Remarketing: Somebody’s Watching Me!

Woman Holding Coffee Mug

I’ve had a lot of questions lately about remarketing (sometimes known as retargeting), a marketing technique that targets your site visitors with ads for your organization AFTER they’ve left your website. For example, I shopped for lamps last year on and then, for weeks afterwards, it seems like every site I visited presented me with ads for, many with the specific lamps I’d viewed!

You’ve probably experienced this yourself and realized that these ads are no coincidence but rather an aggressive marketing tactic by which one site follows you around the Internet with ads after a single visit.

I don’t like remarketing (so much so that I sometimes find myself writing snarky poetry about it like this). I find it to be annoying, intrusive and clumsily heavy handed. While remarketing is less intrusive when shopping for lamps – for something truly important and personal, like my health, it would be more than annoying. It would be downright creepy!

As a consumer, I don’t like remarketing and have steered clients away from the practice. But, as my friend Linda’s coffee cup reminds me on many a Monday morning, “Your opinion, although interesting, is irrelevant.” A quick Google search shows that many healthcare organizations are using remarketing today. As a technique, remarketing works for many advertisers or it wouldn’t be gaining in popularity.

I’ve been forced to reevaluate remarketing based on its merits as a marketing tool for healthcare organizations.

There are three reasons that I’ve avoided remarketing: Ad blockers, Google’s terms of service and the potential for patient privacy issues under HIPAA. Let’s examine each in more detail.

Ad Blockers

The first concern I have with remarketing is the growing use of ad suppression tools such as Ad Block Plus (ABP). ABP claims to be the most popular browser extension for both Chrome and Firefox with over 200 million downloads and it’s only one of a large number of tools that allow users to monitor what tracking technologies are in use on a particular site and prevent them from operating.

If your site is blocked by ABP or others you won’t be paying for those users, but the more that advertising is used and abused, the greater the incentive for users to install these preventive measures.

Google has made some very smart moves on this front in the past several months. In particular, they’ve opened a new use of the DoubleClick technology underlying their remarketing network as an analytics tool. You may have heard of Google Analytics’ new Demographics and Interests Report which provides greater insight into the gender, age and interests of the consumers who visit your site. That data is gleaned from the DoubleClick ad network and requires sites to replace their typical analytics tracking code (GA.js) with DoubleClick code (DC.js).

This shift has given Google the final push it needed to avoid ad blockers. Remarketing with Google doesn’t share information about individual visitors with either advertisers or the sites on which ads run. Now, Google can further argue that such blocking is actually tampering with website analytics! These arguments (reportedly along with payments to the ad blocker tools) have allowed Google to get DoubleClick whitelisted by the most commonly used list of advertising tools.

Google’s Terms of Service

The terms of service for Google’s remarketing services call out healthcare services directly. An initial reading of this information may make you think that health-related advertisements are completely forbidden. A more detailed read shows that they’re actually trying to draw some lines around what is and isn’t allowed. The following situations are a big no-no according to Google:

  • Basing ads on the individual’s heath condition (or anything that implies the same)
  • Pharmaceuticals or treatments for a specific disease
  • Anything awkward or embarrassing

In other words, no selectively triggering remarketing based on the viewing of a specific health condition or treatment page and certainly no use of any actual information about the individual’s health situation when remarketing. Also, no ads that imply the knowledge of the consumer’s health condition, no ads for drugs or procedures that are used only for one condition and nothing that might make the consumer embarrassed (such as sexual dysfunction or HIV).

That seems to leave a number of things on the table including, in most cases, general messaging about the organization, screenings, health fairs, or informational lead-ins for conditions based on demographic information (ex. “Is your joint pain normal? Take this quiz to find out.”)


Certainly HIPAA issues are a more important concern than Terms of Service violations. There are a few possible scenarios that I’ve been concerned about from a HIPAA perspective:

  • Marketing based on actual knowledge of an individual’s health situation – this falls under HIPAA’s restrictions for such communications, but most of us are well versed in these issues and can skirt these problems.
  • Shared computers – this seemed the stickier situation. With remarketing, it seemed that the health searching behavior of one user of the computer could indicate important information about that individual’s health status to another user of that computer.

It turns out that consumers who wish to keep this private have a responsibility to take basic steps to protect themselves such as using separate accounts on the computer, using one of the private browsing capabilities offered by most browsers today, or disabling or clearing cookies.

The analogy is that this is no different from when a patient is given a printed discharge summary – if they wish to keep it secret, they have a responsibility not to leave it on the kitchen table for family members to find!

While Google is in hot water with Canadian authorities over health privacy law violations it seems that, with caution, such marketing can be OK in the United States.

In The End, Remarketing is All About Avoiding the “Creepy Factor”

Remarketing needn’t be left off the table altogether. While some commentators encourage marketers to swing for the fences and let Google shut them down if they don’t approve, I’m of the mind that this is a tool that should be approached and used with a little more caution.

Before moving forward with a remarketing effort, place yourself in the shoes of the recipient of your ads. How does the experience rate in terms of the “creepy factor.” Take this heart healthy quiz feels OK.  Better options for managing your chemo-induced nausea is way over the line. The tough ones are somewhere in the middle – have you thought about surgical weight loss options where you can easily be targeting on demographics and interests, but starts to cause the creepy factor to rise.

Use Your Power for Good and Not for Evil

Can you, as a healthcare organization, use remarketing? Yes – in the right situations. Here are a few pointers to keep you on the right path:

  • Take some time to understand the details of how the remarketing network that you’re using really works (there are a number of alternatives to Google Remarketing). Do they share information on individuals with advertisers or ad hosting sites? Is the network itself a reputable organization (the network certainly has information on individuals and their browsing behavior)?
  • Use the creepy factor test. How would your mother feel if she visited your site and then saw your ad? Twitter’s retargeting program, for example, allows brands to follow (on Twitter) individuals who visit their sites. Creepy!
  • Keep your cap low. Your frequency cap, that is. Subtlety is the key here and your best tool in that battle is to keep the frequency of messaging on the low end of the scale.
  • Think the process all of the way through. Retargeted ads often require their own landing pages and modified calls to action.
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This entry was posted in Best Practices, Consumer Expectations, eHealth, Industry Trends, Marketing, User Experience by Ben Dillon. Bookmark the permalink.
Ben Dillon

About Ben Dillon

Ben’s a big picture type of guy. He loves sharing new ideas in digital marketing, keeping a watchful eye on healthcare industry trends and seeing how it all intersects. A sought-after speaker, writer, blogger and current SHSMD board member, Ben’s an influential voice in healthcare marketing, helping organizations across the country embrace online strategies to engage health consumers. Combine his industry savvy with his background in software development and you can see why he’s also an important member of Geonetric’s software team, ensuring our content management system stays a step ahead of market needs. Ben holds a master’s degree in eBusiness and strategic management from the University of Iowa and a bachelor’s degree in computer engineering from the University of Michigan. When he’s not traveling and evangelizing, Ben enjoys cooking with his family and playing the Big House with the University of Michigan Alumni marching band.

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