MC Competitive Analysis

December 20, 2011

One S. Pinckney St Suite 500 Madison, WI 53703 P: 608-251-7070

Table of Contents
I. Overview II. Information Architecture & Usability Review III. Content and Search Engine Optimization Review a. Website Analytics b. Website Optimization IV. User Engagement, Outreach and Integration of Social Media channels and Microsite Review V. Online Advertising Strategy Review VI. Next Steps VII. Appendixes

Overview
Typically, a comprehensive digital strategy would involve tying back goals to the overarching business strategy that a client has in place. In the absence of such goals, a competitive analysis plays an even more important role in strategic planning including: Helping management understand their competitive advantages/disadvantages relative to competitors Generating understanding of competitors past, present, and most importantly, future strategies Providing an informed basis to develop strategies to achieve competitive advantage in the future Helping forecast the returns that may be made from future investments (e.g. how will competitors respond to a new product or pricing strategy?)

Competitive intelligence is identifying important competitors and then evaluating their positions according to different factors. An in-depth analysis of Marshfield Clinics direct and indirect competitors as well as a deep-dive analysis of admired brands was completed. Competitors were analyzed and reviewed with the objective of: Identifying architectural shortcomings that MC can take advantage of Reviewing content optimization and search optimization employed by competitors User engagement, outreach and integration of social media strategies and microsite review Looking to other industries where social integration is executed well and effectively Identifying competitors online advertising strategies

The list of sites reviewed: Local Competitors 1. Aspirus Health 2. Gundersen Lutheran 3. Aurora Health Care 4. Ministry Health 5. Mayo Clinic of Eau Claire Admired Clinic Systems 1. Kaiser Permanente 2. Mayo Clinic 3. Cleveland Clinic

Information Architecture & Usability Review

What is usability?
According to the Usability Professionals Association, usability is the degree to which a website, software, or anything else is easy to use and a good fit for the people who use it. It is a quality or characteristic of the product. It is whether a product is efficient, effective and satisfying for those who use it. It is the name for a group of techniques developed by usability professionals to help create usable products. It is a shorthand term for a process and approach to creating products, also called usercentered design.

What is Information Architecture?

Information Architecture, as defined by the Information Architecture Institute, is the science of organizing and labeling web sites, intranets, online communities and software to support findability and usability. The goal of the information architect is to create and maintain a useful body of information.

Our approach
LSB follows a standard grading rubric when evaluating websites for their usability and content organization. The sites were reviewed across seven categories; conssiderations for each category are listed below. Site organization Is the site organization and content grouping intuitive? Are labels on section headers easy to understand? Are labels consistent with the language of the target user, with words, phrases and concepts familiar to the user, rather than system-oriented terms? Are labels consistent within the site or are different words or actions used to mean the same thing? Does the site implement web standards (search location, button positions, etc)? Home page How informative is the home page? Does it set an appropriate hierarchy of information? Is vital information perceptible, noticeable and meaningful? Does it set the proper context for visitors? Does it have an appropriate mix of branding/promotional messaging to content? Navigation Is the navigation intuitive? Is the navigation visible? Does the navigation provide context? Does the site use consistent within-site navigational conventions? Is the global navigation persistent from page to page? Does the site make effective use of hyperlinks to tie related items together? Does the site use (approximately) standard link colors? Are the links obvious in their intent and destination or are they ambiguous ("click here")? Content Is there sufficient depth and breadth of content offerings? Does the content seem to match the mission of the organization? Is the site developing its own content or syndicating other sources?

Is there a good mix of in-depth material (detailed case studies and articles) versus superficial content (press releases and marketing copy)?

Readability Is the font easy to read? Are line lengths acceptable? Are page lengths acceptable? Is the site easy to scan, with chunked information, or is it solid blocks of text? Does the site serve users with disabilities? Search and search results Is the search engine easy to use? Are there basic and advanced search functions? Are search results organized and easy to understand? Do they give relevance weightings or provide context? Do the search results remind you what you searched for? Performance Is load time appropriate to content, even on a slow dial-in connection? Are graphics and applications like search and multimedia presentations optimized for easy Web viewing?

