Hospitals Evals Are Going Social

For the savvy medical observer, it is commonplace to refer to industry standards of hospital quality in choosing one hospital over another. Those quality measures are set forth by trusted indicators, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)—a survey measurement of hospital patient satisfaction which includes feedback on 18 measures across eight broad topics. However, the HCAHPS is rather obscure to the average person, but there is general accessibility to rating sites like Yelp. Typically, such rating sites have not been harnessed for hospital screening, but that has been steadily changing. According to a recent study published in the British Medical Journal Quality and Safety in November 2012, social reviews conducted on Yelp are positively correlated to better outcomes on HCAHPS.[i] What this portends is a democratization of hospital review data in a more accessible patient-to-patient method.

The Yelp study mentioned above is noteworthy in that of the 962 hospitals with a Yelp score, only 270 achieved the highest rating of five stars or 28%, and those high-scoring institutions tended to be large, urban non-profit academic hospitals. University of California, San Francisco researchers conducting the Yelp Study also demonstrated that high Yelp scores were associated with hospitals maintaining lower readmission and mortality rates. These findings suggest that being a city-dweller, where social media thrives, is a benefit for people looking to evaluate hospital quality on-the-fly by using Yelp.

This is not an isolated phenomenon either. In an independent study published in the American Journal of Medical Quality this year, investigators found that Facebook “likes” were signals of hospital quality and patient satisfaction.[ii] This Study was conducted among 40 hospitals within a 25-mile radius of New York. Researchers discovered that Facebook “likes” have a strong negative correlation with 30-day mortality rates and are positively associated with patient testimonials. Given the ubiquity of Facebook among Internet users, this Study suggests that health care users now have a ready-made proxy to more formal rating standards.

The Facebook Study also noted an association between “likes” and the degree of activity on the page. Specifically, investigators found that the greater number of administrator posts, community posts, administrator responses, and days where pages are active, all predicted higher “like” volume. This is good news for hospitals seeking to justify greater social engagement. Reaching out to the public has concrete reputational benefits.

However, the Facebook Study conflicts with the Yelp Study in that teaching hospitals were found to be negatively associated with Facebook “likes.” Researchers surmised this could be because of larger quality issues present at such institutions. However, this does not explain why the academic hospital profile is positively correlated with favorable Yelp reviews. The upshot is that further research is needed on why there is such a variance between the two social platforms.

In case you were wondering about hospital reviewers stacking the odds, issues related to artificial inflation of  “likes” were addressed by Facebook back in August 2012 when the company instituted their anti-fraud system. Bots or fictitious profiles were purged, as were any “likes” related to such accounts.

Social platforms will continue to evolve as those who use them adapt them for new purposes. This includes users of rating sites and social networks, who are now evaluating hospitals as they would a restaurant or dry cleaners. It won’t be long now before an aggregator of both sources of online hospital data emerges with a one-stop shop. Hospital Evals-to-Go, anyone?

[i] Aungst, T., Study shows high Yelp rating correlates with better Hospital outcomes, iMedicalApps, Feb 22, 2013,; see also Rau, A., New Reasons to ‘Like’ Online Hospital Reviews, Kaiser Health News, March 1, 2013,

[ii] Facebook ‘Likes’ a good indicator of quality hospital care, EurekAlert!, Feb. 28, 2013,; see also , Timian, A. et al, Do Patients “Like” Good Care? Measuring Hospital Quality via Facebook, American Journal of Medical Quality, available free for a limited time here:

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