Patient satisfaction measures: Goodbye HCAHPS, hello Yelp

I have always contended that the experience of care is the total experience, and I go out of my way in my keynotes to look at how the experience impacts everything--billing, patient safety and quality, discharge and transitions. Yet HCAHPS only looks at a small slice of this, if any at all.

I also spend a lot of time talking about family caregivers. Just one in three physicians ask for their input into a loved one’s care, and only one in six physicians ask the caregiver themselves how they are doing. My doctor, on the other hand, called me back four months after my annual physical because he was concerned about my stress level as a family caregiver to my 94-year-old mom.

Consider further that according to an Experience Innovation Network (EIN) study only 13 percent of organizations were giving top priority to patient and family voice in 2015. And a Beryl Institute benchmark report showed slightly better scores with 37 percent of responders committed to giving priority to patient and family engagement. This further reflects in other EIN data that shows very little patient and family caregiver engagement in discovery and data gathering, implementation, testing, process mapping. And of course, family voice is not measured by HCHAPS.

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Which bring us to Yelp. I knew Yelp was being used in healthcare, as it had partnered with ProPublica to track emergency department wait times and also to uncover lawsuits against long-term care providers.

So I guess I was only slightly surprised that a Health Affairsarticle illustrates Yelp as a representative tool comparable to, if not better than, HCAHPS.

Researchers compared the content of Yelp narrative reviews of hospitals to the topics in the HCAHPS survey. They noted that “while the domains included in Yelp reviews covered the majority of HCAHPS domains, Yelp reviews covered an additional twelve domains not found in HCAHPS.”

They further found that “the majority of Yelp topics that most strongly correlate with positive or negative reviews are not measured or reported by HCAHPS.”

The HCAHPS business is a multi-billion dollar business, but is it really producing actionable data? It almost always provides a high-level baseline that has to be dug into before you uncover the systemic issues. Tools like Yelp (and there will be more) cut right to the chase. They provide actionable data and they include not only patient--but also the family caregiver--voices. This is not much different than saving customer experiences through Twitter.

This is not to say HCAHPS has no value. A new study in theJournal of the American Medical Association “found that a higher CMS star rating was associated with lower patient mortality and readmissions.” Researchers concluded that “hospitals with more stars not only offer a better experience of care, but also have lower mortality and readmissions.” Some of course would disagree.

If patient experience professionals would pay more attention to the “free” chatter out there and analyze it, they could improve experiences much more quickly and systemically. Oh and they would save millions of dollars in vendor fees, not to mention paper (yes much of HCAHPS is still paper-driven). Of course this would require a new look at transparency from CMS. Yelp and other emerging tools will provide that transparency and could save the health system lots of money.

Isn’t it time we really scrutinize where the best actionable data is coming from? Especially when there are tools that help drive family caregiver engagement, whose information is invaluable.

Anthony Cirillo, F.A.C.H.E., is president of the Aging Experience, which specializes in experience management and strategic marketing across the continuum of care. Anthony is a monthly contributor on The Charlotte Today program, the about.com expert in Senior Care, an executive board member of CCAL and a member of the Dementia Action Alliance.

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