7 takeaways on University of Utah Health Sciences' process and decision to go transparent with physician ratings

Salt Lake City-based University of Utah Health Sciences' decision to post its physician reviews online was not an easy one. System stakeholders had to weigh "the right thing to do" against the potential upper-hand it might give competitors or the possibility providers might be inclined to bend to unreasonable demands from patients. Ultimately, the choice to do so paid off.

The organization attributes its rise from the 28th percentile nationally for patient satisfaction to the 85th and its physicians' improved Press Ganey scores in large part to its decision to become more transparent, according to its Innovation Report 2015.

Rising consumerism trends in healthcare combined with increasing out-of-pocket costs are prompting patients to become more thoughtful and invested in the care the seek. These factors are giving patients the upper hand in determining where they receive care.

Here are seven thoughts and takeaways on the process and impact of transparent physician ratings from the University of Utah Health Sciences' Innovation Report 2015.

• Information asymmetry is a fundamental problem in healthcare. When members of the university investigated why patient feedback on physician performance was being kept private at all, they were confronted with the fact that enormous amounts of data are collected on many aspects of care, yet little is shared even internally. Consumers are often left with little data to inform their care decisions, instead opting for advice and suggestions from friends, family or even strangers.

• Patients are becoming increasingly empowered and are not as satisfied as they once were to acquiesce to physicians. They'll turn to the Internet for answers and suggestions about care and procedures. But the Internet doesn't provide the necessary resources to truly enable most patients to become "equal partners" in their care.

• More data isn't the answer. While federal "data dumps" that compare costs and safety among hospitals can bring some order to the noise for patients seeking insights about care, they aren't easy to understand. For those who do have the time and patience to sort through the data, it doesn't always result in meaningful answers. Although certain online tools, such as ProPublica's Surgeon Scorecard, are getting better, some providers have criticized the association it draws between readmission rates and physicians' skills.

• Some physicians see the release of physician ratings as a strong offensive move.. By being transparent with patients and competitors, Thomas Miller, MD, CMO of University of Utah Health Sciences thought the increased transparency could help the system trump the control other outlets, such as Yelp and Healthgrades, had over its reputation among patients.

• Press Ganey scores, which are nationally benchmarked, served as a good baseline for feedback on physician ratings and improvements over time. Combined with thorough patient satisfaction surveys focused on professionalism, communication and shared decision-making, the scores reflected progress from before and after the move to transparent ratings. This was an enormous shift for physicians who were dubious about a meaningful connection between the metrics and quality care. In light of this, the hospital budgeted for amenities such as complimentary valet parking and patient ambassadors to help improve the overall experience.

• A shift from paper surveys to email surveys boosted patient responses by nearly 400 percent, according to the report. The feedback was also more detailed and timely. Once the departments made their scores transparent, physicians became accountable and the system's satisfaction number began to climb quickly. By the time the system decided to go completely public with physicians ratings, they had enough experience with the systems to put fail safes into place, like only including reviews for physicians who had been working for more than six months, so a couple of negative reviews wouldn't completely skew their averages.

• A potential next step for the system is to integrate cost data with quality metrics, specifically those related to health goals for specific patients. By 2016, one third of the university's outpatient units will be using a system that gives every orthopedic patient a tablet upon entry into the hospital to determine their feelings and needs. Treatments can be tailored based on this data and eventually physicians will be able to use it to predict more precisely what will help individual patients.

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