The COBALT Framework: AI SEO and the Future of Healthcare Writing

Hi, I'm Geoff Meakin. I've been doing healthcare SEO for over a decade, working mainly with private clinics, and I was recently invited by the International Medical Writers Association (IMWA) to talk about AI SEO and where healthcare writing is heading. This article is the written version of that conversation, aimed squarely at freelance healthcare and medical writers.

You're already skilled wordsmiths. You know how to communicate complex clinical information safely and accurately. But there's a big change happening across the industry, and it's being driven by AI. Clinics no longer just want health information on the page. They want you to drive real, measurable results. This is genuinely the moment to prove your worth, and the framework below is how I'd approach it.

Geoff Meakin in conversation with the IMWA on AI SEO and the COBALT framework.

From "health information" to measurable outcomes

The whole point of this presentation is to look at how to turn health information into measurable clinic growth. I've focused a lot on private healthcare clinics, that's my bread and butter, so some of this may need adapting if you work for other kinds of healthcare organisations, but the principles stay almost exactly the same.

What "outcomes" actually means depends on the client:

• Companies wanting more sales of specific healthcare products.
• Clinics wanting more enquiries and consultations.
• Charities and nonprofits wanting more visibility, awareness and donations.

With the rapid rise of AI overviews in search results, and chatbot platforms like Claude, ChatGPT and Perplexity, it's becoming harder to know whether what you're writing is actually working. And here's the commercial truth for you as a writer: the more you can help clients, and demonstrate that you're helping them, the more likely they are to keep you on. That's why the goal here is always measurable online growth.

What COBALT stands for

To get to measurable growth, I've built what I call the COBALT framework. It stands for:

• CConversion rate optimisation, turning visitors into enquiries, customers or donations.
• OOn-page optimisation, the SEO fundamentals on every page.
• BBacklinks, getting other websites talking about and linking to the clinic.
• AAI & content marketing, the part most important to you as a writer.
• LLocal SEO, being found for "near me" and location searches.
• TTechnical & tracking, proving the whole thing is working.

You might think "I just write articles", but what you write can impact every one of these stages. Let's unpack them one at a time.

C is for Conversion Rate Optimisation

Conversion rate optimisation means making sure the people who visit the site actually turn into inquiries, customers, or donors. It's about looking closely at how people behave once they're on the page.

A couple of years ago there was an algorithm leak from Google that confirmed something a lot of us suspected: they do look at user behaviour, at how people interact with a site. So your copy has to resonate straight away, so people don't click back to the results, and the page has to keep them engaged enough to read on.

The key to that is writing for the patient, not the practitioner. I see this constantly: clinical practitioners want to lead with their credentials, their research papers, what separates their experience from everyone else's. But as a healthcare writer, you should be writing for the patient, reflecting their pains and problems back to them. If someone clicks through, lands on a page all about the clinic's credentials, and thinks "this isn't for me, they don't get it", they bounce back to the search results and pick another result. That's a terrible signal, and it's exactly what we want to avoid.

One free tool I'd recommend to your clients is Microsoft Clarity. Once installed, it shows you exactly where people focus on a page. If visitors are fixated on pricing, that's a clear signal to go in and rewrite or expand that section. Clarity colour-codes attention: red for high, yellow for medium, blue for low. It's brilliant for going back to a client and saying, "look, lots of people are reading this exact section, so let's make it as compelling as possible", and driving them towards the conversions that actually matter to the clinic.

If you want to go deeper on this, I've written about turning website visits into booked appointments and why so many healthcare landing pages quietly cost clinics enquiries.

O is for On-Page Optimisation

On-page optimisation is the SEO fundamentals, and honestly it's about 80% of what you do to optimise a page for both traditional and AI-driven search. People make this far more complicated than it needs to be. Stripped right back, there are four things that matter.

• URL. Get the keyword into the web address. If the page is about heart conditions, make sure "heart conditions" is in the URL.
• Page title. What people see in the search results, often a patient's very first interaction with the clinic. Make sure your target keyword is in it.
• H1. The visible headline. Put your keyword here. It needn't be huge, but it reassures a visitor they've landed in the right place.
• Body copy. Mention the keyword naturally in the text. "Keywords are dead" is half-true, but using your target terms still makes ranking far easier.

Consistency matters. If someone searches "cardiac conditions", clicks your result, and the first headline they see is "how to deal with a cardiac arrest", that's a mismatch, and it hurts. Keep the message consistent from search result to headline to body. Do these four things well and you've done 80% of your SEO before you ever worry about schema or canonicals. For more on this, see my guide on how healthcare clinics can choose keywords and the wider foundations of SEO for healthcare.

B is for Backlinks

Backlinks confuse a lot of clients. They think it's about linking from their site to others, when it's the opposite: we want as many websites as possible talking about and linking to the clinic. This still matters in AI search, an AI answer doesn't strictly need a link, but it does weigh up mentions. If everyone's talking about a particular hospital, that hospital becomes better known inside the AI platforms.

