This document summarizes research on best practices in digital social media for hospitals and health systems. The research assessed the social media presence of over 2,400 hospitals on five dimensions: accessibility, content, marketing, technology, and usability. Scores on each dimension ranged from 0-10, with higher scores indicating better performance. On average, hospitals scored highest on content (6.49) and lowest on technology (4.43). The results imply that a strong, well-designed social media presence is important as it may be patients' first interaction with a facility and influence decisions. Hospitals should standardize website information quality and address accessibility, compliance, and search engine optimization.

1. Best Practices in Digital Social Media
Timothy R. Huerta, PhD, MS
Associate Professor
Family Medicine and Biomedical Informatics
College of Medicine
The Ohio State University

2. The Bottom Line
• Meaningful Use positions HIT to transform care
• Most primary care facilities do not have the
expertise to manage an IT infrastructure, but
will be required to in the future or pay a penalty
• Best practice design in web and social media

3. Background
Healthcare is Changing
• More than 80 percent of adults
reported using Internet
resources to support
healthcare decisions in 2011
• Traditional patient interaction
is being replaced by frequent
interactions with integrated
medical groups and health
systems
• People seeking illness-related
information behave differently
than those seeking wellness
information
Social Media is becoming
more Important
• Increasingly important for these
organizations to have an effective
social media presence
• A organization’s home page is the
first point of contact for consumers
• A well-designed website and social
media strategy are critical features
of the modern healthcare
organization
• If a organization’s website doesn’t
meet customer’s standards, negative
inferences about facility quality will
influence the decision-making
process

4. The Objective
Assess the social media presence of
hospitals and their health systems on five
dimensions
Accessibility
Content
Marketing
Technology
Usability

5. Research Design
2,407 unique web domains covering 2,785 hospital
facilities or their parent organizations were identified
and matched against the 2009 American Hospital
Association (AHA) Annual Survey
The names, cities and
states for every:
“non-government,
not-for-profit
(NFP)” or
“investor-owned,
for-profit” were used
1) Links were inspected to identify whether a
hospital could be identified
2) When matching facility could not be found an
additional manual search was conducted
3) When a facility had its own domain, we assessed
that domain separate and apart from the
network or health system of which it was a part
4) Website of each organization was secured using
a custom-built webcrawler
5) Analytic engine scored content along five
dimensions

6. Hospital Characteristics for all US AHA
hospitals by inclusion in the study
Hospital
Characteristics
Matched
Not-Matched*
Total US AHA
Hospitals
Count of AHAID
2,785.00
738.00
3523.00
Number of Births
899.73
1,035.24
928.12
Adjusted Patient
Days
79,030.26
82,914.00
79,843.82
Transfer-Adjusted
Admissions
15,299.73
16,595.29
15,571.13
Total Expenditures
152,355,799.64
160,273,331.85
154,014,368.69
FTE Employees
1,011.65
1,088.71
1,027.80
Number of Surgical 6,387.38
Operations
7,297.25
6,577.98
Total Visits
146,552.48
149,520.98
147,174.32
Number of Beds
181.04
191.52
183.24
Average Daily
Census
116.40
125.38
118.28

7. Our Method
Is a four-fold improvement from prior research
We believe it to be a census assessment of the
online presence of U.S. hospitals and their health
systems
Dimensions were investigated with an
automated content analysis using a suite of tools
Scores range from 0-10
Higher score = better comparative performance
Rankings on each dimension and an average
ranking are provided for the top 100 hospitals

8. Accessibility Dimension
Critical factor
for reaching
as many users
as possible
Scoring:
 An assessment of a
website’s ease of use for
individuals with lower
computer literacy levels

9. Content Dimension
Scoring:
Tests of spelling
Degree to which the site adds
new material
Calculated reading age of the
text on the pages
Freshness
Amount of content
An assessment of a
website’s overall content
quality without taking
into consideration the
technical limitations of
the site
Up-to-date content is a positive indicator to consumers that the
organization is engaged in state-of-the-art activities

10. Marketing Dimension
An assessment
of how readily
and reliably
information is
accessed using
search engines
Performing this effectively helps
health systems maintain a
consistent corporate image
Scoring:
Search engine results
Search placement
Use of content
keywords that search
engines rely on to
prioritize websites

11. Technology Dimension
Scoring:
 Website download
speed
 Site structure
 Code quality
 Use of cascading style
sheets to organize
content
 Speed measure
An
assessment of
how well a
website is
designed,
built, and
maintained

12. Usability Dimension
Attempts to answer
the question of how
good a particular
website is
Scoring:
 Cross-sectional
composite of a number
of metrics used in
other scales
 A composite of metrics
Why?
 Enables comparisons across a
number of critical areas of site
presentation
 Provides clear information about how
each individual organization
performs
 Offers clues as to how improvements
in these scores might be made

13. Results
2,785 facilities were scored
Summary Statistics for Scales
Variable
(N=2407)
Mean
Std. Dev.
Min
Max
Accessibility
5.08
2.22
0
9
Content
6.49
0.96
0
8.6
Marketing
5.03
1.33
.8
8.5
Technology
4.43
2.19
0
8.7
Usability
5.16
1.43
0
8

14. Accessibility

15. Content

16. Marketing

17. Technology

18. Usability

19. Implications for practice
The social media presence = first contact
A strong and well-designed social media presence can be
the difference
Health organizations should strive to standardize the
quality of information presented on their websites
Should also take care to deal with issues of accessibility,
standards compliance, and search engine optimization