Digital Strategy Healthcare Marketing

No More Read Receipts and A/B Subject Line Testing with Apple’s Next iOS Update

Apple’s announced changes to their email privacy features effectively ends tracking of opens, forwards, location and IP addresses. This means no more A/B testing of subject lines, knowing if your email was forwarded to someone else or which organization the recipient works at. Marketers are now scrambling to adjust their strategies before the next iOS update in September 2021.

Apple Doubles Down on Privacy

Apple’s annual Worldwide Developers Conference (WWDC) is the event where the company drops the latest news about its upcoming products and enhancements. Normally it is where new devices and internal hardware is previewed. This year, privacy changes took center stage.

Over the past several years, Apple has sought to differentiate itself by being a champion for user privacy and security. They were the first to offer block of third-party cookies in its Safari browser in 2020 and was the first to offer App Tracking Transparency (ATT) which would make it clear what activity various apps were tracking and allow you to adjust accordingly.

At WWDC21 they doubled down on their privacy push by introducing Mail Privacy Protection which will be defaulted to “on” in iOS 15. What will this new feature do? This slide presented at WWDC21 sums it up neatly:

Image: Screen Capture of WWDC21 from Anupam Chugh

Hidden Pixels and Proxy Servers

Email platforms like MailChimp and Constant Contact along with marketing automation systems like HubSpot, Marketo, Pardot and Act-On have used hidden pixels to track when and where emails are opened. At a high level, here is how hidden pixels work:

  1. Any email that is sent using these systems have a small 1×1 pixel image appended to the content
  2. When the email is opened, the 1×1 pixel image is loaded
  3. The system tracks this image request and knows that the email was opened
  4. The information from the requesting email client is deciphered and used to identify: the geographic location of where the email was opened, the IP address the email recipient is opening the email from, the application used to open the email.

Most people outside of marketing did not realize these hidden pixels exist or that they are used to track their email behavior. Privacy advocates have complained for years about hidden pixels, but not a lot has been done about those concerns – until now.

Apple’s MPP enhancement in iOS 15 will disable hidden pixels and route email open requests through multiple proxy servers to obscure the location and IP information of their users. These changes will mean marketers will no longer be able to:

  • Track email opens.
  • A/B test subject lines
  • Embed dynamic content in emails based on real-time location
  • Know which organization the user opened the email from

Email Opens

Email open rate has been a standard marketing metric for a long time – since the dawn of email marketing back in the 90s. It is a useful metric that can help gauge how email are (or aren’t) resonating with a target audience. Unfortunately, this metric will be rendered useless when iOS 15 rolls out in September 2021.

According to the latest data from Litmus, 51.8% of all emails are opened using Apple with a whopping 90% of mobile email opens happening on Apple’s iPhone (vs 3.5% on Google Android). When iOS 15 is rolled out, Apple users will be asked whether they would like to enable Mail Privacy Protection (and it is expected that the default will be “on”). It is anticipated that most Apple users will opt to turn it on.

Since most emails are opened on Apple, this means that open rates will look like they will have dropped by 30-50% overnight…making open rate an almost pointless metric to track.

For healthcare organizations and Health IT vendors that leverage 3rd party email advertising (ie: with an association or media outlet) this means you will need to find a different metric to gauge the effectiveness of a campaign. It also means that you should no longer pay a premium to companies that claim to have a high open rate.

A/B Testing of Subject Lines

The loss of tracking email opens has significant implications for marketers that use A/B testing of subject lines. Apple’s MPP feature means this practice will come screeching to a halt in September.

The whole point of testing different subject lines was to determine which one would result in more opens by recipients. This type of testing was common for organizations with large email lists.

Some email platforms and marketing automation tools even had automated workflows that would test and select the best subject lines automatically (sending out small batches of emails to test the subject line and then selecting the most with the most opens automatically for the remaining big batch of emails).

The loss of A/B testing of email subject lines at scale is a significant blow to any marketer using email marketing. Marketers will have to infer the effectiveness of their subject lines from the clickthru data of email call-to-actions.

Changing Approach to Email

The changes Apple is making to its email privacy should not scare healthcare marketers into abandoning email marketing as a channel. If your house email list was properly curated from interested parties or from home-grown community activities rather than purchased lists, then you already have an advantage – your email recipients have expressed interest in remaining in contact with you.

If you continue to create engaging content, your email audience will still click to read more or click to download it. Once they land on your website/landing page, you can capture their activity through first-party cookies which are still allowed.

Personally I hope that Apple’s announcement deters marketers who were simply blasting their email lists over and over again in an attempt to monetize their open rate. I want them to abandon email marketing as a viable channel so that healthcare marketers have less noise to overcome.

For more on Apple’s announcement, check out this great post from Anupam Chugh.

About the author

Colin Hung

Colin Hung is an award-winning Marketing Executive with more than 15yrs of healthcare and HealthIT experience. He co-founded one of the most popular healthcare chats on Twitter, #hcldr and he has been recognized as one of the “Top 50 Healthcare IT Influencers”. Colin’s work has been published in the Journal of the American College of Radiology, American Society for Healthcare Risk Managers, and Infection Control Today. He writes regularly for Healthcare Scene and here at HITMC.com. Colin is a member of #pinksock #TheWalkingGallery and is proudly HITMC. His Twitter handle is: @Colin_Hung.

1 Comment

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  • This is a big change. Although, you should also evaluate how many of your readers are on iOS devices since that will determine how big it is for your organization.

    What’s even more interesting about this change is that it may have the opposite effect of what they want. By not allowing this, all of the rules around lack of engagement (at least the open ones) can’t be applies. So, those who would have stopped emailing people who aren’t opening their email can’t do that now. Plus, with less transparency, some will turn up the email volume.

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