Ratings games

Most Americans believe there are fair and reliable ways to gauge the quality of health care. 9 in 10 Americans are interested in their health plans having a website where you could rate doctors on issues like trust, communications, medical knowledge, availability and office environment – and participating on such social networks (think: The Health Care Scoop, or Zagat/WellPoint).

The latest Wall Street Journal/HarrisInteractive survey published March 25 finds that 3 in 4 consumers favor patient satisfaction surveys – once again asserting they value opinions from peers (aka “people like me”) even more than those coming from institutions, whether private sector (e.g., employers or health plans) or public (e.g., government agencies).

Nonetheless, consumers still do value other sources for ratings:

– 66% like medical boards
– 65% value assessments by third parties, such as JCAHO
– 64% of consumers like measurements on preventive screening tests
– 58% believe the use of EMRs is a proxy for quality
– 42% see malpractice suits as a useful measure of quality health care.

The timing of this poll nicely coincides with the news that Angie’s List – known for its home repair service ratings – launched a health care ratings service earlier this month. On Angie’s List, consumers will be able to rate some 50 types of health care providers – including doctors, dentists, pharmacies, hospitals and health plans.

This effort represents the kind that the WSJ/HarrisInteractive poll says consumers want: peer-to-peer recommendations.

Angie’s List is operational in 124 U.S. cities. Those who subscribe to Angie’s List pay as much as $59 a year to access ratings on about 280 categories of local services.

Angie’s List polled their membership, 76% of whom said they wanted health care ratings on the List.

They will use the same grading system the List uses for plumbers: grades of A to F for price, quality, responsiveness, punctuality and professionalism.

For those consumers who value government-sponsored sites, last week the Centers for Medicare and Medicaid Services launched their new site on hospital quality.

The Hospital Compare Web site includes geographically-specific data on hospitals, outcomes and process measures. One consumer-friendly measure included in the site, for example, is how often nurses communicated well with their patients. The data for the site were drawn from a random sample of patients from October 2006 and June 2007.

Jane’s Hot Points: Consumers want ratings, and they’re getting them. There are report cards and analyses from public and private sources, provided by ‘experts’ and consumers themselves. Consumers will clearly confront a growing list of choices for ratings. These sites will be organized differently and based on different methodologies. It is too soon to tell what the critical success factors for these sites will be. In the meantime, consumers will have a growing array of choices, and therefore some confusion will ensue. Still, that sort of heavy lifting will be useful for consumers who want to engage in the journey of learning what health care quality is, and as important, helping to define just what it is by leveraging the power of social networks and the wisdom of crowds.

9 replies »

  1. Hey, beautiful site but there is a issue whereby sometimes I am sent back to the base page whenever I view different pages within your page.

  2. The Prevention of Ignorance
    Historically, information sources provided to American citizens were limited due to the few methods available to the public. And also this information was subject to being filtered and, in some cases, delayed. This occurred for a number of reasons, which included political ones.
    Now, and with great elation, there is the internet.
    Soon after the advent of the internet, web logs were created, that are termed ‘blogs’. At that time, about a decade ago, the blogs were referred to as personal journals or diaries visible on line. As time passed, blogs became a media medium, and blog communities evolved on topics that often were not addressed in mainstream media. In addition, blogs provide immediate contributions by others instead of the cumbersomeness of opinion and editorial pieces historically and not always presented in such media forms as newspapers. The authors of blogs vary as far as their backgrounds and intent of what they present are, just as with other media forms. Furthermore, they are not exonerated from the legalities of what is written, such as cases of libel. While we can presume that they like to write, they may not be quality writers.
    Yet presently, blogs have become quite a driving force for those with objectives often opposed by others, and are a threat to big business and politics both who presently monitor the progress and content of blogs that provide instant information on events, which might affect their image and activities not yet exposed.
    This includes information released from whistleblowers
    While one disadvantage of blogs is the potential lack of reliability, blogs however do allow the posting of documents that typically are not created for view of others besides perhaps a select few. For example, blogger Dr. Peter Rost, a whistleblower himself, not long ago posted a newsletter on his blog site given to him by pharmaceutical maker AstraZeneca employees who called themselves the ‘AZ Group of Seven’ to bring to the attention to others the illegal activity of off-label promotion of one of their cancer drugs. Yet this is not what caught the attention of so many with all of the content of this newsletter. It was instead a comment stated by former regional AZ manager Mike Zubalagga, who in this newsletter referred to doctors’ offices as ‘buckets of money’. Again, the statement was authentic and in writing in this newsletter.
    Mr. Zubalagga was fired the next day due to this comment. His manager resigned soon afterwards.
    And there have been other whistleblower blog cases in addition to this one, so blogs have become a very powerful and threatening medium of information release that does not allow others to prevent such releases. This is true freedom of information, free of alteration or omission. One step closer to social utopia.
    Yet again, the information on these blogs should not be taken as absolute truth without proof to verify claims that may be made. Of course, documents that are authentic are in fact proof, as illustrated with the above example. And this, in my opinion, is the blog’s greatest value, combined with the comments on blogs from the growing number of readers who are allowed to contribute to the subject matter so quickly, which fuels the objectives of the blogs.
    Because we, the public, have a right to know what we are entitled to know and what we want to know. This is especially true if the information could potentially be adverse to our well-being.
    “Information is the seed of an idea, and only grows when it’s watered.” — Heinz V. Berger

  3. I don’t believe consumers should have to pay for quality data or ratings information. I also believe satisfaction data should be analyzed in conjunction with quality data. http://www.WhereToFindCare.com provides consumer ratings and govt data and it is free to use.
    It’s still in Beta, and people can give their 2 cents at http://www.wheretofindcare.com/blog.aspx. I think this is great b/c it is ultimately the consumer that decides what the critical success factors are. They might as well be involved in building a site!

  4. John, take your pick.
    1. a disorderly or riotous crowd of people.
    2. a crowd bent on or engaged in lawless violence.
    3. a group of persons stimulating one another to excitement and losing ordinary rational control over their activity.
    4. a flock, herd, or drove of animals: a mob of sheep.
    5. of, pertaining to, or characteristic of a lawless, irrational, disorderly, or riotous crowd: mob rule; mob instincts.
    6. directed at or reflecting the lowest intellectual level of the common people: mob appeal; the mob mentality.

  5. Did it ever occur to you Peter that you are a member of a mob?
    There are clearly smart mobs and dumb mobs.
    Perhaps you’d care to expound on the difference between a mob and a crowd?

  6. Did it ever occur to you Peter that you are a member of a mob?
    There are clearly smart mobs and dumb mobs.
    Perhaps you’d care to expound on the difference between a mob and a crowd?

  7. We have seen the power of social networks and ratings with sites such as Amazon.com. I often buy a book based on these ratings. But Peter’s point is well taken. Just because the masses agree upon a point, doesn’t necessarily make it a valid reason to take action. The masses all believed that the world was flat once, and it seems that everyone used to smoke cigarettes about 40 years ago too. Sometimes the “wisdom of the crowds” is just plain bad; it is almost always fickle.

  8. “leveraging the power of social networks and the wisdom of crowds.”
    Or the wisdom of mobs?