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BMJ Qual Saf. 2016 Jun;25(6):404-13. doi: 10.1136/bmjqs-2015-004309. Epub 2015 Oct 13.

Measuring patient-perceived quality of care in US hospitals using Twitter.

Author information

1
Center for Biomedical Informatics, Harvard Medical School, Boston, USA Informatics Program, Boston Children's Hospital, Boston, USA.
2
Center for Biomedical Informatics, Harvard Medical School, Boston, USA Informatics Program, Boston Children's Hospital, Boston, USA Department of Pediatrics, Harvard Medical School, Boston, USA.
3
Virginia Bioinformatics Institute, Virginia Tech, Blacksburg, Virginia, USA Computer Science, Virginia Tech, Blacksburg, Virginia, USA.
4
Informatics Program, Boston Children's Hospital, Boston, USA.
5
Informatics Program, Boston Children's Hospital, Boston, USA Department of Pediatrics, Harvard Medical School, Boston, USA Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
6
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
7
Informatics Program, Boston Children's Hospital, Boston, USA Department of Pediatrics, Harvard Medical School, Boston, USA.
8
Department of Primary Care and Public Health, Imperial College London, London, UK.

Abstract

BACKGROUND:

Patients routinely use Twitter to share feedback about their experience receiving healthcare. Identifying and analysing the content of posts sent to hospitals may provide a novel real-time measure of quality, supplementing traditional, survey-based approaches.

OBJECTIVE:

To assess the use of Twitter as a supplemental data stream for measuring patient-perceived quality of care in US hospitals and compare patient sentiments about hospitals with established quality measures.

DESIGN:

404 065 tweets directed to 2349 US hospitals over a 1-year period were classified as having to do with patient experience using a machine learning approach. Sentiment was calculated for these tweets using natural language processing. 11 602 tweets were manually categorised into patient experience topics. Finally, hospitals with ≥50 patient experience tweets were surveyed to understand how they use Twitter to interact with patients.

KEY RESULTS:

Roughly half of the hospitals in the US have a presence on Twitter. Of the tweets directed toward these hospitals, 34 725 (9.4%) were related to patient experience and covered diverse topics. Analyses limited to hospitals with ≥50 patient experience tweets revealed that they were more active on Twitter, more likely to be below the national median of Medicare patients (p<0.001) and above the national median for nurse/patient ratio (p=0.006), and to be a non-profit hospital (p<0.001). After adjusting for hospital characteristics, we found that Twitter sentiment was not associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (but having a Twitter account was), although there was a weak association with 30-day hospital readmission rates (p=0.003).

CONCLUSIONS:

Tweets describing patient experiences in hospitals cover a wide range of patient care aspects and can be identified using automated approaches. These tweets represent a potentially untapped indicator of quality and may be valuable to patients, researchers, policy makers and hospital administrators.

KEYWORDS:

Healthcare quality improvement; Patient satisfaction; Performance measures; Quality improvement methodologies; Quality measurement

PMID:
26464518
PMCID:
PMC4878682
DOI:
10.1136/bmjqs-2015-004309
[Indexed for MEDLINE]
Free PMC Article

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