Demystifying Medicine One Month at a Time

Exploring Emotion

Data mining turns up gold. (NYT image)

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

-Maya Angelou

This quote was used as an epigram in a couple of different talks at the first-ever Patient Experience Summit hosted by the Cleveland Clinic.

The summit was an opportunity to bring together leaders and innovators in the area of patient experience.

It should come as a pleasant surprise that health care entities (hospitals, doctors’ offices, home health agencies) are starting to care more than ever about how they treat patients, not just medically, but emotionally as well.

Patients are more empowered than ever in making decisions about their health care. Providers are competing for their business, and when patients feel unsatisfied as customers, they take their business elsewhere.

Not only that, but patients now have many ways to give feedback about their experiences. They can do it in traditional ways, like answering questionnaires sent by the hospital after a visit. They can call and register feedback with the hospital. Or more likely, they can turn to the Web and offer their feedback on social networking sites like Facebook and Twitter, or give feedback on user rating sites like Yelp or Angie’s List.

[Analogy: Savvy travelers like my wife never go anywhere without cross referencing destinations on TripAdvisor.]

One of the talks I heard at the summit really inspired me [slides here]. It was given by Rick Siegrist, CEO of Press Ganey Associates. For those of you not immersed in health care, Press Ganey is the 800 lb. gorilla of hospital surveyors. They dominate the hospital market across the U.S., providing customer feedback to more than two thousand clients, including nine out of the top ten hospitals in the U.S. News & World Report rankings.

All hospitals want to improve their quality and adopt “best practices.” Press Ganey uses standardized survey methodology to collect information from patients about their experiences at hospitals, and feeds it back so that management can use the data to improve areas of lower satisfaction or perhaps offer a sentinel of problems in safety and/or quality.

Siegrist has become interested in a field called sentiment analysis, which looks at how the emotional language of customer feedback can be “harnessed into hard data.” He estimates that up to 80% of any organization’s data is “unstructured,” occurring in “free text” and therefore lost to analysis. The typical 5-point Likert scales can only get us so far.

Siegrist gave examples of different kinds of comments, and how sentiment analysis would convert them into categories and score them accordingly. I think you “had to be there” to feel the impact of his examples, but I found them compelling in terms of helping a hospital understand things like

  • who its key performers are
  • who its underperfomers are
  • how service performance is trending
  • early warning signals.

Let’s say you’re a VP at a 250 bed hospital tasked with managing patient satisfaction surveys. If you get 750 surveys back a month, 80% of which have comments on them (with an average of 3 comments), you’d be looking at 1800 comments/month. An overwhelming load for any one person; even any team. Without a way to quantify and measure them, the data become a flood of anecdotes; only the most stridently negative or positive comments will leap above the fray.

And by reacting to the most strident comments, you might not be focusing your resources in the most prudent manner.


  1. The 50 Best Health Blogs

    “Patients are more empowered than ever in making decisions about their health care. Providers are competing for their business, and when patients feel unsatisfied as customers, they take their business elsewhere.”

    Do patients really have more choices? It seems like big hospital chains are gobbling up other hospitals and private practices, so that many patients find themselves locked into one group of doctors.

    Jim Purdy

    • glasshospital

      You’re correct as far as consolidation in local markets actually lessening the choice of providers.

      [I think one unintended consequence of health care reform will be more consolidation, on a massive scale. As millions of newly government-insureds enter the market, the only way to make a margin on the tight reimbursement will be economies of scale. The yeoman private practice doc is an endangered species, except of course in psychiatry.]

      But regarding choice, I was referring to patients (consumers) having ever more health care knowledge and resources at their fingertips. And for those already with insurance and some form of chronic (or as GlassHospital executives likes to call it “complex”) illness, people are willing to travel across (or even out of) their region to find the best (or at least the best marketed, or best reputed) centers.

      • Dr cynical

        Patients should not be given choices. Doctors should not treat themselves and people with 100 IQs should definitely not choose their care.
        A little knowledge in an idiot’s head is enough to get him very sick.

        • glasshospital

          I think patients SHOULD be given choices. Seems like a fundamental principle.

  2. joe marlin

    Such concerns are long overdue but sadly hospitals are responding partly because of competitive concerns. Being concerned about how patients/families feel also reduces lawsuits, I hear. One of the ironies of health care is that the profession that was more centrally concerned (I believe) than any other in health care, the social work profession, about patient/family concerns has historically not had a very lofty ranking in the hospital hierarchy. Of course I’m biased having been a hospital social awork director at two different Chicago hospitals before retirement.

    • rgold

      I don’t think you are biased and I would include chaplaincy in addition to social work as another profession centrally concerned and experts in patient/family emotional and spiritual wellbeing.

      • Dr cynical

        Hospice and “compassonate care may save money for the hospital DRGs but is it what people really want ?

        Most people on hospice want to live.

  3. Traditional Chinese Herbs

    Very noble article which relations must think on the order of.

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