Emergency care and the patient experience: Using sentiment analysis and topic modeling to understand the impact of the COVID-19 pandemic.

The COVID-19 pandemic has presented many unique challenges to patient care especially in emergency medicine. These challenges result in an altered patient experience. Patient experience refers to the cumulative impression made on patients during their medical visit and is measured by a standardized survey tool. Patient experience is considered a key measure of quality of care. The volume of survey data received makes it difficult to spot trends and concerns in patient comments. Topic modeling and sentiment analysis are well documented analytic techniques that can be used to gain insight into patient experience and make sense of vast quantities of data. This study examined three periods of time, pre, during and post-COVID-19 first wave in order to identify key trends in sentiment and topics related to patient experience. Previously collected, anonymized Press Ganey (PG) survey data was used from three northeastern emergency department that make up an academic emergency department. Data was collected for three contiguous time periods: Pre-COVID-19 (12/10/2019- 3/10/2020), During COVID-19: (3/11/2020-6/10/2020), and Post-first wave COVID-19 (6/11/2020- 9/10/2020). Preprocessing of the data was carried out then a sentiment label (i.e., positive, negative, neutral, mixed) was assigned by the tool. These labels were used to assess the validity of Press Ganey labels. Next, a topic modeling approach from machine learning was used to analyze the contents of the patient comments and uncover concerns and perceptions of patient experiences. Themes that emerged from the analysis of patient comments included concerns over personal safety and exposure to the virus, exclusion of family from decision making and care and high levels of scrutiny over systems issues, care, and treatment protocols. Topic modeling showed shifting priorities and concerns throughout the three periods examined. Prior to the pandemic, patient comments were largely positive and focused on technical expertise and perceptions of competence. New topics and concerns that patients reported relevant to the pandemic were identified during-COVID-19. Comments on systems issues regarding processes to limit viral spread and concerns over family/visitor restrictions were dominant. Although there was evidence of praise and appreciation of the efforts of staff there was also a high level of scrutiny of the processes encountered during the emergency visit. Sentiment analysis and topic modeling offer a unique method for organizing and analyzing the shifting concerns of patients and families. Suggestions of interventions are made to address these evolving concerns. The automation of analysis using artificial intelligence would allow for rapid and accurate analysis of patient feedback.