Reviews of healthcare providers on social media sites like Yelp are filling gaps in traditional ratings programs driven by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, a new study in Health Affairs claims.

In fact, authors suggest that Yelp can help policymakers pinpoint the hospital quality measures that matter most to patients and caregivers.

While social media sites like Yelp are largely unstructured and at risk of being gamed by users, the authors claim the sites often reveal exactly what the problem or positive occurrence was that affected a patient's experience.

Yelp is the 33rd most visited website in the United States and the 155th most viewed site globally, with 142 million unique monthly visitors. To date, it's the most widely used, and freely available, commercial website in the United States for hospital ratings.

The site also encompasses more categories than the traditional HCAHPS survey. In all, researchers found 12 topics covered in Yelp that don't have a corollary in more formal surveys: cost of hospital visit, insurance and billing, ancillary testing, facilities, amenities, scheduling, compassion of staff, family member care, quality of nursing, quality of staff, quality of technical aspects of care, and specific type of medical care.

In addition, four of the top five Yelp topics most strongly associated with positive reviews were not covered by HCAHPS -- caring doctors, nurses and staff, comforting, surgery procedure and peri-op, and labor and delivery.

Two of the top five Yelp topics, meanwhile, are associated with negative reviews — insurance and billing and cost of hospital visit— also were not covered by HCAHPS.

The findings suggest a larger-than-expected role for social media when it comes to gauging the patient experience. Seventy-two percent of U.S. internet users sought out online health information in 2012, authors said, and 42 percent reported looking at social media for health-related consumer reviews. Only 6 percent of Americans, however, had even heard of the Hospital Compare website as of 2008.

While sites like Yelp have their advantages, the study points out that leaning too heavily on social media can cause concerns. Yelp doesn't solicit reviews from a random selection of patients, the reviews are more likely to come from younger and more educated consumers, and hospitals might have a hard time deciding what to do with unsolicited online reviews. Not only that, but not all hospitals are represented by Yelp, and half have four or fewer reviews; until the use of such sites becomes even more common, this can limit their usefulness.

Yet the report claims that a major barrier to the public reporting movement is engaging consumers in responding to publicly reported quality information. The authors' suggestion is to copy some of Yelp's features into more formal assessments like HCAHPS, which they say could increase patient engagement. The National Health Service in England has already taken steps in this direction.

Additionally, they say lessons can be learned from websites like Amazon, which curates large numbers of consumer reviews by highlighting the most helpful positive and negative reviews.

Yelp, for its part, has already begun to move more formally into the healthcare space. Last year, it teamed up with ProPublica to integrate data from the Centers for Medicare and Medicaid Services onto the business pages of more than 25,000 healthcare facilities in the United States. Its listings now include info on wait times, readmissions and infection numbers at hospitals, nursing centers and dialysis centers.

And Yelp is the top destination for consumers looking for physician reviews, with 27 percent of consumers consulting the site for doctor reviews, according to data from Software Advice — even slightly above Healthgrades and RateMDs. 

Twitter: @JELagasse

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