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Correlation Between COVID Mortality and Online Patient Reviews

In this video, healthcare marketing consultant Ron Harman King discusses the correlation between online patient feedback and COVID mortality rates, and what it might mean for those who work in healthcare.

Following is a transcript of his remarks:

My fellow Americans, it is with the greatest solemnity that I bring you a message from the front lines of today’s revolution. All across this great land fellow countrymen and women are rising up to demand their voices be heard. The will of the masses must be dismissed no longer. And so it is with great patriotic pride that I announce that the people’s voices are at last receiving the gravity of consideration that democracy demands.

I’m talking about online patient reviews, of course. Over the last 12 to 24 months I’ve observed an historic trend of significant impact. Since almost the beginning of the internet, my firm has helped healthcare providers improve online reviews from patients. Back in the old days of 2019 and earlier, a very common request from client physicians was for us to seek to remove a patient’s critical review on websites such as Healthgrades.com, Yelp, and RateMDs.

Unless you want to buy Yelp for close to $2 billion, that’s almost always impossible. For review websites to have any credibility, they must publish the bad with the good.

However, rather remarkably, I don’t recall receiving any such request from a doctor for quite a while now. My takeaway is that a new wave of acceptance has overcome the healthcare profession.

None of us like public criticism, particular when it’s unfair. Yet online ratings have become a part of routine life for pretty much everyone well beyond healthcare these days. Who among us does not routinely check the ratings of a book for sale on Amazon or the number of recommendations a movie has earned on Netflix before committing to purchase the book or the rental of the movie?

This is not to say that the knocks on online patient reviews are groundless. To be sure, there is some validity in the complaints that reviews are voluntary and not scientifically sampled, that one or two unfair public complaints can unduly harm a doctor’s or hospital’s reputation, that reviewers sometimes make misrepresentations in seeing only part of a bigger picture, and that, in a few cases, it’s questionable as to whether the reviewer was actually a bona fide patient.

Fair enough. But here’s another perspective. Perhaps a revolutionary one. We have monitored and formally studied online patient reviews for a long time now. And we’re not the only ones. In point of fact, our observations and conclusions have closely paralleled similar studies in peer-reviewed journals and have been likewise published in some of said journals.

I’ll not bury the lead any longer. My point here is that commonly held beliefs about and distrust in the reliability of online reviews are wrong. Often dead wrong, the opposite of what we and others have found. I hope that is one reason for healthcare professionals’ recently taking online reviews more seriously.

Our latest research provides an example. Would you believe that patients’ level of happiness or dissatisfaction — as generally expressed in online reviews — might be a determinant in who survives COVID-19? I personally would not have until my colleagues and I analyzed the data. What a shock we got.

We compared the rate of COVID mortalities in 100 of the most populous U.S. communities and cities against the highest and lowest healthcare satisfaction levels as measured by aggregated online patient reviews, or what we call the Happy Patient Index, or HPI.

To determine the HPI, we evaluated tens of thousands of online patient reviews and discovered that, on a national basis, the most positive feedback came from reviewers living in the San Francisco Bay Area, Honolulu, and Indianapolis, in that order.

Conversely, in our rankings, we found the unhappiest reviewers in the HPI were living in Bakersfield and Modesto, California; and North Hempstead, New York, in that order.

Next, we compared aggregated online reviews to COVID mortality rates at a certain point in time. The rather astonishing finding was that in every instance, locations with COVID-19 death rates below 1% of all reported novel coronavirus infections had above-average patient satisfaction ratings online.

In addition, true to form, residents of areas with mortality rates greater than 5% usually gave their healthcare experiences below-average online reviews.

The best performing cities with low mortality rates and a high Happy Patient Index were, in order, Madison, Wisconsin; Lincoln, Nebraska; and Anchorage, Alaska. The worst performing cities were New York, Detroit, and Jersey City.

In full disclosure, I point out a couple of noteworthy outliers: New Orleans scored a relatively high HPI of 3.97 stars out of five possible stars in online reviews but has experienced a mortality rate more than 10-fold of cities with the lowest rates. And Bakersfield, California — remember Bakersfield? — has experienced a relatively low mortality rate despite averaging a little more than three stars in online ratings.

Let me be first to say that in no way am I citing a cause and effect, that giving your doctor or hospital a good review will inoculate you against anything. But I am saying that our findings are in keeping with other studies finding a correlation between patients’ positive experiences and positive outcomes.

Multiple research findings published in [JAMA] and other internationally reputable peer-reviewed journals have shown that patients’ experiences with care, particularly with providers, correlate with adherence to medical advice and treatment plans, especially for patients suffering chronic conditions.

Is this so shocking? Of course not. Studies have long established that patients with better care experience have better outcomes. For example, a study of patients hospitalized for heart attacks revealed that patients reporting more positive care experiences had better outcomes a year after discharge.

What may be more astonishing to many of you is the relative reliability of online patient reviews. Well, there have been studies on that, too, including one that revealed that patient reviews of hospitals on Yelp.com not only correlate with ubiquitous HCAHPS [Hospital Consumer Assessment of Healthcare Providers and Systems] surveys published and heavily relied upon by Medicare, but the Yelp reviews further furnished helpful patient feedback in 12 areas not found in HCAHPS.

Given these findings, I choose to believe that we who work in healthcare are coming to a hesitant if not peaceful acceptance of online reviews. Let us henceforth regard them not as a force to be reckoned with but to be accepted as a useful tool for healthcare management.

That, my friends, is the sort of quiet revolution I can get behind.

Ron Harman King is CEO of Vanguard Communications, a healthcare marketing and practice management consulting firm, and is the author of The Totally Wired Doctor: Social Media, the Internet & Marketing Technology for Medical Practices.

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