Aurora Health Care

http://www.aurorahealthcare.org Summary #1 website in the local competitor category. The Aurora Health Care excels in their navigation design and styling. However, a second version of the navigation design detracts from the overall success of the site. The Aurora site also has the most readable content of the local competitors. Content The list of services provided by Aurora, and the amount of web content provided for each gives the Aurora site a substantial content base. However, Aurorahealthcare.org does not provide the related text or multimedia content that are prominently featured in competitor sites like Aspirus or Gundersen Lutheran (For a breakdown of service content by local competitor see Appendix B). Site organization Aurora chose to organize their content around their service lines. Rather than providing a generic section for patient and visitor information, physician and location information is presented as it relates to a specific service. This could be a disadvantage for users visiting the site specifically to find a location or provider, however Aurora fills this gap with very prominent links to search tools. Navigation The navigation on aurorahealthcare.org has the potential to be one of the better sites in the local competitor group. However it mixes two navigational designs, one of which is well designed and another that is less effective. The global (top-level) navigation is clearly visible on the homepage and persists on interior pages. The main navigation uses a topic-based scheme (with the exception of Request an Appointment, which is task-based). There are also tabs to provide audience-based navigation. Dropdown menus on the main navigation allow for a quick view of the breadth of the site. The user is also provided with a utility navigation and consistent quick link boxes (Find a Doctor, Find a Location, My Aurora) to access frequently used sections. Search is supplemented with a global A-Z index by which a user can locate content. The true utility of the global index would need to be determined with usability testing. On secondary pages, left-column navigation displays a section heading with secondary (sibling) navigation below. When third or fourth level navigation is required it is displayed indented beneath their parent section in the left column navigation. Selected states in the navigation and breadcrumbs provide the user with their current place in the site as well as its context in the site hierarchy.

The design of the navigation uses clear text size, indentation and color changes to delineate between parent and children as well as the users current place in the site. One potentially confusing aspect is the Patients and Families tab. It currently links back to the homepage while the other two tabs take the user to a new section. A selected state on the tab, like increasing the tab height, could have helped to clarify the function of the tab. Outside of the navigation; clickable elements are treated with a blue to denote a hyperlink. The navigation of the site is the only element that uses a hover state. The standard navigation scheme of the site is very intuitive. However, there are a few pages that break the rule of consistency. It seems that when the site includes a section header image, the navigational rules change. The section heading is removed, children are displayed using dropdown menus rather than indentation and the breadcrumbs are no longer used. This greatly diminishes the contextual clues of the site and when navigating to third or fourth level sections it is difficult to return to parent or sibling pages with out using the browser back button. Correct Navigation Flow:

2nd level section: Section name displayed above navigation, children display below

3rd level section: When a child is selected, its children are revealed

4th level section: All higher-level sections persist in navigation for easy way finding

Incorrect Navigation Flow:

2nd level section: Section name is NOT displayed above navigation. 3rd level children display in column. Arrows indicate 4th level children

2nd level section: Dropdown to access 4th level sections

4th level section: only section header indicates that the section has changed.

Home page The Aurora homepage features the most content of the group. This includes patient stories, medical news and Aurora press. If updated frequently, this homepage content will keep the site looking fresh and dynamic. The homepage also prominently features quick starts to user tasks, such as a physician search, location search and login to My Aurora. A very brief description of Aurora Healthcare is posted below the fold on the homepage. Readability The type size and line heights chosen for the Aurora site makes it the easiest body copy to read. The user is also able to increase and decrease the type size in the main content area. Line lengths are kept reasonable as are page lengths keeping the web pages easy to scan. On very long pages, anchor tags are often used to create a sub menu. This also aids in the perception of digestible content. Search and search results Google powers the site search. When the results are displayed the results page lists the number returned and displays a search field with the search term pre-loaded. This serves to remind the user of the query, but a user could also use the search box to refine their term if needed. Performance Google Developers gave the site an overall Page Speed Score of 78 of 100. Download Times*: Connection Rate Download Time 56K 69.58 seconds ISDN 128K 23.81 seconds T1 1.44Mbps 5.35 seconds *As generated by http://analyze.websiteoptimization.com/wso

Aspirus
http://www.aspirus.org Summary #2 website in the local competitor category. The Aspirus website provides thorough content supplemented with multimedia. The Aspirus homepage is the best of the local competitor group. However the overall information hierarchy and navigation design detract from the navigability of the site. Content The Aspirus site contains a well-edited, content-rich selection of resources for patients and their families. By comparison to its peers, the Services section does not seem as broad reaching. Aspirus chose to focus on the service lines where they excel, rather than listing every service provided. This allows Aspirus to go deep in key areas without taxing resources. The content depth, including prevalent multimedia, garners credibility and a feeling of specialization for Aspirus. (For a breakdown of service content by local competitor see Appendix B.) The service pages feature: Anatomical diagrams to explain diagnosis or conditions Treatment diagrams to illustrate corrective procedures Video to explain in a patient-friendly format Real patient stories to provide examples of successful outcomes Links to related resources to allow a patient to read deeper The right column is often used to highlight content like screening guidelines, treatment side effects, Aspirus accreditation, or support services. A few examples follow.

