Some topics, though, he points out, are more likely than others to elicit disgruntled sallies: for example, time, money and pain. For that reason, the Boston Children’s researchers warned, “from an individual hospital’s perspective, it might not be useful to heavily weight the number of positive or negative tweets within one topic category at any one moment. However, monitoring these topics over time and detecting when sentiment goes above or below an established baseline could be useful.”

Twitter commentary has a couple of edges over HCAHPS survey data, notes Hawkins. It’s entirely unsolicited and it covers wider ground.

“Our findings have implications for various groups,” his study concluded. “Hospital administrators and clinicians should consider actively monitoring what their patients are saying on social media. Institutions that do not use Twitter should create accounts and analyze the data, while existing users might consider leveraging automated tools. Insight from key leaders at institutions will help to better understand gaps and potential opportunities. Regulators should continue to consider social media commentary as a supplemental source of data about care quality.”

Moreover, Hawkins et al. suggested, “the public should pay attention to what other people are tweeting and posting on social media, and systems to collect, aggregate and summarize this information for a public audience in real time should be considered to complement data from traditional reporting platforms. To increase the utility of these data, we would recommend that each hospital manage [its] own unique Twitter identity, rather than share an account across a larger health care network.”

How’s Everybody’s Driving?

In fact, having built their automated real-time Twitter vacuumer/sorter/evaluator, Hawkins and his colleagues at Boston Children’s have now put it online for free public perusal.

Since February 2015, on a website called CrowdClinical, they’ve been posting the latest tweets about the quality of care received by every U.S. hospital with a Twitter account. Type in the name of a hospital and you’ll find a map of its location, address, a list of the tweets it has received from newest to oldest up to a few weeks previously (they can also be arranged in reverse order or according to sentiment expressed) along with a pie chart to illustrate the proportion of positive, negative and neutral Twitter remarks in the overall picture.

The site also displays the five-star ratings each hospital has received in its most current HCAHPS review categories, as well as bar chart comparisons between the hospital’s and the nationwide average rates of 30-day readmissions and mortality for key conditions, as measured by the Centers for Medicare & Medicaid Services National Healthcare Safety Network.

The Mayo Clinic leads the nation by a mile in number of Twitter followers, CrowdClinical reports — 1.2 million. The Cleveland Clinic and Johns Hopkins health care systems, at second and third, have 459,000 and 321,000 respectively. But it took only 32,000 followers for Duke University Hospital to join the top 10.

“Active engagement ... suggests a hospital is not just in listening mode, but is trying to use the platform to have conversations with [its] users,” the website suggests.

Kaiser Permanente is the most active health care tweetbacker in the land. Its member services department has shot off 66,000 tweets since CrowdClinical launched. The Cleveland and Mayo clinics, with about a third as many responses generated, rank second and third.

And which hospitals have garnered the most laudatory tweets since tracking began? Perhaps not surprisingly, children’s hospitals — in Seattle, Boston, Philadelphia, Minneapolis and Pittsburgh — make up half the top 10. Seattle Children’s and Mayo Clinic run almost neck and neck in Twitter approval, with scores of +0.68 and +0.66 on a range between -1.0 (lousy) to +1.0 (fantastic).

“This novel data stream represents a potentially untapped indicator of quality, and may be valuable to patients, researchers, policymakers and hospital administrators,” CrowdClinical reiterates modestly.

“Health care strategists need to take the lead from consumer organizations and be more flexible, find scrappy ways to gather insights and fail forward fast,” agrees Kim Hofland, senior marketing director of Monigle Inc., a Denver branding consultancy. “The orientation to being nimble and taking quick action is new, but necessary, in health care. With a relentless focus on knowing, understanding and responding to customers, you can forge deep engagement that drives behavior.”

Next: Machine learning and natural language processing give hospitals new, more fine-grained ways to benchmark.

David Ollier Weber is a principal of The Kila Springs Group in Placerville, Calif., and a regular contributor to H&HN Daily.