Why Aren't the Blogging Hospital CEO's Blogging About HCAHPS?? #HCAHPS

According to the blog (http://runningahospital.blogspot.com/) that Paul Levy (President and CEO of Beth Isreal Deaconess Medical Center in Boston) publishes, there are six other hospital CEO's that write/publish blogs.

They are as follows:

• Bill Roper, CEO of Univ. of North Carolina Health Care System
• Bruce Bullen, CEO of Harvard Pilgrim Health Care
• Marty Bonick, CEO of Jewish Hospital in Louisville
• Rob Colones, CEO of McLeod Health in South Carolina
• Scott Kashman, CEO of St. Joseph Medical Center
• Tom Quinn, CEO of Community General Hospital in Syracuse
  

I would also add Todd Linden, CEO of Grinnell Regional Medical Center as a CEO blogger.

First off, I applaud these CEO's for taking the time to communicate their thoughts using a leading social media tool - blogs. These are excellent blogs that cover issues ranging from personal travel, staff events, health care reform, health care quality, new physicians, etc..etc.

Out of this list - only two of these CEO's blogged about their facility's #HCAHPS scores.

• Todd Linden at Grinnell Regional wrote about their #HCAHPS scores (http://toddlinden.blogspot.com/2009/02/numbers-are-in-and-winners-are-patients.html) in his February 5, 2009 blog entry Todd states that "GRMC is at the head of the class in almost every category of patient satisfaction for hospitals within a 60-mile radius including the urban hospitals in Des Moines, Cedar Rapids and Iowa City!" This was followed by a celebration of their "#HCAHPS success" with "hot cocoa and warm cookies to recognize their dedication".
• Tom Quinn at Community General Hospital wrote about their #HCAHPS scores in his blog on April 19, 2008. In this posting he compared his facility to the four other Syracuse hospitals on the first five of ten #HCAHPS questions for the survey period of Oct 2006-Jun 2007. Though Tom did not comment or report data regarding the "would you recommend to friends/family" question.

In Tom Quinn's blog, he states that "CMS will update the patient scores on its website each quarter. We as an industry - and we as an individual hospital - have more to do to improve the percentage of patients who say we "always" meet their needs".

Borrowing Tom's words - we "have more to do to improve" our communication of our #HCAHPS scores to our patients, employees, medical staff, and communities. The mere fact that only 7 of over 5,700 hospital CEO's have blogs is big issue in transparency and communication - coupled with the fact that the ones that are blogging are NOT consistently talking about patient satisfaction and #HCAHPS scores.

Again, we cannot sit back and wait for Consumer Report or our local press folks to use OUR #HCAHPS scores to report who is doing well and who is not doing well. Nor should we expect our patients, employees, medical staff, and communities to navigate the hospital compare website to find our #HCAHPS scores and draw their own conclusions. This is our job! We need to be communicating these out on a regular basis. The drum that I keep beating on this topic is that social media tools are the perfect solution for broadcasting, informing, and educating our folks about our #HCAHPS scores.

Do Social Hospitals Have Better HCAHPS Scores??

People wonder about many different things - do these pants make me look fat? - what will I be when I grow up?.. I wonder if social hospitals have better #HCAHPS scores?? My gut tells me that they do - why?? To me the hospital that has adopted social media tools to better communicate with their patients, employees, medical staff, and community reflects an organizational culture of superior communication.

Check out the publicly reported #HCAHPS questions and you will find that they are mainly based upon "communicated well", "received help as soon as they wanted (they were listened to)", and "always explained". These very same characteristics mirror the basic principles of social media - "communicate well, listen, and explain". It is no secret that if your organizational culture is one of superior communication, there should be a correlation to your hospital's #HCAHPS scores.

Like anything else - show me the numbers - for sake of time this morning I choose to look at one of my favorite twittering hospitals - Sarasota Memorial Hospital (Florida) (http://www.smh.com @SMHCS) - (or perhaps it is just me imagining myself on one of Sarasota's fine beaches!) - Shawn Halls does a wonderful job in managing their twitter account - @SMHCS is currently #21 on @wefollow in the hospital category with 1,263 twitter followers. They also have earned a 97.9 score according to http://twitter.grader.com/smhcs - they also rank #66,888 out of over 3.2 million overall twitter users!

Sarasota Memorial also has a very nice website that earns a 92 score from (http://www.grader.com/site.php?URL=www.smh.com) - with easy to find social media links/buttons to their twitter, facebook, myspace, and delicious accounts. There facebook page (http://www.facebook.com/SarasotaMemorialHospital?ref=mf) is very nice - with many postings about classes, clinical services, community activities, etc. All in all, SMH does a very nice job of utilizing social media tools and engaging their employees, patients, medical staff, and community. With this being said, based upon their scores - I would consider them to be one of the "Best Practice" social hospitals.