Video & patient stories

Diagnosis diagrams & video

Video, patient stories and treatment diagram

To further support the site, Aspirus licenses an illustrated health encyclopedia and other supplementary content from A.D.A.M. They also have a partnership with their local CBS affiliate to produce the HealthBeat 7 video series. Site organization Within each section, the Aspirus site is organized and provides links to related resources for ease of use. However, there are a few global organizational issues that cause confusion. The Aspirus site does an excellent job drawing together all related information on a topic to prevent the user from having to search across the site. A good example is the Service section of the site. In addition to the rich, multi-media content as described in the content analysis, Aspirus also provides sub-pages in each service section to list the locations and physicians specializing in that service. This allows the site user to quickly take action after educating him or herself on the diagnosis. Aspirus also chose to create a utilitarian Patients & Vistors section. This section provides a secondary means to find a location or a physician. It also provides links to functional content like maps and directions, area lodging and payment information. While a prospective patient might browse the Services section for this information, a current patient will want to locate this information quickly. Providing it in duplicate here will be more efficient for those users. Aspirus separated their hospital sites from the parent Aspirus brand or network with the exception of the Wausau Hospital site. This was likely due to a higher number of shared content items between the two entities. However, Aspirus retains the separated branding on the single website. By clicking main and utility navigation only, the user will encounter four different logo changes at the same URL: Wausau Hospital logo - Our Services, Patients & Visitors, For Employers, Home, Contact Us, Press Room Aspirus Clinics logo - Aspirus Clinics section Aspirus Network logo - Aspirus Network section Generic Aspirus logo Careers, Aspirus System This change to the logo sends a false cue to the user that they have left the main Aspirus site. To further disorient the user, Aspirus has created a landing page at www.aspirus.org or www.aspirus.org/landing, which serves only as a link hub, redirecting users to the Wausau/Aspirus site or to the smaller hospital sites. See the end of the section for screenshots. The differentiated branding between Aspirus, the network, the clinics and Wausau Hospital serves the needs of the marketing team. However, LSB does not believe delineation is consistent with the way the user perceives the Aspirus network. This breaks one of the usability heuristics to stay consistent with the concepts and language of the target user, rather than system-oriented concepts, or in this case branding. To stay consistent, Aspirus could match the model set by its competitors. Aspirus as a brand, and as a network, offers a set of services. Those services are then broken out by the locations at which they are offered. Following this model, the whole site could be branded with the Aspirus logo. LSB would recommend a content analysis to determine if Wausau hospital has enough content independent of the network to warrant its own website. If it does not, it could live within the Aspirus site as a location listing. Branding variation screenshots:

Aspirus system site design and logo www.aspirus.org or www.aspirus.org/landing

Aspirus Wausau Hospital site design and logo www.aspirus.org/index

Aspirus Clinics logo http://www.aspirus.org/aspirusClinics/index.cfm?catID=12&subCatID=63&pageID=14&pageTitle=Aspirus-Clinics

Aspirus Network logo http://www.aspirus.org/hospitalsClinics/index.cfm?catID=2&subCatID=16&pageID=16&pageTitle=Aspirus-Network

Aspirus logo http://www.aspirus.org/aboutAspirus/index.cfm?catID=7&subCatID=61&pageID=830&pageTitle=About-Aspirus

Navigation While navigation on aspirus.org is consistent in its navigational elements, a few deficiencies in organization and design make it difficult to maintain a sense of place on the site. The global (top-level) navigation is clearly visible on the homepage and persists on interior pages. Dropdown menus allow easy access to sub sections. The site uses two organizational schemes, navigation by topic and navigation by audience (for Patients & Visitors, Employees, or Physicians). Aspirus also uses a utility navigation in the top right corner and a fat footer to access deeper or less important sections. Though the footer is duplicative of the main navigation structure, it does prevent the user from having to scroll back up after reading a page. On secondary pages, left-column navigation displays the sections siblings as menu items. Rather than displaying the section name above the navigation, Aspirus displays a link to Home. This link takes the user back to the second level section. In the example below, Home would take the user back to the Services section. However, there is also a Home link in the breadcrumbs, as well as in the top right utility navigation. Both of these Home links return the user to the homepage. This labeling overlap is a point of confusion.

