What It Actually Takes to Close the Gap

By now, most health system brand leaders have read some version of the same argument: the gap between brand promise and patient experience is real, it’s growing and it’s costing you trust. Naming the gap is necessary work. But it’s only the first step.

The standard advice—get brand and experience teams designing together, build shared KPIs, align around the journey—assumes a level of willingness that rarely exists naturally in organizations. You can’t schedule your way into it. You can’t propose your way into it. And you almost certainly can’t ask for it directly without triggering the kind of territorial response that kills it before it starts.

What you can do is earn it. And that starts well before anyone else is in the room.

The prescription is right. The conditions for it almost never exist.

In most health systems, closing the gap between brand promise and patient experience feels nearly impossible for two reasons that rarely get named: the organization isn’t structured for it and leadership hasn’t mandated it.

Customer experience, digital, clinical, operations: they all have their own lanes. Each function has a VP with a roadmap, a budget she’s fighting to protect and a team that’s already behind on today’s fires. Nobody in that structure is sitting around waiting for the brand team to show up with a mandate, no matter how collaborative.

So when someone says “brand and experience need to design together,” the VP of customer experience hears: “you want us to take on more work, disrupt our roadmap and give another function a claim on our results.” The answer is usually a tactful version of “thanks, but no thanks.”

This is why so many well-intentioned coordination efforts go nowhere.

Collaboration at this scale requires someone at the top to make it a mandate. But that mandate rarely exists out of the gate.

Earn the mandate, don’t ask for it

Brand is rarely in a position to force a mandate. But what you can do is create the conditions for one by building the kind of shared vision that makes it feel inevitable.

That means building a compelling case by painting a vivid picture of what’s possible and getting the right people excited about being part of it. When that happens, leadership takes notice and the mandate tends to follow.

To exert this kind of influence, brand has to show up with enough credibility to be taken seriously, then use that credibility to change the conversation.

Credibility before collaboration

Brand’s biggest obstacle inside large health systems isn’t lack of effort or intention. It’s perception. Brand is too often seen as the function that understands consumers but not the business. They know what patients are saying but not what it really means for clinical teams, operations or the people managing roadmaps that would actually have to change.

As a result, brand’s recommendations go nowhere. The recommendations may be sharp. But brand hasn’t demonstrated it understands what’s at stake for the people it’s asking to act.

This is the credibility problem brand has to solve before anything else. And it has to be earned.

Know enough to be taken seriously

Brand can’t map the full promise-experience gap on its own. It lives across functions that span the entire organization. But pointing at the problem from a distance isn’t enough either. That just gets you politely dismissed.

The move is narrower and more powerful. Bring what brand uniquely knows—consumer research, patient behavior, where trust is eroding—and connect it explicitly to what the other functions care about. Not “here’s what patients are saying” but “here’s what patients are saying, here’s where that intersects with your roadmap and here’s the question I think we need to answer together.”

In a large health system, each function is responsible for a piece of the work. But accountability by function makes it hard for everyone to see how all the pieces fit together. It’s like building parts of a rocket ship without ever seeing the full set of blueprints.

Brand is uniquely positioned to help their colleagues see the full rocket: close to the consumer, close to the promise, close to where trust is won or lost. Using that vantage point to connect what patients are experiencing to what other functions are building—that’s what reframes brand as a transformation engine. It’s a different conversation than most brand teams are prepared to have. But it’s the one that opens doors.

Paint a vision your whole organization wants to embody

Even with good preparation, you’re unlikely to get the cross-functional collaboration you need by asking for it directly. Organizations this large and this siloed don’t reorganize around a good idea presented in a meeting. They reorganize around a vision they can feel. One that makes them want to be part of what comes next.

Which means brand’s job, before anything else, is to Trojan horse its way in by creating that vision. To create a vision compelling enough that others want to be part of building it.

This isn’t the moment for a run-of-the-mill report or deck. The solution is a “sacrificial artifact”: a provocation that shows what’s possible if your organization works together to close the gap. It could take the form of a rough prototype of an experience that doesn’t exist yet. A set of patient personas drawn from real research, showing who your organization is about to lose. A short film version of a future that only happens if the right people decide to build it together.

The word “sacrificial” matters. The artifact is deliberately incomplete. It’s designed to paint a broad vision and invite reaction, not present conclusions. Done right, people engage with the vision critically, and in doing so, they start to co-own the solution. Done wrong (too polished, too prescriptive), it reads as brand overstepping, which triggers exactly the defensive response you’re trying to avoid. The artifact only works if brand is genuinely willing to let others change it.

Dropbox famously launched with a demo video of software that didn’t exist yet. It wasn’t a product. No working software. No beta. Just a four-minute demo of something that didn’t exist yet. It was a question: would people want this? The answer came back yes, loud enough to justify building it—and 75,000 signups overnight. The fiction was more useful than the facts would have been.

The sacrificial artifact is the same move, applied internally. You’re not asking for approval. You’re asking: “do we believe this is worth building together?”

What brand can’t do alone

None of this works without at least one person at a senior level who decides closing the gap between brand and experience matters. Brand can earn credibility, create a vision compelling enough to change the conversation and build the conditions for a mandate. But someone at the top still has to pick it up.

Getting to yes is harder than it should be. But it’s also the only thing that makes what comes next possible.