Learning by listening: Physicians say online reviews can improve health care
Online platforms that allow users to read and write reviews of businesses and services afford health care providers an opportunity to learn by listening, Penn Medicine physicians say in a new Viewpoint published today in JAMA. The authors point to a growing body of literature supporting the value of unstructured reviews in supplementing ratings from formal sources such as the Hospital Consumer Assessment of Heathcare Providers and Systems (HCAHPS). They call on hospital leaders to pay attention to online reviews to show current and prospective patients that they are being heard.
"Reviews posted to sites like Yelp or TripAdvisor are the modern day version of word-of-mouth testimonials, providing insight into millions of consumer experiences that are not only influential to other consumers, but can and should be influential to service providers," said lead author Raina M. Merchant, MD, MSHP, an assistant professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania, and director of Penn's Social Media and Health Innovation Lab. "It's understandable that in a high-stakes setting like health care, providers may be concerned about these reviews not accurately describing parts of care visible or only understood by other care professionals. But, while we cannot control how these platforms operate, what we can do is take stock of what the reviewers are saying and find ways to make them feel like their concerns or questions are heard."
Each month, more than 80 million users read and write reviews on Yelp alone. Of those, roughly 42,000 describe U.S. hospital experiences, with most comments addressing "patient experience" issues such as parking, the cafeteria, wait times, and navigating the facility. But, results of a recent study of more than 16,000 Yelp reviews about U.S. hospitals showed that many of these services, which are areas of key importance for patients and guests, are not captured by standardized quality surveys like HCAHPS. That survey measures impressions of 11 different domains, including discharge information and the overall hospital environment. The researchers say the content contained in Yelp comments could be organized into an additional 12 areas, including amenities, compassion of staff, and family member care, an area which the authors say addresses an influential group often overlooked by service providers: family and friends.
"Most organized approaches to evaluating care focus specifically on the patient, but many online reviews seem to include either input from or focus on caregivers, friends, family and others who are often bypassed by formalized surveys," said David A. Asch, MD, MBA, a professor of Medicine and Medical Ethics and Health Policy and director of the Penn Medicine Center for Health Care Innovation. "Family members and friends are powerful advocates for vulnerable patients and also experience health services and shape patient perceptions of it. Incorporating these insights from reviews on Yelp and other consumer review platforms can be a powerful differentiator for a business."
While health professionals look for ways to use online platforms to deliver messages to patients, the authors say it's crucial to recognize that the internet is a two-way street, where patients are also sharing important ideas.