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Healthcare & Health Systems

Governance-First AI Marketing Operations for Health Systems and Multi-Location Care

Healthcare marketers answer to more stakeholders than anyone else in the profession: compliance, legal, IT security, and clinical leadership all get a vote before anything ships. Mad Fish Elements was built for that reality. It’s an AI gateway to 33 marketing and analytics platforms where every seat has explicit read, write, and delete permissions, every action ties to a named user, and every operation lands in a full audit trail. Your team moves faster because the guardrails are structural, not procedural - and we’re Mad Fish Digital, so we’ve sat through the same security reviews you have.

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What Mad Fish Elements Changes

One review covers the whole stack

Instead of thirty-three separate access debates, your security team reviews one governed gateway. Every user connects through native OAuth - the same “sign in with your own account” flow IT already trusts - so no API keys get created, stored, or shared. Permissions are explicit per seat, per platform: read, write, and delete, each granted separately and enforced server-side on every call. When IT asks “what can the AI do on behalf of this user,” the answer is a permission matrix they configured themselves. That turns the six-month review into a question with a documented answer. The platform is built around documented security controls.

Every location, one instruction

Google Business Profile sits behind the gateway alongside everything else. Holiday hours change across all fifty locations in one batch operation. New service lines get added to the right profiles in one pass. Unanswered reviews surface as a single queue instead of fifty separate inboxes. The work that was a part-time job done badly becomes a weekly prompt - with every change logged to a named user.

Service-line reports that build themselves

With Google Ads, Meta, GA4, and Search Console in one conversation, a service-line report is a prompt, not a project. Better still: publish each service line’s report once in Data Visualization and let scheduled refreshes keep it current - the same governed report, updated in place, shared with the stakeholders who need it. Analyst weeks convert into analyst judgment, and the cardiology chair sees this month’s numbers this month.

Read-only seats built for leadership

Starter seats are read-only by design. Give your CMO, service-line administrators, and compliance officers seats that can see everything relevant and change nothing - enforced by the gateway on every call, not by hoping each platform’s viewer role was configured correctly. Oversight without sprawl. Visibility without the PDF-export bottleneck.

The audit trail is the product, not an afterthought

Every operation through the gateway - every query, every edit, every deletion, on every platform - is recorded in one full audit trail tied to per-user OAuth identity. “Show us every change last quarter and who made it” becomes a lookup, not a forensic reconstruction across six platforms. Automated error monitoring adds the operational layer: failed operations get flagged and tracked instead of silently piling up.

The Problems Healthcare Marketing Teams Live With

Every new tool is a six-month security review

Your marketers want the same modern stack every other industry uses, but each new platform login triggers an IT security review, a data governance questionnaire, and a debate about who gets access. The result is a team working with fewer tools, later, than their competitors - not because the organization is anti-technology, but because ungoverned access is a risk nobody will own. AI assistants raise the stakes further: the capability is obvious, but “which staff member can make the AI do what, in which system” has no good answer with off-the-shelf integrations.

Fifty locations, fifty Google Business Profiles, zero consistency

Every clinic, urgent care, and specialty practice has its own Google Business Profile - hours, services, phone numbers, holiday schedules, reviews. Keeping fifty of them accurate is a part-time job done badly in the margins, and the failure mode is a patient standing outside a closed clinic that Google said was open. Updates roll out location by location, by hand, and an unanswered one-star review sits in public for weeks because nobody owns the queue.

Service-line reporting takes a committee

Orthopedics wants to know what their campaign produced. So do cardiology, oncology, and the bariatric program - each with its own budget, its own physician stakeholders, and its own definition of success. Building those reports means pulling Google Ads and Meta data, GA4 appointment-request conversions, and Search Console visibility, then reshaping it all per service line. It eats analyst weeks every month, and by the time the cardiology dashboard reaches the cardiology chair, the quarter has moved on.

Leadership wants visibility without edit rights

Your CMO, service-line administrators, and compliance officers all want to see campaign data. None of them should be able to change a campaign - and most ad platforms make that separation awkward, with viewer roles that vary by platform and get misconfigured quietly. So access either sprawls (risk) or bottlenecks through the one analyst who exports PDFs for executives (delay). Neither serves an organization where oversight is the whole point.

Audit requests measured in weeks

When internal audit or compliance asks “show us every change made to our advertising accounts last quarter, and who made it,” your team assembles the answer from six platforms’ change histories - each with different retention, different detail, and different export formats. Some platforms barely log at all. The answer arrives late and incomplete, and every request makes marketing look less governed than it actually is.

Use Cases

System-wide holiday hours in one pass

“Update holiday hours for all 43 locations’ Google Business Profiles: closed December 25, open 9-to-1 on December 24 - and list any location whose current hours didn’t match our standard template.”

