May 23, 2013

Marketing RX: Use Webinars to Increase Your Medical Practice

webinarHave you considered using webinars to enhance your online, patient centered marketing strategies?  If you haven’t now is the time.  As you know, the Affordable Care Act has led to consolidations and higher health care premiums.  Both pose real challenges, especially for those practices that were barely keeping afloat before the acts passage.  Our business has exploded because of the shift from physicians thinking of medical websites as a novelty to a necessity.   As our business evolves so do our strategies.  Now that more and more practices are gaining a web presence, practices that want to stay ahead of their competition are finding they need to compete at a higher level.  Our answer to them is….Webinars!

Webinar Marketing RX:  Quick Facts

1.    Create a Memorable Experience that will move your viewers to action.

2.    Use compelling content to support your “call to action.”

3.    Practice using the gotowebinar.com service BEFORE your first “real” webinar with actual viewers….you can ask Randy why this point is hereJ

What is a Webinar?

Simply put a webinar is a broadcast that is sent to individuals or posted to a website that allows viewers (like your patients or prospective patients) to simply watch or, at their option, participate during a live webcast.  All that is needed is a computer and an Internet connection.  A webinar may also be referred to as a webcast, online event, or web seminar.

What can you do on a Webinar?

A webinar typically includes both an audio and a visual component.  This allows you to use videos or PowerPoint presentations to convey your message.  Your patients get to hear you convey your message and your prospective patients get to see how you interact with people and provide medical information … this is just one more tool to help them decide whether you are someone they should “trust” with their health care.

Webinars are a powerful way to get in front of prospective patients and do not require a huge outlay of time and money.  In fact, your staff could do simple webinars that show patients how to download forms from your site and complete necessary pieces of paperwork for new visits or surgical procedures.

How do I Create Content for my Webinar?

Webinars are a huge promotional tool used by businesses to sell a product or convert website visitors into subscribers.  Surprisingly, many health professionals forget that they are a business and they are selling a product….Your Services are your PRODUCT.  As such, you should structure your webinar in the same way as an on-line business would structure their sales offer.

Reverse Engineering

Step 1:  Start with your offer.  Your offer is the action you want your viewer to take, a.k.a “call to action.”  Once you know what your offer is you work from there to create your introduction.

Step 2:  Introduction.  You want to create an introduction that gives you credibility and keeps your viewer interested.

Step 3:  Body or foundation for your call to action.  This is the place that you educate and plant the seed as to why they must take whatever “call to action” you have requested.

Step 4:  Closing.  (really step 1)  What is your call to action?  What do you want your viewer to do?  Perhaps, it is to call the office to schedule an appointment or subscribe to your newsletter …whatever it might be don’t forget to include it in your closing.

Do you have a website, but no time to create written content? 

Some of our clients who don’t have time to create written content or, in the alternative, they don’t own their website…meaning they have to pay someone every time they want to add something to their website are choosing to create webinars.  Others are simply choosing to increase their exposure by adding webcasts to their site.  Whatever your situation you can’t go wrong by trying something new.  We will be adding a new webinar tab to our site that will contain valuable information for getting you started on your first webinar.

Medical Marketing Enterprises, LLC uses gotwebinar.com

We use gotowebinar.com for our webinars.  If you are ready to automate your medical practice (while keeping it personal) try gotowebinar.com for a month.   The first month is free and you can cancel if it’s not for you.  If you use our link we will get a small (very smallJ) affiliate commission.  If you have used gotowebinar.com and have points, tips or concerns, please comment below so our whole community can benefit from your experience!

To Your Success,

Amy

Want to watch one of Randy’s first videos?

Does Your Medical Practice Have a Google+ Page?

Is your medical practice using Google+?  This post starts a month long series on the benefits of using Google+ and the steps you need to take to set up a Google+ page.  This information will allow you to be at the forefront of medical marketing!

We believe Google+ is the beginning of Web 3.0.  To have an appreciation for the opportunities Web 3.0 will provide it is important to differentiate it from Web 1.0 and Web 2.0.  To simplify, think of it this way:

Web 1.0 is akin to a one way conversation.  A user enters a “word or phrase” in the Google search box.  Every user who types the same word or phrase receives the same search engine results page (SERP).

Web 2.0 is a step up in that it provides users tools to customize their search.  This allows for a two-way conversation. For example, you can limit the location, time and types of results returned.

