Research suggests healthcare consumers may be able to find reliable data on hospital quality in a familiar place–Facebook. Now hospitals accustomed to appealing mainly to payers must shift strategies.
In the era of the engaged patient, consumers shop around for healthcare services. When it comes to hospitals, they could consult several ratings programs for information on readmissions and hospital-acquired infection rates.
But data shows they don't do so in big numbers.
One reason may be that quality measures familiar to providers may mean little to patients. Now, a study suggests that healthcare consumers may be able to find reliable data on hospitals quality in a familiar place – Facebook.
A Massachusetts General Hospital study has found that hospitals with lower 30-day readmissions rates have higher ratings on Facebook than hospitals with high readmission rates.
"The potential impact of social media ratings on healthcare consumer decision-making must not be underestimated in this changing healthcare environment," say the authors of a study published online by the Journal of General Internal Medicine.
Now, hospital patients can comment on their experiences via Facebook with the same five-star rating they use to review restaurants and movies. The result is unfiltered, user-generated comments not unlike those found on other social media sites, For example, one patient gave the MGH emergency department a five-star rating on Facebook with this comment: "No one wants to be in the emergency room, so I really appreciate everyone being so great! " Another offered one star and this comment: "I've never received worst [sic] ER Care."
Radiologist McKinley Glover, MD, of MGH, which rates 4.6 out of five stars with 280 Facebook reviews, was the lead author of the study. He says he started looking into how radiology practices were using social media for marketing purposes. Instead, he became interested in Facebook's then-new ratings.
"I was wondering as a consumer, do these ratings actually correlate with anything? Are they meaningful?"
So, he and his team looked at Medicare's Hospital Compare readmission rates for July 2011 through June 2012. They teased out the 315 hospitals with lower-than-average readmission rates and the 364 with higher-than-average rates.
About 93.3 % of the hospitals with low readmission rates had a Facebook page and their rankings averaged 4.15 stars. About 82.4 % of hospitals with high readmission rate had Facebook pages, and their rankings averaged 4.05 stars.
Glover notes that, as with all user-generated content, the ratings may not be representative of the larger patient experience. "There is always a chance of sampling bias," he says. "People who have experiences on the extreme, either good or bad, are more likely to report their experiences."
Hospitals could take steps to improve the reliability of Facebook ratings, Glover said. For example, patients could receive a code to use to access Facebook comments. That would ensure that only those who were actually treated at the hospital could leave a comment.
As of now, anyone can offer input on social media sites such as Facebook. On the ratings site Yelp, a visitor to Mass General added a rating of the hospital to her list of hotel and restaurant reviews: "Wonderful views from the rooms of the river and city."
Glover thinks social media is a powerful tool for health consumers because it is familiar and accessible. But he suggests that consumers not rely on one source of information: "It's a tool in the arsenal but it should not be the be-all and end-all."
Leah Binder is the president of the Leapfrog Group, which rates hospitals based on quality and patient safety measures such as length of stay, rates of central line infections, and safety training. Her group is considering adding patient-reported data to its survey, but Binder says she would like to see more research.
In the past, hospitals were more interested in appealing to payers than patients, she said. That is changing and she foresees the emergence of more consumer-based rating and reviews in health care.
"Patients have their own idea of what they are looking for," she says. "Providers are wise to pay attention to it."
Ed Bennett manages web operations at the University of Maryland Medical System (25,916 likes and a 4.3 star ranking on Facebook) and tracks the impact of social media on healthcare. He and others note a sharp increase in hospital Facebook pages.
"There has been enough momentum over the past five or six years from marketing, from media relations and consumer affairs saying we have to be in there because that's where people are talking about us," he says. "They're talking about us whether we are there or not."
Benet and Dan Hinmon, president of The Hinmon Agency, agree that hospitals cannot throw up a website and post press releases and ignore users' comments. You have to look at it as a two-way conversation, said Hinmon, who works with health systems to craft social media strategies.
"Hospitals generally have embraced Facebook as a way to engage with patients, he says. "Some are doing it better than others."