In 2025, King of Prussia, Pa.-based Universal Health Services sent more than 1 million text messages to patients to solicit Google reviews, which remain vital for health systems even in the era of AI search, a leader told Becker’s.
Not only that, but UHS, a publicly traded system with 29 acute care and 345 behavioral health hospitals, responded to those reviews in an average of 12 hours, aiming to make current — and future — patients feel like they’re being heard.
Press Ganey recently bestowed the health system with its 2025 Guardian of Excellence Award for ranking in the top 1% of providers for consumer experience. Becker’s caught up with Roselle Charlier, vice president and chief marketing and communications officer of UHS, to learn more about the $17 billion organization’s patient engagement strategy.
Question: What impact has this outreach had on patient trust, brand reputation or market competitiveness across different UHS regions?
Roselle Charlier: Industry experts note that a strong presence on online review sites is a critical factor in consumer decision‑making. Google heavily prioritizes businesses with positive reviews in local search results, weighing factors such as review volume, average rating, recency and relevance. These signals help boost a business’s prominence, trustworthiness and visibility, which often enables it to outrank competitors. Simply put, more reviews and higher ratings support greater credibility and better placement in search results.
Additionally, both reputation and financial performance are at risk when negative reviews go unanswered. The hidden cost of ignoring complaints is the number of potential customers who may never engage with your organization because they see a pattern of unresolved issues. Responding proactively not only protects your brand but also preserves future opportunities. Our team responds to reviews within 48 hours, with an average response time of 12 hours.
Having a strong volume of high‑quality online reviews also significantly improves visibility on AI‑driven search platforms. These reviews provide essential data that AI models use to evaluate credibility, relevance and trustworthiness — making businesses more likely to appear in AI‑generated summaries and recommendations.
With nearly 70,000 Google reviews in 2025 across our U.S. hospitals and facilities, we understand the importance of consumer insights when making healthcare decisions. Our goal remains to be the preferred, trusted healthcare provider in every market we serve.
Q: How do front-line teams and hospital leaders use the feedback generated from these text-message reviews to drive real-time operational or service improvements?
RC: Front-line teams and hospital leaders receive real‑time alerts when online feedback is posted, enabling them to take prompt action on service recovery opportunities and address any potential concerns. Real‑time positive feedback can also boost employee morale, which in turn helps drive excellent, high-quality patient care.
Q: How does UHS balance encouraging reviews with ensuring patients don’t feel pressured or fatigued by digital outreach?
RC: From a logistical standpoint, we work with Press Ganey to adopt the latest best practices for requesting reviews. Key considerations include the timing of our requests and our digital outreach messaging. Our emphasis is always on valuing patients’ feedback, as it helps us understand what we are doing well and where opportunities for improvement exist.
To prevent survey fatigue, we have developed a strategy that encourages patients to share their experiences through both online review platforms and patient‑experience surveys. Responding to online reviews is also an important part of fostering engagement. When patients see that we consistently reply, it helps them feel heard and builds trust by demonstrating that we genuinely value their feedback.
Additionally, UHS adheres to consumer‑protection guidelines by requesting feedback in ethical ways and never incentivizing or pressuring patients to leave online reviews.
Q: What has been the monetary investment and/or the ROI from this program (and how do you measure that return)?
RC: Trust is the most valuable currency in healthcare. It influences whether consumers and patients choose an organization, recommend it to others, and return for future care. Patient trust is not just a value — it is a central driver of growth, market differentiation and long‑term sustainability.
A strong, proactive strategy for managing online feedback helps us prevent trust erosion, increase the likelihood that patients will return to and recommend us, and positively influence our referral sources.
As generational preferences shift, younger consumers — who rely heavily on online feedback — place even greater emphasis on trust in digital spaces. Strengthening our ability to build and maintain trust is an important investment in our future relationships with patients.
Q: What lessons from rolling out more than a million review invitations would you share with health systems considering a similar strategy?
RC: First, the right message at the right time is essential. By sending SMS text invitations the day after discharge, we capture feedback while the experience is still fresh in patients’ minds, which improves recall and leads to more detailed responses. Prompt outreach also supports our commitment to timely service excellence.
Accurately capturing patients’ cellphone numbers is equally critical. To support this, we partner with facility leaders to reinforce best-practice processes.
A strong data strategy for tracking SMS feedback invitations — focusing on key metrics such as invites sent, click-through rate, conversion rate, and opt-out rate — is also vital. These insights help us confirm we’re reaching as many patients as possible and that patients are engaging with requests for feedback.
Industry experts note that businesses that proactively request reviews typically earn higher star ratings than those that don’t. By leveraging our data strategy, we can measure whether review invitations are positively influencing our online ratings.
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