Subscribe to RSS
DOI: 10.1055/s-0040-1708049
Natural Language Processing to Extract Meaningful Information from Patient Experience Feedback
Funding None.Publication History
05 November 2019
01 February 2020
Publication Date:
01 April 2020 (online)
Abstract
Background Due to reimbursement tied in part to patients' perception of their care, hospitals continue to stress obtaining patient feedback and understanding it to plan interventions to improve patients' experience. We demonstrate the use of natural language processing (NLP) to extract meaningful information from patient feedback obtained through Press Ganey surveys.
Methods The first step was to standardize textual data programmatically using NLP libraries. This included correcting spelling mistakes, converting text to lowercase, and removing words that most likely did not carry useful information. Next, we converted numeric data pertaining to each category based on sentiment and care aspect into charts. We selected care aspect categories where there were more negative comments for more in-depth study. Using NLP, we made tables of most frequently appearing words, adjectives, and bigrams. Comments with frequent words/combinations underwent further study manually to understand factors contributing to negative patient feedback. We then used the positive and negative comments as the training dataset for a neural network to perform sentiment analysis on sentences obtained by splitting mixed reviews.
Results We found that most of the comments were about doctors and nurses, confirming the important role patients ascribed to these two in patient care. “Room,” “discharge” and “tests and treatments” were the three categories that had more negative than positive comments. We then tabulated commonly appearing words, adjectives, and two-word combinations. We found that climate control, housekeeping and noise levels in the room, time delays in discharge paperwork, conflicting information about discharge plan, frequent blood draws, and needle sticks were major contributors to negative patient feedback. None of this information was available from numeric data alone.
Conclusion NLP is an effective tool to gain insight from raw textual patient feedback to extract meaningful information, making it a powerful tool in processing large amounts of patient feedback efficiently.
Keywords
natural language processing - knowledge modeling and representation - patient satisfaction - patient engagement - patient - consumer healthAuthors' Contributions
K.N. and G.R. conceived of and developed the project. G.R. provided and analyzed the Press Ganey data. K.N. performed the programming and analysis of the data and wrote the first draft of the manuscript. R.S. provided substantial support including encouragement to publish, as well as extensive writing and editing of the manuscript. All authors approved the final manuscript for submission.
Protection of Human and Animal Subjects
The Geisinger Health System Institutional Review Board ruled that this project was not subject to its oversight as the proposal is “research that does not involve human subjects” as defined in 45 CFR 46.102(f).
-
References
- 1 Press I. Concern for the patient's experience comes of age. Pat Exper J 2014; 1 (01) 4-6
- 2 Press Ganey. History & Mission. Available at: https://www.pressganey.com/about/history-mission . Accessed December 11, 2019
- 3 CMS.gov. HCAHPS: Patients' Perspectives of Care Survey. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS . Accessed December 11, 2019
- 4 CMS.gov. The HCAHPS survey–Frequently asked questions. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Downloads/HospitalHCAHPSFactSheet201007.pdf . Accessed December 11, 2019
- 5 Office of the Legislative Counsel. Patient Protection and Affordable Care Act; Health-related portions fo the Heatlh Care and Education Reconciliation Act of 2010. Available at: http://housedocs.house.gov/energycommerce/ppacacon.pdf . Accessed December 11, 2019