So what is Web 3.0?  Although this is still an emerging concept, one component is thought to be the ability to provide users with a unique, customized search experience.

Why is Google+ Important?

Google+ is important to your medical practice because it has developed a platform that integrates a users real world connections with Google’s databank.  Each time a user enters a search query in Google+ the SERP will return relevant posts, people and content from the web.  To simply restate, the user’s search will have context and that will allow Google to provide a unique SERP. Don’t you want to be listed within a user’s personalized results for the services you offer?

Whether you are a Google lover or hater, Google+ will transform the way in which you search for information….and…market your services.  Maybe not today or tomorrow, but by this time next year we believe you will see the importance of utilizing Google+ in your on-line marketing strategy. We would like to help you get started.  Look for our post next week that will outline how to set up your medical practice’s Google+ page.

 

 

 

Test Your Knowledge: Derogatory Facebook Post

Read Your Employee Calls You a “Scumbag” on Facebook:  Can You Fire Them before trying to answer this question.

Amy, Josette and Suzanne, ophthalmic technicians, are unhappy with one of their colleagues, Pam, who is frequently absent.  Her absences create extra demands on their time and workload.  Amy, along with a few of her colleagues complained to Janna, their office manger; however, nothing was done.  The following Saturday Pam called in sick…again!  Several days later, Amy posted the following on her Facebook wall “Pam called in yet again.  Once again we had to scramble to cover the patient load.  If anyone has additional details about Pam’s absence this past Saturday or any of her other missed days please contact me.”  One of Amy’s Facebook “friends” gave a copy of the posting to Janna.

Amy’s Employee Handbook contained the following Social Media Provisions:

Rule 4:  Employees are prohibited from using any social media that may violate, compromise, or disregard the rights and reasonable expectations as to privacy or confidentiality of any person or entity.

Rule 5:  Employees shall not communicate or post anything that could constitute harassment, embarrassment, or defamation of the medical practice or of any employee, representative or staff member.

Rule 6:  Employees are prohibited from making any statement that lacks truthfulness or that might damage the reputation or goodwill of the practice, its staff or employees.

A week later Janna fired Amy for her Facebook posting because her posting violated the above terms of her Employment Handbook.

Amy files a complaint with the National Labor Relations Board.  Who should prevail in this action, Amy or ABC Eyes, LLC.?

Answer will be posted tomorrow.

Your Employee Calls You a “Scumbag” on Facebook: Can You Fire Them?

If you are like most medical practices you either use a stand alone social media policy or you address social media policies in your Employment Agreement, but how many of you have taken the time to make sure the provisions contained in your agreements are enforceable/legal?   Now is the time to dust off your agreements and read them to make sure you can actually enforce the provisions contained within your Agreements.

So before you decide to terminate your “scumbag” commenting employee you dust off your Agreement and find you have the following two provisions in your social media policy:

“Employees may not make disparaging remarks when discussing the medical practice or supervisors and from depicting the practice in any media, including but not limited to the Internet, without company permission.”

“Employees are prohibited from posting pictures of themselves in any media, including the Internet, which depict the Practice in any way, including their practice uniform/scrubs or logo.”

Clearly being referred to as a “Scumbag” is a disparaging remark, right?  While it would seem to qualify as a disparaging remark you need to remember that that fact alone does not necessarily mean you can fire your employee.

Questions You Should Consider BEFORE Taking any Action:

Where were the remarks made?

When were they made?

Why were they made?

To Whom?

Did a conversation result?

If yes, who was participating in the conversation?

Why do I Need to Ask any Questions?  My employees are At-Will?

An exception to at-will employment is that you cannot fire an employee if your basis for firing them violates a federal law.  Have you ever heard of the National Labor Relations Act ( NLRA)?  If not, then you should know that if you terminate an employee and the basis for your termination violates the NLRA you might be forced to re-employ the employee and pay them any back wages owed.   Do I have your attention now?  Back to our example.

Additional Facts that Led to “Scumbag” Comment:

Where was the “Scumbag” comment made?  On Facebook.

When was the “Scumbag” comment made?  At home, on the employee’s personal computer.

