Search engine optimization. What to think about in 2019? Part 1

First published in Pharma Industry 2/2019, May 2019. Republished in full, translated from the Swedish original.

Editor's note, 2026

The argument in 2019 was that search visibility is won on data, not on assumption: decide who you are writing for, check whether anyone actually searches for the words you have picked, and then build pages a search engine can read. That description of the work still stands, and the section on topic clusters and pillar pages is the part most likely to be useful as written. The closing section is worth reading for the gap it names in itself: it says featured snippets, location-dependent lists and ad slots were taking a growing share of the result page, especially on a phone, and then says outright that how you win those slots is not covered here. Look at the result pages you care about before treating the rest of the advice as the whole picture.

Several recommendations should not be acted on without checking the current position first, and this note names all of them, because naming only some would leave the rest looking settled. First, the numbers and limits, all of them 2019 values. The click-through figures used in "No potential, no result" and "Search engine optimization is built on data" (about 30 to 35 percent of clicks for first place, around 12 percent for second, 10 percent for third and 2.5 percent for tenth) carry more weight in this article than they look like they do, because the entire worked example of Focus #1 against Focus #2 is arithmetic built on them; the method of comparing two keyword groups survives, the traffic figures it produces do not. The title tag limit of 55 to 64 characters and the meta description limit of 164 characters are given as fixed rules, so check the current display limits and check the assumption underneath them, that what you write is what gets shown. The 1,890-word finding under "Content consolidation" is a correlation drawn from one company's study of blog posts, and the article turns it into a target; the reference is given, so read the source before adopting the number.

Second, the things the article treats as established that a reader should test for themselves. LSI keywords are presented as a working category with their own examples, so check whether the search engine you are optimizing for describes anything of the kind before you build keyword work on it. The claim under "Adding multimedia" that bounce rate is something Google measures closely, and the claim under "Sharing on social media" that shares signal value, are both stated as settled ranking signals, and both are worth confirming against current guidance before anyone optimizes for them. The rules that a keyword has to appear in the H1, in the subheadings and inside the first 100 words describe an older, mechanical style of on-page work, and they are the easiest place in this article to overdo it. One recommendation sits outside SEO altogether: "Skilled writers" proposes having a writer interview the subject expert and then ghostwrite the article in that expert's name, and in a life science context authorship and contribution disclosure is governed by publication ethics, so take that one to the function that owns it.

The article carries three numbered references. Other figures in it are given without a primary source, among them Google's 70 and 90 percent share of desktop and mobile search, the traffic loss at prevention.com and patient.info after the August 2018 update, the 75 percent of visitors described as speed-readers, the recommendation that at least half of content production should be video, and the search volumes and competition scores in the worked example and in the answer at the end. On the competition score in particular: check what your own tool measures by that word before reading it as a statement about how hard something is to rank for organically. The closing quiz is worth reading for what it is: the article demonstrates its own method by counting how many times it used its own keywords and quoting a search volume and a competition score for them, and it concludes from that count and from its word length that the piece "would carry weight". That is the 2019 way of showing the work, and the conclusion rests on the same two measures flagged above. Neither this article nor its sequel was written in a world where a generated summary can sit above the links; generative AI arrived in 2023, after both.

In the previous issue of Pharma Industry, the article "Mistakes to avoid when you create a digital strategy" ended by asking whether you as a reader had a question about digital marketing for us to answer, and one of the questions that came in was about search engine optimization (SEO): "What do you think you should keep in mind about search engine optimization in 2019, is there anything in particular to consider?". Fredrik Holmboe works here with his colleague Robert Nyberg, a specialist in international SEO, to describe across two articles some of the most important factors you should have in mind when you commission written content in 2019.

First and above all else, there is one king among the world's search engines and it is, as we all know, Google. In our part of the world, at any rate. In China it is Baidu that rules, in Russia Yandex leads and in South Korea people turn to Naver. But in our part of the world there is no argument. Google is master of the hill and handles about 70 percent of all searches made on a computer and a full 90 percent of all searches made on mobile. With a single target, a single search algorithm, optimizing for search ought to be easier. The problem is that Google likes to update its search algorithm, often.

