenterMarketing Plan                                                         Page 6 of 23
Prepared by Bruce Mulkey                                                              08/03/98
Unexplored Opportunities
Unexplored marketing opportunities that have been identified to date include:

•   Seminars on sleep disorders for primary care physicians, ENTs, pulmonologists,
    cardiologists, neurologists, and pediatricians. CMEs for these seminars
•   Provide educational information about sleep disorders to above groups plus clinical
    psychologists
•   Marketing to local industries, especially those where shift work takes place, about the
    effects of shift work and how sleep deprivation can affect productivity and workplace
    safety
•   Develop sleep assessment for industry wellness programs. Work with Community
    Outreach on this
•   Work with MSJ Human Resources, Health Plan Design Team, and Safety Officer to
    have sleep screening questions included on pre-employment physical and to allow
    more than one sleep study per lifetime
•   Gain presence on MSJ website

Threats
Internal threats to Sleep Center include:

•   The need for greater understanding of the seriousness of sleep-related problems by
    Mission St. Joseph’s Health System
•   The absence of a marketing plan and a unified strategy for attracting new patients
•   The need for updated, effective marketing materials
•   The absence of a designated individual at the Sleep Center to spearhead the marketing
    effort that will be required to achieve goals

Hopefully, the completion and implementation of this marketing plan can address all of
these items.

Customer Profile
The typical adult patient at Sleep Center is a middle-aged Buncombe County resident
who snores. Such patients are typically referred to us by their physician after years of
sleep-related problems. Seventy percent of the adult patients at our center are diagnosed
with obstructive sleep apnea. Ten percent are diagnosed with narcolepsy. The remaining
20 percent suffer from either restless legs syndrome or periodic limb movement disorder
or one of the parasomnias. The typical pediatric patient is four to five years of age and is
typically tested for obstructive sleep apnea and night terrors.

Target Market
Because they refer our patients to us, we must target Western North Carolina physicians,
inform them about sleep disorders, and enroll them into the process of referring their
patients to us when sleep disorders are suspected. Next, we must work with Mission St.
Joseph’s Health System’s Human Resources Department, Health Plan Design Team, and


Sleep CenterMarketing Plan                                                         Page 7 of 23
Prepared by Bruce Mulkey                                                              08/03/98
Safety Officer to recognize sleep disorders as a serious problem, to have sleep screening
questions included on pre-employment physicals, and to allow more than one sleep study
per lifetime. In addition, we must target area industries, especially those where shift work
takes place, and let them know that we can help them increase productivity and reduce the
number of accidents and injuries due to fatigue. Finally, we must let the general public
know that we are here to help alleviate their sleep problems.

Competition
Our competition in Western North Carolina currently consists of Sleep Medicine Center,
Inc. and Sleep Center of Pardee. Each of these centers is profiled below.

Sleep Medicine Center, Inc., 1901 Hendersonville Road, Asheville
Sleep Medicine Center is an accredited sleep center owned by Park Ridge Hospital. This
is a two-bed facility with two board certified sleep physicians and one registered
polysomnographic technologist on staff. The medical director is on the Pardee Memorial
staff and also serves as the medical director of the sleep center at that hospital. According
to the staff at Sleep Medicine Center, they average two sleep studies three nights per
week for a total of six sleep studies each week. The medical staff of Park Ridge staff
refers almost exclusively to this center. Sleep Medicine Center advertises on WLOS-TV
during prime time and has a display advertisement in the Asheville Yellow Pages. One
additional factor: patients can purchase their sleep equipment at this center. It is currently
understood that the Sleep Medicine Center will soon vacate their current location and
move into Park Ridge Hospital. Recently, there have been conversations about
contracting with Sleep Center to manage the Sleep Medicine Center at Park Ridge
Hospital.

Sleep Center of Pardee, Pardee Memorial Hospital, 715 Fleming Street, Hendersonville
Sleep Center of Pardee is located within the hospital in a very clinical setting. This center
is not currently accredited though accreditation is expected this fall. This is a two-bed
facility with two board certified sleep physicians and one registered polysomnographic
technologist on staff. The medical director here also serves as the medical director of the
Sleep Medicine Center. According to the staff at Sleep Center of Pardee, they average
seven sleep studies per week at Pardee and three additional studies per week through their
outreach program at Grace Hospital in Morganton and Harris Regional Hospital in Sylva,
for a total of 10 sleep studies per week. Sleep Center of Pardee has a well-formed multi-
disciplinary physician team interested in expanding their scope of service. Sleep Center is
currently managing this center.




Sleep CenterMarketing Plan                                                          Page 8 of 23
Prepared by Bruce Mulkey                                                               08/03/98
Competitive Roundup
Sleep Center (SC), Sleep Medicine Center (SMC), and Sleep Center of Pardee (SCP) are
compared below. The areas marked by an asterisk (*) are rated on a scale from A to F,
with A being strong and F being weak.


                  Area Sleep Center Competitive Roundup

                                                      SC          SMC         SCP
Accreditation as full-service sleep center?           Yes         Yes          No
Number of board certified physicians                   1            2          2
Number of pediatric sleep specialists                  1            0          0
Number of psychologists/psychiatrists                  1            0          1
No. of registered polysomnographic techs               4            2          2
Management expertise*                                  A           B           A
Flexible scheduling for patients?*                     A            ?          B
Facility design, incl. function and comfort*           A           C           C
Number of beds in facility                             6            2          2
Average number of sleep studies/week                  22          6 (?)       6.7
Number of satellite sites                              2            0           2
Avg. number studies/week from satellite sites         1.8           0         3.1
Consultation cost                                    $162        $180        $180
Sleep study cost                                     $1086       $1050       $1076
Physician interpretation cost                        $325        $300        $300
Patient education*                                     B            ?          C
Patient follow-up*                                    B+            ?          B-
Overall quality of service*                            A-           ?         B-/C
Patient satisfaction*                                  A-           ?           ?
Sleep equip. available for purchase onsite?           No          Yes          No
Support of sponsoring institution*                     A-           ?          B-
Relationship with area physicians*                   A-/B+          ?          A
Strength of marketing program*                         F           B           F
Effectiveness of marketing materials*                  D           B           F
Public perception*                                     B            ?          B
Percent market share                                   ?            ?          ?
Support groups available?                             Yes           ?         Yes
Current competitive strength*                          ?            ?          ?
Potential competitive strength*                        A           C           B

Observations and Conclusions
It appears, from the above information, that we have a competitive advantage over both of
our local competitors. To expand our market share, however, we must develop and
implement a marketing strategy to attain the goals described in the next section of this
plan.



Sleep CenterMarketing Plan                                                     Page 9 of 23
Prepared by Bruce Mulkey                                                          08/03/98
Marketing Goals
This section of the marketing plan will be devoted to establishing Sleep Center’s
marketing goals for the next two fiscal years. First, however, we will review the history of
the Center in terms of the number of sleep studies performed.

History
The table below shows the history of the Sleep Center in terms of sleep studies per
quarter over the past several fiscal years. The total number of sleep studies per fiscal year
along with the average number of sleep studies per month is shown at the bottom of the
table.