Omitting the section name from the sub navigation also limits the users ability to track their progress through the site. The site does use breadcrumbs, which are intended to help the user track their path through a site. However the breadcrumbs also omit the secondary section. In the example above the Our Services section is missing. The design of the navigation uses clear text size, highlighting and color changes to identify users current place in the site. Outside of the navigation, clickable elements are styled in blue with a dotted underline to denote a hyperlink. The navigation of the site is the only element that uses a hover state. Home page The Aspirus homepages provide a clear, written description of the network/hospital. The homepage prioritizes a quick start to frequently used tasks like the MyAspirus login, bill payment and physician search. Readability The Aspirus site uses a medium sized font by default, but sufficient line height and shorter line lengths keep the site easy to read. The user is given the option to increase or decrease font size, however the control manages the full site rather than just the content area. This is less useful than the same option on competitive sites, but still helps with accessibility for users with vision problems. Content can get long with many pages over 7 paragraphs long, especially in the services section. To counteract this, Aspirus uses very defined headline styling to break the content into sections. For very long pages they often employ an accordion menu to hide content until the user clicks to view. An example of this is the Technology & Treatments page in Cancer Services.

Search and search results Google powers the site search, which takes a while to load. While loading, the user only sees an empty search box on the results page. This makes it seem as though the search was not run or failed. When the results are displayed the results page lists the number returned, but does not retain the search term. Performance Google Developers gave the site an overall Page Speed Score of 61 of 100. Download Times*: Connection Rate Download Time 56K 23.60 seconds ISDN 128K 9.86 seconds T1 1.44Mbps 4.33 seconds *As generated by http://analyze.websiteoptimization.com/wso

Gundersen Lutheran
http://www.gundluth.org Summary #3 website in the local competitor category. The Gundersen Lutheran website is well organized with basic, but efficient navigation. The navigation design is the second best in the local competitor group. Content is good, but not as thorough as Aspirus or Aurora. Content Gundersen Lutheran provides a broad base of content in their service section, rivaling that of Aurora though lacking the depth of Aspirus. While the main content in the service lines is quite strong, Gundersen Lutheran falls short in their overuse of supplemental content. The site uses the right column in the services section to present related links, multimedia and lists of physicians in the service line selected. Unlike Aspirus, the content for this column seems to be automatically selected by a feed from A.D.A.M. rather than manually selected by a content editor. As a result there is an overwhelming number of links presented and the content is often only loosely related to the subject matter. As an example, in the Blood Disorders section the In-Depth reports tab displays links for Acute lymphocytic leukemia, Alcoholism and Anemia. This list seems to be pulled alphabetically based on a category. To someone without a medical background Alcoholism seems to be misplaced. Instead, a content editor could have provided links to in-depth reports for the illnesses listed in the main content area (including anemia, specific bleeding disorders, clotting disorders and blood cancers). Site organization Gundersen Lutherans site has chosen a broad content hierarchy by elevating more sections to the primary navigation. Most of the competitive sites choose the opposite by keeping the main navigation to four items. Gundersen Lutheran also exposes the majority of their site map in their main and secondary navigation. This is different from Aspirus and Aurora who are selective in which sub sections display in the primary navigation and secondary navigation for a section. Both of these choices are helpful to a user, in that they can clearly see the hierarchy of the site from the navigation menus. Content organization is less clear within sections. This is due to the integration of supplemental A.D.A.M content. As discussed content above, Gundersen Lutheran presents A.D.A.M. content in the right column of their services pages. While the content is mostly helpful to the user, the organization and labeling of these link sections are unclear. On the Blood Disorders page, shown below, the right column holds sections labeled Related Links, Health Encyclopedia, In-depth Reports and Read More. There is some differentiation between In-Depth Reports and Health Encyclopedia, but their complete overlap between the naming of Related Links and Read More. Within each of these sections, the link titles are names of different conditions. Its impossible to tell how the Acute lymphocytic leukemia link in In-Depth reports will be different than the Acute lymphocytic leukemia link in Read More.

Navigation The logic behind the Gundersen Lutheran navigation is clear and consistent. The only shortcomings to the navigation are a few small design and mechanical issues. The global (top-level) navigation is clearly visible on the homepage and persists on interior pages. Dropdown menus allow access to sub sections and tertiary sections. Because Gundersen Lutheran exposes their site hierarchy in their navigation, these menus can become quite long. The About Us dropdown uses a scroll function to access the bottom of the list. This is not a rd common function and could be missed by many users. The scroll, along with the 3 level flyout

menu could be difficult for users with mechanical issues. Accessibility is a very important consideration for a healthcare site. Alternatively, a mega flyout menu may make this navigation easier to manipulate. The site uses two organizational schemes, navigation by topic and navigation by audience (for Clinicians, Employees, or Employers). The user segmentation is presented in utility navigation in the top right corner of the site. The site also makes use of a footer to allow access to frequently used sections. This is a different approach to Aspirus who replicated their main navigation in the footer. On secondary pages, left-column navigation displays the sections siblings as menu items. A stylized tab and a section header display the section name clearly. As the user navigates deeper into the site, the left column navigation and the breadcrumbs display the full navigational path. All of these choices create a very navigable site.