Keep up to date: modern SEO

Keeping up with the adjustments that happen, and with how they affect your website's various positions in the search results, is constant work. Among other things, a change to the algorithm on 1 August 2018 took aim at websites with a medical and health focus. Sites such as prevention.com and patient.info were hit hard and saw more than half of their daily traffic disappear overnight. And it is not the first time that has happened.

There are a few larger updates over the past seven or eight years, among them Google Panda (2011), Google Penguin (2012) and Google Hummingbird (2013). Each of these updates has since been updated again in several rounds over the years, with a single aim. To secure a search experience that is as efficient and as relevant as possible.

Because if you stop and think about it for a moment, you can see that one of Google's very first business goals for its customers, the people searching, is to get them to disappear as quickly as possible and not come back. Not many companies have that as a business goal.

The practical reason for this is that if the person searching does not come straight back to Google, then Google has in all likelihood succeeded in connecting that visitor with what they were looking for. If the visitor does come back after a short while, it often means Google failed to connect them with the value they were after.

The central part of all search engine optimization is a working digital machine that produces targeted and valuable content.

A buyer persona creates focus

To get your content production right, and to some extent your SEO strategy too, it is often a good recommendation to start from a buyer persona (see below). The reason is that with a central picture of the target in the form of a buyer persona, it becomes easier to prioritize everything from keywords to which content is valuable and relevant.

With a clear buyer persona you get the chance to answer a lot of marketing questions through the single test "Is this relevant, important or interesting to [name of persona]?".

A buyer persona is a semi-realistic representation of your best, most ideal customer within a chosen target group. A persona is often created in cross-functional collaboration, where sales, marketing and other customer-facing departments work together to arrive at a persona that is as clear and as richly detailed as possible.

No potential, no result

When it comes to keywords, it is important to have a grip on the total potential, that is, how many searches are carried out per month and how many other players are competing for first place, the competition, so that you set your expected result at the right level.

If nobody, or very few people, search for the exact words you want traffic from, then it follows on its own that there will be no traffic even if you end up in first place on Google.

The same applies if the ones you are fighting for first place against are Wikipedia, LinkedIn, Medium or some other genuinely heavyweight site: the results will not come unless you have very large resources and run your SEO perfectly.

Search engine optimization is built on data

We are now going to get fairly technical, which is a large part of successful SEO, for the simple reason that Google loves data.

If we look at the two examples above, search volume and competition for the top positions, they can look like two fairly trivial conclusions. But there is in fact a recent example where a cross-functional working group we worked with chose to go (against our recommendations, which simply has to be said) for one group of keywords, Focus #1, which they felt sat closer to the part of their business they wanted to build.

The total search volume for Focus #1 was around 1,350 searches a month, which was low for their industry. And given that first place on Google's SERP (Search Engine Results Page) captures around 30 to 35 percent of the clicks made,1 that meant they could at most have got around 400 to 470 visitors to their website. If, and it is a big if, they managed to win first place, from which the great majority click onward.

The percentage of the total search volume you can potentially capture falls quickly from first place to second (which gives around 12 percent), to third (around 10 percent) and then keeps falling steadily down to about 2.5 percent for position 10, the last slot on the first page. Statistically speaking, essentially nobody visits page two of Google's SERP.

What we had recommended the company do instead was to focus on a group of keywords, Focus #2, made up mainly of seven or eight keywords. In total, an average of just over 10,000 searches a month were carried out on those keywords, and oddly enough the great majority of them had very low competition. With that focus, first place on Google's SERP would have given somewhere between 3,000 and 3,500 visits a month. Even if it was not the part of the business they wanted to build, Focus #2 was still a large part of their total business, and compared with Focus #1 a far better bet.

