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A Full Service Branding and Digital Agency | Lewis

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Is America heading for a recession? The answer depends on who you ask, but for us, the answer leans quite heavily toward a “yes.” Why? Because if every chief marketing officer put together a top-five list of concerns, “recession” would be on many of those lists right now.

For many of our clients, tariffs and trade wars loom large. If their product inventory and sales margins aren’t directly impacted by rising import taxes, they’re anticipating the effects of consumer uncertainties and recession-like buying behaviors. If you pan out beyond what we’ve observed in our day-to-day interactions with clients and their company’s targeted consumers, general polling substantiates where the minds of many can be found: Four in 10 Americans say the U.S. is in a recession, [according to the latest Economist/YouGov Poll](https://thehill.com/business/5287616-us-recession-economy-trump-poll/).

And that ratio is enough to influence consumer trends in unwanted ways.

“I’ve been through two recessions here at Lewis and, now, possibly a third,” said Jennifer Carter, vice president of channel engagement. Carter, a comparatively young ad executive to have experienced three notable economic declines, weathered the housing market crash and subsequent Great Recession in 2008, the U.S. economy’s response to a global pandemic in 2020 and, finally, tariffs and trade wars in 2025.

Yet, as history affirms, three recessions in 17 years is actually right on time. In the era of modern capitalism, or roughly since World War II, significant declines in economic activity tend to occur every five to seven years. So for any company facing a market downturn, the cliche rings true: It’s not a matter of if, but when.

“With each of these experiences, you’re problem-solving around less-than-ideal economic trends, but you begin to recognize consistencies within the chaos,” said Carter.

She said the conversations and problems are varied, and each represents situations unique to specific market downturns and industries. But what Carter and her colleagues have observed over and over again is how often there are common through lines across every industry and every economic downturn.

“It becomes easier to anticipate the resulting problems of an economic downturn and quickly identify where the opportunities are going to be,” she said.

And there will be opportunities. If we accept the inevitability of the economy’s boom and bust cycles, we can also be galvanized by its promises:

- Each phase of any cycle is not infinite.
- Cyclical behavior assures that what swings downward will soon swing upward again.
- Economic valleys really do signal opportunity in ways that have been proven in both distant and recent history.

Anticipation and Healthy Partnership Are Gateways to Opportunity in a Downturn

True partnership between agency and client becomes paramount in any downturn. Without the residual upside of seamless collaboration, it’s more difficult to anticipate what’s to come and have the conviction to prepare for what’s not yet present.

“The 2020 recession wasn’t just a hardship to overcome — it was an opportunity for prepared partners,” said Jennifer Dira, vice president of account services at Lewis. Dira experienced firsthand what partnership and preparedness did for a leading homeschool curriculum provider and longtime Lewis client. “We didn’t respond to market changes, we’d already anticipated them. Our research had essentially built a roadmap to the very audience that suddenly emerged during the pandemic."

Dira said the pandemic didn’t change Lewis’ strategy, it validated it.

“While other agencies were scrambling to understand the new normal, we were executing on insights we’d gathered over the years leading up to the pandemic,” she said. “For me, that moment defined the difference between reactive marketing and strategic partnership. And it really cemented my convictions about what’s truly possible in a downturn.”

In an environment where competitors in the homeschool space saw sales dip, Lewis’ client experienced a 158% revenue growth.

“The ROI we delivered during the COVID-19 recession wasn't accidental— it was the culmination of years of audience intelligence that positioned our client perfectly for the sudden surge in homeschooling demand. That's not marketing magic, that’s strategic foresight in action,” Dira said.

What to Expect: Reasons for Brands to Avoid “Hunkering Down” During a Recession

Cutting spending and making decisions based on fear or panic, erodes equity. Conversely, opting to stay the course or innovate during these lean periods will keep brands visible and, when aggressive, brands can even gain some ground.

A few reasons why that’s possible:

**> Consumers shift behaviors, not values.**

Core motives remain, even in a downturn. The opportunity remains too, as long as a brand can proactively adjust channel strategy and customer experience to meet shifting behaviors and resulting needs.

**> High-end shoppers “move down the ladder” in search of value.**

Economic downturns can open a line of communication to a consumer group that’s searching for value, making more affluent audience segments potential targets. In the same way, if your brand traditionally caters to affluent customers, you may repurpose messaging for certain products or services to capture less affluent segments during times of economic hardships.

**> Share of voice (SOV) becomes share of market (SOM).**

SOV doesn’t directly result in SOM, but in a downturn, the opportunity to gain SOM ground improves. By keeping or increasing pre-downturn spending, valuable ground weaker rivals have given up can be captured.

**> Competition for attention drops as brands go dark.**

History tells us brands will inevitably go dark, and pause or cut back their marketing spend. Suddenly, the playing field is less crowded, audiences have less information to consume and brands have a greater chance to stand out and make a lasting impression.

During the 2008 recession, Lewis’ partnership with Tiffin Motorhomes helped the recreational vehicle manufacturer pick up SOM as struggling competitors cut back marketing spend.

“When the recession hit, many of Tiffin’s competitors had unsold inventory sitting on dealer lots that needed to be liquidated,” said Lewis Partner Val Holman. “While others went out of business, Tiffin maintained stability.”

Tiffin, on the other hand, was prepared for the inevitable boom and bust cycles of any capital market. Before the recession, they’d put themselves in a strong position by opting for a just-in-time approach to manufacturing, making it possible to manage the ebbs and flows of inventory demands. So when the economy came to a virtual halt in 2008, Tiffin had a clear advantage. They just needed the right message and strategic marketing plan to fully realize their recession-era opportunities, which Lewis was able to swiftly develop. Together, the two partners quickly met customer demand, ensured customer satisfaction, all while avoiding holding onto excessive inventory or being forced to liquidate.

“When we made it to the other side of the recession, we had gained market share from virtually all of the competition,” Holman said. “We were positioned better post recession than we had been going into it.”

Tiffin’s case illustrates both the value of anticipation and the positive gains made when a company continues to do business as usual, which includes maintaining consistent consumer messaging at a steady clip.

