Hospitals seeking to improve how patients perceive their quality of care can simply check Twitter. According to BMJ, patients use their Twitter accounts to provide feedback (and overshare their hospital experiences). A study identified that approximately half of the hospitals in the country have a Twitter presence, and 9.4 percent of the tweets directed to these hospitals were about patient experience. This information could be important to hospitals as they work to achieve better quality under the various initiatives created by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148).
The study analyzed over 400,000 tweets that were directed at hospitals regarding patient experience. Hospitals that received at least 50 patient experience tweets were surveyed about their social media usage, and responses showed that these hospitals were generally more active on Twitter, below the national median of Medicare patients and above the median for nurse-to-patient ratio, and more likely to be a non-profit hospital. The types of patient experience tweets included:
- “epic fail” experience with discharge;
- 12 hours in the emergency room before getting admitted was #notgoodenough;
- waiting several hours for pediatrics to return a call;
- asking a hospital to keep it classy by waiting to make bill collection calls until the bill’s due date;
- no pain management assistance for a sick child while nurses took a coffee break;
- a #silly hospital prescribing a discontinued medication, with @Walgreens getting a shout-out for saving the day; and
- asking a hospital if it is trying to use the terrible cafeteria food to increase the patient population.
When linking this data to quality of care, the study found a difference between the percentage of people giving a hospital high ratings on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey who have a Twitter account (0.71) and those who do not have a Twitter account (0.79). The study pointed out that many tweets discussed topics that did not appear on the HCAHPS survey, such as time, side effects, and food concerns. Hospitals that responded to survey questions about Twitter use indicated that they monitored the site closely and used it to interact with patients. One hospital noted that it does not engage in a discussion about a negative comment, but chooses to apologize and direct the user to the patient relations department.
Limitations and the future
Twitter is most commonly used by those under 30 years of age, although older populations are starting to increase activity. This particular study only assessed tweets that included the hospital’s handle. Hospitals can use various techniques, such as one surveyed hospital that reported geocoding to narrow tweets to within close proximity to the facility to find discussions about health care that do not specifically mention the facility. There are many automated tools available to facilitate social media monitoring. Many companies, such as @comcastcares, @attcares, @verizon, and even @chasesupport keep an eye out for customer complaints and issues and proactively contact complainers, offering help. In busy hospitals with a long chain of command, social media monitoring can be a way for the administration to interact with patients and assure that patients’ voices are being heard.