                      History of Sleep Studies at Sleep Center
                                        (Fiscal Years)

                   FY93       FY 94          FY 95         FY 96         FY 97         FY 98
 st
1 Qtr.              40         62             125           162           163           199
2nd Qtr.             59         75            163           157           212            190
 rd
3 Qtr.               59         75            171           165           224            265
4th Qtr.             58         100           171           185           258           300*
Total               216         312           630           669           857            954
Avg./mo.             18         26            52.5          55.8          71.4          79.5
* Projected number of sleep studies for FY 98 fourth quarter

As shown in the table, the average number of sleep studies per month at Sleep Center has
grown steadily. From an average of 18 sleep studies per month during the fiscal year
ending 9/30/93, the average number of sleep studies per month increased to 71.4 for the
past fiscal year. The average for the first nine months of the current fiscal year is 72.7
studies per month. This growth is illustrated in the graph on the following page.




Sleep CenterMarketing Plan                                                        Page 10 of 23
Prepared by Bruce Mulkey                                                              08/03/98
Average M onthly S leep S tudies per Fiscal Year




                                                                                      79.5
                             80
                                                                               71.4

                             70


                                                                        55.8
                             60
                                                           52.5

                             50
                                                                                             FY 93
                                                                                             FY 94
       Average M onthly Sleep                                                                FY 95
                              40
              Studies                                                                        FY 96
                                                                                             FY 97
                                                  26                                         FY 98
                             30

                                       18
                             20



                             10



                               0
                                                          1992-1998
                                                         Fiscal Years




Sleep CenterMarketing Plan                                                                   Page 11 of 23
Prepared by Bruce Mulkey                                                                         08/03/98
Two-Year Goals
The goal that we wish to attain at Sleep Center is to consistently conduct 145 sleep
studies per month, 130 per month at the Center and 15 per month at the satellite sites. The
table below provides a conservative scenario of how we intend to reach this goal over the
next two fiscal years.


                               Sleep Study Projections for
                                 Next Two Fiscal Years
                                 FY 99                       FY 00
                             Month     # studies    Month         # studies
                      Oct.                93       Oct.              102
                      Nov.                85       Nov.               99
                      Dec.                77       Dec.               81
                      Jan.                93       Jan.               93
                      Feb.                97       Feb.              102
                      March               99       March             110
                      April              101       April             117
                      May                103       May               123
                      June               107       June              130
                      July               111       July              135
                      Aug.               113       Aug.              140
                      Sept.              117       Sept.             145
                               Total     1196             Total      1377
                         Avg./Mo.        99.7      Avg./Mo.        114.75




Sleep CenterMarketing Plan                                                      Page 12 of 23
Prepared by Bruce Mulkey                                                            08/03/98
Average Monthly Sleep Studies per Fiscal Year
                                                     Projected through FY 2000




                                                                                               114.75
                                      120


                                                                                        99.7
                                      100


                                                                                 79.5
                                      80                                                                FY 93
                                                                         71.4
                                                                                                        FY 94
                                                                                                        FY 95
              Average Monthly Sleep                               55.8                                  FY 96
                                      60                   52.5
                     Studies                                                                            FY 97
                                                                                                        FY 98*
                                                                                                        FY 99*
                                      40                                                                FY 00*
                                                    26
                                             18
                                      20



                                       0




Sleep CenterMarketing Plan                                                                                       Page 13 of 23
Prepared by Bruce Mulkey                                                                                             08/03/98
Financial Projections
Below is a summary of financial projections for the next two fiscal years.


                             Summary of Financial Projections
                                 for FY 1999 & FY 2000
                     Fiscal       Total sleep    Fee per          Gross
                     years         studies        study          revenue
                  FY 99           1196          $1086         $1,298,856
                  FY 00           1377          $1086         $1,495,422




Sleep CenterMarketing Plan                                                   Page 14 of 23
Prepared by Bruce Mulkey                                                         08/03/98
Communicating with Our Market
In order to reach our goal of 145 sleep studies per month on a consistent basis, Sleep
Center must adhere to a coherent, effective strategy. In all that we do, we must position
ourselves as the preeminent sleep center in Western North Carolina. We will do this by
developing strong relationships with area physicians, partnering with local businesses,
communicating the strengths of the Center at every opportunity, and providing excellent
and effective care for each patient that enters our doors. Underpinning all of this will be
our compassionate attitude, an attitude and way of being that upholds the dignity of our
patients and everyone involved in delivering care to them.

Marketing Strategy
Below are the prioritized target markets along with the message that we will
communicate to them and the prioritized strategies we will undertake to do this.

I. Physicians in related fields within the Mission St. Joseph’s Health System
   A. Message: We want to assist you in providing the very best healthcare for your
      patients.
   B. Marketing Strategies
      1. Quarterly MAHEC programs for physicians in related fields, including
          primary care physicians, ENTs, pulmonologists, cardiologists, neurologists,
          and pediatricians at Owen Heart Center auditorium. SC physicians, staff, and
          patients to present. CMEs to be offered
      2. Powerful, effective Power Point presentations to be designed to support above
          programs
      3. Produce and send mailer to accompany The Doctor’s Office, a monthly
          newsletter sent to all system physicians by MSJ Marketing and
          Communications Department
      4. Call on physicians’ offices to educate the physicians and/or their office
          managers on sleep disorders. Provide physicians and office managers with
          screening information and educational brochures for their staff and patients
      5. On initial referrals, hand deliver letter from Center regarding the treatment and
          diagnosis of the referred patient within one week of the patient’s treatment and
          diagnosis. Otherwise, send letter to referring physician within two days
      6. Because of the correlation between coronary heart disease and obstructive
          sleep apnea, work closely with Heart Center to identify and treat
          cardiovascular patients with this disorder
      7. Develop educational materials appropriate for public including brochures and
          fact sheets. Develop short-form sleep disorder screening and fact sheets for
          physicians, including fact sheet on How to Refer
      8. Thank you notes to physicians who have referred patients within 48 hours of
          referral
      9. Fast Facts to Physicians postcard mailings to physicians on a monthly basis
      10. Gain presence on Mission St. Joseph website. Include page for public and one
          for healthcare professionals. Have subscription service for daily or weekly
          Fast Facts for Physicians via e-mail

Sleep CenterMarketing Plan                                                        Page 15 of 23
Prepared by Bruce Mulkey                                                              08/03/98
II. Physicians in related fields outside the Mission St. Joseph’s Health System
    A. Message: We want to assist you in providing the very best healthcare for your
       patients.
    B. Marketing Strategies
       1. Host a annual program for physicians in related fields, including primary care
           physicians, ENTs, pulmonologists, cardiologists, neurologists, and
           pediatricians at each satellite site, including Angel Community Hospital,
           Spruce Pine Community Hospital, and Cherokee Hospital. Hold event at local
           restaurant. SC physicians, staff, and patients to present. CMEs to be offered
       2. Use powerful, effective Power Point presentations designed to support above
           programs
       3. Call on physicians’ offices to educate the physicians and/or their office
           managers on sleep disorders. Provide physicians and office managers with
           screening information and educational brochures for their staff and patients
       4. On initial referrals, hand deliver letter from Center regarding the treatment and
           diagnosis of the referred patient within one week of the patient’s treatment and
           diagnosis. Otherwise, send letter to referring physician within two days
       5. Thank you notes to physicians who have referred patients within 48 hours of
           referral
       6. Fast Facts to Physicians postcard mailings to physicians on a monthly basis
       7. Use Mission St. Joseph website with sleep disorder page for healthcare
           professionals. Have subscription service for daily or weekly Fast Facts for
           Physicians via e-mail
       8. Explore opening additional satellite sites