This spending approach in the face of a market downturn bears out in the data, too. According to the [Association of National Advertisers (ANA)](https://www.ana.net/miccontent/show/id/aa-2025-04-when-brands-go-dark?st3=250408mkg360ammsp&utm_source=informz&utm_medium=email&utm_campaign=250408-marketing360-am-msp&_zs=7JO9o1&_zl=dEd9A), consumers continue to spend during a recession, albeit at slightly reduced levels, while marketers tend to cut spend drastically. As a result, those brands that choose to stay the course benefit: 60% of advertisers have achieved higher ROI by spending more during past recessions.

Matching Consumer Mindsets to Product Groupings During a Market Downturn

A recent [Gallup poll](https://www.cbsnews.com/news/tariffs-trump-gallup-poll-inflation-prices/) found that nearly 90% of Americans expect tariffs to drive up prices this year, so there’s no longer any concern that candid messaging about tariffs will create unnecessary consumer fear and hesitation. Both are fully present and accounted for.

As such, a moment like this one gives brands a chance to meet consumers where they’re at and create a shared sense of identification with targeted groups. We recently developed a tariff-related social ad for LED Technologies, a light therapy skin care company and Lewis client. The message addressed tariffs directly, and used the economic downturn to share an opportunistic message to boost sales.

When developing timely messages like this one in a down market, brands can expect to encounter one of four mindsets:

**Slam-on-the-brakes:** This customer segment is highly anxious and typically looking to cut everything.

**Pained-but-patient:** A group defined by a cautious mindset, this segment tends to take a wait-it-out approach.

**Comfortably well-off:** An economic downturn may make this group more selective, but they’re still spending.

**Live-for-today:** They’re motivated by experiences, and they’ll carry on largely unaffected.

In the same way customer segments can be defined in unique ways based on the effects of a down market, products can be redefined and grouped based on how each is impacted by these short-term customer mindsets.

Here are four recession-era product categories:

**Essentials:** Products considered essential to survival and well-being.

**Treats:** Small indulgences worth justifying, despite how dire things feel.

**Postponables:** Items that are wanted, but can wait.

**Expendables:** Luxury items that are no longer justifiable.

In 2009, these consumer mindsets and product groups were featured in a lengthy [academic article](https://hbr.org/2009/04/how-to-market-in-a-downturn-2) published by the Harvard Business Review and written by Harvard Business School professor Dr. John Quelch and marketing researcher and writer Katherine E. Jocz. Their work demonstrates how each mindset will likely behave based on each product group, charting the correlation between behavior changes and “risk of sales downturn.”

Of the four product groups, those items that fall into “postponables” and “expendables” will be the items presenting the toughest sales challenges in a down market. They’re also the areas where nimble marketing can make the most impactful differences.

For “postponables,” a brand can work with its marketing partners to answer questions like these:

- How can you reframe certain products as cost-effective replacements to more luxurious and expensive competitors?
- Identify emotional ROI for products falling into the postponable category, and consider how each of these products improve wellbeing during difficult times?
- Determine feasible ways to offer customer flexibility — should your company introduce payment plans, risk-fee trials with low upfront costs or similar tools to improve flexible options for struggling customers?

For “expendables,” consider the following:
- How can you create urgency by giving customers a limited-time justification to buy, perhaps through promotions or seasonality?
- Nurture brand affinity by exploring ways to stay top of mind, even if a customer segment isn’t buying in the downturn. Can you find ways to leverage marketing, free resources or community-building content?

Final Thoughts

Recessions and economic downturns are great teachers. Above all, they demonstrate their lack of staying power. In the same way hard times don’t last, nor do the shifting cycles of a free market.

So here’s the thing: Shifty markets are best managed by shifty brands. How do you harness a nimble, shifty approach? First, it starts with a strong partnership. When there’s seamless collaboration between agency and client, it’s most often a consequence of communication and trust. And finally, when all stakeholders are pulling from the same rope, anticipation and preparedness — two essentials for finding opportunity in a downturn — come easy.

All these things set a company up to succeed in difficult markets. Successful brands can quickly shift messaging, recast a product or service to match changing consumer needs and effectively reintroduce themselves in light of buyer behaviors fueled by economic fears and uncertainties.

Quite frankly, in times of turmoil, you need a marketing mentality that’s not afraid to “MacGyver it.” After all, finding opportunity in an economic downturn is nothing more than fashioning timely solutions from what you already have on hand. It’s the sort of nimble ingenuity that delivers no matter the market — boom or bust.

_**Share of Voice**: A marketing metric that allows a company to compare brand awareness on different marketing channels against competitors._

_Share of Voice is a metric that comes up big when a company is measuring its impact during a market downtown. While it’s always important, gaining Share of Voice in a sluggish economy or recession can translate to picking up Share of Market, but doing it better and bigger than in times of economic stability. In a recession, Share of Voice becomes a company’s guiding light. When companies commit to grabbing Share of Voice through marketing spend, they’ll ensure they’re holding the line — no ground is lost. But there’s another factor too: History and common recession patterns over time teach us that companies will cut marketing dollars during a downturn, leaving a vacuum for bullish companies to fill. Share of Voice becomes easier to grab, while Share of Market is in play as well, but at a greater clip. As competitors hunker down and prepare to ride it out with a quiet approach, a vacated landscape is there for the taking. Our advice: Get loud!_

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How Brands Can Embrace Uncertainty, Create Opportunity in an Economic Downturn

**MOBILE, Ala. (April 23, 2025)** — Lewis, an independent, integrated creative and media agency founded in Mobile in 1951, is proud to announce its relocation from its 37-year home on Government Street to a beautifully renovated building in the heart of Mobile’s business district.

“Lewis has grown into an internationally-acclaimed company with three offices across the South thanks to our beginnings in Mobile,” said Ellen Faulkner, Lewis’ CEO.

“We wanted to be sure our presence in our hometown is as innovative and vibrant as our company is today. Our goal was to create an environment for putting fresh thinking into action; a space for the biggest ideas Alabama has ever seen.”

“By planting our roots downtown, we’re investing in the future of Mobile. We want to be where innovation happens, where stories are shared and where community thrives. Downtown gives us that energy and opportunity.”

The move to 500 St. Louis Street marks a new chapter of growth for Lewis and the company’s commitment to economic development of the city. From purchase, to demolition, to renovation, Lewis has invested $7 million to bring their new office to life and has set an example for how other businesses can invest in Mobile’s economic future.