Why were they made:  You asked the employee to prepare an incident report concerning a patient complaint.  She requested union representation and was denied.  You then threatened her with discipline when she tried to invoke her right to representation.  (Don’t tune-out…it doesn’t matter whether you have a unionized workplace or not)

To whom:  Her Facebook friends, to include co-workers.

Did a conversation start?  Yes.

Who participated?  Co-workers participated in an on-line discussion of your supervisory action.

You fired the employee and she filed a complaint with the National Labor Relations Board.  Here’s what they found:

Both policies were found to be unlawful.  For our purposes, it is important to realize that in this example the employee, while off duty, was discussing the terms and conditions of employment with co-workers.  This type of activity is protected under section 8 (a) (1) of the NLRA.  Had you taken the same employment action you would now be posting a notice at your work site, bringing the employee back to work, and providing them with all back wages due.

Test Your Knowledge:  Answer the following question.

I am an attorney, but I am not your attorney.   Anything on this blog or in this post should not be construed as legal advice or legal services. If you have an employment law question, you should consult your attorney.

Employee Agreements Need to be Explained

Employment AgreementYou Need Your Employees and They Need You

The end of the Chicago teacher’s strike brought to mind the fact that many well-meaning employers often lose sight of their end goal.  So what do the Chicago teacher’s strike and your medical practice have in common?

For ease of discussion, lets surmise that Chicago teachers felt that their problems/challenges were not being addressed by their current collective bargaining agreement.  Now let me ask you…how many of your employees feel that you welcome their opinions and are committed to working together to make your medical practice the premier provider and employer in your community?

 NOTE:  A collective bargaining agreement sets out the terms and conditions of employment much like an employee agreement, handbook or manual.

How many medical practices have employee agreements or handbooks?  Most, I would hope.  Assuming you have an agreement, have you or your office manager taken the time to find out how your employees feel about the provisions that make up your agreement?   Do your employees even understand the terms of their employment?  Did anyone sit down with them when they were hired and explain the terms in language they could understand and yes, that would mean using non-lawyer speak and using real life examples?   From my experience, the answer is that very few employers take the time to engage with their employees to discuss the conditions of their employment…that is, until there is a problem.

Office Meetings:  Worthless unless Communicated from the Employee’s Point of View

I know many of you will disagree with me on this, but try to put yourself in your employees place.  For example, who prepares the agenda for your weekly/monthly meetings?  Do employees have an anonymous way to convey concerns or recommend agenda items?  Once you meet, how much time is allocated to the concerns of management?   Employee concerns?  A key point to keep in mind is that your employees don’t really care about your issues or that of the medical practice unless they feel they are part of the practice.  Therefore, a rule of thumb is that only 20% of the agenda should focus on the individual physician or their practice.  80% of the meeting should focus on the employee, their thoughts, ideas and concerns.  This is not to say 80% of the meeting is spent discussing non-practice related issues; rather, it means that the way in which those issues are communicated should be from the employee’s perspective.  If done correctly, this will allow for employee engagement and buy-in to whatever end result is agreed upon.

Create Lasting Relationships with Your Employees FIRST

            …..this in turn will create lasting relationships with your patients.  

Having spent the last eight years working with management and unions to solve workplace issues I believe the key to success is to have regular, open communication.  Open communication leads to mutual respect for one another and will shift the focus from the individual concerns of you, your practice or your employee to what really matters and that is the desired goal.  If done correctly, this shift will change the overall tone of your practice and unify your practice in ways you never thought possible.

To Your Success,

Amy

I am an attorney, but I am not your attorney. Anything on this blog or in this post should not be construed as legal advice or legal services. If you have an employment law question, you should consult your attorney.

How to Convert Prospective Patients into Raving Fans

Converting prospective patients into paying patients should be a breeze if you have a system in place.  To help you with creating effective systems we created The Patient Attraction System TM.  This system is essentially a blueprint that allows anyone to run your medical practice without you being there to direct the show.  And more importantly, patient care is delivered in the exact same way, whether you are directing or someone else is directing.

There are essentially six systems that are integral to developing a brand and providing superior medical services.  There are of course many components to any system, but for illustration purposes let’s discuss one piece that serves as the cornerstone of the Patient Attraction System TM.

Step 1:  Prospective Patients

You have worked hard to engage with your community both on and off line, now those efforts are finally paying off.  Prospective patients are calling to schedule appointments with you.  The method that your staff engages with these calls can very well determine whether the prospective patient will actually follow through and trust you with their care.  So if you haven’t already, now is the time to have systems in place that will assure that all of your online efforts are not thwarted by the reception they receive when they first call your office.