III. Mission St. Joseph’s Health System
     A. Message: The System must recognize sleep disorders as a real problem for a large
        percentage of people in the service area, including the Mission St. Joseph’s staff
        and their family members.
     B. Marketing Strategies
        1. Work with Human Resources to have changes made in the number of sleep
            studies now allowed (one) and to have sleep screening questions included in
            the pre-employment physical. Visit and provide copies of recent news articles,
            brochures, fact sheets
        2. Work with Health Plan Design Team to have changes made in the number of
            sleep studies now allowed (one) and to have sleep screening questions
            included in the pre-employment physical. Visit and provide copies of recent
            news articles as well as brochures, fact sheets
        3. Work with Safety Officer regarding staff productivity and safety issues related
            to sleep problems, sleep deprivation
        4. Write quarterly articles, place ads in SCOPE about sleep disorders




Sleep CenterMarketing Plan                                                      Page 16 of 23
Prepared by Bruce Mulkey                                                            08/03/98
IV. Area Businesses
    A. Message: We can help increase your productivity, reduce the number of accidents
       and injuries due to fatigue, and help boost company morale.
    B. Marketing Strategies
       1. Call on company OSHA/Safety Officers to help educate them on the effects of
          sleep disorders and sleep deprivation. Provide them with brochures and fact
          sheets. Develop presentation including fact sheets that specifically address
          productivity and accident issues
       2. Develop schedule of company health screenings and health fairs. Participate in
          these on a regular basis
       3. Become part of the health screenings provided by Mission St. Joseph’s
          Community Outreach Program. Include postcard-sized self-assessments on
          brochure rack of CARE van.

V. General Public
   A. Message: We can help bring relief to your sleep problems.
   B. Marketing Strategies
      1. Change Center name to Mission St. Joseph’s Sleep Center in order to benefit
         from MSJ’s name recognition and reputation for quality care in Western North
         Carolina
      2. Hold open house when Center expansion is complete. Send invitations to
         physicians, Mission St. Joseph’s staff (including Human Resources
         Department, Health Plan Design Team, and Safety Officer), OSHA/Safety
         Officers at local companies, current and former patients, support group
         members, etc.
      3. Participate in radio and television programs including Evening Rounds
         (WCQS), Healthy Living (WWNC), and Medical Minute (WWNC & WLOS-
         TV). Concentrate on this in the months preceding the open house
      4. Invite Asheville Citizen-Times health editor to write story about newsworthy
         patient as tie-in to Center open house. Write guest column in 1999
      5. Send news releases to area media (print, radio, television) regarding opening
         of expanded Center and for such events as support group meetings, staff
         changes, new satellite sites, upcoming lectures, etc. Be certain to also send
         releases regarding upcoming events to editors of community calendars
      6. Secure Yellow Page display advertisement and listing in Physicians section
         and listing in Sleep Disorders section
      7. Write articles for Health Words for Women, a quarterly newsletter concerning
         women’s health issues that is sent to selected area women on a quarterly basis
      8. Write quarterly articles, place ads in SCOPE about sleep disorders. Also, list
         support group meetings in community calendar
      9. Maintain regular contact with Health Connection. Update them on latest
         developments at Center so that they can respond appropriately to all sleep
         problems and guide callers to the Center




Sleep CenterMarketing Plan                                                   Page 17 of 23
Prepared by Bruce Mulkey                                                         08/03/98
10. Develop system for tracking patients (how they found out about the Center)
             and referring physicians (how they made the decision to refer patient to
             Center). Such a system will be used to determine which marketing methods
             are working best and which do not seem to be working
         11. Develop patient education video to free up more of Center physicians’ time




Sleep CenterMarketing Plan                                                     Page 18 of 23
Prepared by Bruce Mulkey                                                           08/03/98
Exhibits



                      A. Map—Sleep Center Service Area

                      B. Marketing Action Plan




Sleep CenterMarketing Plan                               Page 19 of 23
Prepared by Bruce Mulkey                                     08/03/98
Sleep Center Marketing Action Plan
   Sec. I        Action                                    Primary Responsibility             Date Due          Primary Support
I.B.1       Quarterly programs for MSJ physicians        Dr. James McCarrick        Qtrly. beg. in 12/98   Jean Hardy
            a. Enroll physician, staff, patient
                presenters
            b. Choose dates, site
I.B.2       Develop presentations, handouts              Dr. James McCarrick        Qtrly. as needed       Bruce Mulkey
I.B.3       Produce and send bi-monthly informational    Jean Hardy                 On hold                Bruce Mulkey
            mailer with The Doctor’s Office (Use                                                           Ernest Williamson, Sleep
            Diagnosing Sleep Disorders fact sheet) [1]                                                     Sciences
I.B.4-5     Call on physicians                           Jean Hardy                 As needed              N.A.
I.B.5.a     Send letter from Center to referring         Leigh Patton               As needed              N.A.
            physicians
I.B.5.b     Review letter from Center to referring       Jim Tate w/                11/16/98               Bruce Mulkey
            physicians for PR value                      Dr. James McCarrick
                                                         Dr. Charles O’Cain
I.B.6       Meet with Shonnie Lavender to determine      Jean Hardy                 11/1/98                Shonnie Lavender, Heart
            strategy for interacting with Heart Center                                                     Services
I.B.7       Develop brochures, fact sheets, letterhead Jean Hardy                   10/15/98               Bruce Mulkey
            a. 6 patient brochures                                                                         Ernest Williamson, Sleep
            b. 6 physician fact sheets                                                                     Sciences
I.B.7       Final proofs to physicians                 Jean Hardy                   10/30/98               Bruce Mulkey
I.B.7       Final proofs reviewed                      Dr. James McCarrick          11/6/98                Jim Tate
                                                       Dr. Charles O’Cain
I.B.7       Brochures, fact sheets, etc. received from Jean Hardy                   11/20/98               Bruce Mulkey
            printer                                                                                        MSJ Print Shop
I.B.8       Determine procedures for thank you notes Jim Tate w/                    11/16/98               Bruce Mulkey
                                                       Dr. James McCarrick
                                                       Dr. Charles O’Cain
I.B.9       Mail Fast Facts to Physicians              Leigh Patton                 On hold                Merrell Gregory, Marketing
I.B.10      Gain presence on MSJ website               Jim Tate                     On hold                Rod Whiting, Marketing




Sleep CenterMarketing Plan                                                          Page 20 of 23
Prepared by Bruce Mulkey                                                                08/03/98
Sleep Center Marketing Action Plan (cont.)
  Sec. II                        Action                       Primary                             Date Due         Primary Support
                                                              Responsibility
II.B.1        Annual program at each satellite site        Dr. James McCarrick         Qtrly. beg. in 12/98   Jean Hardy
              a. Enroll physician, staff, patient
                  presenters
              b. Choose dates, site
II.B.2        Develop presentations, handouts              Dr. James McCarrick         Qtrly. as needed       Bruce Mulkey
II.B.3-4      Call on physicians at satellite sites        Jean Hardy                  As needed              N.A.
II.B.4        Send letter to referring physicians          Leigh Patton                As needed              N.A.
II.B.5        Determine procedure for thank you notes      Jim Tate w/                 11/16/98               Bruce Mulkey
                                                           Dr. James McCarrick
                                                           Dr. Charles O’Cain
II.B.6        Mail Fast Facts to Physicians                Leigh Patton                On hold                Merrell Gregory, Marketing
II.B.7        See I.B.10 above                             N.A.                        N.A.                   N.A.
II.B.8        Develop strategy to open additional          Jean Hardy                  On hold                Sonya Greck, VP Regional
              satellite sites                                                                                 Services
   Sec. III                       Action                      Primary Responsibility              Date Due         Primary Support
III.B.1       Human Resources to meet to consider          Jim Tate                    11/13/98               Tim Macklin, MSJ HR
              request for changes
III.B.2       Meet with Health Plan Design Team to         Jean Hardy                  On hold                Claudia Muse, Exec. Dir.,
              request changes                                                                                 Health Delivery Inc.
III.B.3       Meet with Safety Officer to request          Jean Hardy                  On hold                Angela Jones, MSJ Safety
              changes                                                                                         Officer
III.B.1-3     Develop presentation package including       Jean Hardy                  On hold                Bruce Mulkey
              brochures, fact sheets, articles, etc. for                                                      Ernest Williamson, Sleep
              above meetings                                                                                  Sciences
III.B.4       Write articles for SCOPE [2]                 Jean Hardy                  Qtrly. beg. 11/15/98   Bruce Mulkey
                                                                                                              Carole Donnelly, SCOPE
                                                                                                              Editor