“When Lewis started the search years ago we knew that we wanted to be in the downtown Mobile area, and we particularly liked the vibe and excitement that was just beginning on St. Louis Street,” said Lewis Chairman Larry Norris. “We are delighted to be in the historic Automobile Alley District and are excited for the infrastructure upgrades and other investments and improvements coming here.”

The new office is designed to foster creativity and cross-functional teamwork and features open workspaces, stadium seating, a gym and a rooftop patio. It’s a complete overhaul of the former space, which Lewis first toured in 2018.

“In spite of the dark, dated interior with not a single window, we loved the potential — tall wooden ceilings with skylights, beams and the original (but covered-over) clerestory windows. And, secure, onsite parking for all our staff members,” said Norris, who previously oversaw renovations of Lewis’ offices in Birmingham (2015) and Nashville (2019).

Lewis worked with Jared Fulton of Chambless King Architects to design and restore the St. Louis Street property and OEC Workplace Solutions to furnish it.

The Mobile Chamber of Commerce celebrated the new office with a public Ribbon Cutting at the building on April 23, 2025. A private Open House is set for May.

**About Lewis:** Lewis is an award-winning, full-service marketing agency that delivers business growth at pivotal moments for companies. With over 70 years of experience and offices in Mobile, Birmingham, and Nashville, Lewis develops internationally acclaimed branding and creative advertising campaigns, based on our own business intelligence and data science, to deliver provable results with measurable ROI.

Open-concept meeting space with stadium seating and modern kitchen

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Lewis Creative Agency Relocates to St. Louis Street

Artificial Intelligence (AI) is both an emerging innovation of the future and an effective tool of the here and now. Already, this technology is making a measurable difference on how work is done in almost every industry. For our creative professionals here at Lewis, it’s a new frontier.

While there’s much to be learned, we’re [using AI and its relevant platforms](https://lewis-corp-nextjs-frontend.onrender.com/post/ai-is-already-a-part-of-the-marketing-industry-but-how-exactly-are-agencies-like-lewis-using-it) to heighten control of creative outcomes and improve our workflows, speed, vision and possibilities. To that end, Lewis recently hosted an AI workshop. The hands-on training event, _Hacking Visual Content Creation with AI_, was led by AI expert Rory Flynn and included creative teams from our three offices in Nashville, Tenn., Mobile, Ala., and Birmingham, Ala., where the event was hosted.

Flynn, founder of Systematiq AI, is a leading figure in AI training for creative teams. He’s known for his work in helping companies operationalize AI tools and improve creative quality and output. Considered a leading voice in AI-powered content creation, his expertise lies in injecting AI into workflows to amplify productivity.

“Having someone like Rory who is literally building his business around AI tools like Midjourney and Runway gives our team the opportunity to see how this technology is being leveraged,” said Robert Froedge, Executive Vice President at Lewis. “Our team was able to focus on practical skills for integrating generative AI into daily workflows and expand what’s possible for our clients.”

Hands-On Learning: An Investment in Our Team

Throughout the workshop, our creative team engaged in lengthy Q&As and interactive exercises. The sessions helped bridge the gap between traditional design processes and AI-driven innovations.

“The workshop helped give me a better background on how the AI platforms actually work,” said Jason Headrick, Associate Creative Director in Lewis’ Birmingham office. “This, along with building prompt structures and thinking through the workflow process, will help generate better results.”

Headrick said he expects these AI tools to aid his work in various ways throughout the creative process. In the early stages of a project, AI can quickly provide better keyframes for storyboards or comp images for layouts that create the tone and look he’s working to convey.

Topics covered included:

- **AI-Powered Image Generation** – Exploring tools like Midjourney, Runway and Krea to create striking visuals from well-crafted and expansive text prompts.
- **Enhancing Workflow Efficiency** – Utilizing AI tools to accelerate ideation, automate repetitive design tasks and streamline production timelines.
- **Personalizing Content at Scale** – Examining how AI can help tailor visual content for diverse audiences while maintaining brand consistency.
- **Ethical Considerations and Best Practices** – Discussing the responsible use of AI in creative industries and ensuring that human creativity remains at the center of storytelling.

“We use a lot of AI tools out there, and much of it is now built into our production software,” said Lee Little, a Lewis Senior Graphic Artist in Birmingham. “Our advanced users have made a focused effort into these new platforms and technologies, and to hear their questions during the workshop brought a great deal of insight. Dialogue with Rory also helped demystify the art of writing an AI prompt to efficiently get the search results we’re looking for.”

One of the biggest takeaways from Hacking Visual Content Creation with AI was seeing how AI can be used in relatable, day-to-day workplace situations. By seeing how AI solves common problems in the creative process, you begin to understand what’s possible.

“Everybody is talking about AI,” said Pablo Riquelme, UX/UI Designer in our Nashville office. “So, OK, I want to use it. But it’s an entirely new way of approaching your work and workflow. Then, we do this workshop and it’s like, ‘Oh yeah, I can see what’s possible and how to harness it.’”

AI as a Creative Partner

When it comes to integrating AI into our work, we’re aiming for balance and a useful mix of emerging technologies and human creativity. For instance, AI-generated images can serve as a springboard for designers, automating the base level work and providing inspiration that can be refined and personalized by creative minds. While AI-driven automation can handle mundane tasks, our creative teams are freed to focus on high-level conceptual thinking.

“At one point, Rory spoke of the excess of time spent by art directors and designers looking for existing stock to match an idea you have in your head and how significant editing may still have to be done to somewhat match your original vision,” said Audrey Mecke, a designer in Lewis’ Mobile office. “I’m excited to use AI to curate that vision from scratch.”

The Hacking Visual Content Creation with AI workshop was just the beginning. As we continue to explore AI’s potential, we’ll seek out new tools, refine our processes and identify opportunities to integrate AI-driven solutions into our client work.

Final Thoughts: Team Chemistry

While investing in our creative teams and their continued education was key, there was also the secondary goal of bringing coworkers together across offices. Teams from Mobile, Birmingham and Nashville were able to share lunch and dinner together, before an evening out at Topgolf.

“I loved that we all blended together to make cross-office Topgolf teams,” said Mecke.

In team sports, it’s not uncommon for players and coaches to tout the intangible benefits of team chemistry and rapport among team members. These traits are equally important in professional offices like ours, impacting job satisfaction and, as a result, performance.