Let’s start with how you handle incoming calls to your office.  What is your system?

Patient Attraction System TM:  The Initial Phone Call

How is the phone answered at your medical practice?   This seems like a pretty basic question, but after you have spent hours building your brand on and offline this is often an overlooked part of what can be a defining moment for a prospective patient.  Consider the following exchange and compare it to the intake system you have in place at your medical practice.

The First Step:  The Call

Hello, welcome to the Randall Wong Retina Eye Center, this is Amy, how may I assist you.”  Keep in mind the tone is warm, inviting and definitely with a smile.

What have we told our prospective patient?

The caller was greeted, she knows she dialed the correct number, she knows who she is talking to and she knows that “Amy” is not in a hurry and more importantly, that “Amy” wants to assist her.

Note:  Your receptionist/intake specialist, I prefer to use the term patient care representative,  should know how integral they are to the patient attraction process and should never be expected to rush through a phone call.  Think of it this way…are you running a factory or a patient centered medical practice.

The Second Step:  Intake Information

Now, the next step will hopefully lead to the caller scheduling an appointment.  At this point “Amy” will lead the caller through a questionnaire that was designed to put the caller at ease and gather essential information for the appointment.

The Third Step:  The Welcome Package

Once “Amy” has finished with her scripted intake questionnaire she will thank the patient and let the patient know that they should be receiving a welcome package within the next several days.

The Welcome package will have an assortment of materials, but the most important piece will be the business card with Amy’s information.  Amy will serve as the patient’s point of contact because a personal connection has already been established.  The patient will have a familiarity with “Amy” and will hopefully not hesitate to call should she have additional questions prior to her appointment.

Note:  How many receptionists, patient care representatives, or other staff members at your office are given business cards.  If you are like most offices, the answer is likely very few.  This is something I have never understood….give all of your staff members their own business cards.  Not only does this increase your exposure with each card that is handed out, but think of it from the employee’s perspective; i.e., the business card shows they are valued and have an important role in your medical practice.

The Fourth Step:  Confirm the Appointment by Postcard

Yes, there is a small cost associated with sending a postcard and a welcome package; however, the patient will surely remember the extra special measures that were taken to ensure a seamless first appointment.

Side note:  Many practices like to use their website for directions and contact information.  We believe using on-line and off-line measures to ensure your patient makes it to the office is worth the small expenditure.  Do the math yourself…is the office visit worth the two bucks you spent, and even less after factoring in the relative tax implications.

The Fifth Step:  Confirm the Appointment by Calling the Patient

This is very important; “Amy” will call the patient the day before to confirm the appointment and answer any last minute questions the patient may have.

So… What’s the System?

The system is the process that is used to assure that each patient has the same experience.  In the example that was used above, if you were to implement the five step intake process you would need to have a system in place that would track the completion of each step and automatically send reminders to the patient care representative to remind them of the next task needing to be completed.  This may sound like a lot of work, but once your system is in place you will have created a system that can be employed by anybody.

 

How do You Value Your Medical Practice?

How to Value Your Medical Practice

What math are you using to figure out the relative value of your medical practice?  If you are like most physicians you are probably using traditional methods to determine the value; i.e., revenue, profit and market conditions.  If this is the type of math you are using it is fairly safe to assume that you are focusing on the number of patient encounters you have each month.  This is fine if you are content with traditional valuing methods.  After all, this method is consistent with the traditional sales approach.  Generally speaking, the greater the number of sales, the greater your return on investment for that particular month, quarter or year.

But What if You Want More?

If you want more, then you will need to learn a new math.  Focusing on brand development will make traditional valuation methods worthless.  If you have created an online brand then you have likely carved out a niche within your particular practice area.  Therefore, your total net value is worth far more than the number of patient encounters you have on any given day.

Presumably, at some point, you will want to sell your medical practice.  The time to start planning for that day is now.

Have you Created a Brand for Your Medical Office?

Creating a brand requires a marketing strategy; however, once implemented you will find that your efforts have made your medical practice a valuable asset, one that cannot be measured by traditional valuation methods.

