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Semantic Search Changes SEO Rules

Updated: Mar 5, 2019

Online marketing strategies focused on optimizing keywords is so last year. In 2019, healthcare marketers should be focused on how semantic search will impact their content plans.

In short: Search engines are now interpreting searcher intent — not just keywords — and rewarding “hubs” of in-depth content that provide comprehensive information desired by searchers on a particular subject. That shift requires an updated online strategy that moves away from optimizing individual pages and more toward understanding and answering patient questions in topic hubs.

What Is Semantic Search?

To understand this shift, you need to understand how users are conducting searches today. Users are no longer entering a list of critical keywords into search. Instead, they use long-tail keywords and questions to narrow their search results and focus on what is often very specific information. This trend is heightened by the increasing use of voice search over phone, tablet, and particularly in-home devices such as Alexa.

Beginning with its Hummingbird algorithm update in 2013, and continuing with its RankBrain update in 2015, Google began moving away from a focus on keywords as the basis of search to a focus on semantic search. Search algorithms are now able to discern what a searcher is looking for based on the context of a search query, rather than just keywords. Targeting specific keywords is less important than targeting key subjects.

How Healthcare Marketers Can Improve SEO

The shift in search engines to semantic search means that trying to optimize a single page for a list of keywords is not especially useful. Instead, search engines are rewarding hubs of interlinked content that optimize not just a specific keyword, but also related keywords and synonyms for those keywords.

In order to optimize your online healthcare content under the new SEO rules, you have to know first what questions consumers are asking and then answer those questions. Think of the difference between trying to write copy to optimize the term “genetic breast cancer” versus “What is my risk of inheriting the gene that causes breast cancer?” (Yes, we know it is actually a genetic mutation, but consumers are more likely to think — and ask — about the gene that causes cancer, another argument for knowing the specific questions your potential patients are asking.)

Developing content that answers consumers’ questions and addresses their pain points is key to being found in search today — in a nutshell, searchers will want your content if it’s useful to them. While it’s important to do keyword research and all of the other SEO tactics discussed in this blog, having useful content is the foundation of a successful content marketing strategy.

Before you start worrying about SEO or start developing content, it’s critical to understand consumers’ concerns, the underlying questions they’re trying to answer, and their path to care. As content marketers, we cannot emphasize this enough. According to recent research, 71 percent of marketers say that less than half of their content is being consumed. Don’t be one of those marketers — instead, spend the time up front to:

1. Learn what questions potential patients are asking

2. Develop and understand your patient persona, their information needs, and their path to care

3. Then create content to answer potential patients’ questions and address their information needs

Some keyword software tools, such as and, can help determine what questions searchers are asking. After entering a short phrase, such as “search engine marketing,” into the software, it returns a list of potential search queries in the form of questions.

The Right Time and Place for Keyword Research

All of this is not to say that keywords no longer have a place in SEO — it’s just a different place. When developing content hubs, we have moved our keyword research phase until after we develop the patient persona, outline a path to care, and research consumer questions. By moving it later in the process, we ensure that our biases are not influencing the editorial plan. Yet, we don’t exclude it completely because it helps us prioritize content.

Here is an example: When researching consumer questions around spine surgery recovery, we found a lot of interest in foot drop. After our keyword research, however, we saw it was not high in monthly searches. As a result, we included foot drop as a subtopic on our pillar page. But there was no need to create a separate page or content cluster around the topic.

How to Use Keywords Today to Improve SEO

In the early days of search engine optimization (SEO), the best way for a website to be found in online search was to use the keyword you wanted to rank for in numerous places throughout your page copy. Now known as “keyword stuffing,” this tactic focused on keyword density, or making sure your keyword accounted for a certain percentage, usually 5-7 percent, of your total page copy.

Writing to incorporate a particular keyword in such a large proportion seemed almost unnatural, but it was a technique practiced by many web copywriters to improve page rank. Some early SEO practitioners also listed their target keywords below the copy block to aid in search. What’s now known as “black hat SEO” was another tactic that involved placing keywords in white font at the bottom of the page in hopes that the search algorithms would be fooled into a high page rank.

Today, we know that search engines will penalize websites for these practices — not to mention that consumers typically do not find these tactics useful. Some basic keyword rules, however, still apply.

In developing content around a given topic, you still need to determine one to three primary keywords per page, and make sure they have sufficient monthly search volume and a reasonable difficulty level so you are able to rank on these terms. Your primary keywords should be used in your URL, page title, H1 headings, and meta description. While these factors don’t factor highly into search algorithms, they do entice searchers to click on your content, and then help them navigate the page.

Use keywords in copy as part of good writing. But update your copywriting practices with these new rules:

~Keywords don’t have to appear in the exact order of a search to count.

~You no longer need to write “spine surgery recovery” throughout your page, but instead can use similar phrases such as “recovery from spine surgery.”

~Search engines now recognize synonyms and count them toward the related keywords.

Other Tactics to Improve SEO

Depending on who you talk to, there are various and ever-changing factors that affect how your website content ranks in search. SEMrush recently conducted research on 17 factors that impact Google search rank. Direct website traffic was the leading factor with the greatest impact on search results. Other factors that have strong influence on page rank include time on site, pages per session, bounce rate, and links (including total referring domains, total backlinks, and total referring IPs).

Overall, the factors outlined in the research all point back to the importance of producing good content.

MarketingProfs has a nice summary of the SEMrush research in a recent article. You can download the full study here.

Some additional factors that impact search are outlined below. Though not an exhaustive list, these factors should be taken into consideration as part of your content strategy.

Interlinked Content

In addition to searcher intent, search engine algorithms now look for interlinked content. HubSpot and others have done extensive research around the concept of organizing and interlinking content around a topic cluster. Topic clusters include a central page — referred to as a topic page or pillar page — with overarching content, and multiple supporting pages with detailed content that link back. At Clementine, we call topic clusters “content hubs.”

Research conducted by HubSpot shows that content hubs work in part because of the interlinked content: the more interlinking, the better placement in search engines and the more impressions or views generated.

Well-Organized Website and Positive UX

While interlinking is critical, another key to SEO is well-organized content that promotes a positive user experience (UX). Searchers must be able to find what they want once they arrive at your site. A content hub website structure can help organize your content to meet this goal. Your content strategy might begin with a website audit, so you can determine if you need to reorganize your website to make information easier to find.

Incoming Links and Domain Authority

SEO experts still believe that quality incoming links, sometimes called backlinks, and domain authority go hand in hand in SEO. Writing good quality content increases the likelihood that other high-quality websites will want to link to your site. And, incoming links from high-quality websites increases your domain authority.

Domain authority is a scoring system developed by Moz that predicts how well a website will rank on search engine results pages (SERPs). If you would like to learn more about domain authority, read more from Moz here.

Domain authority is a comparative rather than absolute metric. While it is tough to influence, you can improve your site’s domain authority by improving your overall SEO, and by obtaining incoming links from other respected sites that have lots of their own incoming links.


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