Sleep CenterMarketing Plan                                                             Page 21 of 23
Prepared by Bruce Mulkey                                                                   08/03/98
Sleep Center Marketing Action Plan (cont.)
  Sec. IV                      Action                        Primary Responsibility              Date Due        Primary Support
IV.B.1.a    Develop list of area companies and visit       Jean Hardy                 1/18/99               Bruce Handley, Community
            OSHA/Safety Officers                                                                            Outreach
IV.B.1.b    Develop business presentation and              Jean Hardy                 12/31/98              Bruce Mulkey
            materials re productivity, safety issues                                                        Ernest Williamson, Sleep
            a. Brochures                                                                                    Sciences
            b. Fact sheets
            c. Presentation
IV.B.2.a    Develop schedule of business health            Jean Hardy                 11/1/98               Bruce Handley, Community
            screenings, fairs                                                                               Outreach
IV.B.2.b    Create professional booth and participate      Jean Hardy                 1/30/99               Bruce Mulkey
            in screenings, fairs [5]                                                                        Ernest Williamson, Sleep
                                                                                                            Sciences
IV.B.3.a    Meet with Community Outreach to explore Jean Hardy                        11/1/98               Bruce Handley, Community
            becoming part of their program                                                                  Outreach
IV.B.3.b    Postcard sized self-assessments in      Jean Hardy                        11/15/98              Bruce Handley, Community
            brochure rack of CARE Van [7]                                                                   Outreach
  Sec. V                      Action                          Primary                            Date Due        Primary Support
                                                              Responsibility
V.B.1       Change Center name to Mission St.              Jean Hardy                 10/1/99               Bruce Mulkey
            Joseph’s Sleep Center                                                                           Janet Moore, Marketing
V.B.2       Plan and hold Open House                       Jean Hardy                 On hold               Bruce Mulkey
V.B.3       Schedule participation in radio and TV         Jean Hardy                 1/15/99               Bruce Mulkey
            programs, write scripts [4]                                                                     Rod Whiting, Marketing
V.B.4       Invite Citizen-Times to write story about      Jean Hardy                 On hold               Bruce Mulkey
            pediatric patient. Later, write guest column                                                    Merrell Gregory, Marketing
            [3]
V.B.5.a     Develop list of area media                     Jean Hardy                 On hold               Bruce Mulkey
                                                                                                            Merrell Gregory, Marketing
V.B.5.b     Send news releases re Open House and           Jean Hardy                 On hold               Bruce Mulkey
            other Center and sleep disorder news                                                            Merrell Gregory, Marketing


Sleep CenterMarketing Plan                                                            Page 22 of 23
Prepared by Bruce Mulkey                                                                  08/03/98
Sleep Center Marketing Action Plan (cont.)
  Sec. V                      Action                      Primary                     Date Due           Primary Support
                                                          Responsibility
V.B.5.c     Send upcoming events info to Community Susan DuRant            Monthly beg. 8/14/98   N.A.
            Calendars
V.B.6       Display ad, listings in Yellow Pages [6] Jean Hardy            3/1/99                 Bruce Mulkey
                                                                                                  Rod Whiting, Marketing
V.B.7       Write articles for Health Words for Women Jean Hardy           On hold                Bruce Mulkey
                                                                                                  Harley Dartt, Marketing
V.B.8       See III.B.4 Also list upcoming events in   Jean Hardy          11/15/98               Carole Donnelly, SCOPE
            SCOPE                                                                                 Editor
V.B.9       Update Health Connection                   Jean Hardy          Qtrly. Beg. 11/15/98   Barbara Moore, Health
                                                                                                  Connection
V.B.10      Develop tracking system                    Jean Hardy          1/1/99                 Computer Services
V.B.11      Develop patient education video [8]        Jean Hardy          1/15/99                Bruce Mulkey
                                                                                                  Ernest Williamson, Sleep
                                                                                                  Sciences




Sleep CenterMarketing Plan                                                 Page 23 of 23
Prepared by Bruce Mulkey                                                       08/03/98