To determine whether you have successfully created a brand consider the following four questions:

  1. What does the market, your market, think about your medical practice?
  2. How, when and where is the market talking about you or your medical office?
  3. What is the experience the market has with your medical office?
  4. Is your brand dependent on you?

Keep in mind the fourth question is paramount.  If your brand is dependent on you then you haven’t created residual value.  Why?   Because the value cannot be replicated by a new owner.  So how do you create a brand in a medical practice that is not dependent on you, the physician?  After all, you are the one who ultimately renders the services.  The key is to develop systems.

An Online Marketing Strategy is Key to Increasing the Value of Your Medical Practice

If you are building your practice much the same way you would read a book or watch a movie, then you haven’t created systems; i.e.,  you have no idea of how the story will unfold.   Meaning if you have no idea of how or when you will sell your practice then you are passively engaging in the practice of medicine without a real plan.  You need to start creating your exit strategy now and it doesn’t matter whether you plan on retiring in 1 year, 5 years or 10 years.  The key is to start developing your marketing strategy now.

If you create a brand that allows any physician or group to simply take over where you left off then you will have created a valuable asset.  If you have incorporated online branding and reputation management then you will need to go beyond traditional accounting to recognize the full value of your medical practice.

Have you created systems to brand yourself? Have you created systems to measure your online efforts?   If so, please share in the comments so our community can gain through your experiences.

~Amy

Does Your Practice have a Story? Are Your Employees Proud to be Part of That Story?

Medical Practice Branding, Telling Your Story to Brand Your Practice

A story can help you create a brand.  Your story can engage your patients.  Tell a story and make your employees part of it.  Does your medical practice have a story?

Approximately twenty years ago I (about Amy Wong) took a summer job working for, Katzen Eye Group, one of the largest ophthalmology practices in the state of Maryland.  This summer job lasted eight years and I only left because I decided it was time to go to law school.  So what kept me at a summer job that was only supposed to last until I found a job in the field for which I was trained.  The answer is I became part of the Katzen Eye Group (KEG) story because I knew that together we really did make a difference in our patient’s lives.

***As you are reading this consider whether any of your employees, twelve years from now, would refer their friends, family members and colleagues to your practice.  If you’re not sure, then now is the time to create a story that you and your employees are proud to not only be a part of, but one they enjoy sharing.

The Story Background

When I first started working at Katzen Eye Group I was hired as a receptionist; however, within a month, at my request, I was being trained by the lead technician to learn the duties of an ophthalmic assistant.  Shortly thereafter, I was shadowing the owner and director, Dr. Leeds Katzen; or to those lucky enough to be in his inner circle, Jack Katzen.  Note:  You’ll have to ask him yourself how, as young boy, he got this nickname and why it has stuck with him his whole life.

What makes Dr. Katzen different from his Colleagues?

Dr. Katzen has an innate ability to make everyone (his staff and patients) feel at ease.  He is non-assuming and contrary to most of his counterparts spends more time listening than treating.  His patients, all of them, even the PIA’s are valued.  This sometimes may have meant taking 30 minutes with a patient that was supposed to be a 10 minute follow-up exam.  Now in most practices this would likely have caused disgruntled patients and disgruntled staff members for the remainder of the day…not for us.  We rarely got complaints and when we did they rarely left the office unhappy.    Keep in mind our normal schedule without add-ons usually started with approximately 50 patients.  By the end of the day we had likely seen closer to 60.  So how did he do it?  He did it with his story and by developing that story with his team who supported him throughout the day.  His story, my story, our story evolved each day we were together and, if asked, continues to be retold to this day.

His Story

As a young boy, Dr. Katzen, liked to play ball in Patterson Park and when the sun would finally set he would return to his small row house in Baltimore City, Maryland.  His sleeping quarters were small and for the most part, there were no material luxuries in his life.  His parents were not working professionals so he didn’t have the connections that are usually associated with getting into medical school. In short, nothing was easy for him and he had to work hard to attain everything he achieved, but he had a vision and worked tirelessly to achieve his vision.

His Success Lies in the Fact that he Never Forgot his Story

Dr. Katzen never forgot where he came from and never failed to show his appreciation to those who helped him continue his vision each day.  To this day, he is passionate about his practice, patients, and staff members.