The design of the navigation uses indentation and bolding to identify users current place in the site. From a design perspective this is less sophisticated than the Aurora site, which relies on shading, but it is still effective. Outside of the navigation, clickable elements are styled in blue with an underline in the hover state. Home page The Gundersen Lutheran homepage is the most promotional of the group. The moving slideshow and scrolling News section demands the attention of the user. Despite this prominence, the site does still fit a doctor search, quick links, MyCare access and an A.D.A.M. symptom navigator above the fold. Unlike the competitor sites, there is no description of the health system on the homepage.

Readability The line length on the Gundersen Lutheran site is among the shortest, which should make the pages easy to scan. The type size is not as large as a few others, however the text is still quite legible. There are also buttons provided to increase and decrease the type size. Search and search results Google powers the site search, which takes a while to load. While loading, the user only sees an empty search box on the results page. This makes it seem as though the search was not run or failed. When the results are displayed the results page lists the number returned, but does not retain the search term. Performance Google Developers gave the site an overall Page Speed Score of 47 of 100. Download Times*: Connection Rate Download Time 56K 265.19 seconds ISDN 128K 90.65 seconds T1 1.44Mbps 20.29 seconds *As generated by http://analyze.websiteoptimization.com/wso

Mayo Clinic of Eau Claire

http://www.luthermidelfort.org Summary #5 website in the local competitor category. The Mayo Clinic Eau Claire website is a utilitarian offering that supplies information specific to the clinic, but little more. Content Because of the relationship with the parent Mayo site, the content of the Mayo Clinic of Eau Claire site is concentrated in the hospital specific sections. The services sections are very shallow by comparison to the competitive sites, focusing on the clinics ability to treat rather providing indepth information on conditions. The site does provide a supplemental health encyclopedia, but much of this content links back to the main Mayo site. However, for a patient who is only interested in the specifics of their visit, the site content will fulfill their needs. Site organization The organization of the Mayo Eau Claire site is very linear. Nearly every section is placed in the main navigation. This very cluttered, broad and shallow organization can lead to exhaustive review, where users repeatedly look at the same links and menus before making a selection. Navigation As described above, there is very little hierarchy to the Mayo-Eau Claire navigation. Because of this, the navigational design does not need to work as hard to keep users aware of their location in the site. The site relies on global left hand navigation. In the few sections with secondary navigation, the sections are displayed as indented links. Selected sections are represented in bold and with an arrow icon. The site does not use breadcrumbs. Given the relationship with this sub site and the larger Mayo clinic site, there are many outbound links in the navigation and within content. It would be best practice for the Mayo-Eau Claire site to label outbound links with an icon and to open these links in a new browser window. Home page In general, the design for the Mayo-Eau Claire site is quite utilitarian. It is obvious that the emphasis was placed on ease of duplication rather than branded design. As such the homepage looks identical to the interior page design. The homepage provides a description of the clinic along with quick links to frequently visited pages. Given that the site relates to one location, address and contact information is prominently displayed. Readability The Mayo-Eau Claire site is one of the least readable of the group. Short pages help the issue. But due to the small text size, the line lengths are rather long. The user is not provided with the ability to increase text size. Search and search results The search results are run by the CMS for the Mayo clinic affiliates. Because of this the results contain matches from all of the clinic sites as seen in the screenshot below. The results are paginated and results per category are provided for easy filtering. The search term is displayed on the results page.