“It’s great when you have a chance to spend time with coworkers outside of the office,” said Riquelme. “You get to know the people you work with. And, honestly, it’s awesome. We all have a lot in common because of the shared work we do, and the shared interests that brought us into this type of work in the first place.”

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Lewis Creative Teams Attend AI Workshop on Visual Content Creation and Innovation

Being a challenger isn’t about the size of your budget. It’s about the size of your ambition and the cleverness of your strategies.

The Challenger Brand Ethos

Challenger brands lack the advantage of vast resources or market dominance – they’re the underdogs of the industry. But what they lack in strength, they make up for in agility and innovation. These brands compete by challenging the status quo, disrupting their markets, and looking for angles to outsmart rather than outspend their competitors.

Brand Evaluation Metrics: Quality, Selectability, Resources, and Differentiation

To navigate this challenge, it’s crucial to step back and evaluate your brand from multiple angles. This isn’t just about how your brand is perceived, but also understanding your capabilities.
<ul><li dir="ltr">How does your product or service quality measure up against competitors?</li><li dir="ltr">Are you easy for customers to select?</li><li dir="ltr">Do you have sufficient resources to meet marketing goals?</li><li dir="ltr">How distinctive is your brand positioning?</li></ul>

Approaches for Common Brand Challenges

Depending on where your gaps are, here are strategic pointers for each scenario:



If your product feels like it’s blending into the background, it’s time to spice things up. Advocate for enhancing the quality of your organization’s products or services. This might mean investing in better materials, technology, staff, or highlighting the unique aspects of a product or service that are not well-associated with your brand today.

Make it easier for customers to choose your brand by enhancing your visibility. Improve your online presence, optimize your SEO strategies, and ensure your unique selling propositions (USPs) are front and center where your potential customers are looking.
If selectability varies across your organization, take the lead in developing collaborations across your organization to gather data that points to areas that already have access and those that aren’t ready to convert leads.

If you’re operating with a lean team or low budget, focus your efforts on high-impact marketing activities. Re-prioritize and automate tools to handle repetitive tasks where possible, so your team can focus on the efforts that have the biggest impact on reaching your organization’s goals.

We often hear marketing leaders struggle to identify the value of investing in branding. 
<ul><li dir="ltr">Use large data analysis that spans industries to point to the value of investing in brand-building:<ul><li dir="ltr"><a href="https://indd.adobe.com/view/b6033624-f784-4869-a0eb-6b6e14fcb43c" target="_blank" rel="noreferrer noopener">Kantar’s analysis</a> of 170,000 consumers across 17 years of corporate financial and quantitative research has found strong brands not only have higher market shares but they also recover from market fluctuations more quickly. </li><li dir="ltr"><a href="https://www.nielsen.com/wp-content/uploads/sites/2/2024/04/2024-Nielsen-Annual-Marketing-Report.pdf" target="_blank" rel="noreferrer noopener">Neilsen analysis</a> found that a 1-point gain in brand metrics, such as awareness and consideration, drives a 1% increase in sales. In contrast, a brand loses an average of 2% of future revenue for every quarter it stops advertising.</li><li dir="ltr">Peter Field and Les Binet’s analysis published in The Long and Short of It reviewed more than 700 brands in more than 100 profit and non-profit categories and found brand campaigns support market share growth more strongly over the short and long term than direct response campaigns.</li></ul></li><li dir="ltr">Forge relationships with your finance, sales, and operations teams to identify key performance indicators (KPIs) to evaluate together, such as:<ul><li dir="ltr">Immediate impact KPIs<ul><li dir="ltr">Brand interest</li><li dir="ltr">Lead volume</li><li dir="ltr">Quality of leads</li></ul></li><li dir="ltr">Long-term impact KPIs<ul><li dir="ltr">Perception of brand </li><li dir="ltr">Perception rank</li><li dir="ltr">Willingness to use</li><li dir="ltr">Key business metrics, such as sales and market share growth</li></ul></li></ul></li></ul>

A brand that’s distinctive drives recall when someone is ready to look for your products or services. Distinction is best achieved by both aligning with your target audience’s values and presenting your brand in a way that’s not easily confused for your competitors. 
Many brands struggle not only with how to present their brand, but also what to say. We have found staff and customer interviews, as well as focus group research, to be an effective way to inform how to distinctly speak about your organization to your target audiences.
But it’s not only important to select what to say. It’s incredibly important how you say it. High-quality creative can be a powerful element to set your brand apart from competitors.
<a href="https://indd.adobe.com/view/b6033624-f784-4869-a0eb-6b6e14fcb43c" target="_blank" rel="noreferrer noopener">Kantar analysis</a> found brand distinction was the biggest factor common among the world’s leading brands.

WRAP UP

Embracing your status as a challenger means adopting a mindset where challenges are reframed as opportunities. Focus on what will move the needle for your brand, say no to everything else, and prepare to disrupt the status quo. 
If you have questions or need guidance in navigating your market, Lewis would be happy to assist. Reach out to <a href="mailto:hello@lewiscommunications.com">hello@lewiscommunications.com</a> to set up a free initial consultation call.

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Navigating the Waters as a Challenger Brand: A Marketing Specialist’s Guide

Artificial Intelligence (AI) is not just a buzzword in healthcare anymore; it's a tool that’s rapidly reshaping the industry's landscape. From content creation to personalized patient experiences, AI technology is creating new opportunities for healthcare marketers and practitioners alike. So what does that mean for your organization?

The Lewis team recently attended the Healthcare Marketing and Physician Strategies Summit hosted by the Forum for Healthcare Strategists—an event where industry leaders gathered to discuss the power and potential of AI. Here are a few of our key takeaways:

AI Applications in Healthcare Marketing:

According to a survey of attendees, most healthcare marketers currently use AI for content creation (referred to widely as Generative AI). However, everyone agrees that the tool’s potential extends far beyond that, encompassing customer segmentation, predictive analytics, and much more.

Despite its widespread adoption, AI governance remains very much a mixed bag. As Carlton Wood, Lewis EVP and Partner, points out: “Some organizations employ detailed plans and staff, while others still lack a structured approach. We’re still in a relatively new phase of this era.”

Generative AI: open vs. closed networks

Currently, healthcare networks are using either open or closed networks for their Generative AI purposes—and there are benefits and drawbacks to both.

Closed networks allow information to be put into the system from multiple sources, but put up a firewall to keep the information from going back out to the open web. These networks make it easier to maintain data security and compliance, but they also negatively impact transparency and innovation.