But the choice had been made, and as expected the search statistics did not change much to begin with, which led the deputy CEO among others to start questioning how effective the chosen strategy was, and we were given the chance to come back to the question of where the effort should be focused. A decision was taken to change course towards Focus #2, at which point the results began to show, both in visitor statistics and in the business-driving conversions on the website.

The upshot is that to get your search engine optimization right and reach the best results, you have to base your decisions on data and not on assumptions.

Skilled writers

It should be mentioned briefly that another factor which decides your SEO strategy is hiring good writers. There is a large difference between writing text for online and writing for print, and a whole article could be written on that subject alone. Here is the short version.

Your writer needs both a basic understanding of SEO and deep knowledge of the subject at hand. These two are often hard to find in one and the same writer, which is why it is not unusual for good writers who can write for strong SEO to interview the subject expert who knows the topic and then ghostwrite articles in the expert's name.

This is a good way both to keep the total cost per article down (total production time and cost, quality, readability and the expert's time spent) and a good way to explore your own organization's need for different kinds of specialists before you hire staff.

And with that small aside out of the way, back to search engine optimization.

On-page optimization

On-page optimization, also called on-page SEO, makes sure that the search engines understand what your page is about and can therefore match it against relevant searches.

A list of the factors normally counted as on-page SEO:

• Unique keywords
• URL
• Title tags
• Meta description
• Main heading (H1)
• Intro paragraph
• Subheadings (H2/H3)
• Body text
• Formatting
• Adding multimedia
• Internal linking
• External linking
• Page speed
• Sharing on social media

Unique keywords

One of the most important aspects of SEO is that you as a company "speak the same language" as the people you want to be found by. That can look obvious, but it is in fact not unusual for a company to make the mistake of focusing on the words it wants to work with itself, and so end up in the wrong place and miss relevant visitors.

There are different types of keywords, given below in English because a Swedish translation simply made them less clear:

Short-tail keywords

• 1 to 3 words with higher search volume, higher competition and relatively imprecise
• Example: Raincoat

Long-tail keywords

• 3 or more words with lower search volume, lower competition but more precise
• Example: Raincoat for a small dog

Short-term fresh keywords

• Often event-related, with a larger but often short-lived effect
• Example: Avengers: Endgame

Long-term evergreen keywords

• Words with relevance over time, though often with lower effect
• Example: Search engine optimization

Product defining keywords

• Words that describe a specific product property, high purchase intent
• Example: instead of wound tape, "elastic suture tape"

Customer defining keywords

• Words that describe the persona you are aiming at
• Example: Elastic suture tape for emergency nurses

Geo-targeting keywords

• Words aimed at a particular city, for instance
• Example: Avengers: Endgame Gothenburg

LSI (Latent Semantic Indexing) keywords

• Words closely related to a word you have chosen, often appearing as suggestions when you start typing in Google's search field
• Example: Lemon can give lemon tea, organic lemon and so on

Intent targeting keywords

• Informational: words focused on answering questions
• Example: What is elastic suture tape
• Commercial: words often related to service or product information
• Example: Suture tape specifications
• Transactional: words focused on some form of action
• Example: Donate money childhood cancer foundation

The list above, together with a detailed persona description, is the basis for finding the subjects and the language that marry your offer to the relevant searches carried out every day.

From this you create a list of around 10 to 15 keywords, which in turn forms the basis for a deep keyword analysis. Read more about this in my article "Mistakes to avoid when you create a digital strategy" in PI 1/2019.

When an article is then to be written, decide which keyword is in focus together with two or three supporting keywords. One example could be "elastic suture tape" as the main focus keyword, with "wound tape small wounds" and "taping wound edges together" as supporting keywords.

The trick in this part of an SEO strategy is finding the keywords that, in unique combinations, have high potential, "speak the same language" as your persona and, woven into the text, give a positive reading and user experience.