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Sample Marketing Plan

  • 2. Sleep Center Marketing Plan Table of Contents Market Analysis........................................................................................................... 3 Our Mission................................................................................................................ 3 Services Offered ......................................................................................................... 3 Market Definition....................................................................................................... 4 Strengths..................................................................................................................... 5 Weaknesses ................................................................................................................ 6 Opportunities.............................................................................................................. 6 Unexplored Opportunities .......................................................................................... 7 Threats........................................................................................................................ 7 Customer Profile ........................................................................................................ 7 Target Market ............................................................................................................. 7 Competition................................................................................................................ 8 Competitive Roundup ................................................................................................ 9 Observations and Conclusions ................................................................................... 9 Marketing Goals ........................................................................................................ 10 History...................................................................................................................... 10 Graph—Average Monthly Sleep Studies per Fiscal Year........................................ 11 Two-Year Goals ....................................................................................................... 12 Graph—Average Monthly Sleep Studies per Fiscal Year Through FY 2000 .......... 13 Financial Projections ................................................................................................ 14 Communicating with Our Market ........................................................................... 15 Marketing Strategy ................................................................................................... 15 Exhibits ....................................................................................................................... 19 A. Map—Sleep Center Service Area B. Marketing Action Plan Sleep CenterMarketing Plan Page 2 of 23 Prepared by Bruce Mulkey 08/03/98
  • 3. Market Analysis According to the Report of the National Commission on Sleep Disorder Research, sleep disorders affect millions of Americans. In fact, nearly half of all Americans suffer from some type of sleep-related problem. Additional findings include: • Forty million Americans suffer from sleep disorders. Eighteen million of these suffer from obstructive sleep apnea, while 250,000 to 375,000 suffer from narcolepsy. • Sixty million Americans, one-third of all adults, suffer from chronic insomnia. • Twenty to 30 million Americans experience intermittent sleep-related problems. • Twenty five percent of children between ages one to five experience some type of sleep disturbance. • Over half of the 19 million people now over 65 experience some disruption of sleep. • Millions more Americans obtain inadequate sleep because of their work schedules or their lifestyle. • Fewer than five percent of Americans who suffer from sleep-related problems are diagnosed and receiving appropriate care at accredited sleep centers. Since advancing age is an important risk factor for many sleep problems, the sleep problems facing the United States may become even more prevalent as our population ages as expected in the coming decades. Our Mission Our mission at Sleep Center is to provide high quality, affordable sleep medicine services to all patients in need and to improve the level of awareness of sleep medicine in the professional community as well as the public. We provide diagnosis and treatment for a broad range of sleep disorders, including sleep apnea, narcolepsy, insomnia, parasomnias, and circadian rhythm disturbances for adult and pediatric patients. Services Offered Sleep Center provides the following services to patients with sleep-related problems who reside in Western North Carolina: • Physician evaluation, including history and physical for adults and children (adult evaluations also available at satellite sites in Angel Community Hospital in Franklin and Spruce Pine Community Hospital in Spruce Pine) • Polysomnography, usually referred to as sleep study (adult studies also available at satellite sites at Angel Community Hospital in Franklin and Spruce Pine Community Hospital in Spruce Pine) • Multiple Sleep Latency Testing • Maintenance of Wakefulness Testing • Insomnia specific evaluation and treatment • Community education programs, including talks to various groups and participation in area health/wellness fairs Sleep CenterMarketing Plan Page 3 of 23 Prepared by Bruce Mulkey 08/03/98
  • 4. Market Definition The market for our services consists of the populations of the following Western North Carolina counties: Sleep Center Service Area County 1998 Population* Primary Service Area Buncombe 188,385 Subtotal 188,385 Secondary Service Area Haywood 48,400 Henderson 78,262 Madison 17,335 McDowell 36,385 Yancey 15,990 Subtotal 196,372 Tertiary Service Area Cherokee 21,342 Clay 7,515 Graham 7,263 Jackson 28,191 Macon 26,368 Mitchell 14,472 Swain 11,927 Transylvania 27,259 Subtotal 144,338 Total of 14-County Service Area 529,095 Other Service Areas Alexander 29,899 Alleghany 9,772 Ashe 22,392 Avery 15,105 Burke 79,051 Caldwell 73,522 Catawba 129,710 Polk 15,829 Rutherford 59,956 Watauga 40,119 Wilkes 60,644 Subtotal 535,999 Total population entire service area 1,065,094 * Projected population, Land of the Sky Regional Council, 2/6/95 Sleep CenterMarketing Plan Page 4 of 23 Prepared by Bruce Mulkey 08/03/98
  • 5. We conservatively estimate that 20 percent of the total population of the 14-county primary, secondary, and tertiary service areas served by Sleep Center has serious sleep- related problems. Since the total population of these service areas is 529,095, we can assume that the market for our services is 105,819 individuals in these counties (20% x 529,095 = 105,819). As this population grows and ages, an even larger market can be assumed. It should be noted, however, that the majority of our patients come from Buncombe County at this time. While the estimated 105,819 Western North Carolinians suffering from sleep-related problems is the market we must reach, the primary method of doing so is through the referrals of physicians in the service areas. Therefore, we must target Western North Carolina physicians, inform them about sleep disorders, and enroll them into the process of referring their patients to us when sleep disorders are suspected. In addition, industries, especially those where shift work takes place, provide a secondary target. The Mission St. Joseph’s Health Plan now allows for only one sleep study per lifetime. In addition, no sleep screening questions are asked during pre-employment physicals. Therefore, the Mission St. Joseph’s Human Resources Department, the Health Plan Design Team, and the Safety Officer must be lobbied to make changes in this regard and, thus, provide a tertiary target. Strengths The strengths of Sleep Center include: • Accreditation as full-service sleep disorder center by the American Sleep Disorders Association—Distinguishes us from some other local sleep centers • Staff physicians with over 30 years combined experience in the evaluation and treatment of sleep disorders (One board-certified; one expected to attain certification in 1999)—Assures exceptional patient care • Pediatric sleep specialist—Effective treatment offered for children • Staff psychologist—Enables us to treat insomnia, usually with behavior modification • Four registered polysomnographic technologists, with two additional staff members completing their registration—The quantity and quality of these technologists assure attention to patient needs and high quality sleep studies • Sleep Sciences, Inc. in Atlanta provides services—Leading provider of sleep medicine services in U.S. • Positive treatment results—Success rate of approximately 60 to 80 percent in improving the quality of our patients’ sleep overall. Approximately 90 to 95 percent success rate in compliant patients • Home-like sleep facility with six private beds—Comfortable setting with substantial privacy • Convenient locations—Right off I-40 in Asheville and satellite sites at Angel Community Hospital in Franklin and Spruce Pine Community Hospital in Spruce Pine • Satellite sites (two locations currently with three other locations under consideration)—Patients near these programs can be seen without driving long distances, and referring physicians in outlying regions can retain care of their patients Sleep CenterMarketing Plan Page 5 of 23 Prepared by Bruce Mulkey 08/03/98