Open AI networks, on the other hand, enable data to flow between and among multiple networks, platforms and geographical locations. And while these networks allow for higher transparency and data growth, they also present serious security and quality challenges.

Jennifer Carter, VP Channel Engagement at Lewis, has a word of caution about the latter. “The main challenge with open generative AI is that a company’s intellectual property is at stake. Are you willing to share that information with everyone?”

The Lewis team recommendation is that most healthcare networks are better off using closed networks and stay compliant with regulations.

AI in Healthcare Operations:

In the operations arena, AI offers a huge capacity to automate, assist, and augment human work. Many healthcare systems use the tool to optimize data analysis, consumer experience and even live agent assistance. Everyone agrees, however, on the importance of partnering with reputable vendors and data security.

A few conference speakers championed a more cautious approach to AI adoption, with some blocking platforms like ChatGPT to safeguard proprietary information and others even developing their own encrypted chatbot for internal use.

The New Era of Search

AI is also transforming search experiences, with conversational chatbot searches gaining traction over traditional Google searches. Content strategies need to adapt to embrace long-tail keywords, address local voice queries, and optimize for featured snippets.

Our Thoughts

There’s no doubt AI is revolutionizing healthcare marketing and operations, offering unprecedented opportunities for efficiency, personalization, and innovation. However, navigating the AI landscape requires careful consideration of ethical, privacy, and security concerns alongside strategic implementation and collaboration across all levels of healthcare organizations. As the industry continues to evolve, embracing AI will be essential for staying competitive and delivering exceptional care to patients worldwide.

Read on to see [how we’ve begun leveraging AI at Lewis.](https://lewis-corp-nextjs-frontend.onrender.com/blog/ai-is-already-a-part-of-the-marketing-industry-but-how-exactly-are-agencies-like-lewis-using-it)

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Navigating the AI Landscape in Healthcare Marketing: Key Insights from HMPS 2024

Bring up AI in a casual conversation and you will likely trigger a passionate discussion or even a heated argument. (And that’s _before_ the subject of machines taking over the world even comes up). Let’s face it: good, bad or ugly—everyone has an opinion on AI these days and the subject is only about to get more complicated as time marches on.

This is especially true of the marketing industry. With the use of AI technology increasing with each passing day, many of our business partners are beginning to ask some important questions. How is AI being used at your agency? Which departments are most frequently using it? More importantly, exactly how effective is it?

A growing partnership

True to our innovative spirit, the Lewis team has been exploring the possibilities of AI technology since it first became widely available. In fact, many of our team members are already using AI tools such as ChatGPT, Jasper, and MidJourney on a regular basis. From marketing research and copywriting to image creation and even basic coding, our associates increasingly tap into the ever-evolving AI resources to help them solve some of their daily challenges.

There’s a “but”…

Of course, the extent to which they use it, and the results they get, can vary widely from case to case—and a lot of it has to do with AI’s relative newness. As is the case with any nascent technology, there are many limitations to what AI can currently accomplish. So no: there is no magic button you can press that will generate the work for you—at least not as of today. But we’re happy to report that AI does come in handy in a number of different ways.

How AI works for us

Most of our team members view AI as a useful thought-starter tool or a broad idea generator—and it’s a notion that holds true across multiple different departments.

“AI might provide that initial spark or impulse when you’re feeling stuck on a project,” says Tom Johnson, VP Integrated Creative Director. “It could even help you look at something from a slightly different angle.”

Struggling with Javascript? ChatGPT can help you generate some code—though it might need a few passes for the results to become usable. Need some new ideas for a product name? Jasper might come up with one or two off-kilter choices you might not be inclined to think of. Not sure about the syntax in the email you’re writing? Grammarly’s integrated AI feature can assist you with that.


Just don’t ask for too much

The key is knowing how to work around the technology’s current limitations. For example, while many members of the Lewis creative department use various AI programs to help them create images for storyboards, the results are often erratic and lacking in crucial details. And when one of our copywriters recently asked ChatGPT to create some TV scripts for him… well, let’s just say the results were unusable—not to mention unintentionally comical.

Not going anywhere anytime soon

One way or another, AI is here to stay. But using it to its fullest potential still requires human creative input and supervision, at least for the foreseeable future.

Looking forward, another intriguing question presents itself, quite similar to the one the marketing industry faced when computers began popping up on our desks: now that everyone has access to a potent new tool, how do you use it to take your work to a new level of creativity—and do so in a way that makes you stand out among your competitors?

Curious about how Lewis can help your business navigate challenges in the age of AI? Drop us a line at [hello@lewiscommunications.com](mailto:hello@lewiscommunications.com).

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AI is already a part of the marketing industry. But how exactly are agencies like Lewis using it?

The past few months have seen significant changes in the weight loss industry. So how does this impact healthcare providers serving patients interested in losing weight?
Interest in drugs like Ozempic, Wegovy, Semaglutide, Tirzepatide and Saxenda for weight loss has surged. What’s more, these drugs have received heavy media coverage over the past year—so much so that the supply has been strained for diabetes patients who rely on them.
Google search volume has risen over the past six months for all of these drugs. Particularly for Ozempic, starting when the topic hit the news cycle earlier this year.

But it doesn’t stop there. Telehealth solutions have also become big business in this space, including well-known consumer brands. Weight Watchers recently purchased Ozempic provider Sequence, while Noom announced their own telehealth program, Noom Clinical. 
A bariatric service line often serves as a dependable financial stream, with treatments averaging around $10k per procedure. But the rise of weight loss drugs could change that.

Weight loss drugs can be seen in two ways:

(1) An alternative to surgery — weight loss can be up to 22% with these drugs, compared with weight loss surgeries which can reduce body weight between 15-29%.
(2) A compliment to weight loss surgery - aka, “combination therapy”. Most modern weight loss programs today recognize there isn’t a one-size fits all approach — weight loss drugs aren’t always in direct competition to bariatric surgery. They might be an option for one patient, or part of a combination approach for another. People are looking for providers who’ll evaluate all therapies, then recommend the best solution for their situation.