Title tags

• Maximum length: 55 to 64 characters (length is what decides, that is, the pixel width of the characters).
• Add at least one keyword, and do not repeat the same keyword twice.
• Feel free to use informal modifiers such as Top, Best, Find, Deadline.
• Use the pipe sign "|", brackets and parentheses as separators.

An example: Best diet for you with colon cancer | Vegetarian (2019)

URL

There are a few rules of thumb for a URL, and the most important of them are these:

• A URL should be unique to the page, which means it is static for as long as a change is hard-coded into the page's HTML. The other option, a dynamically generated URL, is a URL created specifically for one unique visit and based, for instance, on a search in an underlying database, and this type of dynamic URL can increase the risk of duplicate content in Google's indexing, which is bad for good SEO.
• A URL should be short and contain the page's main keyword. Together with the page's title tag, headings and content, the URL is one of the most important factors for Google when it comes to interpreting what the page is about.
• The URL should be of the https:// type and not http://, which means the visitor's connection to the site is protected by a security certificate.
• Use hyphens to separate words.

An example: https://domainname.se/vegetarian/diet-colon-cancer-2019

Meta description

A meta description is the text that briefly describes each result in Google's SERP, for instance.

• Maximum length: 164 characters
• Add at least one keyword, and do not repeat the same keyword twice.

An example: The 2019 update. 10 examples of vegetarian food that have given considerably better quality of life with colon cancer. Read more about the best diet for you with colon cancer.

Main heading (H1)

The main heading should be an H1 in the HTML code and contain at least one of the keywords.

Intro paragraph

The page should open with a short intro of at most 45 to 50 words summarizing what the page contains, so the reader gets a quick understanding of the value waiting for them. The purpose is mainly to catch the visitor's interest so that they stay and read on.

Subheadings (H2/H3)

The subheadings should be an H2 or H3 in the HTML code and contain at least one of the keywords.

Body text

The chosen focus keyword should appear somewhere among the article's first 100 words. After that, work with supporting keywords from your list along with synonyms and words or phrases related to the keywords you chose for the article.

Formatting

Text with poor formatting makes reading harder for the visitor, which is particularly relevant online. Focus on readability and the visitor experience, and bear in mind that many visitors, around 75 percent, do not read the content on your site word for word (so-called speed-readers).

• Choice of font and font size
• Contrast between background and text
• Limit characters per line to 50 to 60
• Short paragraphs, 1 to at most 5 lines per paragraph
• Get straight to the point, following The Inverted Pyramid (value first rather than last)
• Create breaks in the text with bullet lists, quotes, images and so on
• Use bold text for variation and to highlight important information

Adding multimedia

As mentioned above, a break in the text with an image can be positive for the reading experience. But films and infographics can also reduce bounce rate, that is, the visitor leaving the page too quickly, something Google measures closely.

As for images, they should have a descriptive alt text that contains the chosen keyword. As for films, aim to fill your website with a lot of film, both shorter and longer; many global thought leaders in digital marketing recommend that at least 50 percent of your content production should be film today.

Internal links

Today Google rewards something called topic clusters, which means that a website's internal link structure is focused on individual subjects. Add strong internal links to important pages you want to give an extra SEO boost, and use keywords to describe the link. A tool such as aHrefs can be used to identify which links on your site are strong. Read more about SEO, topic clusters and internal linking under Internal linking below.

External links

Outgoing links to pages with related content help Google understand what your page is about. Be clear in your choice of words so the visitor understands where they will end up when they click, and include one of the page's main keywords. Add one or two outgoing links.

Page speed

Optimize the page's content, for instance the file size of images, to reduce the time it takes to load the page. Slow pages are punished with worse positions in the search results. If you are unsure how quickly your page loads and want to know what measures you can take to speed it up, you can test it using Google's tool Page Speed Insights.

Sharing on social media

Make it easy for the visitor to share the content on social media. More shares on social media signal that the content is valuable and increase the chance of getting so-called backlinks, that is, links from external sources to your website. More information about backlinks and what that type of link means for your search engine optimization is coming in the next issue.