The other hospital in Sarasota is Doctors Hospital of Sarasota. They too have a very nice visual website - (http://www.doctorsofsarasota.com/) - it has their "ER Wait Times", great links and pictures to their events, key service lines, CEO welcome letter, etc. But in contrast to SMH - their website only scores a 64 according to grader.com (http://www.grader.com/site.php?URL=www.doctorsofsarasota.com). Though, their website also does not show any links/buttons to any social media tools/accounts. I did find that they have a facebook page - with only 1 member, I was unable to find a twitter account for them, and they are not listed on Ed Bennett's social media list (http://ebennett.org/hsnl/).

Now let's see how their #HCAHPS scores compare to their competitor - while many of the ten #HCAHPS patient experience ratings are very close - there is a material difference in what I consider the most important question - "Percent of patients who reported YES, they would definitely recommend the hospital" - 77% of Sarasota Memorial Hospital's patients would "definitely recommend" - whereby 71% of Doctors Hospital of Sarasota would "definitely recommend".

While a 6 percentage point difference may not seem like a lot - and certainly 71% is not substandard - Sarasota Memorial had 13,615 discharges in FY2008 (according to their Medicare cost report) - this 6 percentage point difference represents 817 more discharges (patients) that "would definitely recommend" SMH, as compared to Doctors Hospital's 71% rate. In applying this same logic to Doctors Hospital - they had 3,627 discharges in FY2007 (according to their Medicare cost report) - this same 6 percentage point difference represents 218 less discharges (patients) that "would definitely recommend" DHS to their friends and family.

You can draw your own conclusions about the data - this example to me shows that potentially an organization's "superior communication" culture - whether in social media adoption, hospital operations, and patient care - could translate into higher #HCAHPS scores. I will continue this research and looking for other similar markets.

Does Your Hospital Tweet or FB Post Your HCAHPS Scores?

We are clearly an industry under attack these days from all directions - the national media, politicians, regulators, etc..etc.. What better time to substantially ramp up our social media and transparency efforts?? What better place to start than our HCAHPS scores? What better way to develop social media best practices than to broadcast, tweet, post, blog, whatever media you choose your hospital's HCAHPS scores?

Do a Google search on either "HCAHPS Scores" or "Hospital HCAHPS Scores" - you will find many companies willing to help you improve your scores - you will also find the very popular link to www.hcahpsonline.org and www.hospitalcompare.hhs.gov - these are great sources of information - for healthcare 1.0 and healthcare marketing 1.0 - NOT for healthcare 2.0 and healthcare marketing 2.0 - and certainly not for a hospital that has or has not embraced social media.

If your hospital has embraced social media - congrats! You are on the cutting edge! But I ask the question "Does your hospital tweet or facebook your HCAHPS scores?" Do you sit back and expect your patients, employees, physicians, board members, and communities to spend their valuable time surfing and navigating the internet looking for HCAHPS scores? Or do they expect you to be broadcasting this information (not data) to them? I would expect the latter - and I believe strongly that it is the latter. After all, this is publicly reported data for all eyes (with a computer) to see.

At my small, rural midwestern hospital we routinely post entries on our blog, facebook page, and twitter account about our recent HCAHPS scores - as well as post recent comments from patients regarding the great service that they receive. What is more motivational to a staff member than seeing their name mentioned in a survey and broadcast out to hundreds and in some cases thousands of people/friends/followers/readers?? Is your weekend, night ICU nurse pumped up at 3:00 a.m. on a Saturday morning to see his/her CEO proclaiming that "their hospital is the best in the area"??

What else is coming down the pike? Consumer Reports announced on August 3, 2009 that for the first time, they will "provide patient satisfaction ratings for more than 3,400 hospitals across the U.S." (for an annual subscription price of $19). So we are going to sit back and wait for our patients and communities to PAY $19 to see our data in a meaningful and easy to read format? Or are we going to be proactive as an industry and use these great social media tools to broadcast our own scores and results?

I did a simple search on twitter for the hashtag #hcahps - guess what?? There are NO results. Until now - as I am going to officially start the #hcahps march to better transparency and information.

The next step is to provide a file (for the time period of Oct 2007-Sep 2008) that shows all of the results of the HCAHPS reporting hospitals for what I consider the most important HCAHPS question - "Would You Recommend The Hospital To Friends And Family?" - You will see that I have sorted this file by the percentage of patients that would "definitely recommend" the hospital. To me, your goal should be to create "raving fans" among your patients and this question shows the hospital's effectiveness in this area.

http://spreadsheets.google.com/ccc?key=0Ak-sSK0Ze5jHdGhGdkdsak14dmYtdWR2d1ZYeVdRd2c&hl=en

In summary, our goal as a hospital needs to continue to improve our transparency. I believe that the utilization of social media tools is a tremendous way to communicate your message. I am going to continue to dissect this data and will continue to publish this data in the near future.

