For $50,000, the agency got data reports from SAI, along with analysis and qualitative information, including particularly illustrative comments the researchers found. “South Carolina Medicaid seriously sucks!!” wrote one online forum user. “We have to deal with them some because we are so close to the state line and I hate it when I see that a patient has it.” Seeing negative comments was one of the difficult parts of this project, said John Supra, CIO of the DHHS, but that type of candor was also identified as valuable because it’s generally not found elsewhere.
All the comments found through the SAI had to be put into the proper context, Supra said, but once completed, the department was in some cases able to fix the issues that people had, and he hopes that DHHS employees will update their processes too. “I don’t know, at this point, if overall by doing social media listening we are getting that back into our overall processes to continually improve,” he said. “I’d like to believe our team is using this information, but I think that is something that we are still learning.”
Supra said there have been several instances where the agency fixed problems by contacting people who wrote about their issues online. In one case, a Medicaid applicant was having trouble adding his or her child. In another case, someone had mistaken North Carolina regulations for those of South Carolina. The department was able to get the correct information to that person, he said.
It’s important, Supra said, to have a “very frank, honest and open look into what’s on our South Carolinians’ minds regarding our program, and it helps us to be better connected with them. It’s part of an ongoing effort for our department to be more customer focused.” The information gained from this type of data collection, he said, is more frank than what's traditionally gathered through paper or phone surveys.
The idea to improve customer service came as South Carolina, and the rest of the country, began adapting to the president’s Affordable Care Act legislation. South Carolina is a participant of the federal exchange, and processing online applications is new for the state. Supra shared that the state went from processing zero applications online before Healthcare.gov launched, to about 30 percent being processed online by March.
“As we make that shift to online services, we need then to make that equal shift to monitor customer service in an online environment,” Supra said.
South Carolina is around the middle of the pack as far as health-care enrollment goes. The state is doing a “fair job,” said Gartner Research Director Rick Howard, but he added that it's on the right track in the partnership with the SAI.
“For all states, providing good – even excellent – customer service is an expectation of citizens and is called for in the Affordable Care Act,” Howard said. “Health insurance marketplaces are essentially e-commerce websites. Just like any business with an online portal, government is expected to provide retail-grade shopping experiences to citizens or, as we saw in the first few months after the launch of these marketplaces, face anger and ridicule if they don’t.”
Supra emphasized the importance of providing great service to the state's citizens, but didn’t discuss using social media as an enrollment or promotional tool. Right now, it seems South Carolina is just listening.
There was a lot of work in the first couple months to get the agency the information it was looking for, said Jason Thatcher, director of the Social Analytics Institute. “We had a conversation right before the health-care exchanges went live, and they didn’t know what to expect and they were really interested in how they could use social technologies, particularly listening, not necessarily pushing out a signal,” he said.
Thatcher said the DHHS was interested in finding bottlenecks in its system, customer service “issues” and data that would help it get better at providing Medicaid services to the public.
When the DHHS first started looking for data online, it found a lot of high-level political discussions — not exactly what it was looking for. And by “high level” Thatcher meant in concept, not necessarily in content. It found many comments like “Obamacare sucks,” which weren’t useful to the department, he said — it wanted to know about people’s experiences with the agency’s Medicaid system. It eventually found useful information by redefining filters and search terms and drilling further down into what data would be helpful, Thatcher said.
The SAI consists of Thatcher, two post-doctorate students, one full-time staff member and several interns, as well as occasional help from student groups and university staff on loan. “It’s labor intensive,” Thatcher said. “The tools are automated to a degree, but you have to develop content expertise in order to work in the space.”
It was important to work closely with the department as the SAI went along to ensure the data it was providing was useful to the state, Thatcher said. The SAI pulled out various pieces of information that would give the agency an idea of how it was doing performance-wise, such as common keywords that people were using to describe their experience, where people were talking about the agency online, and which people talking about the agency had the most influence in their circles.
Using existing social media structures to gather data is great because the infrastructure is already there and people are already using it, Thatcher said. “We shouldn’t be paying people to create new tools necessarily,” he said. “What industry is using is so far ahead of what you’re going to buy. Really what you need to think about is finding the right analytic tool.”
Thatcher said the DHHS is kind of a unique case, as it's the only government agency the SAI works with.
