Co-presented with Maggie Rafferty at 2nd annual Hospitality in Healthcare Conference, Las Vegas, 11-14-16

1. Dr. Maggie Ozan-Rafferty, Chief Experience Officer
Kate Grey, Vice President, Strategic Marketing
2nd Annual Hospitality in Healthcare Conference
The Impact of Social Media on
HCAHPS

2. • One of nation’s largest health care systems
– Fifth-largest hospital system; Largest not-for-profit provider in Calif.
• 55,000 employees, 9,000 affiliated physicians
• Nevada: 4,000 employees, 3 hospitals (2017: seven),
multispecialty medical group, other services. Multi-year NRC
Consumer Choice award winner: Strongest brand in market.
About Dignity Health
1

3. • Changing health-care environment and impact on feedback
• One health system’s story: Leveraging Online Patient
Experience Information
• The Future of Patient Experience
Agenda for today
2

4. 24% >
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©2014 The Advisory Board Company • advisory.com • 29385A
Source: Experian MarketingServices, “Cross-Device Video Analysis,” April 17, 2014, available at: www.experian.com; Manjoo F, “Comcast vs. the Cord Cutters,”
The New York Times, February 15, 2014, available at: www.nytimes.com; Health Care Advisory Board interviews and analysis.
Paying for More Than You Use
“This is the battle hymn of the cord cutter: You are
paying too much for television, and you aren’t
watching most of what you’re paying for.”
Farhad Manjoo, The New York Times
U.S. Households
With Internet
But No Cable, 2013
6.5%
U.S. Adults Age 18-34
With Netflix or Hulu But
No Cable, 2013
18.1%

5. • Employers
• Insurers
• Managed-care organizations
Historical wholesale decision makers
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6. • ACA - Consumer insurance exchanges
• Private exchanges - By 2017, estimated 1 in 5 Americans will
purchase benefits from private exchange
• In addition, growth of high-deductible plans expose consumers
to greater proportion of costs
The new decision makers
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7. • Price
• Convenience
• Experience
Consumers decide by assessing …
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8. 7
50
Welcome to the Renewals Business
Patient Experience Vital For Securing Purchaser Choice Year Over Year
Network Selection and Ongoing Experience
Day 1
Day 365
Care Decision
Care
Decision
Care
Decision
Care Decision
Clinical interactions
represent repeated
opportunities to
reinforce patient
preference through
superior experience
Annual network
selection in fluid
insurance market
implies consistent
reevaluation of
network performance
Patient
Experience
©2014 The Advisory Board Company • advisory.com • 29385A Source: Health Care Advisory Board interviews and analysis.

9. • Think about your last Amazon experience
The Shop-Experience Cycle
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10. • Now in health care – ZocDoc
The Shop-Experience Cycle
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11. • More actively engaged in health
• The FitBit culture
• Paying out of pocket naturally leads
to consumer involvement
Consumerism and Access to Information
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12. A promise

13. How we typically obtain feedback
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Patient Discharged Send Surveys Survey Responses Prepare
Results
Send to Hospitals Analyze and Share
Results
Lagging Indicator (8-10 Weeks)

14. What’s missing from what we measure?
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15. Feedback also comes from leading sources
Suggestion
Box

16. Social media – the next feedback frontier
75 % of online
users seek Healthcare
Information
42 % health social
media users look for
consumer reviews
100 K Mobile
Health Apps

17. Internal data provides additional insights
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-3
-2
-1
0
1
2
3
Listen to patients
Skill & expertise of staff & admin
Responsiveness
Reputation
Great service
Comprehensive healthcare system
Convenience
Up-to-date technology
Leader in healthcare
Efficiency
Promotes healthiness
Compassion
Up-to-date facilities
Innovation
Internal
Consumers
Q20: How important are the following factors in your selection of a healthcare provider?
Please pick the 3 most important factors.

18. Our wake-up call
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19. Our reaction
Marketing
Patient
Experience

20. • Deeper dive into social media policy and current practices
• Informal network development
– Who? What? When? and response-time expectations
• Education for stakeholders
• Assistance with problem resolution
• Leveraging event reporting system as a repository
• Development of initial tracking tool
Operationalize - what processes are needed?
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21. Turning 1 star into 5: Shawn’s story
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22. Drowning in data
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EHR/EMR Data
Department Data
Billing Data
Financial Data
Internal – Structured 3
Avatar Surveys
Patient Letters Rounding Notes
Call Center Notes
Internal – Un-Structured 2
GOV Sites / Rankings
Social Media
External
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23. Missing Link – algorithmic narrative content analysis
?
Is this Good
or Bad ?

24. How have we leveraged?
Alarms
Standouts
Processes
Performance
ROI
Culture
• Processes Improvement
• Enhanced Communication
• Culture
• Focused Learning and
Development
• Proactive Identification of
Hot Spots
• Increase Top and Bottom
Line Impact?

25. 24
No Questions asked -
shipped a Playstation to
replace one stolen from
doorstep
Suggests local
restaurants based on
previous concierge
interactions
Shoe shopper upgraded to
Zappos VIP, so she can get
free shipping to try any
shoe instantly
These industries know their customers, follow their customers
everywhere and learn about their habits to provide a better
experience.

26. Social media as predictive measure of HCAHPS?
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90% of the decisions get made after visiting these
websites, Is Healthcare Different ?

27. • Conclusion Despite the relatively small number of hospitals that
had Yelp reviews, it is apparent to us that online consumer
review platforms such as Yelp can supplement information
provided by more traditional patient-experience surveys and
contribute to patients’, providers’, and policy makers’
understanding and assessment of hospital quality. The content
of Yelp narrative reviews mirrors many aspects of the HCAHPS
survey but also reflects new areas of importance to patients
and caregivers that may have important implications for policy
makers seeking to measure the patient experience of hospital
quality and hospitals attempting to improve patient
Health Affairs
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28. • The majority of Internet reviews of primary care physicians are
positive in nature. Our findings reaffirm that the care encounter
extends beyond the patient–physician dyad; staff, access, and
convenience all affect patient’s reviews of physicians. In
addition, negative interpersonal reviews underscore the
importance of well-perceived bedside manner for a successful
patient–physician interaction.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358396/
Journal General Internal Medicine
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29. • Analytics and trending
• Expanding digital marketing team
• 24/7 Monitoring
• Virtual Patient Advisory Boards
• Additional mechanisms for instant feedback
• More story telling and culture building
• Correlations between leading indicators and HCAHPS
Future steps
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30. Questions & discussion
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31. Thank you
Dr. Maggie Ozan-Rafferty
Chief Experience Officer
meorafferty@gmail.com
Kate Grey
Vice President, Strategic Marketing
kate.e.grey@gmail.com