  • 6. Flexible scheduling—Around-the-clock testing accommodates patients’ varying sleep schedules • Reasonable cost—The cost of evaluations and treatment is considerably lower than the Southeastern U.S. average • Affiliated with Mission St. Joseph’s Health System—System has strong regional presence and provides opportunities such as the capture of the sleep medicine portion of managed care contracts • Adjacent to hospital—Medical treatment is available in case of emergency • Support groups for patients with sleep apnea, restless legs, and narcolepsy—Free support groups offers sufferers of these disorders ongoing physical and emotional support In marketing, our most powerful assets are: • The relationships built with local and regional physicians by our medical directors • Our affiliation with Mission St. Joseph’s Health System and its stellar reputation • The ability to offer everything that someone with a sleep-related problem might need, including sleep studies, therapy, and when required, continuing support • Our moderate pricing • Our technical expertise Weaknesses There are several apparent weaknesses in our services. They include: • Delays, especially in the evaluation of new patients, because of physicians’ schedules • Lack of interaction with specialists in related fields, including ENTs, pulmonologists, cardiologists, neurologists, pediatricians, and clinical psychologists. • Lack of feedback from referring physicians regarding collaboration on patient treatment plans • Lack of data on compliance and outcomes from referring physicians and patients • Lack of patient follow-up The issue of physician scheduling must be addressed in the weeks to come. The interaction between the Center staff and other physicians, especially specialists in related fields will be addressed in the marketing strategy portion of this plan. An effective method for obtaining feedback from physicians and patients will also be addressed. Opportunities The opportunities to market our services that have been explored include: • Obtaining patient referrals from physicians • Yellow page display ad in Physicians section in the Asheville telephone book • Talks to wellness groups, community organizations, and support groups • Participation in health and wellness fairs • Alumni group Sleep CenterMarketing Plan Page 6 of 23 Prepared by Bruce Mulkey 08/03/98
  • 7. Unexplored Opportunities Unexplored marketing opportunities that have been identified to date include: • Seminars on sleep disorders for primary care physicians, ENTs, pulmonologists, cardiologists, neurologists, and pediatricians. CMEs for these seminars • Provide educational information about sleep disorders to above groups plus clinical psychologists • Marketing to local industries, especially those where shift work takes place, about the effects of shift work and how sleep deprivation can affect productivity and workplace safety • Develop sleep assessment for industry wellness programs. Work with Community Outreach on this • Work with MSJ Human Resources, Health Plan Design Team, and Safety Officer to have sleep screening questions included on pre-employment physical and to allow more than one sleep study per lifetime • Gain presence on MSJ website Threats Internal threats to Sleep Center include: • The need for greater understanding of the seriousness of sleep-related problems by Mission St. Joseph’s Health System • The absence of a marketing plan and a unified strategy for attracting new patients • The need for updated, effective marketing materials • The absence of a designated individual at the Sleep Center to spearhead the marketing effort that will be required to achieve goals Hopefully, the completion and implementation of this marketing plan can address all of these items. Customer Profile The typical adult patient at Sleep Center is a middle-aged Buncombe County resident who snores. Such patients are typically referred to us by their physician after years of sleep-related problems. Seventy percent of the adult patients at our center are diagnosed with obstructive sleep apnea. Ten percent are diagnosed with narcolepsy. The remaining 20 percent suffer from either restless legs syndrome or periodic limb movement disorder or one of the parasomnias. The typical pediatric patient is four to five years of age and is typically tested for obstructive sleep apnea and night terrors. Target Market Because they refer our patients to us, we must target Western North Carolina physicians, inform them about sleep disorders, and enroll them into the process of referring their patients to us when sleep disorders are suspected. Next, we must work with Mission St. Joseph’s Health System’s Human Resources Department, Health Plan Design Team, and Sleep CenterMarketing Plan Page 7 of 23 Prepared by Bruce Mulkey 08/03/98
  • 8. Safety Officer to recognize sleep disorders as a serious problem, to have sleep screening questions included on pre-employment physicals, and to allow more than one sleep study per lifetime. In addition, we must target area industries, especially those where shift work takes place, and let them know that we can help them increase productivity and reduce the number of accidents and injuries due to fatigue. Finally, we must let the general public know that we are here to help alleviate their sleep problems. Competition Our competition in Western North Carolina currently consists of Sleep Medicine Center, Inc. and Sleep Center of Pardee. Each of these centers is profiled below. Sleep Medicine Center, Inc., 1901 Hendersonville Road, Asheville Sleep Medicine Center is an accredited sleep center owned by Park Ridge Hospital. This is a two-bed facility with two board certified sleep physicians and one registered polysomnographic technologist on staff. The medical director is on the Pardee Memorial staff and also serves as the medical director of the sleep center at that hospital. According to the staff at Sleep Medicine Center, they average two sleep studies three nights per week for a total of six sleep studies each week. The medical staff of Park Ridge staff refers almost exclusively to this center. Sleep Medicine Center advertises on WLOS-TV during prime time and has a display advertisement in the Asheville Yellow Pages. One additional factor: patients can purchase their sleep equipment at this center. It is currently understood that the Sleep Medicine Center will soon vacate their current location and move into Park Ridge Hospital. Recently, there have been conversations about contracting with Sleep Center to manage the Sleep Medicine Center at Park Ridge Hospital. Sleep Center of Pardee, Pardee Memorial Hospital, 715 Fleming Street, Hendersonville Sleep Center of Pardee is located within the hospital in a very clinical setting. This center is not currently accredited though accreditation is expected this fall. This is a two-bed facility with two board certified sleep physicians and one registered polysomnographic technologist on staff. The medical director here also serves as the medical director of the Sleep Medicine Center. According to the staff at Sleep Center of Pardee, they average seven sleep studies per week at Pardee and three additional studies per week through their outreach program at Grace Hospital in Morganton and Harris Regional Hospital in Sylva, for a total of 10 sleep studies per week. Sleep Center of Pardee has a well-formed multi- disciplinary physician team interested in expanding their scope of service. Sleep Center is currently managing this center. Sleep CenterMarketing Plan Page 8 of 23 Prepared by Bruce Mulkey 08/03/98
  • 9. Competitive Roundup Sleep Center (SC), Sleep Medicine Center (SMC), and Sleep Center of Pardee (SCP) are compared below. The areas marked by an asterisk (*) are rated on a scale from A to F, with A being strong and F being weak. Area Sleep Center Competitive Roundup SC SMC SCP Accreditation as full-service sleep center? Yes Yes No Number of board certified physicians 1 2 2 Number of pediatric sleep specialists 1 0 0 Number of psychologists/psychiatrists 1 0 1 No. of registered polysomnographic techs 4 2 2 Management expertise* A B A Flexible scheduling for patients?* A ? B Facility design, incl. function and comfort* A C C Number of beds in facility 6 2 2 Average number of sleep studies/week 22 6 (?) 6.7 Number of satellite sites 2 0 2 Avg. number studies/week from satellite sites 1.8 0 3.1 Consultation cost $162 $180 $180 Sleep study cost $1086 $1050 $1076 Physician interpretation cost $325 $300 $300 Patient education* B ? C Patient follow-up* B+ ? B- Overall quality of service* A- ? B-/C Patient satisfaction* A- ? ? Sleep equip. available for purchase onsite? No Yes No Support of sponsoring institution* A- ? B- Relationship with area physicians* A-/B+ ? A Strength of marketing program* F B F Effectiveness of marketing materials* D B F Public perception* B ? B Percent market share ? ? ? Support groups available? Yes ? Yes Current competitive strength* ? ? ? Potential competitive strength* A C B Observations and Conclusions It appears, from the above information, that we have a competitive advantage over both of our local competitors. To expand our market share, however, we must develop and implement a marketing strategy to attain the goals described in the next section of this plan. Sleep CenterMarketing Plan Page 9 of 23 Prepared by Bruce Mulkey 08/03/98