My hospital has a Facebook page & a Twitter Account! Now What??

Your CEO/Administrator came to you and told you that she/he wanted you to get your hospital on Facebook and Twitter. You jumped right to it and got it done. Great! Check that off of the "to-do" list! Back to the newsletter, newspaper ad, direct mail campaign, the 132 unread emails in your inbox - whatever you were working on.

You ask yourself - "Self, what do I do now?" Self replies - "Do you have a strategy?" - You answer- "Sure, to make the CEO/Administrator happy?" Ok - so the cart is now in front of the horse and you need to reign it in a bit and get a plan developed.

As Chris Brogan stated in his June 13, 2008 (yes there was social media before 2009) blog article "Starting a Social Media Strategy" (http://www.chrisbrogan.com/starting-a-social-media-strategy/) - "Begin with the End in Mind" - further defined that "strategy isn't the goal. It's the path you plan to take to get there."

As a simple financial minded person - my approach is a bit elementary - it is the 5 "W's" of "who/what/where/when/why"...

WHAT - Before you start some busy work answering the "Now What?" question - figure out what you are trying to accomplish - what is the goal - what is the end game. Are you trying to increase your patient/customer base, increase market share, reduce outmigration, promote your medical staff, become a health information resource in your community, improve internal communication with your staff, promote service lines... the list goes on and on...

WHO - who is going to maintain your social media activities? while these are "free" tools - there is considerable staff time required to maintain them and execute your plan appropriately. Make sure you get this figured out and and make sure that "who" matches up with the "what" - get the right people/person on the right seat on the bus!

Where - what social media channel are you going to be on besides Facebook and Twitter? There are dozens of social media channels/tools/avenues available to you. My advice - start small - do not over commit yourself - do a couple right to begin with - make sure you have solid execution of your plan/strategy. From a hospital perspective - I would probably advocate for just starting with a Facebook page. You will be amazed at how many of your employees already have a Facebook account. Invite them to "fans" of your hospital - encourage them to promote your hospital page to their friends - this is where the "viral" component comes into play. Facebook is very powerful and has many tools to use - i.e. video, audio, etc.

When - when are you going to provide updates/information? daily, weekly, hourly, monthly?? This really depends on what you are trying to accomplish and what messages you are trying to convey. Remember that a key component and advantage of these social media tools is to "engage your community (fans)" not necessarily "market" to them. Encourage a dialog among your community. Be consistent - your community/fans needs to "hear" from you on a fairly consistent basis or they will forget about you - remember this is a "microwave" world now.

Why - this needs to be tied back to your strategy - why are doing this? Why are you promoting your Women's Services, new docs? You should be past the point of justifying why you have adopted social media tool(s). You do not want to be part of the "the internet is a fad" crowd. These tools are clearly here and either we adopt them or we will be left in the dust.

In summary - like anything else you do , to be successful you need to have a solid strategy, plan of attack, and answers to the 5 "W's". There are MANY resources available to you by simply doing a Google search on "How" to use the tools - but these are more logistical-based rather than answers to your facility-specific goals and objectives.

Best wishes and good luck with your social media journey!

Call For Action to All Hospital Twitter Leaders

How many hospitals are on Twitter? How do I network with other "Twittering" hospitals? What are other hospitals twittering about? The questions go on and on...

According to Ed Bennett's (www.ebennett.org) last update - there were 213 hospitals with Twitter accounts. As this number continues to grow (explode) - it will become increasingly difficult to manually track what hospitals are on Twitter. While this list is manageable, I strongly believe that we need to adopt some standardization of where we begin to track social media performance and R.O.I.

My question to the twittering hospital industry is - "why not use a free service to link all of us together?" - http://wefollow.com/twitter/hospital is such a service - I have absolutely no financial arrangement with wefollow - nor do I even know much about the company other than they do a very good job of tracking twitter users by industry (tag). As you will see - there are only 118 twitter users currently in their "hospital twitter users" database. Based upon Ed's list and seeing additional users come online in the past several weeks, I would anticipate that this number is approximately 400 today.

Try to think about this from your administrators office - as your social media computer time continues to increase - I would anticipate some questions from your C-suite. Get yourself prepared for these questions by proactively monitoring and reporting where your facility stands among the overall "Hospital Twitter Users" list on http://wefollow.com/twitter/hospital. You simply can drop you C-suite folks a quick email stating that your hospital is #27 on the list. The competitive nature of your C-suite will kick in and they will want to know where you stand as compared to your competitors.

Plus this service provides you with an excellent source for other twittering hospitals. I would highly encourage you to review what other hospitals are doing - are they reporting on overall health news? are they tweeting on health care reform issues?

