Yelp Yourself: UUHC Embraces Patients’ Feedback

Online reviews are all the rage with consumers these days, including reviews of the medical care they’ve received. Given that patients are not medically trained and can be inclined to view their personal experiences without the benefit of full context, medical professionals are understandably worried about the accuracy, fairness and tone of such reviews—especially negative posts that could unfairly reflect on a healthcare facility’s reputation.

Nevertheless, online reviews appear to be an unstoppable trend. As a result, perhaps the best way for healthcare providers to cope with them is by engaging the review trend positively—or, as the old adage says, if you can’t beat ’em, join ’em.

The logic of proactive review engagement appeals to University of Utah Health Care (UUHC), Utah’s only university healthcare system and provider of patient care to a five-state area. For the past seven years UUHC has been actively soliciting feedback from its patients. Since December 1, 2012, it has been posting this patient feedback on its Find a Doctor website (https://healthcare.utah.edu/fad/) for the world to see.

“We have been using this feedback to inform and motivate our practitioners to do better,” says Vivian Lee, MD, PhD, MBA, CEO of University of Utah Health Care, senior vice president of UUHC University Health Sciences and dean of UUHC’s School of Medicine. “In combination with our many other efforts, the results speak for themselves: A quarter of our practitioners now rank in the top 1% for patient satisfaction, and about half are in the top 10%.” UUHC is also rated as Utah’s top hospital provider by U.S. News and World Report and one of the top 10 U.S. hospitals in terms of its National Quality Rating by the University Health System Consortium (UHSC).

Meaningful Data

Of course, an information survey is only as good as the data on which it’s based. So rather than gathering random patient comments online, UUHC has been proactive in devising, distributing and collecting meaningful data using its own electronic Medical Practice survey, for which it partnered with top patient-satisfaction organization Press Ganey. This questionnaire targets the points considered relevant to accurately assessing the quality of medical care received and the patient’s perception of this treatment. The overall goal of the survey is “to provide each patient with an exceptional experience of care,” says the UUHC survey website (https://healthcare.utah.edu/fad/pressganey.php).

The content of the UUHC Medical Practice survey’s 20 questions is key to garnering meaningful, actionable feedback from patients about the in-person care they received from UUHC medical staff. Rather than ask for personal responses, the survey solicits qualitative feedback using a five-point spectrum where the answer choices are very poor (1), poor (2), fair (3), good (4) and very good (5).

“Using this system, we ask patients to answer/rate items such as the friendliness/courtesy of the caregiver; the caregiver’s efforts to include you in decisions about your care; the degree to which the caregiver talked with you using words you could understand; and your likelihood of recommending this caregiver to other people, among others,” says Lee. “Such responses, which are linked to the actual caregivers’ files in our database, provide clear, measurable answers that also provide real insight into the patient’s perception of their experiences here.”

The survey is e-mailed to all University of Utah Health Care patients a few days after their last appointment. (The entire process is independently administered for UUHC by Press Ganey.) About 50,000 patients are surveyed every year. All comments, whethersitive or negative, are published in their entirety online, as long as they’re not libelous, profane or slanderous and don’t violate the privacy of those mentioned.

The Value of Candor

UUHC has certainly taken the high road when it comes to the arm’s-length collection of patient feedback. It maintains this integrity by openly publishing patients’ responses and assigning a five-star rating to each of the rated medical staff on its Find a Doctor site. But what about the impact on the hospital and its staff—is such candor wise?

This and other timely questions were tackled recently by UUHC CEO David Entwistle in a presentation called “Embracing Transparency to Drive Change.” Entwistle delivered this at the 24th Annual Health Forum and the American Hospital Association Leadership Summit in San Diego last July.

Citing data from various sources, Entwistle opened by noting that 72% of Internet users looked online for health information in 2014; 35% selected a physician based on seeing a good rating, and 37% avoided physicians with bad ratings.

Having established the impact of online physician ratings on patient choice, he dug into issues of concern to medical care professionals: Using UUHC-compiled data, Entwistle indicated that positive reviews did indeed boost physician visits, but negative reviews did not appear to significantly reduce them; that UUHC’s active use of this data to improve patient treatment (and caregiver/patient interactions) resulted in its UHSC National Quality Ranking rising from 50 in 2008 to 6 in 2014; and that UUHC’s overall patient satisfaction rating has gone from 45% in fiscal year 2011 to 88% in the first quarter of fiscal year 2014.

Entwistle concluded his talk by noting that collecting and posting patient reviews has two key benefits: It gives patients useful information that lets them make informed decisions when choosing physicians, and it encourages healthcare professionals to change their behaviors for the better. So, yes, posting patient medical reviews is wise.

Conclusion

If there is a moral to this tale, it is that conscientiously designed, collected and analyzed patient medical reviews can be a positive force for both consumers and healthcare providers.

“One of our star surgeons told me his son had called him from across the country, having looked at his father’s online patient ratings,” says Lee. “After studying them, the son commented, ‘Dad, you’re actually a pretty good doctor!’ That’s the kind of conclusion that we want our patients and prospective patients to reach from reading our reviews, and to experience through our exceptional quality of care.”