- 6 Dottino JA, He W, Sun CC. , et al. Centers for Medicare and Medicaid Services' Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and gynecologic oncology surgical outcomes. Gynecol Oncol 2019; 154 (02) 405-410
- 7 Schron E, Friedmann E, Thomas SA. Does health-related quality of life predict hospitalization or mortality in patients with atrial fibrillation?. J Cardiovasc Electrophysiol 2014; 25 (01) 23-28
- 8 Dominick KL, Ahern FM, Gold CH, Heller DA. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res 2002; 14 (06) 499-508
- 9 Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997; 38 (01) 21-37
- 10 Maslowska E, Malthouse EC, Viswanathan V. Do customer reviews drive purchase decisions? The moderating roles of review exposure and price. Decis Support Syst 2017; 98: 1-9
- 11 Davidson KW, Shaffer J, Ye S. , et al. Interventions to improve hospital patient satisfaction with healthcare providers and systems: a systematic review. BMJ Qual Saf 2017; 26 (07) 596-606
- 12 López A, Detz A, Ratanawongsa N, Sarkar U. What patients say about their doctors online: a qualitative content analysis. J Gen Intern Med 2012; 27 (06) 685-692
- 13 Ellimoottil C, Hart A, Greco K, Quek ML, Farooq A. Online reviews of 500 urologists. J Urol 2013; 189 (06) 2269-2273
- 14 Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013; 3 (01) e001570
- 15 Doing-Harris K, Mowery DL, Daniels C, Chapman WW, Conway M. Understanding patient satisfaction with received healthcare services: a natural language processing approach. AMIA Annu Symp Proc 2016; 2016: 524-533
- 16 Li J, Liu M, Li X, Liu X, Liu J. Developing embedded taxonomy and mining patients' interests from web-based physician reviews: mixed-methods approach. J Med Internet Res 2018; 20 (08) e254
- 17 Keras: The Python Deep Learning library. Available at: https://keras.io . Accessed December 11, 2019
- 18 Chandrasekar P, Qian K. The Impact of Data Preprocessing on the Performance of a Naïve Bayes Classifier. In: Proceedings - International Computer Software and Applications Conference. Vol 2. IEEE Computer Society; 2016: 618-619 . Doi: 10.1109/COMPSAC.2016.205 Available at: https://www.semanticscholar.org/paper/The-Impact-of-Data-Preprocessing-on-the-Performance-Chandrasekar-Qian/f624888aa484238383513a406accb2a958ed90d9 . Accessed February 18, 2020
- 19 Vijayarani S. Research scholar MP. Preprocessing techniques for text mining-an overview. Int J Comp Sci Comm Networks 2015; 5 (01) 7-16
- 20 Mitkov R. The Oxford Handbook of Computational Linguistics. 1st ed. Oxford, United Kingdom: Oxford University Press; 2003. . Doi: 10.1093/oxfordhb/9780199276349.001.0001
- 21 Guresen E, Kayakutlu G. Definition of Artificial Neural Networks with comparison to other networks. Procedia Comput Sci 2011; 3: 426-433
- 22 Gohil S, Vuik S, Darzi A. Sentiment analysis of health care tweets: review of the methods used. JMIR Public Health Surveill 2018; 4 (02) e43
- 23 Kreimeyer K, Foster M, Pandey A. , et al. Natural language processing systems for capturing and standardizing unstructured clinical information: a systematic review. J Biomed Inform 2017; 73: 14-29
- 24 Ranard BL, Werner RM, Antanavicius T. , et al. Yelp reviews of hospital care can supplement and inform traditional surveys of the patient experience of care. Health Aff (Millwood) 2016; 35 (04) 697-705
- 25 Nikfarjam A, Ransohoff JD, Callahan A. , et al. Early detection of adverse drug reactions in social health networks: a natural language processing pipeline for signal detection. JMIR Public Health Surveill 2019; 5 (02) e11264
- 26 Parwez MA, Abulaish M. Jahiruddin. Multi-label classification of microblogging texts using convolution neural network. IEEE Access 2019; 7: 68678-68691
- 27 Lee SH, Levin D, Finley PD, Heilig CM. Chief complaint classification with recurrent neural networks. J Biomed Inform 2019; 93: 103158
- 28 Google AI. Blog: open sourcing BERT: state-of-the-art pre-training for natural language processing. Available at: https://ai.googleblog.com/2018/11/open-sourcing-bert-state-of-art-pre.html . Accessed December 11, 2019