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It's Judgment Day for Hospital Websites

 |  By cclark@healthleadersmedia.com  
   August 22, 2013

Not only are hospitals' quality metrics under tight review by payers, but now the honesty and relevance of their websites' claims and content is getting scrutinized.

The funny, if not shameful, thing about most hospitals' websites is how little they reveal about the quality and safety of care their patients receive. These portals could boast, say, their organization's specifics in preventing readmissions or infections, or how well patients scored their acute care experience.

But no. With a few hours spent browsing around, one realizes that what most of these platforms display are mere bromides and platitudes, even links to the area weather report. Many boast the hospital is "state-of-the-art," whatever that means, or that quality "is the cornerstone of everything we do," or "our mission is to offer healthcare services with compassion and dignity," or that the ER "provides 24-hour emergency services."

My pet peeve is when a hospital uses a third of its home page real estate for photos—not of the hospital's own, living, hard-working doctors, nurses and other members of the team—but instead wastes space with stock images of unrealistically beautiful, often even sexy, models wearing V-neck scrubs cut just low enough.

Now, a reality check on all of this banal puffery has finally arrived. And none too soon. Not only are hospitals' quality metrics under tighter review by payers, the honesty and relevance of their websites' claims and content is now getting scrutinized too.

This week, the employer-based Leapfrog Group, which last year started doling out hospital safety scores from A-F, and the accreditation program URAC announced their joint 2013 Hospital Website Transparency Awards. The idea is to applaud those hospitals that have begun to use their sites for real information and education rather than disingenuous hype. And by omission, Leapfrog and URAC hope to shine a light on those who don't.

"We recognized that the vast majority of hospitals weren't really doing anything on their websites to promote transparency, but some hospitals were doing an outstanding job," says Erica Mobley, Leapfrog Group's senior manager of communications.

"We wanted to formally recognize these hospitals in a way that would not only draw attention to them, but help other hospitals recognize that this is the kind of transparency consumers expect, and what they should be stepping up to do as well."

Adds Jane Webster, URAC's senior vice president of research and development: "Today, the range of information on these websites is huge, from very good information to that which isn't very relevant."

Rather than conveying useful information, Webster adds, the material on hospital websites "is more of a marketing message and lacks information to substantiate the claims they're making. Hospitals really need to move the bar up, put more facts behind the statements they're making," she says.

It's important for hospitals to understand that payers and patients think this is extremely important, Mobley says. "I don't think that when someone has a heart attack, they're going to rush right over to check out some hospital websites. But it's our hope that when it's a planned procedure or there's an opportunity to make a decision… they'll look at hospital websites."

Many within the healthcare industry are increasingly fed up with how meaningless marketing strategies seem to have taken over hospital websites, often in bad taste. In her column for The Health Care Blog last April, Joanne Conroy, MD, Chief Health Care Officer for the Association of American Medical Colleges, asked "Can We Put the Hospital Marketing Genie Back in the Bottle?"

Advertising techniques, she wrote, "usually include a da Vinci Robot and orthopedic surgery that will 'get you back in the game.' They claim to be 'state-of-the-art,' 'leading edge,' or 'cutting edge,' with actors playing doctors and nurses in masks."

"There is minimal oversight of hospital marketing compared with the active role the U.S. Food and Drug Administration plays guiding the direction of advertising for food and drugs," she wrote. "I wonder what the FDA would say about some of our hospital marketing: Does it educate the consumer?"

With the attention they hope their award will draw, that's what URAC and Leapfrog are asking as well. Last year, when the organizations launched the idea, many hospitals just couldn't get through the application process, Webster recalls.

"They wanted to participate, but they realized there was just a lot of work they needed to do to provide a better site, rather than just providing directions to the hospital or listing their doctors." Only 26 hospitals applied, and only seven made the cut. They couldn't say "yes" to at least 50% of the measures for each of five domains, Mobley says.

"Even if they got 80% for four, but only 20% in the fifth, that disqualified them," Mobley explains. The award algorithm is based on the National Quality Forum and Agency for Healthcare Research and Quality's guidelines for "consumer-focused Internet-based public reporting of health performance data."

The seven winners are:

This year, URAC and The Leapfrog Group are revamping their criteria. Instead of requiring thresholds, they will evaluate based on the applications they receive, and disclose their methodology. A panel of judges who also serve as advisers for those groups will review the submittals and validate claims.

Hospitals may apply for the award if they have a "consumer-facing website," have completed the free and voluntary 2013 Leapfrog Hospital Survey, (about 1,300 hospitals do so) and publically report quality data from their Joint Commission accreditation survey, Medicare's Hospital Compare ratings, their own state's reporting results, or the Leapfrog survey data.
There is no charge to apply or to post an award, if a hospital's website is a winner.

The award criteria factors nearly 50 measures in five categories:

1. Transparency

  • Does the website display the most recent safety and quality data, and give the dates of performance?
  • Can visitors compare your hospital's data with other hospitals in the state or nation?
  • Are there definitions or links to explain the information that's displayed?
  • Does the data shown have links to the source?

2. Design

  • Does the site have easily navigated layout with working and recognizable links?
  • Is the website available in several languages?
  • Can the font size be adjusted and can the content be printed?
  • Is advertisement labeled, to distinguish it from other content?
  • When data tables are displayed, are row and column headers identified?
  • Is there an explicit "About Us" or "History" section containing information about the facility, the staff and services?

3. Credibility

  • Does the website list at least one author, editor or reviewer to assure medical information is up-to-date and consistent with evidence and standards of practice?
  • Does the website include references for its content
  • Does the website explicitly state its purpose, goal, or mission?
  • Is the date of the site's last update displayed, so viewers know it is current?

4. Literacy

  • Is more than half of the information o the site at or below an 8th grade reading level?
  • If acronyms, jargon, or abbreviations, are used, are they defined?
  • Is there a glossary or index of terms?

5. Connectivity

  • Does the site include a phone number or e-mail address for viewers to contact the hospital?
  • Does the site have a link to telephone numbers for various departments and physicians?
  • Does the site have information to help viewers select an appropriate provider?
  • Does the site provide information on specific medical conditions and their treatments? For example, Northwestern Memorial Hospital includes overview information on various diseases and lists of specialists, clinical trials and quality data, as well as podcasts on related topics.
  • Can users access the web page from a mobile device?

As I look over these questions, I can see a few more I'd include to gauge the quality of a hospital website. At the top of the list would be this:

Does the site prohibit the use of models posing as providers and happy patients?

Glad I got that off my chest.

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