In summary, I fully realize that Twitter is just one component of a social media campaign/initiative - but it is a very important piece. As social media continues to evolve in the hospital industry, we need standardization! As early adopters of this technology, let's set the pace and standards now for the future!

How Does This Best Practice Hospital Grade Out??

Children's Hospital Foundation in Washington D.C. (http://www.childrensnational.org/give) is a best practice hospital in their utilization of social media tools. They are the top U.S. hospital on Twitter with 2,906 followers (@childrenshealth). On their facebook page, they have 1,666 fans. Certainly with these numbers of fans and followers they certainly have a solid "social capital" base of fans, followers, and friends.

Their website is excellent - with ways to financially support their mission, learn about events, and a great section dedicated to meeting children that they have cared for!

As the utilization of social media tools continue to evolve - I believe that the 2.0 version of social media will turn towards quantifying and measuring the "social capital" and "social effectiveness" of organizations and businesses that have adopted these tools. The hospital CFO mind in me wants to see a report/score card format for hospitals using social media tools.

It is very important for us to engage our communities by having tons of followers, friends, and fans. But as we move towards to social media 2.0, how are we capitalizing on our new online engaged communities? Are the friends, fans, and followers that we have really quality, local customers/patients? Are our social media efforts and initiatives translating into a stronger market share, more surgeries, outpatient revenue, and ultimately bottomline impact?

I am starting to work on a social media scorecard that will measure and track hospital and health system social media grades/scores. I believe that this scorecard will be very important for our business and we progress into a social media 2.0 world.

Children's Hospital Foundation's website has earned a grade of 76 out of 100 (according to http://www.websitegrader.com/) - Here is a copy of their report - http://www.grader.com/site.php?URL=www.dcchildrensfoundation.com/site/PageServer

As you will see - there are very specific areas that they can improve on with their website to maximize their excellent efforts in this area.

Their twitter efforts certainly show with a grade of 98.4 out of 100 - here is a copy of their report - http://twitter.grader.com/childrenshealth - their follower/following history is excellent with a great growth of both on this chart http://twitter.grader.com/history/childrenshealth.

As mentioned above Children's Hospital has 1,666 fans on their facebook page - http://www.facebook.com/childrens.national - they do a great job in presenting a "presurgical tour" online, interviews of their medical staff that appeared on CNN and even a visit by President Obama!

Great job - Children's Hospital Foundation for a solid scorecard and great use of social media tools!!

DIY or Outsource Your Hospital's Social Media Activities??

With the current low hospital and hospital association social media adoption rate - I would tend to conclude that there are multiple factors that are keeping this number low. Is it a cost issue? Is it a knowledge/awareness issue? Is it a time issue? We could speculate all night as to what the driving factors are behind this issue.

As I have documented in some recent posts, the issue for a hospital is not whether to adopt/implement these tools as much as it is who is going to become the "social media" champion within their organization.

Ok - so your CEO just came into your weekly administrative meeting and proclaimed that your hospital is going to become the next "social media superstar" within thirty days. What do you do? Do you take on the steep learning curve and spend the next 2-3 weeks learning how facebook, twitter, blogs, and Youtube work? Do you contact your marketing company to see if they know how do social media? Do you do a Google search for "outsource social media" companies?

According to a July 7, 2009 article by Lydia Dishman - http://www.entrepreneur.com/ebusiness/expandingyouronlinepresence/article202500.html - she states that "as the number of platforms grows, so does the time it takes to feed and groom each account. Not to mention the front-end investment of setting everything up". She also poses the question "for those caught up in a social media blitz - and those contemplating taking the plunge - why not consider outsourcing"?

If you are considering outsourcing your social media and are looking for an "expert" - I would recommend that you script your interview questions using Ian Lurie's "10 Questions to Evaluate a Social Media Expert" - http://www.conversationmarketing.com/2009/07/10-questions-for-social-media-experts.htm - this is a very good place to start - as well as give you a basic idea of what to look for. The upside to outsourcing is that (in theory) you will be engaging a social media expert (no learning curve), quick implementation, cheaper than hiring a dedicated employee or a portion of an FTE, and they will be up to date with social media tool trends. The downside is that there is a lot of pressure to select the right firm out of many that claim they are "experts", lack of control, and the typical outsource management issues (i.e. performance, responsiveness..etc).

From the D.I.Y. (Do It Yourself) side of the ball - you can hire a person or people to take on your social media program - the advantages of this is that you will maintain direct control over the messages, your branding, and promotions. The downside is that you will have to deal with typical employee relations issues (i.e. sick/vacation time), cross training, steep learning curve, and large time commitment.

You can certainly make a very compelling case for either DIY or outsourcing your social media strategy. As with any strategic decision, make sure you do your homework before you choose your path.

Good luck with your selection! I look forward to seeing and reporting on your future successes!!