Exploring the Utility of Patient Stories on Social Media for Healthcare Quality Improvement

This thesis explores the phenomenon of patient stories on social media. This phenomenon represents the intersection of two phenomena: patient experience and social media. Healthcare experience refers to the interactions of a patient with the healthcare system members, including the nurses, physicians, and staff, and the resultant emotional and behavioural effects of these interactions on patients, including patient satisfaction, patient commitment to health, and patient adherence to treatment plans. Social media refers to the internet-based applications that enable people to communicate, interact, publish, and exchange all types and formats of information, including text, pictures, audio, and video. Patient stories on social media refer to patients' posts that describe their healthcare experiences. This thesis aims to assess the utility of patient stories on social media for healthcare quality improvement and explore the health system and policy factors that can positively or negatively affect this utility in the healthcare system in Ontario. The thesis is comprised of an introduction chapter, a theoretical perspective chapter, four studies presented in chapters 3 to 6, and a conclusion chapter. Additional material is provided in several appendixes, including a definitions section in Appendix 1.A. The first study seeks to understand the perspectives of healthcare providers and administrators in Ontario regarding the factors affecting the patient experience. Qualitative data were collected between April 2018 and May 2019 by interviewing 21 healthcare providers and administrators in Ontario. Interviewees included physicians, nurses, optometrists, dietitians, quality managers, and policymakers. The study findings show that there are two perspectives on patient experience: the biomedical perspective, which prioritizes health outcomes and gives high weights to healthcare experience factors that can be controlled by healthcare providers, while ignoring other factors, and the sociopolitical perspective, which recognizes the impacts of healthcare politics and the social context of health on patient experience in Ontario. The second study explores the perspectives of healthcare providers and administrators on patient stories on social media and whether they can be used for evaluating healthcare experiences. Data were collected between April 2018 and May 2019 by interviewing the 21 healthcare providers, and administrators in Ontario noted in study one. Study finding