Big Brother isn't watching you - but he is listening.

The S.C. Department of Health and Human Services, one of the largest, costliest agencies in state government, pays Clemson University's Social Analytics Institute $50,000 a year to "scrape data" from 150 million public, real-time feeds each day and report back to the agency what people on the Internet are talking about.

That includes Medicaid patients who may be complaining about the application process on Twitter or bloggers who criticize Gov. Nikki Haley's decision to reject Obamacare's Medicaid expansion.

But they say they're doing this "social listening" in the name of customer service, not surveillance.

"What people post on social media is essentially public information, and it should be thought of in that context," said John Supra, deputy director and chief information officer for the department. "People should be aware when they post their opinion on social media, they're making their opinion public."

It's not uncommon for federal and state agencies to engage the public using social media websites, such as Twitter, Facebook and Instagram. It's rare to find a department or politician that doesn't use one of these outlets to promote programs or distribute news.

There also are plenty of private businesses that routinely use social media to interact with their customers. A spokeswoman for BlueCross BlueShield of South Carolina, the largest private health insurer in the state, said the company used Facebook as a "very valuable medium for addressing customer concerns" during the Affordable Care Act's first open enrollment period.

But the contract that the Health and Human Services Department signed with Clemson University in the fall is unique. The Social Analytics Institute runs a sophisticated search each day for terms related to the state Medicaid program and the Affordable Care Act, then aggregates what it finds into daily, weekly and monthly reports that offer insight about what the public is saying.

"I don't know of another state agency that is doing this pro-actively," Supra said.

Jason Thatcher, director of the Social Analytics Institute, confirmed that the S.C. Department of Health and Human Services is the only government agency he works with.

"It sounds like it's 'government Big Brother,' but you have to remember we're looking at public data. We're using literally the exact same tools that virtually everyone in the Fortune 500 is using to do customer service." Thatcher said. "Really what we're doing is taking a private-sector way of delivering superior customer service and we're translating it to the domain of health care in South Carolina. That's it."

Recently, the institute found a woman on Twitter who was complaining about problems she had encountered filing a Medicaid application. The department was able to address the issue almost immediately.

In another case, the institute discovered a blogger who published misinformation about the agency.

"(The blogger) had read a story where people were having trouble getting into Medicaid in North Carolina, but in his blog he kept saying South Carolina," said Becky Appleford, an analyst at the institute. "I was able to tell them this was happening down in Columbia, and they were able to use their staff and hopefully get the right information out there."

Both of these online posts were already public, but it may have been difficult for the department's staff to find them without using software available through the institute. None of the information culled for the reports comes from private Facebook accounts or emails. Still, some say it raises concerns about privacy and the extent to which the government should track what residents are saying online.

Even the federal government acknowledges that ensuring citizen privacy has traditionally been difficult for agencies that engage in social media analysis.

"I think government is held to a higher standard," said Beth Sundstrom, a strategic health communications expert and a professor at the College of Charleston.

While a debate about the government's ethical use of "social listening" is ongoing, Sundstrom said the partnership between the Health and Human Services Department and the Social Analytics Institute should be perceived positively.

"We should want and even demand for the government to listen to us," she said. "It's essential for all organizations, whether they're government or non-government, to listen to the public."

Meanwhile, the Health and Human Services Department is evaluating the extent to which it will continue to use the Social Analytics Institute, Supra said. The department is now negotiating the terms of a second-year contract.

"What do we need based on what we learned from this year?" he said. "How much of this should we have someone doing in-house? ... That's the balance that we don't know."

Reach Lauren Sausser at 937-5598.