The Art of the Content Audit

Originally published on Pulse, University of Utah Health’s intranet, June 12, 2017, this is a case study about a content audit for the Women’s Health Services website at University of Utah Health.

Content, if you haven’t noticed, is a complex beast. For example, we spend a lot of time focusing on good content, what it is, where we get it from, and how we deploy it. But we spend less time than we ought on considering the outcome we want from the content we curate and post.

A content audit is a tool that allows us to review the content we have and take its pulse. It’s a great benchmarking tool with which to craft and test which content pieces are performing the best and where there might be gaps in the content. If there is important content missing that would benefit our users, a content audit is likely to reveal this.

Goals​

For our content audits [at University of Utah Health], we have identified these specific goals:

  • Reduce number of website pages with thin or low-performing content
  • Combine pages with thin content OR flesh these pages out, depending on website goals
  • Archive pages that are out of date, no longer applicable, or very low performing
  • Identify areas where we might want to add content

Where to Start

An audit can be as in depth or concise as the site necessitates. You can also tailor the information you collect in the audit to fit your overall site goals. The typical content audit might include these items:

  • Analytics
    • Page views
    • Time on page
    • Bounce Rate
  • SEO factors
    • Meta title & length
    • Meta description & length
    • H1 heading
    • H2 heading
    • Subtitles: additional use?
    • Word count
  • Content type (video, form, text, etc.)
  • Contact information
  • Images
    • Type of image
    • Image alt text
  • Affiliated documents
  • Duplicate content
  • Last modified

We determined to add in these additional audit points as particularly applicable to our patient-facing sites:

  • Call to action
  • Referring physician link included?
  • Specialist list included?
  • Related MBM specialty?
  • Affiliated service line
  • Affiliated marketing campaign
  • Affiliated research or other programs
  • Any additional content
    • Patient experience story included?
    • Health Feed/Scope inclusion? [U of U Health blog and podcast respectively]
    • Related tags to Health Feed/Scope
    • Clinical trials inclusion?
    • Patient education?
    • Vendor library content included?

Once you have outlined what you would like to inventory, you can begin to collect the data.* Take a look at the content inventory for our women’s health services website:

Redacted content audit women's health
What the full content audit looks like for women’s health services; please forgive the omission of analytics data!

Now that we’ve inventoried the content (rather exhaustively), we can examine how each piece is performing and make some assumptions as to whether the page should be kept, revised, or removed.

Example: Content About Midwives

Previously, we had two website pages about midwives on our women’s health services site.​ The page /what-is-a-certified-nurse-midwife.php receives far fewer page views than the /midwives.php page. However, this is not necessarily a bad thing, particularly as the time on page is over 1 minute. That’s a lot of time in our virtual ‘verse. So the content is important to those who are looking at it, even though the page doesn’t receive a lot of traffic.

In this case rather than get rid of the content, we are going to optimize it by moving it onto a page with more visibility, in this case /midwives.php. This should increase the main midwife page’s value while indicating to Google that we have both updated our site and checked our content for accuracy. (When search engines crawl websites they look for a number of factors that might tell the importance of the webpage. One of these factors is the date the page was last modified.)​

Webpage featuring content about midwifery (or midwives) on University of Utah Health’s women’s services website

The sticky navigation (a navigation bar stays with you as you scroll down the page) allows readers to access all the content about midwives and our services without leaving this page for another. Thus we’ve consolidated a low-performing, but important, page into the content with which it fits, letting the search engine know that we’ve updated the content by modifying the page, while keeping content that is clearly valuable for our readers.

End Objective: Increase Quality of Page Visits

This is just one page treatment out of many options that we might use when it comes to structuring content. All of the content audit goals lead to the most important objective of our content strategy: increase not just traffic to the website, but the quality of the traffic; namely, we want this content to show up for the right people at the right time in the right place.

Where Do We Go Next?

What happens after an audit? We look at the recommendations we’ve made after reviewing each page and determine who is responsible for whatever action needs to be taken. We also track the progress of the content updates.​

Ideally, we apply this process to all our websites on a regular basis, ensuring that our content remains up to date and within best practices.

And that, my friends, is the short of it (the long is all wrapped up in all that data and detail gathering). In the next few months, we’ll keep checking in on this content to see how the website data analytics change (usually we must allow about six months to get a relatively accurate picture of how the content is performing—performance has leveled out by then after the significant changes have been made to the site by then).

*I’m afraid I’ve had to redact the data here; I’m sure you understand!.

The Business Proposition: Keeping the Bird’s Eye View

Healthcare’s Miserable Business Model

Any of you familiar with The Innovator’s Prescription by Clayton Christensen? It’s a book that nails healthcare’s major problems right where it hurts (I leave the anatomical reference to your imagination)—and it starts at the top. Healthcare is an industry forged of multiple business models with more power players attached to it than mafia family heads in New York, Chicago, and Vegas collectively.

Ever sat in a meeting with a client and realized their goals are completely different than yours? Not only that, but it’s like they expect you to read their mind and magically intuit what it is they need and why they hate your solutions! It’s a communications nightmare!