An overview of the weight loss audience:

<ul><li>Patients engaging providers for weight loss help range from ages 18 to 70+, but typically skew towards females 40 to 54 — a patient base that influences all of their family’s healthcare decisions. </li></ul>
<ul><li>Patients dealing with multiple conditions — diabetes, heart disease, obesity and more.</li></ul>

Marketing and communications: 4 strategies to address the changing weight loss conversation:

1. Speak to this topic to drive brand consideration

<ul><li>Share messaging with patients and consumers that demonstrate your cross-specialty care teams are ready to answer their questions.</li><li>Expand the impact of this messaging by placing it on your website and social channels, and boosting this content to expand its reach.</li><li>Customize a pitch to local news providers to increase earned reach.</li><li>Engage major payors and employers in your area, becoming their subject matter expert in navigating the risks and benefits to their employees.</li></ul>

2. Check the impact on your bariatric referral stream by examining:

<ul><li>Share of search for obesity drugs and weight loss in your area.</li><li>Shifts in click-through-rate month over month for bariatric service line paid search ads that use the term “surgery”.</li><li>Lead count trends for surgery-focused seminar and education guide registrations month over month.</li></ul>

3. Optimize patient communications and marketing campaigns

<ul><li>What are the top-converting keywords in your paid search buy? Is your content speaking to those?</li><li>Does your content answer the most common questions bariatric candidates have been asking in the past 3-6 months? I.e. insurance, weight loss shots, and more?</li><li>Does your content push one solution, or does it address what prospective patients are looking for: an appropriate, sustainable weight loss solution that’s cost-effective for them in the long-term?</li></ul>

4. Assemble your CSO, CMO, CFO, and COO to assess future opportunities with this patient base

<ul><li>Evaluate your system’s financial upside in the weight loss category for the year. Consider these factors: existing patient base propensity modeling, market shifts, channels available to reach audiences, your brand perception with this audience, the competitive landscape, shifts in the reimbursement landscape, existing referral streams, and referral leakage.</li></ul>

Questions? Looking for a deeper dive into this topic? Get in touch.

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4 strategies to protect your bariatric procedure revenue from the rise of weight loss drugs.

You’ve probably already heard the news: as of July 1, 2023, GA4 will become the only Google Analytics product available for website tracking.

The much-anticipated tool was primarily created for the future of GDPR-compliant measurement—effectively changing how data is collected, stored and moved. In addition, GA4 is also designed to track user activity across websites, apps and devices for clearer vision into how consumers engage with companies.
Whether you’re a marketer or a business executive, here’s what you need to keep in mind as you navigate the transition from Universal Analytics to GA4:

What You Should Know About GA4

<ul><li>Privacy - As consumer perception around privacy continues to evolve, GA4 will offer multiple elements directly addressing privacy concerns and regulations.<ul><li>The reliance on first and third party cookies will be reduced by discarding IP addresses and leveraging anonymized user data through signal detection and machine learning to predict future behavior.</li><li>User consent will be recognized under “Consent Mode” by dynamically adjusting tracking based on user requests and preferences.</li><li>GA4 will also offer flexibility in data retention. The new version will default to 2 months but can be adjusted for up to 14 months. Campaign measurement and attribution windows should be evaluated to select the most appropriate retention window.</li><li>For businesses that operate in geographies with strict privacy regulations, GA4 will have localized controls built-in to respect these varying regulations.</li></ul></li></ul>
<ul><li>Website and App Event-Based Model - The previous model used session-based data with varying website and app data sources. GA4 will track both website and app and uses an event-based model with deduplication allowing for a unified cross-device and cross-platform consumer journey view. GA4 will allow for a higher volume of events to be tracked allowing for more customized mapping throughout the consumer journey.<ul><li>Currently established conversions will not transfer and will need to be set up in GA4.</li></ul></li></ul>
<ul><li>Granular Measurement - GA4 has the capability to enable granular measures, such as time, to better understand the behaviors of website visitors (i.e. time taken from homepage visit to form submission).</li></ul>
<ul><li>Custom Audiences - Audiences created in GA4 can easily publish to other Google products, such as Google Ads.</li></ul>
<ul><li>Third-Party Tools (such as call tracking or form builders) - These may need to be updated by their parent companies to be compatible with GA4.</li></ul>
<ul><li>Previous Analytics Data and Data Retention - UA will stop collecting data 7/1/23, while GA360 will cease collecting data 10/1/23. Data from previous analytics tools can be exported.<ul><li>Based on these data changes, companies may want to consider utilization of a data warehouse.</li></ul></li></ul>
<ul><li>Google Product Connection - GA4 will not automatically connect to other Google products (Google Ads, Google Business Profile, etc.). To avoid tracking issues, GA4 should be linked to other Google products once ready to use GA4 full-time.</li></ul>

How GA4 Affects Healthcare Marketing

In addition to analytics advancements GA4 will offer, there are many privacy enhancements that support online privacy. GA4 will reduce the reliance on first and third party cookies by discarding IP addresses and leveraging anonymized user data through signal detection and machine learning. Google will also introduce Consent Mode as part of this transition, which respects user cookie consent decisions, and models and populates data accordingly. 
Though this change in Google Analytics is a significant step in the right direction, it’s also worth noting that Google currently will not sign a Business Associate Agreement (BAA). For full protection and HIPAA compliance related to data storage and transfer, healthcare organizations can also choose to take a more conservative approach by working with a third-party company under a BAA to de-identify data gathered through pixels prior to sending the data back to Google.
For more detail on how this affects the healthcare industry, see our blog <a href="https://lewis-corp-nextjs-frontend.onrender.com/blog/ga4-healthcare-industry-implications" target="_blank" rel="noreferrer noopener">here</a>.

How GA4 Affects Financial Marketing

Along with planning for external data storage, financial marketers should also ensure that their ability to filter out returning customers and their online banking activity from their data will not be impacted during the GA4 transition. GA4 offers a similar solution to UA through segmentation. A segment can filter a specific combination of event name and parameter values to exclude users who have triggered an event that is only accessible by existing customers, such as signing into an account. 
When analyzing site traffic, online banking actions (i.e. users checking their account balance) may still be configured to filter out certain URL values. Once configured, segments can be applied directly to outgoing data exports to ensure all data streams remain consistent. Segments may also be applied in numerous third-party visualization applications. This method allows for the flexibility to view the entirety of a data set while also quickly and accurately filtering down to potential new customers for marketing efforts.
For more detail on how this affects the financial industry, see our blog <a href="https://lewis-corp-nextjs-frontend.onrender.com/blog/ga4-financial-industry-implications" target="_blank" rel="noreferrer noopener">here</a>.
At Lewis, these new insights and applications for various industries are at the forefront of our planning and optimization efforts. GA4 is positioned to benefit companies and marketing performance, but transitions can be challenging. If you have questions or concerns related to GA4, feel free to contact us at <a href="mailto:measurement@lewiscommunications.com">measurement@lewiscommunications.com</a>.