  • 10. Marketing Goals This section of the marketing plan will be devoted to establishing Sleep Center’s marketing goals for the next two fiscal years. First, however, we will review the history of the Center in terms of the number of sleep studies performed. History The table below shows the history of the Sleep Center in terms of sleep studies per quarter over the past several fiscal years. The total number of sleep studies per fiscal year along with the average number of sleep studies per month is shown at the bottom of the table. History of Sleep Studies at Sleep Center (Fiscal Years) FY93 FY 94 FY 95 FY 96 FY 97 FY 98 st 1 Qtr. 40 62 125 162 163 199 2nd Qtr. 59 75 163 157 212 190 rd 3 Qtr. 59 75 171 165 224 265 4th Qtr. 58 100 171 185 258 300* Total 216 312 630 669 857 954 Avg./mo. 18 26 52.5 55.8 71.4 79.5 * Projected number of sleep studies for FY 98 fourth quarter As shown in the table, the average number of sleep studies per month at Sleep Center has grown steadily. From an average of 18 sleep studies per month during the fiscal year ending 9/30/93, the average number of sleep studies per month increased to 71.4 for the past fiscal year. The average for the first nine months of the current fiscal year is 72.7 studies per month. This growth is illustrated in the graph on the following page. Sleep CenterMarketing Plan Page 10 of 23 Prepared by Bruce Mulkey 08/03/98
  • 11. Average M onthly S leep S tudies per Fiscal Year 79.5 80 71.4 70 55.8 60 52.5 50 FY 93 FY 94 Average M onthly Sleep FY 95 40 Studies FY 96 FY 97 26 FY 98 30 18 20 10 0 1992-1998 Fiscal Years Sleep CenterMarketing Plan Page 11 of 23 Prepared by Bruce Mulkey 08/03/98
  • 12. Two-Year Goals The goal that we wish to attain at Sleep Center is to consistently conduct 145 sleep studies per month, 130 per month at the Center and 15 per month at the satellite sites. The table below provides a conservative scenario of how we intend to reach this goal over the next two fiscal years. Sleep Study Projections for Next Two Fiscal Years FY 99 FY 00 Month # studies Month # studies Oct. 93 Oct. 102 Nov. 85 Nov. 99 Dec. 77 Dec. 81 Jan. 93 Jan. 93 Feb. 97 Feb. 102 March 99 March 110 April 101 April 117 May 103 May 123 June 107 June 130 July 111 July 135 Aug. 113 Aug. 140 Sept. 117 Sept. 145 Total 1196 Total 1377 Avg./Mo. 99.7 Avg./Mo. 114.75 Sleep CenterMarketing Plan Page 12 of 23 Prepared by Bruce Mulkey 08/03/98
  • 13. Average Monthly Sleep Studies per Fiscal Year Projected through FY 2000 114.75 120 99.7 100 79.5 80 FY 93 71.4 FY 94 FY 95 Average Monthly Sleep 55.8 FY 96 60 52.5 Studies FY 97 FY 98* FY 99* 40 FY 00* 26 18 20 0 Sleep CenterMarketing Plan Page 13 of 23 Prepared by Bruce Mulkey 08/03/98
  • 14. Financial Projections Below is a summary of financial projections for the next two fiscal years. Summary of Financial Projections for FY 1999 & FY 2000 Fiscal Total sleep Fee per Gross years studies study revenue FY 99 1196 $1086 $1,298,856 FY 00 1377 $1086 $1,495,422 Sleep CenterMarketing Plan Page 14 of 23 Prepared by Bruce Mulkey 08/03/98
  • 15. Communicating with Our Market In order to reach our goal of 145 sleep studies per month on a consistent basis, Sleep Center must adhere to a coherent, effective strategy. In all that we do, we must position ourselves as the preeminent sleep center in Western North Carolina. We will do this by developing strong relationships with area physicians, partnering with local businesses, communicating the strengths of the Center at every opportunity, and providing excellent and effective care for each patient that enters our doors. Underpinning all of this will be our compassionate attitude, an attitude and way of being that upholds the dignity of our patients and everyone involved in delivering care to them. Marketing Strategy Below are the prioritized target markets along with the message that we will communicate to them and the prioritized strategies we will undertake to do this. I. Physicians in related fields within the Mission St. Joseph’s Health System A. Message: We want to assist you in providing the very best healthcare for your patients. B. Marketing Strategies 1. Quarterly MAHEC programs for physicians in related fields, including primary care physicians, ENTs, pulmonologists, cardiologists, neurologists, and pediatricians at Owen Heart Center auditorium. SC physicians, staff, and patients to present. CMEs to be offered 2. Powerful, effective Power Point presentations to be designed to support above programs 3. Produce and send mailer to accompany The Doctor’s Office, a monthly newsletter sent to all system physicians by MSJ Marketing and Communications Department 4. Call on physicians’ offices to educate the physicians and/or their office managers on sleep disorders. Provide physicians and office managers with screening information and educational brochures for their staff and patients 5. On initial referrals, hand deliver letter from Center regarding the treatment and diagnosis of the referred patient within one week of the patient’s treatment and diagnosis. Otherwise, send letter to referring physician within two days 6. Because of the correlation between coronary heart disease and obstructive sleep apnea, work closely with Heart Center to identify and treat cardiovascular patients with this disorder 7. Develop educational materials appropriate for public including brochures and fact sheets. Develop short-form sleep disorder screening and fact sheets for physicians, including fact sheet on How to Refer 8. Thank you notes to physicians who have referred patients within 48 hours of referral 9. Fast Facts to Physicians postcard mailings to physicians on a monthly basis 10. Gain presence on Mission St. Joseph website. Include page for public and one for healthcare professionals. Have subscription service for daily or weekly Fast Facts for Physicians via e-mail Sleep CenterMarketing Plan Page 15 of 23 Prepared by Bruce Mulkey 08/03/98
  • 16. II. Physicians in related fields outside the Mission St. Joseph’s Health System A. Message: We want to assist you in providing the very best healthcare for your patients. B. Marketing Strategies 1. Host a annual program for physicians in related fields, including primary care physicians, ENTs, pulmonologists, cardiologists, neurologists, and pediatricians at each satellite site, including Angel Community Hospital, Spruce Pine Community Hospital, and Cherokee Hospital. Hold event at local restaurant. SC physicians, staff, and patients to present. CMEs to be offered 2. Use powerful, effective Power Point presentations designed to support above programs 3. Call on physicians’ offices to educate the physicians and/or their office managers on sleep disorders. Provide physicians and office managers with screening information and educational brochures for their staff and patients 4. On initial referrals, hand deliver letter from Center regarding the treatment and diagnosis of the referred patient within one week of the patient’s treatment and diagnosis. Otherwise, send letter to referring physician within two days 5. Thank you notes to physicians who have referred patients within 48 hours of referral 6. Fast Facts to Physicians postcard mailings to physicians on a monthly basis 7. Use Mission St. Joseph website with sleep disorder page for healthcare professionals. Have subscription service for daily or weekly Fast Facts for Physicians via e-mail 8. Explore opening additional satellite sites III. Mission St. Joseph’s Health System A. Message: The System must recognize sleep disorders as a real problem for a large percentage of people in the service area, including the Mission St. Joseph’s staff and their family members. B. Marketing Strategies 1. Work with Human Resources to have changes made in the number of sleep studies now allowed (one) and to have sleep screening questions included in the pre-employment physical. Visit and provide copies of recent news articles, brochures, fact sheets 2. Work with Health Plan Design Team to have changes made in the number of sleep studies now allowed (one) and to have sleep screening questions included in the pre-employment physical. Visit and provide copies of recent news articles as well as brochures, fact sheets 3. Work with Safety Officer regarding staff productivity and safety issues related to sleep problems, sleep deprivation 4. Write quarterly articles, place ads in SCOPE about sleep disorders Sleep CenterMarketing Plan Page 16 of 23 Prepared by Bruce Mulkey 08/03/98