Platforms Google Business Profile

What took a coordinator two days of clicking happens in one governed batch, with a logged record per location. The template-mismatch check catches drift you didn’t know you had.

The weekly review queue

“Show me every Google Business Profile review from the last 7 days across all locations rated 3 stars or below, grouped by location, and draft a compliant response for each for my review.”

Platforms Google Business Profile, Google Docs

Reputation stops being fifty separate inboxes. A marketer reviews and approves drafted responses in one sitting, and no negative review sits unanswered for weeks.

Service-line performance on demand

“Summarize the orthopedics campaign this quarter: Google Ads and Meta spend and conversions, GA4 appointment-request completions from the ortho landing pages, and Search Console impressions for our joint-replacement queries.”

Platforms Google Ads, Meta, GA4, Google Search Console

The report that took a committee assembles in one thread, formatted for the service-line meeting. Repeat it per line, or publish each as a refreshing Data Visualization report.

Leadership check-in, read-only

“Give me a plain-English summary of this month’s marketing performance across all service lines - spend, appointment-request conversions, and anything trending unusually.”

Platforms Google Ads, Meta, GA4

A read-only Starter seat lets an administrator self-serve this answer without edit rights anywhere and without queueing for the analyst. The gateway guarantees the seat can look but never touch.

The audit response

“List every write and delete operation performed on our Google Ads and Meta accounts in Q2, grouped by user, with timestamps.”

Platforms Google Ads, Meta, plus the gateway’s own audit trail

The compliance request that took three weeks of platform archaeology becomes a same-day answer, complete and consistently formatted, because the gateway recorded every governed action as it happened.

Local landing pages that match local campaigns

“Check that each of our 12 urgent-care Google Ads campaigns links to the matching location page on our WordPress site, and flag any mismatched or broken destinations.”

Platforms Google Ads, WordPress, GA4

Campaign-to-page integrity across a multi-location footprint gets verified in minutes - protecting your budget and the patient who clicks an ad expecting to land on the right clinic.

Five Prompts To Steal

Paste any of these into Claude once you’re connected - each one runs inside whatever permissions your seat allows, and every action is logged.

“Audit every location’s Google Business Profile for missing service lists, outdated phone numbers, and empty descriptions, and rank locations by profile completeness so we know where to start.”

A system-wide hygiene scorecard in one pass - the fix list arrives prioritized before anyone opens a profile.

“Show the GA4 funnel from landing-page session to appointment-request submission for cardiology this quarter, compare it to orthopedics, and tell me where prospective patients drop off.”

A step-by-step read on where the funnel leaks - so the fix targets a specific page, not a hunch.

“Compare cost per appointment request by service line in Google Ads for the last 90 days versus the prior 90, and flag any line where it rose more than 15%.”

An early warning on rising acquisition costs, per program - before it surfaces in a budget meeting.

“Draft two Google Business Profile posts for each of our three new pediatric locations - a welcome post and a services overview - and hold them for my approval before anything publishes.”

Location content written and staged, with you as the gate - nothing goes live without sign-off.

“Build a monthly view of spend, appointment-request conversions, and cost per request by service line from Google Ads, Meta, and GA4, and publish it as a dashboard I can share with clinical leadership.”

Read-only visibility for physician stakeholders - the same governed link every month, always current, never editable.

Data Visualization for Healthcare

Service-Line Performance Report

per service line: Google Ads and Meta spend, GA4 appointment-request conversions, cost per conversion, and Search Console visibility trends. Service-line administrators and physician leadership read it, refreshed on schedule ahead of each monthly review.

Multi-Location Visibility Board

Google Business Profile health across every location: review volume and ratings, response status, profile completeness, hours accuracy. The digital team checks it weekly; regional operations directors check it monthly.

Executive Marketing Summary

system-level spend, conversions, and trend lines across all channels, annotated by the marketing team. Your CMO and executive leadership read it, and because the same governed report refreshes in place, the link in the board packet is always current.

The chart types that tell your story

Healthcare dashboards carry an extra burden: physicians and administrators need to trust them at a glance. These are the chart types we’ve seen earn that trust:

Bar

service lines side by side on spend, conversions, and cost per appointment request. It’s the fairest way to put orthopedics and cardiology on the same page without an argument about formatting.

Geo map

performance by market and location. For a multi-site system, the map shows which regions are underserved by your marketing before a spreadsheet ever would.

Funnel

impression to click to appointment request. It shows each service line where prospective patients drop off, which turns “the campaign isn’t working” into a specific fix.

Line

booking volume over time. Seasonality, campaign launches, and referral shifts all show up as movements a clinical audience reads instantly.

Heatmap

appointment requests by day of week and hour. It tells you when patients actually reach out, which shapes both ad scheduling and call-center staffing.

