OBJECTIVEThe purpose of this study was to assess the impact of certain demographics, social media usage, and physician review website variables for spine surgeons across Healthgrades.com (Healthgrades), Vitals.com (Vitals), and Google.com (Google).METHODSThrough a directory of registered North American Spine Society (NASS) physicians, we identified spine surgeons practicing in Texas (107 neurosurgery trained, 192 orthopedic trained). Three physician rating websites (Healthgrades, Vitals, Google) were accessed to obtain surgeon demographics, training history, practice setting, number of ratings/reviews, and overall score (January 2, 2018–January 16, 2018). Using only the first 10 search results from Google.com, we then identified whether the surgeon had a website presence or an accessible social media account on Facebook, Twitter, and/or Instagram.RESULTSPhysicians with either a personal or institutional website had a higher overall rating on Healthgrades compared to those who did not have a website (p < 0.01). Nearly all spine surgeons had a personal or institutional website (90.3%), and at least 1 accessible social media account was recorded for 43.5% of the spine surgeons in our study cohort (39.5% Facebook, 10.4% Twitter, 2.7% Instagram). Social media presence was not significantly associated with overall ratings across all 3 sites, but it did significantly correlate with more comments on Healthgrades. In multivariable analysis, increasing surgeon age was significantly associated with a lower overall rating across all 3 review sites (p < 0.05). Neurosurgeons had higher overall ratings on Vitals (p = 0.04). Longer wait times were significantly associated with a lower overall rating on Healthgrades (p < 0.0001). Overall ratings from all 3 websites correlated significantly with each other, indicating agreement between physician ratings across different platforms.CONCLUSIONSLonger wait times, increasing physician age, and the absence of a website are indicative of lower online review scores for spine surgeons. Neurosurgery training correlated with a higher overall review score on Vitals. Having an accessible social media account does not appear to influence scores, but it is correlated with increased patient feedback on Healthgrades. Identification of ways to optimize patients’ perception of care are important in the future of performance-based medicine.

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Healthcare safety is the product of many interrelated parts of the health system that change over time, so efforts to improve safety also need to evolve and modernise to pre-empt emerging risks. One major shift is that the records and data infrastructure necessary to support safety improvements and evaluation are increasingly facilitated by, or dependent on, digital technologies. Continuing to reduce harm and save lives requires taking a closer look at digital technologies, both in the risks they present and the solutions they offer. The priorities for digital clinical safety can be considered in two parts: first, the intrinsic safety of technologies, and second, the extrinsic ability of technologies to drive safety. Embracing these two components requires digital clinical safety to become part of the healthcare culture, with everyone understanding their role in digital clinical safety. It must include processes being easy to follow with clear, accessible guidance, accompanied by targeted standards. Patients and staff must be equipped and empowered via digital clinical safety training. Finally, the vision for digital safety includes safety solutions that should be digitally enabled, with digital technologies appropriately applied to tackle major patient safety issues.

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