Performance Google Developers gave the site an overall Page Speed Score of 51 of 100. Download Times*: Connection Rate Download Time 56K 47.48 seconds ISDN 128K 16.48 seconds T1 1.44Mbps 3.99 seconds *As generated by http://analyze.websiteoptimization.com/wso

Ministry Health
http://www.miistryhealth.org Summary #4 website in the local competitor category. The Ministry Health website has the best internal search of the local competitors. The organization and navigation is sufficient, but nothing more. The homepage is uninspired. Content Ministry Health provides service line content across a fairly broad list of services. Rather than providing exhaustive descriptions of illnesses and treatment plans, however, Ministry Health focuses on their approach or expertise in the service. In general this limits the content per service. Ministry does not focus on the supplemental health information as seen on Aspirus, Aurora or Gundersen Lutheran. Their right column displays locations and doctors treating the condition as well as any patient stories available. Multimedia is displayed in the main content area only occasionally and the graphics are often less compelling than the competitors. Site organization The site organization is not complex, however it is larger than the global navigation portrays. A few of the top-level sections were not included in the navigation, which forces the user to return to the homepage to access them (including News, Events and the A.D.A.M. health information). The labeling of sections matches the division of information very well. The labels are concise, clear and use user language. Navigation Ministry Health uses a global navigation bar and a utility navigation bar only. There are no dropdowns on this navigation and there is no persistent local navigation within the sections. To navigate within the site, the user must rely on the breadcrumbs, their browser back button or renavigate to a section using the global navigation. Occasionally when tertiary navigation is needed, a related information section will display at the top of the content column. The issue with this design is that when the related content is selected, the navigation bar disappears on that tertiary level section. This does not allow the user to navigate between sections easily. It also does not help the user remember their place in the site.

Audiology section with a tertiary navigation bar.

A child page of the Audiology section, the tertiary navigation bar has disappeared.

The issues with the tertiary navigation become compounded when fourth-level navigation is required. In the Cancer Services section, there is a Related Information section in the third-level, however when Treatment is selected a fourth-level completely replaces this navigation. This can be confusing since the design and page layout does not change, only the contents inside the menu are switched.

The Cancer Services section with a tertiary navigation bar.

The Cancer Services > Treatments section. The tertiary navigation bar is replaced with fourth-level navigation.

Home page The design of the Ministry Health Care homepage is outdated and uninspiring. The page consists of one large rotating promo area with a description of the healthcare system. Below that are three columns of links. Not only are there too many text links to review without exhaustion, but also the section labels do not provide much context and there could be overlap in the meaning of each. Readability The text size for the Ministry Health site is slightly smaller than the competitors, however the line height helps with readability. The user is not given the option to increase or decrease text size. Page lengths kept quite short, even in the Services section where page length runs longer on the competitor sites. Search and search results The site search is powered internally. The search page features static quick links to find a doctor, health info or an event. The search results are paginated and the search term is listed. Performance Google Developers gave the site an overall Page Speed Score of 82 of 100. Download Times*: Connection Rate 56K

Download Time 58.90 seconds

ISDN 128K T1 1.44Mbps

21.23 seconds 6.04 seconds

Recommendations for Marshfield Clinic Create one branded website with individual clinics listed as locations versus websites for each clinic or hospital. Provide deep content on the service lines offered. This should include images, diagrams and videos to help explain concepts. Reducing the amount of service lines listed is acceptable, to a point. If using content services like A.D.A.M. or EBSCO Publishing, fine-tune the automated feeds used. Make use of audience-based navigation for groups like patients, physicians, or employers. Create easy access points on the homepage for the location and physician searches. Ensure navigation is persistent and that the users path is clearly marked. Aurora is a good example. Use a larger type size with adequate line height. Aurora is a good example. Provide the user with the ability to increase or decrease text size.

Appendix A Content across local competitors

Aspirus Content About the Center (e.g. History, Leadership) Services/Departments Hospital Prices Patient Stories Health Information/Encyclopedia Health How-To Videos Procedure Videos Research/Trials Training/Residency Fund Raising Giving/Contributions Community Programs News/Press Releases Publications & Archives Events/Classes Careers/Job Openings Volunteers Maps/Directions/Lodging Virtual Tours Request an appointment Bios of Physicians/Staff Contact Information Policies Expert Podcasts Online Nursery Baby Blog Personalized Patient Websites Send Gifts/Greetings to a Patient Audience-Specific Information Medical Professionals Suppliers Employees Employers Patients Families/Visitors Y Y Y Y 1 Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 2 Y Y
1

Aurora Y Y Y 3 Y
3

Gundersen Y Y Y 1 Y

Mayo - EC Y

Ministry Y Y Y Y Y Y

**

Y Y Y Y Y Y Y Y Y Y * Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y *** Y
5

Y Y Y Y Y Y Y Y Y Y Y Y

Y Y Y

Y Y Y

Y Y Y

Y Y

Y Y Y

Y Y

Y = Yes, the website contains that functionality. * Not provided on a separate webpage outside of search tool and services listings. ** Redirects to mayo.com. *** Discontinued 10/1/11. 1 rd Provided by 3 party A.D.A.M. 2 rd Provided by 3 party Caringbridge.org 3 rd Provided by 3 party EBSCO Publishing 4 Aurora offers this service but it is not advertised on the site and requires a code to view. Found though a site search.