As a writer, you're the person who can actually create the content that earns these links. Here are the avenues I'd focus on:

• Leveraging partner companies and brands. Private clinics often work with imaging companies, procurement firms, medical secretaries. Offer a testimonial they can use, or write a post about how they've helped you, in exchange for a link back.
• Answering journalist requests. Platforms like Help A Reporter Out (HARO) and ResponseSource in the UK connect journalists with expert sources. Provide those expert insights on your client's behalf and you can earn links from powerful publications like The Guardian and The Independent.
• Writing press releases. A new service, a new CEO, proprietary data or research, all of it can go out as a release that news outlets pick up and link to.
• Optimising 404 pages. A bit more technical, but AI now hallucinates URLs a lot, so reclaiming and redirecting dead pages is worthwhile.
• Publishing unique data. Original data or even government reports give journalists a reason to cite and link to you.
• Events and speaking opportunities. Seminars, webinars and conferences almost always link back to their speakers.
• Podcasts. Platforms like PodMatch actively connect podcasters with experts. Get your client on a show, it gets syndicated, and you earn easy links, exactly like the conversation this article is based on.

If you want the fastest wins, I've written separately about finding the easiest healthcare links quickly and easily.

A is for AI & Content Marketing

I'll spend a little longer here, because this is probably the most important part for you as a medical writer. The number one thing to understand is query fan-out.

When you put a prompt into an AI platform, it doesn't run one search. Say you ask for "the best sunscreen if you have eczema". Instead of searching that phrase, it expands into multiple topics, the price of sun cream, how eczema is affected by the sun, where to buy eczema-specialist sun cream, and so on. It retrieves all of them, combines them, and gives you a single answer. The more of those related topics your content covers, the more likely you are to be cited in the final answer.

A lot of writers are nervous about AI taking their jobs. This is exactly where you prove your worth, by explaining how this works and mapping out all the topics a client needs to cover to be that number-one answer. Beyond query fan-out, I'd use AI for:

• Clarity. Make answers specific, clear and concise so platforms can pull them out easily.
• Deep research. Google is one of the only companies I know that fact-checks its own AI answers, so Google Deep Research is genuinely useful and accurate for research.
• Mentions. Track where your client is mentioned across platforms. I'm building my own tool for the healthcare sector specifically. This lets you tell a client, "your patients are searching for these topics and you don't currently show up in ChatGPT or the AI overviews for them, here's how we fix it".
• Multimedia. Offer to draft scripts for YouTube medical explainers. In my own research, YouTube is the fourth most-cited source in AI overviews, so it's genuinely powerful.

Generally, one prompt produces 10 to 28 synthetic sub-queries, that's a lot of topics you can potentially write about. This shifts you away from traditional SEO, where you'd only chase terms with search volume. Many of these AI sub-queries are so specific they have no measurable search volume at all. One addiction clinic I work with had a sub-query of "private clinic for celebrities in London", something no traditional keyword tool would ever flag, but the AI landscape treats it as important. Writing that specific piece of content becomes a real opportunity.

For more on this shift, read my pieces on ranking your clinic in ChatGPT, Gemini and Perplexity and how the rise of AI search is reshaping demand.

L is for Local Search Footprint

You might feel local search isn't your department as a writer, but AI is pulling a lot of these elements into its answers, and there's plenty you can influence.

Start with the business description on the Google Business Profile. I've seen clinics with something as bare as "we are a gynaecology clinic". Expand it: tell people why you're different, faster treatment times, more experience, a more one-to-one approach. Fill in the service pages in the profile. Add weekly posts about news, events, even links to blog posts you've written, anything that shows the business is active and part of its community. This is how you win searches that include "near me" or a location.

Reviews matter too. Google now summarises reviews at the top of a profile, pulling out frequently mentioned phrases. So guide your clients: when they ask for reviews, suggest patients mention the specific procedure they had and anything that stood out, like "excellent bedside manner". You're not telling anyone what to write, you're giving them scaffolding, because most people simply don't know what to put. For the compliance side of this, see my guide on staying GMC, MHRA and ASA compliant in your content, and for the full local playbook, winning "near me" searches for your private clinic.

T is for Technical & Tracking

Again, this may not feel like your job as a writer, but I'd encourage you to get involved, because it's how you prove your work is having an impact.

At a minimum, get access to Google Analytics or Matomo so you can see website traffic and the queries people use. Ideally, add Google Search Console and Bing Webmaster Tools as well. These are what let you demonstrate, in black and white, that what you're writing is benefiting the client, which is the whole point of measurable growth.

The Medical Writer's COBALT Checklist

To wrap it all up, here's the checklist I'd keep beside you on every piece of work.

• CConversion — is the copy patient-led (pain) rather than clinic-led (credentials)?
• OOn-page — are the keywords in the title, H1, body and URL?
• BBacklinks — are we generating links via PR, data or podcasts?
• AAI & content — have we used AI for query fan-out and deep research?
• LLocal — are the local profiles updated and the patient reviews specific?
• TTechnical & tracking — are we using Analytics and Search Console to see the benefits?

That's COBALT. If you're a healthcare or medical writer, this is how you move from simply providing information to delivering the measurable growth clinics now expect, and how you make yourself indispensable in the age of AI search. If you're ever unsure how to adapt any of this, I'm very active on LinkedIn and always happy to help.