Physician Transparency Requires Understanding Patients’ Comments

This is a guest blog post by Andrew Gallan, PhD, a teacher, researcher, and adviser to organizations on designing services to improve patient experience.

Now that over 50 healthcare organizations regularly publish patient evaluations of physicians on their public-facing websites (Ed Bennett Consulting 2017), transparency around physician ratings and reviews has become a growing focus in healthcare. University of Utah Health Care is a pioneering institution in today’s transparency movement.

While transparency around ratings can (understandably) be stressful for physicians, it can be very useful for patients
searching for the right physician for their own care (Patient Engagement HIT 2017). Transparency is about presenting digestible data to patients to help inform their purchasing decisions.

To that end, survey scores are converted into a five-star system; and all comments, positive and negative, are posted on a hospital’s website with redacted identifying or personal information.

Why are healthcare organizations adopting physician rating transparency?
It is now imperative for health care organizations and professionals to manage their online presence and reputation (PatientTrak2017). While Yelp and other third-party online sources capture attention, physician profiles on providers’ websites typically outrank other sources of information and provide more valid and reliable data (Mahoney 2016). CMS-mandated data, such as those collected from CAHPS surveys, are from verified patients of a specific provider, and the questions have been developed with good psychometric qualities.

When a healthcare organization transitions toward online physician transparency, they motivate physicians to improve performance, explains Vivian Lee, M.B.A., M.D., Ph.D. in a recent article for the New England Journal of Medicine. When physicians are compared to one another, very often they seek out counsel to improve the service they provide to patients. This can lead to improved patient-centered care and quality outcomes.

Then, the question for physicians and healthcare leaders becomes: If I’m being held accountable to certain standards, how can I improve my scores?

The answer to this question lies in patients’ comments. Patients might give high survey scores to physicians, but they describe their true care experiences in their comments. Physicians can learn from these first-person accounts about what patients need and expect of their care. It’s also true that people identify with stories over numbers, so a sample of patient comments that represent a specific trend out of aggregate qualitative data would resonate very well with physicians about the improvements they need to make.

How can healthcare organizations manage what is now transparent to potential patients?
As a result of physician transparency, it is more important now than ever to bring a scientific approach to understanding what patients are saying in their own words. Healthcare organizations need to make sense of both structured data (survey scores) and unstructured data (patient comments). By analyzing patient comments, providers can learn about patients’ experiences above and beyond CAHPS domains. Artificial Intelligence (AI) and Natural Language Processing (NLP) are methodologies that provide the capability to analyze and make sense of large amounts of text. When this analytical capability is coupled with intuitive visualizations on dashboards and easy-to-digest reports, such as those offered by NarrativeDx, it becomes so much easier for providers to learn from and build improvement actions on what patients are saying.

The goal of patient experience improvement is to gain a better understanding of what is important to patients.

Some examples that bring this issue to life include:

  1. If patients complain about food, what are they saying? Are they commenting about taste, temperature, choice, or other issues?
  2. If patients complain about noise, what are they hearing? Alarms, conversations, other patients, visitors?
  3. If patients don’t understand discharge information, what do they recall? Do they remember the timing of when the information was given, the amount of information provided, instructions surrounding new medications, follow-up appointments, or other issues?

Patient experience professionals can now engage new techniques and tools to unearth additional insights from existing data that will help improve care experiences, and happy patients and families will in turn give much higher ratings to physicians.

Andrew Gallan, PhD specializes in researching, teaching, and advising organizations on designing and delivering patient-centered care. He has worked with organizations including Mayo Clinic (AZ), University of Chicago Medical Center, UPMC, and Advocate Health Care on their journey toward delivering world-class care. Andrew has engaged audiences as a keynote speaker, breakout presenter, and committee facilitator and advisor. His graduate class on Patient Experience, the first in the nation, is among the most highly rated classes at DePaul. He is a Beryl Institute speaker.


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