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Analysis

How IU Health Manages Online Ratings and Reviews to Better Serve Patients

By Christopher Cheney  
   January 15, 2020

Becoming more customer-friendly for patients was the primary reason IU Health launched its online ratings and reviews initiative, executive director of digital marketing and experience says.

Indianapolis-based IU Health has launched and implemented an extensive effort to post physician and clinic-level star ratings and reviews online.

After University of Utah Health pioneered online physician reviews in 2012, a small but growing number of health systems have followed in its footsteps. For health systems that have implemented posting online ratings and reviews, the initiatives are viewed as an essential element of transparency and patient experience.

Becoming more customer-friendly for patients was the primary reason IU Health launched its online ratings and reviews initiative in 2018, says Jeremy Rogers, the health system's executive director of digital marketing and experience.

"We heard from our patients through studies and surveys that they wanted to have this type of information when they were making critical decisions about who their next physician or provider would be. We all know in our modern lives that we use ratings and reviews for almost every decision we make—whether it's our next vacation or purchasing a new car. One of the first things we do is go online and look for reviews from other customers," he says.

The IU Health initiative has achieved significant results since its launch a year-and- a-half ago:

  • The health system is publishing ratings and reviews for more than 1,500 clinicians
     
  • About 150,000 reviews have been posted online
     
  • The volume of reviews is growing by about 7,500 reviews per month
     
  • The average provider star rating is between 4.6 and 4.7 out of 5 stars
     
  • More than 500 IU Health locations are getting star ratings. "These locations are at the clinic level, so a hospital could have dozens of locations with star ratings," Rogers says.

How online ratings and reviews are generated at IU Health

Star ratings and online reviews are drawn from a patient experience survey developed at IU Health three years ago.

For every patient inpatient and outpatient encounter, within 48 hours patients receive an email or a text message asking them to respond to the survey. The survey has a half-dozen questions such as likelihood to recommend a clinician to friends and family, whether the clinician spent enough time with the patient, and whether the clinician made the experience easy for the patient.

"We get a strong response rate to our surveys—about 20% to 25% of patients respond. On an annualized basis, we are processing about half a million survey responses," Rogers says.

In addition to generating star ratings for physicians and advanced practice practitioners, the data is used internally for score cards that go out to administrators and individual clinicians to show the experience they are providing to patients.

Online reviews are more difficult to administer.

"Every month, we load the raw data from the third-party administrator of our experience surveys. We then have processes such as scrubbing out protected health information and scrubbing out profanity and incoherent language. These processes are all done using machine learning and artificial intelligence techniques. We have published about 150,000 patient reviews over the past year and a half. Once we've done the scrubbing, we then publish the reviews automatically," he says.

IU Health publishes both positive and negative reviews, and the health system rarely blocks publication of a review, Rogers says. "Our intent is to never edit a comment. We want to have the patient's review in their own words."

There is also a governance model to manage reviews when clinicians raise concerns about patient comments. A common example that requires governance is when a clinician questions whether a patient review should be directed to another provider because the patient has commented on the wrong clinician, he says.

"We have patients who have multiple IU Health physicians and they can have multiple appointments in a week. Occasionally, these patients may respond to the wrong survey for an encounter. In these cases, we have a governance process [in which] our team digs into the electronic medical record to verify the data based on the encounter ID of the survey."

Other clinician concerns are less clear cut, such as when a provider thinks that a review is unjust or does not reflect a patient encounter accurately. In those cases, the chief medical officer for the physician group in question conducts research to help determine whether a review should be removed.

"We're not trying to be punitive to our providers or trying to foster a culture where they feel disrespected, but we must be transparent. So, we are balancing both transparency for our patients and fairness for our physicians," Rogers says.

Impact of online reviews

IU Health has made several changes based on comments in online reviews, he says. "Part of our overall effort with online reviews is to empower our providers and other staff to drive change at the local level. For example, based on the real-time feedback from patients, our team members and providers have leveraged reviews from the patients to improve the performance of registration staff or add valet parking to their location."

Wait times are a common topic in negative reviews, which have prompted the health system to improve access at some clinics, Rogers says. "We use the data from the reviews to analyze how we are scheduling the providers, and, in some cases, how we are recruiting providers. If we see areas where we don't have sufficient access, we make changes to address that issue."

At IU Health, online ratings and reviews have become a key ingredient for patient engagement, he says.

"When you talk about consumers in healthcare, it is no longer optional for patients to have choice and options in their care. For us, we are moving beyond just physician ratings and reviews. We publish ratings for locations such as urgent care clinics. We are publishing ratings and reviews for advance practice providers. Patients expect this level of transparency and empowerment."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

IU Health has implemented a robust online ratings and review initiative, with about 150,000 reviews published over the past year and half.

The health system is publishing online star ratings and reviews for more than 1,500 clinicians.

Both positive and negative reviews are published, with editing limited to redaction of protected health information, profanity, and incoherent language.


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