Content consolidation

Companies that have worked at publishing articles over a longer period can see in their analytics tool which articles perform best and which perform worst. By worst is meant no visitors or few, and no links or few from external sources.

One company analyzed 1,000,000 blog posts to find out whether the length of the content has any bearing, and found that it does. Longer articles performed better in the search results than shorter ones, and above all they found that articles of at least 1,890 words performed best.2 That is one of the reasons why you as a company should focus your search engine optimization on a few, longer articles according to the topic cluster model described under the next heading.

A quick way to reach a substantial mass in each article is to look at whether the worst-performing articles on your site can be reused. If they are not generating value for your business they are only gathering digital dust, and they can usefully be rewritten a little and worked into a larger whole.

SEO and internal linking

The purpose of a good and considered link structure on your own site is partly to give the visitor a good user experience and good opportunities to find more interesting related content on your website, and partly to show Google which pages are more important than others.

What matters today is to separate subjects as far as you can, and even to clear up your current link structure on the site, in order to arrive at what are called topic clusters. In issue 4/2018 of Pharma Industry I touched on topic clusters if you want to read more.

In short, topic clusters are about creating clusters around a so-called pillar page, that is, a page containing a general, all-encompassing, long and well-written article about one subject, one topic. Schematically, this pillar page is surrounded by a number of cluster pages containing more in-depth articles. These cluster pages link to the pillar page and thereby signal to the search engines that the pillar page is an authoritative page on the subject, something that over time helps that page rise in the search engines' results.

If you follow this strategy for internal linking over time, you eventually create topic clusters.

First place is always the goal

All search engine optimization aims at reaching first place in the search results, whether that is at Google, Yahoo, Bing, Baidu, Yandex or Naver, and getting there is not easy. Google looks at more than 200 factors3 and in this article we have touched on some of the most basic ones.

Something that has not been covered is how, for instance, Google's SERP has changed over time and which results are listed. This article has been about the organic result list, since that is still the one which in the great majority of cases captures most of the clicks.

But today things like featured snippets, location-dependent lists (local listings) and ad slots take up an ever larger share of what we see after a search. Especially on a smartphone, which we search from more and more, and there are of course strategies for how you win those slots.

Not everything fits into one article and some of it will not fit at all. But in the next article we put the focus on what is called off-page SEO, which is the part of the world of search engine optimization that happens beyond your own website. More about that in the next issue.

But before we round off entirely.

This article has been written with a certain amount of search engine optimization in mind, and before you read on, think about what I have done. Did you notice it while reading, or can you see it if you look back over the text?

The answer follows at the end of this article.

Until we meet online or in the next issue of Pharma Industry.

Fredrik Holmboe

Head of Inbound & Content

Robert Nyberg

International SEO specialist

The answer

The article used words such as search engine optimization (14 times, H1 once, H2 once), SEO (17 times, H2 twice), keyword and keywords (27 times), digital marketing twice, SEO strategy 3 times, and on top of that a range of variants such as search engines, modern SEO, on-page SEO, SEO boost and combinations such as search engine optimization SEO.

The keywords listed here have a total monthly search volume (in Sweden, with Swedish selected as the language) of a full 11,800 searches, with a competition factor of 27 out of 100, which is low.

The article runs to just over 3,300 words, which is above the 1,890 words that have been shown to be an optimal level for successful SEO.

As part of a developed SEO strategy and a continuous flow of articles following the topic cluster model, this article would carry weight. Provided it gave you as a reader value, which I of course hope it did. Do get back to me.

References

1. https://www.smartinsights.com/search-engine-optimisation-seo/seo-analytics/comparison-of-google-clickthrough-rates-by-position/
2. https://backlinko.com/search-engine-ranking
3. https://backlinko.com/google-ranking-factors

Read the Swedish original at pharma-industry.se, and Part 2 is here. Keyword work, topic clusters and a steady flow of articles that hold together are what the Content Engine Sprint is built around.