Omaha World Herald
Consumers in this Internet age are accustomed to going online to check recommendations and ratings for all kinds of goods and services, often on third-party websites. Doctors and hospitals are no exception, with a variety of sites such as Healthgrades.com and RateMDs.com offering ratings and reviews of health care facilities and providers.
Last week Nebraska Medicine became the first health system in the Omaha metropolitan area to launch its own star-based online rating system for the physicians in its clinics, based on surveys of past and current patients. The rating system, found under the Find a Doctor section of NebraskaMed.com/Doctors, also includes comments from patients.
Chad Brough, the health system’s chief experience officer, said patients indicate that they value ratings and comments from other patients.
“For most people, health care is still a very word-of-mouth experience,” he said. “We’ve attempted to take that phenomenon and put it online so people can make informed choices.”
University of Utah Health pioneered the strategy, he said, first posting star ratings and comments in 2012. Bryan Health in Lincoln began posting star ratings for its provider groups in August and added patient comments earlier this month. Nebraska Medicine officials estimated that about 40 organizations across the country now are posting ratings.
“If people are looking for a doctor, it’s important for them to hear what current patients think,” said Deb Boehle, a Bryan Health spokeswoman.
Officials with several other Omaha health systems said they have discussed or are exploring the possibility of adding online ratings, but none has established a timeline. Most already offer a Find a Doctor section on their websites that includes basic information about doctors and other providers.
Matt Hazen, division director of service excellence for CHI Health Clinic, said all practices of a certain size are required by the federal Centers for Medicare and Medicaid Services to conduct patient satisfaction surveys, and most organizations already are doing it as a matter of course.
CHI Health has been posting such scores internally for nearly four years, he said. Making them available publicly probably will await an upgrade in information technology capabilities.
Nebraska Medicine and Bryan Health officials said providing their own ratings and reviews ensures that patients are seeing reviews by their doctors’ actual patients.
Dr. Sarah Richards, Nebraska Medicine’s medical director of patient experience, said patients often have no way to know whether ratings or reviews on third-party sites were posted by people who actually saw the doctor. Some ratings may be based on only a handful of reviews. “As a provider, you want accurate information out there,” she said.
About 270 Nebraska Medicine physicians, physician assistants and nurse practitioners currently have received the minimum of 30 reviews required for their ratings to be posted. Eventually they should have them for about 350 providers. All averaged between four and five stars on the five-star scale.
Doris Peter, director of Consumer Reports’ Health Ratings Center, agreed that third-party sites’ ratings are flawed by their lack of validation. Those provided by health systems, she said, will become more valuable if they add more information, including cost and quality measures.
But Brough said offering provider ratings is an important first step. He anticipates that the health system eventually will post additional cost and quality metrics online. Consumers, who are taking a greater role in health care decision-making, increasingly are seeking such information.
The star ratings are based on 10 questions focused specifically on the care provider. Among other things they ask patients to rate the degree to which the provider talked with the patient using words the patient could understand and the patient’s confidence in the care provider. They post the average star ratings for each of the 10 questions plus an overall average. The questions don’t address the outcome of the visit; say, whether a condition was improved through care.
The team met with doctors and other providers before the launch, explaining that making the ratings public gives them an opportunity to take ownership of their online reputations. They even asked providers to pull out their cellphones and Google themselves to see what ratings already were out there.
Dr. Sean Langenfeld, a colon and rectal surgeon with Nebraska Medicine, gives talks on social media to physicians around the country. “What we’re saying is ‘This is the future,’ ” he said. “Patients are going to find their information online, so we need to provide them with good information.”
Langenfeld said it can be difficult for doctors to respond to or correct negative ratings or comments on third-party websites. He got some on one third-party site about four years ago, from what appeared to be an angry patient. But the comments weren’t characteristic of how he practices, and he questioned whether they came from one of his patients. When he contacted the website operator to see how they validated reviews, he was told that he’d have to subpoena the information.
The health systems’ surveys, on the other hand, can serve as a kind of report card, Langenfeld said.
Richards said comments are reviewed internally and will be edited or removed if they contain information that could identify patients in violation of privacy regulations. Doctors can contact the team if they have concerns. Comments also can be removed if they don’t pertain to the provider in question.
But Chaise Camp, executive director of patient experience, said they won’t pull negative opinions, of which there have been few so far. “When one occurs, that validates all the great comments they get,” he said.