Gauge

goal attainment per service line. When each program has its own target, a gauge gives every stakeholder a one-second answer to “are we on track?”

Governed Access Your Compliance Office Will Sign Off On

Mad Fish Elements is governance-first by design. Every user authenticates through native OAuth under their own identity - no shared logins, no API keys - so every action is attributable to a named person. Read, write, and delete permissions are assigned per seat, per platform, and enforced server-side on every call; a read-only seat cannot write, no matter what it asks the AI to do. Every operation is captured in a full audit trail, and the platform is built around documented security controls. This is healthcare marketing data - campaigns, analytics, business profiles - handled with the access discipline your organization already expects of its systems.

Per-user OAuthRead / write / delete per seatFull audit trailDocumented security controls

Ad ops pricing

Ad Ops Pricing

A higher base buys a lower rate. Pay more up front and keep more of your spend. Every Ad Ops tier includes governed platform access, per-user grants, and administrator controls.

Ad Ops Reporting

Diagnose

$499/mo

No managed-spend fee

See what's wrong across every account.

Unlimited platforms & connections
Read-only access
Basic support

Included playbooks

Cross-Platform Account Health Check

Request Early Access

Ad Ops StandardMost popular

Diagnose + Fix

$799/mo

+ 1.25% of managed spend per month

Find issues and fix them — full read/write automation.

Unlimited platforms & connections
Read + Write + Delete
Full audit trail
Email support (48hr SLA)

Included playbooks

Everything in Reporting, plus:

Google Ads Account Audit
Meta Ads Health Check
Microsoft Advertising Health Check
Budget Pacing Review
Negative Keyword Mining
Tracking Hygiene Check
Google Tag Manager Audit

Request Early Access

Ad Ops Premium

Optimize

$1,499/mo

+ 1% of managed spend per month

Proactive optimization across every brand you own.

Unlimited platforms & connections
Everything in Standard
Multiple workspaces
BYO OAuth included
Priority Slack support
365-day audit retention

Included playbooks

Everything in Standard, plus:

Creative-Testing Methodology
Budget Reallocation & Spend Forecasting
Competitive Intelligence Scan
Automated Anomaly Watch — scheduled monitoring with alerting
Search Intent & Query Mapping

Request Early Access

Ad Ops Enterprise

Orchestrate

Starting at ,500/mo

Negotiated (typically 0.30–0.50%)

Your playbooks, your rules, at scale.

Unlimited platforms & connections
Everything in Premium
Custom playbooks built for your workflows
Volume + commitment pricing
SSO / SAML
Direct line to the founding team · Custom SLA

Included playbooks

Everything in Premium, plus:

All playbooks + custom playbooks

Talk to Sales

Interactive estimate

Monthly managed ad spend calculator

Plan notes:Reporting stays base-onlyStandard and Premium prices update as you adjust spend

How managed spend is measured: total spend on connected ad accounts during the billing month, measured from the platforms' own metrics APIs at billing time, regardless of where changes originated. Exact accounts and queries are visible in the audit trail. Disconnected accounts are excluded.

Data Visualization is tenant-wide: Viz Starter /mo for up to 50 saved reports, Viz Team 9/mo for up to 100 reports (included with Ad Ops Premium), or Viz Scale 9/mo for unlimited reports.

Talk to us about your Ad Ops plan

Frequently Asked Questions

Does this touch patient data or PHI?

No. Mad Fish Elements connects to marketing, analytics, and operations platforms - ad accounts, GA4, Google Business Profile, CMS, and similar systems. It works with healthcare marketing data: campaign performance, web analytics, and business-profile information.

Can we guarantee certain staff can never modify or delete anything?

Yes, and the guarantee is structural. Starter seats are read-only by definition, and on any tier, write and delete are separate per-platform grants enforced server-side on every call. A seat without write permission can’t make changes no matter what it asks the assistant to do.

How does this get through our IT security review?

As one review instead of thirty-three. Native OAuth means no API keys get created or stored; credentials are per-user; permissions are centrally configured and server-enforced; every action is audit-logged; and the platform documents its security controls for your security team to evaluate directly.

Can it manage Google Business Profiles for all of our locations?

Yes. Google Business Profile is a connected platform, and batch operations handle multi-location work - hours updates, service changes, review monitoring and response - in one governed pass, with each change logged per location and per user.

Which AI assistants can our team use?

Claude, ChatGPT, Microsoft Copilot, and Gemini all connect to the gateway. Permissions and the audit trail apply identically regardless of the assistant, so your team’s tool preference doesn’t change your governance posture.

Move Faster Because You’re Governed, Not Despite It

Here’s what we’ve seen: the organizations that market well in healthcare aren’t the ones that avoided AI - they’re the ones that adopted it with structure. Mad Fish Elements gives your team the speed and your compliance office the record, in the same system. Bring both to a walkthrough.