1. Bias toward hospitals participating in The Leapfrog Group's survey
"Chief among our concerns is that the methodology The Leapfrog Group uses appears to favor its own survey over other similarly reliable sources of information," Umbdenstock said.
Of all the hospitals in the U.S., only about 1,000 participate in the Leapfrog Group's voluntary reporting program, which collects information on whether the hospital uses a computerized provider order entry system (CPOE) and whether it has dedicated intensivists in the intensive care unit.
For hospitals that don't voluntarily participate in the Leapfrog survey, a secondary source was used, such as the American Hospital Association's own Health Information Technology annual survey.
Leapfrog participant hospitals can earn 100 points toward a high letter grade in each of those categories, but non-participating hospitals judged on the AHA's HIT survey, can get only 15 points.
"Therefore it is unclear why The Leapfrog Group would give so little weight to an answer to a similar question in the AHA survey," he wrote.
"By assigning vastly different point scores to similar information derived from reliable secondary sources, we are concerned that the scorecard can lead patients to inappropriate conclusions," he wrote.