Provided by 3 party CarePages.com

rd

Appendix B Services content across local competitors

Taken from the visible navigation structures, this list shows which services each site prioritizes. In some cases, like Gundersen Lutheran in particular, viewing all services shows a much more comprehensive list than is represented below. Services were also grouped into like naming conventions. A parenthesis in the service name shows alternate terms for the same service. Aspirus Functionality & Supplemental Service Content Alphabetical Service Search Video Slideshows Patient Stories Diagnosis/Treatment Diagrams Listing of Doctors Specific to Service Listing of Locations Specific to Service Services Listed Advance Technology Lenses Allergy & Asthma Anesthesia Art Therapy Audiology (Hearing) Bariatrics Behavioral Health Birthing Center Blood Disorders Breast Cancer Breast Health Cancer (Oncology) Cataracts Childrens Medicine Cardiology (Heart, Cardiac) Clinical Research Colon Cancer Complementary (Integrative, Alternative) Medicine Consumer Credit Counseling Corneal Disease Cosmetic Eyelid Surgery Cosmetic (Reconstructive, Plastic) Surgery Contact Lenses Dental Dermatology Diabetes Care (or Education) Diagnostic Imaging & Radiology Dialysis Disc Replacement Ear, Nose & Throat (ENT) Aurora Gundersen Mayo - EC Ministry

Y Y Y Y Y Y

Y Y Y

Y Y Y Y Y

Y Y Y

Y Y Y Y Y Y

Y Y Y Y Y Y

Y Y

Y Y Y

Y Y Y Y Y Y Y Y Y Y Y

Y Y Y Y

Y Y Y Y

Y
1

Y Y

Y Y Y

Y Y Y Y

Y Y

Y Y Y Y Y

Y Y Y

Y Y Y

Y Y Y

Y Y Y Y Y

Y Y Y Y

Electrophysiology Emergency & Trauma (CCU) Employee Assistance Program Endocrinology Epilepsy Care Exercise Physiology Eye Muscle Conditions Eyewear Family Medicine (Primary Care) Family & Social Services Fertility (Infertility) Gamma Knife Surgery Gastroenterology (Digestive Care, GI) Genetic Counseling Glaucoma Hand Surgery Hand Therapy Headache Care Hematology (Blood) Home Delivered Meals Home Health (Home Care, Inhome Care) Home Medical Equipment Hospice (End of Life Care) Hospitalists (Inpatient Care) Immigration Physicals Immunology Immunotherapy Incontinence Infectious Disease Internal Medicine Joint Replacement Laboratory (Pathology) LASIK Library Low Vision Lung Cancer Macular Degeneration Medical Transportation Memory Disorder Movement Disorder Multiple Sclerosis Neonatal Intensive Care Unit (Newborn ICU) Nephrology (Kidney) Neurointerventional Neurosciences (Spine, Neurological Care) Nuclear Medicine Nutrition Counseling Obstetrics/Gynecology Occupational Health Ophthalmology (Eye Care, Eye

Y Y

Y Y Y Y Y Y Y Y Y

Y Y

Y Y

Y Y
2

Y Y Y Y Y

Y Y Y

Y Y Y

Y Y Y

Y Y Y

Y Y Y Y Y Y Y Y

Y Y Y

Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y Y

Y Y Y Y

Y Y Y Y Y Y Y Y

Y Y Y Y

Y Y Y

Y Y Y Y

Diseases, Vision Centers) Organ Transplants Orthopedics Orthopedic Trauma Osteoporosis Pain Management Palliative Care Parkinson Care Pediatric Cancer Pediatric/Adolescent Medicine Pharmacy Physical Medicine Podiatry (Foot & Ankle) Pulmonary (Lung, Respiratory) Medicine Prostate Cancer Radiation Oncology Rehabilitation/Outpatient Services Retinal Diseases Rheumatology Robotic-Assisted Surgery Senior Health Shoulder Injury Sleep Disorders Sexual Assault Treatment Speech & Language Spiritual Services (Parish Nursing) Sports Medicine Stroke Surgery Survivorship Total Health Traumatic Brain Injury Travel Clinic Urgent Care/Walk-In Urology Vascular Weight Management Womens Health Workers Compensation Wound & Hyperbaric (Ostomy Care) Provider Specific Content Aspirus Health Foundation Aspirus Heart & Vascular Institute Aurora Accountable Care Network Aurora Freedom+ Aurora Second Opinion Program Aurora Womens Pavilion

