Introduction

In an era where online platforms heavily influence consumer decisions, a hospital’s reputation on platforms like Google and Yelp can significantly impact its success. Via our internal research and a review of published literature, most hospitals’ general online public reputation scores are poor^[i]. Review scores for most hospitals are low (2.5 to 3 stars), and comment sentiments are primarily negative or neutral, with a sparse number of reviews (given high patient volumes). 

In this article, we will explore the causes of few and poor reputation scores and effective strategies and technologies to enhance the volume and character of reputation scores on Google and Yelp. These methods will allow hospitals to foster trust, attract more patients, and demonstrate their commitment to quality healthcare.  

Most hospitals have made a Faustian bargain of running money-losing Emergency Departments (EDs) whose population and rules are defined by government mandates, combined with trying to run the remaining hospital profitably where possible. Given the limited resources in ED and the stress to all parties, most of the negative public reviews come from ED patients, no matter the quality of service provided.    

Given human nature, it is unsurprising that hospital leadership generally sees little reason to invest in getting more negative reviews if almost all they see are negative.

Vicious Cycle of Emergency Department Losses Due to Poor Reputation

The gold standard for hospitals and other practices is patients with high reimbursement rate plans (i.e. PPOs) and those who will pay for services personally at published rates rather than the lowest negotiated insurance rate. Patients with options will check the public ratings of the hospital and their providers on Google and Yelp. They are seeking locations with many reviews (>100-500 recent reviews) and generally all 5-star reviews. These patients will bypass hospitals and providers with 2.5-3 star reviews.  

The net effect of not putting any effort into getting public reviews is diverting high-value patients to alternative facilities with better reviews.

The Misconception of Negative Hospital Reviews

All things being equal, consumers tend to write negative rather than positive reviews. The reason is simple: the passion from a bad experience motivates consumers to take action to be heard or to get justice or revenge. As in so many human conflicts, they frequently stem from a lack of communication. Given the frenetic nature of healthcare and limited staffing, ideal regular communication between practitioners, patients, caregivers, and families suffers, especially in highly stressful ED scenarios.

How do you create a highly communicative, curated, personalized experience for patients and their guests that will satisfy them, and how do you motivate them to take the time to create a review?  

REALITY: Current EMRs, practice management, and patient engagement solutions are NOT designed for modern patient engagement and reputation management.  

The labor necessary to achieve modern patient expectations is impractical except for large donor VIP engagements with teams of experienced patient concierge specialists.

Achieving Modern Patient Engagement Expectations

The modern curated experience requires automated real-time pushed communication and facility resources available to patients, caregivers, families, and guests. The team at Analog Informatics Corporation (https://www.analoginformatics.com) created that platform for FHIR-based EMRs.

There is a great reluctance to turn over clinical communications to an unsupervised AI assistant. We agree and have focused on harvesting EMR data to create logistic communication updates for all phases of the patient journey: Admit, Discharge, Transfer (ADT), pathology completion status, electronic pre/post-op care plans, post-discharge wellness checks, visit thank you, birthdays, requests for public reviews, engagement for no-shows and cancellations.   

We have created 43 editable workflow templates that are driven from the EMR based on appointments, encounters, and service orders.  Fail-safes throughout the code check for reasonableness and try to achieve an optimal communication volume to not fatigue message recipients.

As we were designing workflows, we tried to anticipate the information needs that an external phone call, trip to the nurses’ station, or walkup question to the check-in desk staff would typically handle.

Information is pushed out via Email, SMS/MMS, and voice communication at the appropriate time and contextually relevant for each audience.

A later message directs all parties to a personalized page that allows each person to select a charity of their choice where a donation will be made for their review (your 501C3 organization is probably listed, but they can be highlighted).  If the patient or third party does not submit a review, they are sent reminder messages to complete the review.

To keep track of your reputation scores for multiple facilities, we have a reputation crawler service that reports on daily/weekly/monthly/yearly reports of reputation vs. peers.  

Revenue Improvement and Earned Media

Our portal maintains statistics of reputation review requests, trips to the personalized donation page, and actual clicks that land consumers on the Google or Yelp page for the facility. We calculate taking action from a message to opening the review/donation landing page at $50 per visit and $200 for each completed Google or Yelp click, which is generally a 5-star review.

In our testing with a regional ambulatory dermatologist practice with 20+ offices, we saw over $100K in monthly earned reviews and about 20% of patients clicking the reviews link in the review message. Practitioners commented about their surprise at seeing multiple 5-star reviews on the first day of deployment when there had been none for months. Other comments included a surprise in same-day rescheduling of no-show appointments by patients due to immediate reminders and grateful responses from patients receiving automated thank you and wellness checks.

Ordered pathologies are proactively tracked, and all authorized parties receive immediate notification of their collection and completion with instructions on how to get a consultation of the results. There is no need for patients or caregivers to call in to check for completion status periodically.

Because pre-visit facility familiarization is provided by our welcome messages, which redirect the patient and 3^rdparties to a customizable per-facility amenity page, everything for patients and guests is provided electronically. Amenities like parking, links to Uber/Lyft, food, pharmacies, and other local merchants by distance are easy to find and get to via their mobile phones.

^[i] Zitek T, Bui J, Day C, Ecoff S, Patel B. A cross-sectional analysis of Yelp and Google reviews of hospitals in the United States. J Am Coll Emerg Physicians Open. 2023 Feb 25;4(2):e12913. doi: 10.1002/emp2.12913. Erratum in: J Am Coll Emerg Physicians Open. 2023 Mar 24;4(2):1. PMID: 36852191; PMCID: PMC9960977.