
Compliance and performance don’t have to be mutually exclusive.
THE CLIENT
A prominent healthcare system operating multiple medical centers offering comprehensive care from primary to specialty services. Known for clinical excellence and advanced medical technology, they serve diverse communities with a focus on quality outcomes.
Our Results
54%
CPA reduction in 30 days
82%
Improvement in CPA by month 3
83%
Increase in appointment volume
Challenge
Limited tracking capabilities created a ceiling for performance optimization and stakeholder reporting.
When new guidance from the Office of Civil Rights at HHS rendered virtually all third-party tracking a de facto HIPAA violation, our client’s compliance team acted swiftly and decisively by removing all third-party tracking and analytics from their website. It was a bold move on behalf of data privacy but created a significant challenge for the Wheelhouse team, whose mission is to fill appointments through compliant digital advertising.
The challenge was clear: How can we understand performance and optimize our digital advertising if none of the performance data that typically would be used for this purpose is available? Without tracking, we couldn’t leverage automated bidding strategies that require conversion data, we had no systematic way to prove campaign performance to stakeholders, and perhaps most critically, our client still needed to book patients and maximize physician capacity, all while “flying blind” in terms of the 3rd-party data and signals.
Approach
Predictive Modeling Bridges the Gap: Fully Compliant Measurement Unlocks Performance
With the performance data that typically guided our campaign optimization unavailable, the Wheelhouse team needed to find another way to understand what was and wasn’t working so we could continue to optimize campaigns and accurately report on the value our work was delivering. We did this by developing a sophisticated predictive modeling environment that married appointment booking information with the limited campaign data still available to us. The predictive results were strikingly accurate, earning praise from our client’s CFO as his “new favorite report” and providing the Wheelhouse team with the signals they needed to maintain effective campaign optimization.
With an interim measurement in place, our collective focus turned to development and implementation of a new approach to analytics and campaign measurement that would both satisfy an increasingly restrictive regulatory environment and provide the marketing team with the data they needed to maximize and demonstrate marketing ROI.
Solution Design
Engineering a Proprietary Data Solution for Compliant Campaign Optimization
The solution was implementation of a new HIPAA-compliant Data Solution developed by Wheelhouse. This solution replaces all third-party tracking with a single, private client ID and enables client organizations to fully control both data collection and data sharing down to a single data attribute. We guided our client through a complex stakeholder landscape, helping marketing leadership secure buy-in from understandably conservative compliance and legal teams.
Upon implementation, our approach delivered a fully compliant measurement system that both the digital conversion signals required for effective marketing and the backend appointment booking validation that had proven so valuable in our predictive modeling.
Our Digital Advertising team then developed a hybrid optimization approach that maximized available data through strategic conversion selection, custom attribution modeling, intelligent bidding deployment, and continuous testing loops. This wasn’t simply “turning on tracking and letting Google optimize,” it required deep expertise in how automated bidding systems function with incomplete data and how to architect a measurement framework that delivers exceptional results even when you can’t see the complete picture.
Outcomes
Appointment Bookings Nearly Double Within Six Months
Our strategic deployment of conversion-based bidding improved cost per acquisition almost immediately, decreasing CPA by 54% within 30 days. By month three, CPA had improved by 82% from baseline, demonstrating our hybrid attribution model’s continued effectiveness. Within six months, appointment volume increased 83%.
Achieving these results required deep expertise in performance marketing for privacy first industries. Our experience shows us that healthcare organizations don’t need perfect data, they need partners who know how to drive exceptional performance in highly regulated, HIPAA-compliant environments.