While working with him I enjoyed listening to him reminisce with his patients about what it was like to grow up in Baltimore City, as well as the lessons he learned while in his first years of practice.   It is only now, some twenty years later, I realize this was his way of breaking the perceived doctor/patient barrier.  His stories put everyone at ease and facilitated the entire exam process.

Lessons Learned

To create a memorable story that is worth retelling you will need to engage with your patients as people first and patients second and more importantly, as Dr. Katzen so astutely realized, engage your staff as people first, and employees second.

How to Create Your “About Me” Page

Start branding your medical practice and don’t wait to develop your “About Me” page.  The “About Me” is often one of the highest ranking pages on a website. So why then do most physicians/medical practices put so little thought into the development of their “About” section?

Engage Your Patients

Think of the “About Me” as your opportunity to engage with your patients in a personal and unique way that will allow you to set yourself apart from your competition. It really should be the first page that is developed and it should set the tone for your entire website.

When you meet with an SEO guru see if and when they discuss the “About Me.”  True gurus understand just how important this section is and will spend a great deal of time exploring the many facets that are involved in branding your practice through your “About Me” page. If they skip it or rush it….run for the door.

Starting the “About Me”

First , you will want to visualize that you are having a conversation with a new patient and that they have asked you these four questions:

  1. Why do you do…what you do?
  2. How can you solve my problem?
  3. Why should I trust you?
  4. When you aren’t working, what do  you enjoy doing?

This will hopefully get you thinking about the many reasons that you love your chosen profession and how you enjoy your free time. The point is to give your readers a glimpse of who you really are, and that, of course means, going beyond the accolades listed in your resume. Give them a reason to want to connect to you.

Optimize Your “About” Page

You will also want to optimize your SEO for “About Me.”  So, just as with every other page on you website, choose a few keywords and work them into your content.

How to Organize Your “About Me”

Readers often remember what have last read. Consider designing your page in the following order:

  • Name
  • Profession
  • Specialty
  • Education
  • Qualifications
  • Hobbies
  • Personal Message

Always Include Your Contact Information

Even if you have separate section devoted to ways to contact you, be sure to include the same information on your “About Me” page. The easier you make it for your readers to reach out to you, the more likely they will actually do it.

Last, but Certainly not Least…Thank Your Readers!

The bottom line is that the development of your “About Me” is to either begin or continue a conversation with your reader/patient/referring physician. Be sure when you do this, you are authentic to yourself and your readers. No matter what, you will always want to increase your personal and professional brand with integrity.

SEO Tip for Your Medical Website

Presumably, you have taken a great deal of time to develop your “About Me” page so be sure to optimize it. Consider the following:

Is your website within the first ten results on Google TM for a chosen keyword?

If the answer is yes, then optimize your “About Me” with the same keyword.

Then link your “About Me” with your main page by using anchor text.

Then go to your main page and create anchor text to link your main page back to your “About Me.”

Does Your Medical Practice Have a Story?

Medical SEO, Telling a Story About Your Practice

 

Fresh out of law school I began my legal career with the Department of Defense. At the time I had thought DoD’s primary job was to ensure the production of tanks, planes, ammunition, and other war fighting paraphernalia. While those items are necessary and certainly a part of DoD’s story, the truth is that it is the people who fly the planes, shoot the guns and protect our nation that make-up DoD’s story.

Surprisingly, this information was not part of my initial orientation. It was not until I actually listened to the stories of the soldiers and civilian workers who had deployed that I realized they were my true employers, not DoD. This realization changed my perspective and gave me purpose.

So How Does this Relate to Your Medical Practice?

When you hire a new receptionist, technician, or office manager what do you include in your orientation? Do you start with all of the legal paperwork or do you start with your story, your purpose?

Who is the true hero in your story? For some practices the hero may be the patient, for some it may be collective heroism, meaning the staff as a whole and for some it may be the physician. Practice managers who develop their practice’s story and then market that story to both internal and external stakeholders will create purpose for their staff members and patients.

To give you a sense of reference, think of your story as collective pool of water. Each patient or staff member who comes into contact with the pool adds a drop of water. This pool of water is dynamic and is constantly adding to the collective vision. And this vision is continuously reflected out to your internal and external communities.

Why Storytelling?

By creating and retelling your story you give a purpose to your call of action. For employees, you inspire them to add to and continue the collective “pool.” For patients, you give them a sense of belonging and ownership in the practice.