There might have been a situation not too long ago where I sat in a meeting trying to understand why we were coddling a new provider so much. Why were we privileging them over our all the others who must abide by standard best practices that are modeled on protecting the institution’s best interests? Turns out that particular service has had trouble recruiting and keeping this particular type of specialist, forcing us to have to cede, enacting practices that aren’t necessarily optimal for our site users. (I am keeping this deliberately vague to protect the agitator.)

Why does it have to be that way? Lemme’ tell you why: We’re not all playing on the same field.

Nobody’s on the Same Page!

Nobody’s on the same page. Yeah, I just wrote that again ’cause I know you all relate. And I’m not just talking about seeing eye to eye and having things in common and striving for a company culture of unity. I’m talking about top-down bottom’s-up confusion built on multiple premises that we stupidly expect to play nice together.

If there’s anything that I’ve learned over and over and over again in 2017, it’s this: a siloed* department will not stand, or more importantly, will not bring about accolades, accomplishment, or awards-except on an insular individual-centric basis.

So we need to start keeping the bird’s eye view in mind, ’cause if we don’t rise above our siloes, we will continue to kick against the pricks, as it were.^ We need to listen and determine what our colleagues’ endgames are. Only this will help us craft more effective marketing plans and content strategies.

Models of Three, Leave Them Be

That classic mnemonic^^ could really be “models of three, leave them be,” as in don’t try and smush together things that don’t go together. But let me clarify that for you. As defined by Christensen in his prescription, healthcare is made up of three businesses:

1. Solution shops
2. Value-adding business processes
3. Facilitated business networks

We are perhaps most familiar with the solution shop: an entity diagnosing and providing solutions hoping to effect an improved outcome. That pretty much defines the most familiar healthcare business model we know. Providers see patients, compile data, and make a recommendation that we then pay for: fee for service.

The value adding model combines resources and people in a process to output a better product. A restaurant sources food, brings in a chef, and puts out extraordinary (we hope) food selections for us to choose from. In some cases this can be repetitive work, enabling optimization processes that can reduce overhead costs.

Hospitals and clinics bring people and resources together to provide care at lower prices than individual practices can often do. This can evolve into a fixed price system, embedded in equipment and processes.

And business networks. We are familiar with these via social networks, where we get recommendations from friends, keep in touch with peeps, and occasionally buy and sell things. This model offers a network that makes this possible. In healthcare this can be seen in professional business ties to treat chronic illnesses in a more effective manner or pass on knowledge to general practitioners (telehealth models).

The Bird’s Eye View

With three different business models, no wonder no one is on the same page!! No wonder doctors and subject matter experts can’t understand why we make the recommendations we do! They have almost completely different needs! Are they even operating under the same financial model that we are? In many healthcare organizations (or maybe I just mean mine), no!

For example, are healthcare providers individually reimbursed by health insurance separately per patient they bring in making it more effective to emphasize their personal practices? Or is there a blanket payment for sum total patients for the entire service area?

Almost every single group of providers I meet with has different needs. Some need to make money from out of pocket procedures, some need to recruit and retain providers/faculty, some are driven to separate out their own “practice” from the institution due to payment/reimbursement models that will benefit them. And yet others need to reduce hospital readmissions to maintain reimbursements or be penalized.

Lemme’ tell you, it may take awhile to get the lay of the land, but when you catch that bird’s eye view, it really starts to come into focus, albeit a little at a time.

The Proposition

(Remember There Is Always More to the Situation Than Meets the Eye)

So where does that leave us professionals? Hopefully not on the couch at 2 am watching Are You Being Served and trying to think of how to make everybody happy. Because the reality is, nobody’s happy, and nobody’s going to be happy, as long as we continue to operate in siloes. Let me adjust that sentence. The people who are happiest tend to be at the top of the heap in their silo OR the people who actively choose to take the best from their situation and squeeze lemon juice onto their salads.**

What I’m trying to say, in this delightfully amusing (I hope) yet informative post, is that if the confusion starts at the top, we need to realize that and include that in our work satisfaction calculations. What I’m proposing here colleagues, is that we recognize and validate others in their own business models.

We need to figure out what their end goals are before we can effectively diagnose and make recommendations for effective marketing, management, or content strategies. We need to keep the bird’s-eye view in mind.

*Btw, siloed is actually a verb-I just double checked. Silo can be either a noun, a verb, or an adjective referencing isolation, to isolate, or isolated.
^This is a Biblical reference, and a disgusting one. I will leave it up to you to suss out the hairy details however.
^^You know, after that mnemonic about poison ivy “leaves of three, leave them be…”; a mnemonic, might I add, that was no help when I ventured in to some stinging nettle across the pond. Did our wilderness trainers never consider that we might venture farther abroad than our own back woods? Don’t answer that.
**We are sooooooo tired of lemonade. Unless it’s pink. Then I could be persuaded. What about shocking pink? (Elsa Schiaparelli’s signature color and one I came to appreciate when working for a costume designer whose love for it was almost as great as mine has now become. There were sequined dresses.)