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Making It All Public

Cheryl Clark, for HealthLeaders Media, May 13, 2014
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Why is online transparency by providers so important when many surveys suggest patients make decisions on where to get care based on their health plan, or recommendations from family, friends, and physicians, not based on what they see on a hospital website?

"The hits on these websites are not that high," Sands acknowledges. "But transparent reporting's strongest impact has been internal. There's the overall message that we're confident enough in our performance to share information publicly, and the accountability that it signals. It's generated a series of conversations about what we want to make sure we're doing well at, that we're tracking it."

Payers as well as patients say they like going to a hospital that's prepared to show that data," Sands says. And it's even inspired a friendly spirit of competition among service lines to improve measures where the hospital may have fallen short in the last reporting period.

Sands knows that other hospitals will soon adopt transparency strategies for their websites, but they need to take special care on one important point: accuracy.

"If you're going to maintain credibility with your own clinicians, you have to be excruciatingly accurate, because they take this very seriously. If you're saying you did 47 carotid endarterectomies last quarter, you better be sure your vascular surgeons agree that it was not 46 or 48." That may not seem important, "but our learning shows that it is."

At the 4,450-bed Cleveland Clinic Health System, Chief Quality Officer J. Michael Henderson, MD, takes pride in the fact that the clinic's home page has dedicated real estate for five types of quality reporting, from data available on Hospital Compare to the organization's "Outcome Books," now prepared for 14 service lines.

When they were launched five years ago starting with heart and vascular care, Henderson says, the books "were really prepared for our referring doctors" and some of the employer groups the clinic contracts with directly for patient care. "But by putting them on the website, we're making them available to patients as well."

These PDF documents are posted online and show hundreds of data points, including surgical volume by campus, outcomes, use of new technologies, mortality rates by procedure, and process measures such as door-to-balloon times for cardiac care. It is a much deeper dive into quality measurement, more information than Medicare requires, Henderson says.

But the result has been improvement in processes and outcomes for most specialties, he says.

Henderson says that there was "a bit of pushback from a few of the groups that didn't have the best numbers initially. But that didn't come from our leadership, not from the board, and not from our marketing people."

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