Healthcare Transparency FAQ:

Q: How did this healthcare transparency movement begin?

In 2012, University of Utah Health Care pioneered the practice of publishing patient experience data in the form of patient reviews and comments. Their press release and explanation are available here.  These efforts earned them a lot of attention and accolades in the health system community, and many other health systems took notice.

The “movement” didn’t really begin until April 2014 when Piedmont Healthcare in Atlanta became the second hospital in the country to publish physician-specific ratings and comments derived from their patient experience survey data.  Piedmont utilized NRC Health technology to implement their transparency program. Since then many other healthcare systems have followed suit, solidifying the trend towards transparency.

Q: How are the star ratings calculated?

As it is of utmost importance to protect the online reputations of physicians while also providing accurate and actionable information to healthcare consumers, the methodology employed for this calculation is of utmost importance.As the leader in healthcare transparency, NRC Health has explored this question with some of the top healthcare systems in the country and we have settled on our recommended best practice methodology for converting CAHPS survey questions into Star ratings. You can access the full methodology here.  Meeting these methodological requirements will ensure a provider-based transparency initiative that is accurate, simple, and objective.

Q: What about the question of “wait time?”  Should it be included in these calculations?

We all know that wait time is an important element of the overall patient experience.  For the healthcare systems that have undertaken transparency initiatives to date, some include this question of wait time in their ratings calculation and others do not.  NRC Health feels that both positions are defensible, and that the determining factor should be whether the physicians are ultimately in control of the elements which contribute to a patient’s wait time.Because ratings are intended to be physician-specific measurements, if a patient’s wait time is beyond the control of the individual physician then it should not be included when calculating that physician’s rating.  Alternatively, if a healthcare system empowers their physicians to control their own scheduling, then those physicians should be measured on wait time and held accountable for it.

It is important to make it clear to consumers which elements are and are not included in the ratings that are displayed on a healthcare system’s website.

Q: How does embracing transparency benefit marketing?

There are several areas of benefit for a healthcare system’s marketing group, and they primarily fall into these three categories:

Improve physician online reputations – Sharing this large volume of data allows your physicians’ online reputations to reflect an accurate assessment of the experience patients have with your providers—not just the voice of a small minority who took the time to leave a review online. In the absence of a transparency solution, healthcare systems face the issue of a low number of online reviews which tend to be skewed disproportionately negative.

Search engine optimization ­– All things being equal, the first Google search result wins about 33 percent of the web traffic for that search. The first 10 results get over 90 percent of all traffic. As the empowered healthcare consumer spends more time online researching their care options, Google search rankings are going to become an increasingly important component of your new patient acquisition strategy.While some subtleties of search engine optimization change over time, regularly posting patient ratings and comments will deliver three components which are always rewarded by search engines like Google: recentness, relevancy, and uniqueness.  This ideal content translates into higher search engine rankings for your physician profiles, which results in increased web traffic, converting into increased new patient acquisition.

Promote a forward-thinking image for your healthcare system – Consumers are demanding transparency, and the trend is gaining momentum. Implementing a transparency initiative can be accomplished on a relatively short timeframe if your approach is aided by the proper expertise. Consumers will view healthcare systems  that embrace this movement early as progressive, credible and trustworthy.

Q: How does embracing transparency benefit physicians? 

Correcting and protecting their online reputations – Many physicians are out of touch with the current state of their online reputation on third-party ratings sites.  Even if physicians have a decent average rating, most physicians have a low number of reviews on these sites, as such one frustrated patient could have a significant negative impact on their overall online reputation.By publishing all of the patient experience survey results, physicians can feel confident that their average rating is based on a valid sample size of at least 30 patient survey responses, and that the resulting rating is a valid reflection of the care they are delivering to patients.  Furthermore, even if an occasional frustrated patient voices their displeasure, this voice will be placed in context among the other patients who are predominantly happy and satisfied with the care they receive.

Q: How does embracing transparency benefit service excellence teams?

In a word: improvement – Transparency has proven to be a powerful motivator for improvement among physicians. University of Utah Health Care claims that since implementing their transparency initiative they have seen significant jumps in the percentage of their physicians placing in the top decile of patient satisfaction measures.  In addition, Utah has been able to reduce the full-time employees needed for coaching these physicians.  Overall, this program led to more improvement in patient experience measures with less effort.

Q: How can my organization prepare to go transparent with our patient experience data?

There are many resources available within this site to help your organization prepare for a transparency initiative, but there is one quick and easy step that every healthcare system should undertake if they think there is the slightest chance that they will want to publish this information at some time in the future.  Add appropriate disclosure language to your outgoing surveys and/or cover letters to let patients know you may publish this information.  Work with your organization’s legal/compliance team to develop language that is acceptable for your organization. In most cases it’s as simple as adding the one phrase such as “we value your feedback and may share patient comments anonymously on our website.”For most healthcare organizations, the inclusion of this language marks the “start date” after which patient comments will be eligible for publishing on the provider’s profiles.

Q: Are 100 percent of patient comments published?

While the ultimate goal of a transparency effort is to share everything, a small portion of comments prove unfit for publishing.  Specifically, patients will occasionally write comments that contain personally identifiable information or PHI.  Even after adding appropriate disclosure language to your surveys, it is not appropriate to put a patient’s privacy at risk by publishing comments of this nature.  In addition, comments containing profanity or libel are generally considered appropriate for exclusion from publishing.The important thing for a healthcare system is to clearly define and articulate these “exclusion criteria” for comments, and publish these criteria on the website where the transparency program is explained.  Clients of NRC Health are subject to periodic audits of “archived” comments, to ensure compliance with the published exclusion criteria.

Q: Why would we need a technology vendor/partner to publish our own data?

Some healthcare systems have successfully published this information using only internal resources.  NRC Health also has clients who initially undertook their transparency initiative as an internal-only project and realized that there was more depth to the requirements and more complexities to implementation and upkeep than they realized.  They reached out to explore the NRC Health solution and concluded that it made the most sense to transition over to our technology.If your healthcare system excels with technology and can commit the resources to launch and support an initiative like this, then it is certainly an attainable goal to publish your ratings and comments using an “in-house” team.

Many healthcare systems find tremendous appeal in the idea of a software-as-a-service platform which focuses exclusively on the domain of publishing physician ratings and comments.  The main benefits are speed of implementation, access to expertise, and worry-free maintenance and support.

NRC Health has now helped more than 100 healthcare organizations build a transparency program from the inside out—preparing their organizations operationally and culturally, through improved communication and coaching, before sharing patient feedback online with consumers. Our transparency solution works with every content management system. Our product roadmap is driven by input and feedback from our market-leading clients. And our team of experts stay on top of all new SEO best practices to deliver the best possible results for your organization.

To help explore this question, NRC Health assembled this vendor evaluation checklist.  It can also be a valuable tool to think through what competencies you would need in an in-house team to successfully implement and support a transparency initiative.

Have a question we didn’t address?  We would love to hear from you, and we’ll do our best to address all relevant questions.  Please visit our contact page or email info@nrchealth.com

Have a question we didn’t address?  We would love to hear from you, and we’ll do our best to address all relevant questions.  Please email us at info@nrchealth.com

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