Satisfaction Goes Social

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By Laurie Gelb, MPH
Independent Consultant

In the social media, something called “sentiment analysis” (the ratio of or content of positive vs. negative mentions) is often used as a measure of brand equity. However, it’s pretty clear that this measure doesn’t capture the duality and constraints of health care. We can love the care but hate that it has to happen. We can love the provider but hate the outcome. And death, the ultimate negative outcome, claims us all.

Nowhere is this more evident than in what is drolly called “patient satisfaction” (because often it’s neither).  How “satisfied” can patients be with pain, worry, lost sleep, strange people examining their bodies, but unwilling to exchange much information of value, often unwilling even to prognosticate? Well, that’s pretty much a typical hospital stay. Outpatient encounters feature many of the same “product attributes.”

And then comes the bill(s). Dealing with duplicate invoices, insurance mishaps, collection notices, contradictory correspondence is why managed care networks are frequently objects, largely negative ones, of “social buzz.”

Yet, for all the complaints about care that networking surfaces, the stakes are nowhere higher.

Those with large groups of followeds or friends may well see personal health updates almost daily, and these posts, links and tweets often feature many reasons to visit or not visit a particular provider, or to seek care at all.  Moreover, the proliferation of ratings sites such as Yelp signal a strong perceived need and usage of peer feedback to drive provider selection.

Health care’s reputation, often subject to fear, denial and anger under the best of circumstances, can take cumulative hits when [dis]satisfaction goes social. Yet providers, payors and third party stakeholders alike want patients to seek care if/as appropriate. A negative, fatalistic approach to self-care and care-seeking benefits no one.

Social media listening thus offers the opportunity to study and intervene based on evidence of health choice drivers:

  • Domains that are important to patients and caregivers (e.g. preserving dignity, respecting preferences)
  • Measures within these domains: for example, do staff at the hospital condescend and dole out information by the teaspoon, or are they transparent and proactive?
  • Thresholds for these measures: many patients are transferred to other care when s/he and/or a caregiver experiences or observes something that “crosses the line.” Most critically, where the line was crossed, the threshold broken, is unknown because the patient simply goes elsewhere; subsequent ROI requests for/from new providers are not logged by Marketing. Moreover, that line-crossing event is often reported across the social Web, and often it occurs during a crisis of some sort., heightening its emotional charge.

Appropriate analysis of social media content also helps identify the evaluation criteria that drive denial, visits, admits, referrals, transfers and public warnings to “stay away,” toward competitive advantage and optimal outcomes for your organization.


Laurie Gelb, MPH is an independent consultant in Seattle. Laurie wanders the intersection of outcomes research and marketing content. She blogs for Managed Care On Line, writes on assistive technology for examiner.com and recently served as a PCORI merit reviewer.

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