Online reviews and ratings provided by the likes of Tripadvisor and Yelp have changed how people select their hotels, restaurants, flights, plumbers and hair salons. Even hospitals and health clinics have got in on the act, with websites such as Care Opinion, Doctify and Google Opinion.
But healthcare is different from other sectors. The way patients write comments can have an effect beyond just helping other patients choose a doctor. We’ve found evidence it can lead to better healthcare.
This optimistic view that patients’ comments could lead to better healthcare is not an idea shared by everyone. In 2008, the launch of the patient review website iWantGreatCare in the UK caused upset among healthcare professionals.
Some doctors claimed that allowing patients to rate and review every medic who has treated them will expose these healthcare workers to abuse, libel and even personal attack.
There was a similar reaction elsewhere in the world. Healthcare professionals raised concerns about the accuracy and reliability of online reviews. How can patients without a medical background evaluate the doctors and the relevance of their decision?
Also, there are concerns about the potential for biased or malicious reviews that could unfairly tarnish a professional’s reputation. There is an entire industry devoted to selling fake reviews – which could be positive or negative.
And, finally, the evaluation of the comments on patient review websites is mostly focused on what could be referred to as “extra care”. The comments and ratings on almost all of these websites are about the facilities, such as the parking, delays or even doctors’ or receptionists’ attitudes, and not about the care or treatment.
Facing these criticisms, patient online comments are often underused – or just plain ignored. For example, Le Point, a French newspaper, published for the first time a ranking of 1,000 doctors, but their ranking is based only on academic publications and does not include patients’ online posts.
In the UK in 2014, the first published report by NHS on patient complaints raised the issue that these online complaints were a “toxic cocktail”. Some health practitioners still use the term to refer to these review websites.
Since patient review websites are still an evolving phenomenon, there are many questions about whether these comments can be beneficial for the healthcare industry and how.
Value in the comments
Drawn to these intriguing questions, our recent study, published in the journal Technovation, found that patient reviews can be used by hospitals to identify where to act (by localising the department or service addressed with the most negative comments), and on what to act (what theme provides satisfaction and so should be kept, or causes dissatisfaction and needs to be improved?). They can also be used to find new ways to improve the service.
Our findings are based on an analysis of 134 negative reviews that a French hospital (anonymized in the study) received on an online rating platform. We applied a qualitative research method to analyse the reviews and found areas of improvement.
As a result, we observed that the hospital’s overall rating on the platform raised from 3.05 (out of 5.00) to 4.47 after consultants recommended improvements based on the comments.
So the value of patient comments is not just in the number of stars given but in the comment posted. These comments, when included in the three ideas above, can be used by hospitals to rethink how patients are cared for.
There are two implications of this result. First, thanks to having these posts publicly available online, a hospital can use feedback, not just from its own patients but from those of other hospitals, to improve its practices. So a patient’s comment can have a much wider impact than the poster intended.
Second, through the written comments left on a patient-feedback website, patients can take an active role in improving healthcare – but only if their comment is constructive and not merely vengeful.
The emerging patient review platforms, therefore, go beyond just being the Tripadvisors of healthcare. They could be used to improve the experience of patients, help hospitals and clinics to improve the quality of care, and gain better results in national healthcare evaluations, which is often essential for securing state budgets – at least in most European countries.
Patient review platforms could shake up healthcare delivery by helping doctors, clinics and hospitals spot weak points and provide better services when resources are increasingly overstretched.
Mohammad Saleh Farazi received funding from the European Horizon 2020 project DiHECO (grant number 952012). He was previously affiliated with the University of Montpellier.
Bez Sea receives funding from the european project H2020 DiHECO (grant number 952012)
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 952012.