Are health care data used for consumer choices?
Whether they use it, people seek info in droves
Some experts suggest that what we deem consumer information really misses the target audience. There is still a question about the kind of health care information mainstream consumers can use.
Mike Killian, director of marketing and public affairs for the two Beaumont Hospitals located in Royal Oak and Troy, MI, states, "We just have an inkling of what consumers want to know about health care organizations. Two concerns seem apparent." Killian describes them below and explains why the health care industry is ill-prepared to deliver solid data on either count.
1. Outcomes. "Health care organizations have a problem with standard measures of mortality and how to explain to consumers when higher mortality rates are appropriate," Killian observes. In a large tertiary institution, for instance, the mortality rates could be higher than at a community hospital, but for the types of cases, actual compared to expected mortality rates might be excellent. "But it’s very difficult to communicate that to consumers," he says.
From a consumer’s point of view, such measures as the top 100 hospitals and other rankings are still in their infancy, he notes: "The data available are difficult to compare because health care organizations measure mortality and length of stay in different ways. Up until now, we have not had data sets to study what these rankings really measure and what they tell us. The challenge is whether these ratings actually help consumers participate more fully in their health care decisions." (To learn more about the annual 100 Top Hospitals ranking, see this month’s cover story and "What do 100 top hospitals lists tell us, our patients?" p. 88.)
2. Safety. This is even tougher to define and explain to consumers, he contends. "We have to be sure that safety procedures are in place, but statistically, how do we communicate that to consumers?"
Telling patients, for example, that there are X number of check points to ensure appropriate administration of medications could raise fears to the point that a person would refuse therapy because of the perceived high risk. "It’s a fine line," he explains. The best solution, he suggests, is to script or train caregivers in personal communication skills that prepare them to assure patients about therapeutic regimens.
Patrice Spath, RHIT, a health care quality specialist with Brown-Spath & Associates in Forest Grove, OR, affirms that we still have much to learn about the kind of quality information consumers can use. The majority of consumers are more likely to follow their doctor’s orders or advice than quality ratings of inpatient facilities, notes Spath, author of the book, Provider Report Cards: A Guide for Promoting Health Care Quality to the Public (AHA Press, Chicago, www.ahapress.com). (For Spath’s comments on targeting what the public wants to know when designing report cards and other consumer information, see QI/TQM, September 1999, "Quality Talk," p. 109.)
As for the impact of data on financial or administrative effectiveness, she contends, "Individual consumers are still too far removed from cost to even consider it in making a choice." Besides, people generally go to the hospital their health plans pay for, regardless of the ratings.
Sarah Loughran, senior vice president of content for Healthgrades.com in Lakewood, CO, concedes that the present state of quality information is not perfect. Designing health care quality ratings is far more complicated than ratings for cars or appliances, she notes, "but the perfect should not be the enemy of the good." When consumers are advised to factor formal ratings in with other types of evaluation, they can come up with good information on which to base health care choices, she says.
Regardless of how — or whether — they use it, consumers evidently have voracious appetites for health care information. For example, seekers of Web-based health care information will continue to increase at roughly twice the rate of the overall online population, according to New York City-based Cyber Dialogue, an Internet customer relationship management company.
Other findings from Cyber Dialogue reveal:
• An estimated 36.7 million adults currently seek on-line health care information.
• In the last 12 months, 7.5 million U.S. adults began searching for health and medical information on-line.
• By 2005, the projected number will exceed 55 million.
Among the reasons for the growth:
• Increased online activity among the age 65-plus population.
• New parents seeking health and parenting information.
People are curious about provider evaluations:
• Of the health information seekers, 76% report interest in physician evaluations, 72% in hospital evaluations.
• Among existing health information sites, 33% provide physician and hospital information.
The visitor traffic at Healthgrades.com attests to the interest in evaluative data. Each month, 60,000 to 70,000 people visit the Web site.
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