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GA4: The New Google Analytics

In case you didn’t hear, back in December, The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a new <a href="https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html#ftn8" target="_blank" rel="noreferrer noopener">guidance bulletin</a> regarding the use of online tracking technologies by covered entities (health plan, health care provider or health care clearinghouse) and business associates under HIPAA. 
The guidance states some regulated entities could potentially be sharing sensitive information with online tracking technology vendors and such sharing could be unauthorized disclosures of PHI with such vendors.
Here are some steps you can take.

What are online tracking technologies?

Tracking technologies are often pieces of code on websites or apps that monitor users behavior as they interact with the website or app. This information is then collected and analyzed by the website owner and/or third parties to draw insights from user behaviors.

What’s considered PHI? 

Per the guidance bulletin, PHI would include “individually identifiable health information” (IIHI), such as an individual’s medical record number, home address, email address, or appointment dates, as well as an individual’s IP address or geolocation, medical device ID, or any unique online or mobile identifying code.

What’s covered under the new guidance bulletin?

<ul><li>User-authenticated webpages (i.e., when user login is necessary before the user can access the webpage): A covered entity must configure any user-authenticated webpages (i.e. those that utilize user logins) that include tracking technologies to allow such technologies to only use and disclose (and secure) PHI in compliance with HIPAA.</li></ul>
<ul><li>Unauthenticated webpages (i.e., publicly-available websites that do not require a user login to access the webpage): Tracking on these webpages is generally not regulated by HIPAA. In some cases, tracking technologies on such unauthenticated webpages may have access to user PHI and may disclose such data to outside vendors, thus triggering the HIPAA Rules.</li></ul>
<ul><li>Mobile apps: Information typed in by a user, as well as device level data (location, device ID or advertising ID) collected by a covered entity must comply with HIPAA for any PHI the mobile app uses or discloses. HIPAA rules do not apply to data that users voluntarily enter into “mobile apps that are not developed by or on behalf of regulated entities.”</li></ul>

Additional Compliance Reminders

<ul><li>All tracking technology vendors must sign a Business Associate Agreement (BAA) with the covered entity and have applicable permission to a disclosure of PHI.</li></ul>
<ul><li>Cookie-consent banners do not constitute a valid HIPAA authorization to a vendor when PHI is being collected, disclosed, used, or stored with the vendor.</li></ul>
<ul><li>It is insufficient for a technology vendor to agree to remove PHI from the information it receives or de-identify PHI before the vendor saves the information.</li></ul>

How to Achieve Marketing Success While Remaining HIPAA Compliant

As you and your partners work to drive targeted service line volume, you’ll want to re-think your digital tagging, tracking, and optimization strategies as well as processes surrounding audience modeling from patient data. 
Based on the recent litigation and emerging knowledge, we suggest a two-fold approach to protect patients–and yourselves. Many new companies and technologies are emerging, offering to replace or provide additional layers of protection within common analytics platforms like Google Analytics. As you evaluate what is right for you and your institution, we suggest two best practices.

Step 1: Create a method to ensure that you are not passing PII to Partners

For example, as it stands today Google’s definition of what is considered PII does not align with the new HIPAA bulletin. Without creating a layer of protection to remove person-centric details such as IP address, account IDs, birthdates, zip codes and medical record numbers, those could be inadvertently passed to Google through your data layer. This does not mean you need to remove your tracking technologies, nor does it mean you can’t collect information on web activity at the individual level. What it does mean is that you need a disruptor to ensure you have a user ID that is anonymized, and that you are blocking the submission of any of these elements being sent back to Google within your data layer. Make sure your marketing partner is able to help you do this through Google Tag Manager (or other mechanism) and that you review this together regularly.

Step 2: Control what you protect, share, and deidentify–without losing the power of individual behavior in your data

Measuring individual behavior is important for marketers to understand and to use to drive the most powerful insights, targeting and optimizations. Creating a mechanism to review and share data that your team needs, and your partners need, to make the most powerful decisions–while protecting user privacy–is critical in deriving the most value out of your consumer data strategy. 
Adopting the right data masking and encryption techniques will allow your internal teams, your marketing and agency partners, and your targeting partners access to the information they need to derive the most value from your marketing, patient, research, CRM and other data sources while offering the protection you need to ensure patient privacy is central to your decisions.
What are some other ways to plan ahead? 
Shorter opt-in windows, greater autonomy and individual privacy control are among the many reasons that health systems are investing in CRM systems that support an opt-in first model. 
<a href="https://cdn.lewiscommunications.com/uploads/general/Lewis_HIPAA_Preview.png">Download Now</a>
Many systems are now weighing the cost of CRM investment against the risk of a privacy violation and utilizing CRMs as part of their overall mitigation strategy. This patient-centric approach allows for more visibility for patients in what types of health-related information they prefer to receive from provider systems, while offering providers and systems more control and visibility into patient-level targeting strategies. 
One key benefit to consider when evaluating systems is integration with digital marketing platforms, visibility into online engagement, and real-time integration of opt-out signals for digital marketing across social channels. CRMs can create segmentation between communication-driven digital outreach that is not considered ‘marketing’, such as communication about products and services covered by a patient’s insurance. CRMs can also serve an important function in creating targeted audience outreach based on health behaviors that can serve as an ETL (Extract, Transfer, Load) solution to build campaign targeting in a secure method that ensures patient data is protected appropriately.

The Lewis Team is available to audit current practices and formulate recommendations for improvements, as well as implement best practices to ensure your patients and your institution remain in compliance with federal guidelines.