  • 17. IV. Area Businesses A. Message: We can help increase your productivity, reduce the number of accidents and injuries due to fatigue, and help boost company morale. B. Marketing Strategies 1. Call on company OSHA/Safety Officers to help educate them on the effects of sleep disorders and sleep deprivation. Provide them with brochures and fact sheets. Develop presentation including fact sheets that specifically address productivity and accident issues 2. Develop schedule of company health screenings and health fairs. Participate in these on a regular basis 3. Become part of the health screenings provided by Mission St. Joseph’s Community Outreach Program. Include postcard-sized self-assessments on brochure rack of CARE van. V. General Public A. Message: We can help bring relief to your sleep problems. B. Marketing Strategies 1. Change Center name to Mission St. Joseph’s Sleep Center in order to benefit from MSJ’s name recognition and reputation for quality care in Western North Carolina 2. Hold open house when Center expansion is complete. Send invitations to physicians, Mission St. Joseph’s staff (including Human Resources Department, Health Plan Design Team, and Safety Officer), OSHA/Safety Officers at local companies, current and former patients, support group members, etc. 3. Participate in radio and television programs including Evening Rounds (WCQS), Healthy Living (WWNC), and Medical Minute (WWNC & WLOS- TV). Concentrate on this in the months preceding the open house 4. Invite Asheville Citizen-Times health editor to write story about newsworthy patient as tie-in to Center open house. Write guest column in 1999 5. Send news releases to area media (print, radio, television) regarding opening of expanded Center and for such events as support group meetings, staff changes, new satellite sites, upcoming lectures, etc. Be certain to also send releases regarding upcoming events to editors of community calendars 6. Secure Yellow Page display advertisement and listing in Physicians section and listing in Sleep Disorders section 7. Write articles for Health Words for Women, a quarterly newsletter concerning women’s health issues that is sent to selected area women on a quarterly basis 8. Write quarterly articles, place ads in SCOPE about sleep disorders. Also, list support group meetings in community calendar 9. Maintain regular contact with Health Connection. Update them on latest developments at Center so that they can respond appropriately to all sleep problems and guide callers to the Center Sleep CenterMarketing Plan Page 17 of 23 Prepared by Bruce Mulkey 08/03/98
  • 18. 10. Develop system for tracking patients (how they found out about the Center) and referring physicians (how they made the decision to refer patient to Center). Such a system will be used to determine which marketing methods are working best and which do not seem to be working 11. Develop patient education video to free up more of Center physicians’ time Sleep CenterMarketing Plan Page 18 of 23 Prepared by Bruce Mulkey 08/03/98
  • 19. Exhibits A. Map—Sleep Center Service Area B. Marketing Action Plan Sleep CenterMarketing Plan Page 19 of 23 Prepared by Bruce Mulkey 08/03/98
  • 20. Sleep Center Marketing Action Plan Sec. I Action Primary Responsibility Date Due Primary Support I.B.1 Quarterly programs for MSJ physicians Dr. James McCarrick Qtrly. beg. in 12/98 Jean Hardy a. Enroll physician, staff, patient presenters b. Choose dates, site I.B.2 Develop presentations, handouts Dr. James McCarrick Qtrly. as needed Bruce Mulkey I.B.3 Produce and send bi-monthly informational Jean Hardy On hold Bruce Mulkey mailer with The Doctor’s Office (Use Ernest Williamson, Sleep Diagnosing Sleep Disorders fact sheet) [1] Sciences I.B.4-5 Call on physicians Jean Hardy As needed N.A. I.B.5.a Send letter from Center to referring Leigh Patton As needed N.A. physicians I.B.5.b Review letter from Center to referring Jim Tate w/ 11/16/98 Bruce Mulkey physicians for PR value Dr. James McCarrick Dr. Charles O’Cain I.B.6 Meet with Shonnie Lavender to determine Jean Hardy 11/1/98 Shonnie Lavender, Heart strategy for interacting with Heart Center Services I.B.7 Develop brochures, fact sheets, letterhead Jean Hardy 10/15/98 Bruce Mulkey a. 6 patient brochures Ernest Williamson, Sleep b. 6 physician fact sheets Sciences I.B.7 Final proofs to physicians Jean Hardy 10/30/98 Bruce Mulkey I.B.7 Final proofs reviewed Dr. James McCarrick 11/6/98 Jim Tate Dr. Charles O’Cain I.B.7 Brochures, fact sheets, etc. received from Jean Hardy 11/20/98 Bruce Mulkey printer MSJ Print Shop I.B.8 Determine procedures for thank you notes Jim Tate w/ 11/16/98 Bruce Mulkey Dr. James McCarrick Dr. Charles O’Cain I.B.9 Mail Fast Facts to Physicians Leigh Patton On hold Merrell Gregory, Marketing I.B.10 Gain presence on MSJ website Jim Tate On hold Rod Whiting, Marketing Sleep CenterMarketing Plan Page 20 of 23 Prepared by Bruce Mulkey 08/03/98
  • 21. Sleep Center Marketing Action Plan (cont.) Sec. II Action Primary Date Due Primary Support Responsibility II.B.1 Annual program at each satellite site Dr. James McCarrick Qtrly. beg. in 12/98 Jean Hardy a. Enroll physician, staff, patient presenters b. Choose dates, site II.B.2 Develop presentations, handouts Dr. James McCarrick Qtrly. as needed Bruce Mulkey II.B.3-4 Call on physicians at satellite sites Jean Hardy As needed N.A. II.B.4 Send letter to referring physicians Leigh Patton As needed N.A. II.B.5 Determine procedure for thank you notes Jim Tate w/ 11/16/98 Bruce Mulkey Dr. James McCarrick Dr. Charles O’Cain II.B.6 Mail Fast Facts to Physicians Leigh Patton On hold Merrell Gregory, Marketing II.B.7 See I.B.10 above N.A. N.A. N.A. II.B.8 Develop strategy to open additional Jean Hardy On hold Sonya Greck, VP Regional satellite sites Services Sec. III Action Primary Responsibility Date Due Primary Support III.B.1 Human Resources to meet to consider Jim Tate 11/13/98 Tim Macklin, MSJ HR request for changes III.B.2 Meet with Health Plan Design Team to Jean Hardy On hold Claudia Muse, Exec. Dir., request changes Health Delivery Inc. III.B.3 Meet with Safety Officer to request Jean Hardy On hold Angela Jones, MSJ Safety changes Officer III.B.1-3 Develop presentation package including Jean Hardy On hold Bruce Mulkey brochures, fact sheets, articles, etc. for Ernest Williamson, Sleep above meetings Sciences III.B.4 Write articles for SCOPE [2] Jean Hardy Qtrly. beg. 11/15/98 Bruce Mulkey Carole Donnelly, SCOPE Editor Sleep CenterMarketing Plan Page 21 of 23 Prepared by Bruce Mulkey 08/03/98
  • 22. Sleep Center Marketing Action Plan (cont.) Sec. IV Action Primary Responsibility Date Due Primary Support IV.B.1.a Develop list of area companies and visit Jean Hardy 1/18/99 Bruce Handley, Community OSHA/Safety Officers Outreach IV.B.1.b Develop business presentation and Jean Hardy 12/31/98 Bruce Mulkey materials re productivity, safety issues Ernest Williamson, Sleep a. Brochures Sciences b. Fact sheets c. Presentation IV.B.2.a Develop schedule of business health Jean Hardy 11/1/98 Bruce Handley, Community screenings, fairs Outreach IV.B.2.b Create professional booth and participate Jean Hardy 1/30/99 Bruce Mulkey in screenings, fairs [5] Ernest Williamson, Sleep Sciences IV.B.3.a Meet with Community Outreach to explore Jean Hardy 11/1/98 Bruce Handley, Community becoming part of their program Outreach IV.B.3.b Postcard sized self-assessments in Jean Hardy 11/15/98 Bruce Handley, Community brochure rack of CARE Van [7] Outreach Sec. V Action Primary Date Due Primary Support Responsibility V.B.1 Change Center name to Mission St. Jean Hardy 10/1/99 Bruce Mulkey Joseph’s Sleep Center Janet Moore, Marketing V.B.2 Plan and hold Open House Jean Hardy On hold Bruce Mulkey V.B.3 Schedule participation in radio and TV Jean Hardy 1/15/99 Bruce Mulkey programs, write scripts [4] Rod Whiting, Marketing V.B.4 Invite Citizen-Times to write story about Jean Hardy On hold Bruce Mulkey pediatric patient. Later, write guest column Merrell Gregory, Marketing [3] V.B.5.a Develop list of area media Jean Hardy On hold Bruce Mulkey Merrell Gregory, Marketing V.B.5.b Send news releases re Open House and Jean Hardy On hold Bruce Mulkey other Center and sleep disorder news Merrell Gregory, Marketing Sleep CenterMarketing Plan Page 22 of 23 Prepared by Bruce Mulkey 08/03/98
  • 23. Sleep Center Marketing Action Plan (cont.) Sec. V Action Primary Date Due Primary Support Responsibility V.B.5.c Send upcoming events info to Community Susan DuRant Monthly beg. 8/14/98 N.A. Calendars V.B.6 Display ad, listings in Yellow Pages [6] Jean Hardy 3/1/99 Bruce Mulkey Rod Whiting, Marketing V.B.7 Write articles for Health Words for Women Jean Hardy On hold Bruce Mulkey Harley Dartt, Marketing V.B.8 See III.B.4 Also list upcoming events in Jean Hardy 11/15/98 Carole Donnelly, SCOPE SCOPE Editor V.B.9 Update Health Connection Jean Hardy Qtrly. Beg. 11/15/98 Barbara Moore, Health Connection V.B.10 Develop tracking system Jean Hardy 1/1/99 Computer Services V.B.11 Develop patient education video [8] Jean Hardy 1/15/99 Bruce Mulkey Ernest Williamson, Sleep Sciences Sleep CenterMarketing Plan Page 23 of 23 Prepared by Bruce Mulkey 08/03/98