Y Y

Y Y

Y Y

Y Y Y Y

Y Y 3 Y Y

Y Y

Y Y Y

Y Y

Y Y Y Y Y

Y Y Y

Y Y

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Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y Y

Y Y Y

Y Y Y Y Y Y

Biorepository (ORBIT) Community Partnerships Health-Link HOPE (Homeowners Options Program for the Elderly) Childrens Miracle Network Hospitals Learning & Development Diagnostic Center MedLink AIR HERS Breast Center Mayo Transitional Care Ministry Spirit Medical Transportation

Y Y Y Y

Y Y Y Y Y Y

Y = Yes, the website contains that functionality. 1 Microsite - http://www.canw.org/ 2 Microsite - https://aspirusgmi.dnadirect.com/grc/patient-site/index.html 3 Rather than a general overview, this pediatrics section includes subsections for each pediatric service, even when duplicative to adult services. 4 Microsite - http://www.aurorahealthcare.org/services/orbit/bg.html

Appendix C Functionality across local competitors

Patient Care Access New patient enrollment Update hospital or account Info Pay online Request appointments Online registration View upcoming appointments View electronic health records (limited) View test results (limited) Request prescription renewals Transfer a prescription Communicate with care team Access health information resources View family members health records when authorized Class & Event Listing Featured Search by Date Search by Keyword Search by Category Search by Name Search by Facility Search by Geographic Location Online Registration Location Search Facility Name Contains Select City Select County City Name Contains Aspirus Y Aurora Gundersen Mayo - EC Ministry

Y Y Y Y Y Y Y Y Y Y Y Y

Y Y

Y Y

Y Y Y

Y Y Y Y Y Y

Y Y Y Y Y

Y Y Y Y Y Y Y

Y Y Y

Y Y Y Y Y

Y Y Y Y

Y Y Y Y

Search by Zip Code Limit by Range Partial Address/Street Name Select Specialty Select Category Browse Map Physician Search Select Name Last Name Contains/Starts with Select staff who are taking new patients Select Specialty Clinic Name Contains Select Clinic Select City City Name Contains Select County Search by Zip Code Limit by Range Limit by doctors with video Select Age Select Gender Select Bilingual Search Alphabetically Health Tools Emailed preventative health reminders Symptom Navigator DecisionAssist Body Navigator Procedure & Surgery Fact Sheet Procedure Video/Animation Drug Database Drug Interactions BMI Calculator Waist-to-Hip Ratio Desirable Body Weight Calculator Basal Metabolism Calorie/Energy Needs Calculator Target Heart Rate Calculator Activity Calculator

Y Y Y

Y Y Y

Y Y Y

Y Y

Y Y

Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y Y

Y
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Y 1 Y 1 Y

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2

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1

Y 1 Y 1 Y 1 Y
1

Y 2 Y 2 Y 2 Y 2 Y Y 2 Y Y Y
2 2

Y 1 Y 1 Y 1 Y
1

Y Y

Y Y

Exercise Guide Calories Burned Calculator Ovulation Calculator Pregnancy Due Date Health Risk Assessments Drinking Risk Smoking Cessation Risk Assessment Career Burnout Risk Assessment Diet & Nutrition Risk Assessment Emotional Health Risk Assessment Fitness Risk Assessment Sleep Health Risk Assessment Work & Life Balance Risk Assessment Allergy Risk Assessment Cancer Risk Assessment Menopause Risk Assessment Pain Risk Assessment Stroke Risk Assessment Depression Risk Assessment Diabetes Risk Assessment Osteoporosis Risk Assessment Breast Cancer Risk Assessment Coronary Heart Disease Risk Assessment Anxiety Screener ADHD Screener Eating Disorder Screener OCD Screener Obsessive Gambling Screener Postpartum Depression Screener

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Y 1 Y Y Y Y Y Y Y Y Y Y Y Y Y Y
1

Y 1 Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
2 1

Y Y

Y Y Y Y Y Y

Strength of Relationships Screener Stress Screener Viewing & Sharing Content Print Bookmark Share Increase text size

Y
1 1

Y Y Y Y

Y Y Y

Y Y

Y = Yes, the website contains that functionality. 1 rd Provided by 3 party A.D.A.M. 2 rd Provided by 3 party EBSCO Publishing 3 Provided by Mayo and redirects to mayo.com. Intuitive, three-step process to identify causes. 4 Provided