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Tangible Steps for Tackling the December 2022 HIPAA Bulletin

Did we just use the “R” word? The National Bureau of Economic Research isn’t yet ready to declare one, but there’s no doubt that both businesses and consumers have the possibility on their minds. 
Is that kind of anticipation changing consumer behavior? More importantly, should it be changing yours?
As a financial marketing professional, you are tasked with stretching every dollar of your marketing funds in the best of circumstances. At the cusp of a possible recession, the temptation is certainly there to pull back. But, our view is that it’s also the most powerful and cost-effective time to build a deeper relationship with your customer base. 
In the course of our own experience with financial institutions, we’ve identified three steps you can take to maximize the impact of your marketing dollar during uncertain times:

1. Make sure you’re talking to the right people.

Audience Intelligence can eliminate waste and focus your marketing dollars where they can do the most good. We offer our clients an array of proven tools they can use to systematize and optimize the impact of their marketing spend.
How well do you know your audience—today? Be sure you have an updated plan to study the demographic data in your specific market. How has it shifted in the past few years? Where are people living and working today? Have commuter and traffic patterns shifted as workers return to the office part-time, if at all? 
Develop a way to measure and quantify not just the demographics of your community, but the personality traits, beliefs, and fears of those engaging with your brand and website. 
There’s never been a more important time to truly understand—and measure—who you serve, holistically. Develop a measurement plan to reach those in your community with the greatest chance to choose you, and prioritize investing in helping them do so.

2. Develop messaging that can speak to more than one segment.

That kind of efficiency in your marketing spend can yield both short-term and long-term rewards. 
We helped one of our clients, a regional credit union, identify a <a href="https://www.lewiscommunications.com/work/humanize-the-brand-gain-market-share" target="_blank" rel="noreferrer noopener">messaging strategy</a> that proved to be deeply meaningful for both older customers and Gen Z, by focusing on their commonly held values and beliefs. 
When the credit union first came to us with their marketing challenge, the ask seemed contradictory. How could we grow traditional deposit investments and continue to reach an older core demographic, while also reaching new, young movers to the area that were arriving post-COVID and for the first time, developing their own financial identity?
Fortunately, we were able to dive into their data and leverage our deep understanding of the customer base. As a result our team was able to concept a campaign featuring these youthful consumers in scenarios that aligned with the values of the older audience. 
The result was a campaign featuring messaging that looked and felt “young,” while speaking to the key similarities in values between younger and older segments. This particular client was able to generate a 22% increase in web traffic for those interested in home purchase in key geographies, and a 117% increase in new deposit value (88% funded by new members).
How can you achieve the same sort of efficiencies for your financial institution? The answers lie in your customer data, and implementing the right tools to help you identify them. 
One of the things we offer our clients are tools that look closely at consumers’ financial behaviors, core beliefs, values and what keeps them up at night. Tracking and trending not just new customer data, but understanding how consumer beliefs are impacted by what is happening around them, can help you develop and curate your own regional identity that feels far less ‘corporate’ than big-box competitors. 
The kind of insights delivered by our tools in turn aid creative teams in developing the kind of powerful, memorable messaging that will resonate with your customer.

3. Be consistent with your efforts.

Turning off the faucet costs a lot more than you think. Because when your marketing efforts resume, you’ll be coming from even further behind and will have to expend more effort and money to return to your desired growth path. 
As tactics are turned on and off, consumers lose confidence that your brand can meet their needs, and they can become more confused in what differentiates you from your competitor. This, in turn, can lead to a slow deterioration of awareness and preference in your market, and can undercut your financial goals of building growth and trust.
In recessionary times, as consumers settle in for more “entrenched” strategies and become less trusting of new entrants into their market, there is substantial risk when your institution delivers an inconsistent brand message. 
Even with consistent product-level market investments, share of search (the bread and butter of new account creation) can continue to decline without a robust, consistent awareness effort, leading to a slow erosion of market position and again, requiring a greater investment to return to baseline levels.
It can be tempting to ‘declare victory’ after reaching a significant milestone or KPI—or to focus on specific promotional efforts that offer more of a quick ‘provable’ than a core brand identity. But there is a real cost to failing to invest in your brand over the long-term, especially in tough economic times. 
The wolf is at the door. No, actually, he’s in the App Store on your customer’s smartphone. The same disruptions that have faced other industries across the American economy are now facing financial markets, with new, digital-exclusive entrants competing for a share of your consumers’ minds and wallets. If there were ever a time for customers to understand your complete brand proposition, it is now.
Creating an on-off approach towards brand presence and identity has not just a cost in the hearts and minds of your community, but it portends a slower, more expensive ramp-up to re-entry.

Economic headwinds create challenges—but they also create opportunity.

A recession has a funny way of giving consumers a laser-focus on what’s truly important in their lives. Changing economic conditions offer new opportunities for you to reduce their worries, and introduce yourself to people who are suddenly thinking about financial situations in new ways.
They may look to increase savings goals, or might be moving to accommodate new jobs. What new services or programs could you offer to demonstrate that you are thinking about their needs?

What about YOUR concerns?

Economic downturns also place new pressure on financial institutions. Everyone in our industry is keeping the blood pressure medicine handy these days. Given the recent challenges presented from the <a href="https://www.wsj.com/articles/bank-collapse-crisis-timeline-724f6458?gclid=CjwKCAjwrdmhBhBBEiwA4Hx5gzzogfmegXW_oGXfpAEdmkoU7MtN1RCRxzS5qhA9l23dHPhYy0SmIxoCGgQQAvD_BwE&amp;mod=&amp;psid=WSJ_DSA_GOO_ACQ_NA&amp;gclsrc=aw.ds&amp;ef_id=X9K1UgAAAISPJ1LS:20230412225008:s" target="_blank" rel="noreferrer noopener">Silicon Valley Bank collapse</a>, investor pressures, and accountability for growth and marketing investment, financial institutions are hardly immune to concerns about economic downturns. 
It can sometimes feel that these pressures are at cross-purposes—how do you manage to meet consumer demand and ease the financial burdens of your customer base, while intelligently facing your own institution’s challenges? 
As costs to acquire new customers rise along with interest rates, brands that can establish a clear position on who they serve, develop efficient messaging strategies and measure their effectiveness, and can measure the value of their brand investment will be well-positioned to build confidence—and gain market share—in their communities during this period of economic uncertainty.
This article was published in the Summer 2023 issue of <a href="https://thefinancialbrand.com/" target="_blank" rel="noreferrer noopener">The Financial Brand</a>'s digital magazine, <a href="https://magazine.tfbinsights.com/view/12598618/82-83/" target="_blank" rel="noreferrer noopener">INSIGHTS</a>.