When patients began reviewing their providers online the way they review restaurants and hotels, many worried that unfiltered comments from the public would have an unhealthy effect on the delivery of medical care. After all, the delivery of care is not at all like the delivery of pizza. In the consumer world, the mantra that “the customer is always right,” does not have an analogy in medicine. When a patient seeks care, he or she is seeking the input of a professional who holds a body of knowledge or a skill set that the patient typically does not have. And delivering care based purely on patient expectations not only could be a violation of the Hippocratic oath, but may have dire consequences and outcomes.
As online review sites gained traction, some feared that physicians would change their plans for treatment to get better reviews, and others pointed out that anonymous commenters could harm the reputations of good providers. But the evidence to date suggests that online reviews have strengthened the relationship between physicians and patients, leading to better health outcomes.
Giving consumers a platform to speak has worked well in retail, hospitality, and a range of other industries, helping people make informed decisions before they buy and clueing businesses in on areas where they could provide better service. And although healthcare features a range of considerations that are not present in retail or other sectors, online reviews have also brought benefit to providers and to patients.
Special Considerations in Healthcare
When you buy a car, you’re allowed to kick the tires. Before you choose which auto dealer to visit, you can read reviews to find out if other customers will vouch for the dealer’s honesty and customer service. You can ask the salespeople about a car’s gas mileage or its turn radius.
This has traditionally not been the case with healthcare, but emerging evidence suggests that in choosing a physician, patients increasingly want to turn to online review sites. A 2014 article in the Journal of the American Medical Association showed not only that 59 percent of the public felt that online rating sites were either somewhat important or very important in choosing a physician, and that although public awareness of online physician rating sites was lower than for other consumer goods, the trend in awareness had ticked up notably since 2008. And more recent data from 2016 indicate that this trend continues to grow, showing that 77 percent of patients turned to online reviews when initially selecting a physician.
Although physicians are often as forthcoming as they can be about medical conditions and treatment plans, the information has traditionally only flowed in one direction. The physician is the one with the information, and provides it to the patient. But starting with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey first released to assess patient experience of hospital care in 2006, patients were given a voice to provide feedback, and this voice has led to online ratings on sites like HospitalCompare. Even with strict regulation of the industry, privacy laws and the many other considerations in healthcare, the information is now flowing both ways.
Studies such as that of Ranard, appearing in the medical journal Health Affairs find that online rating reviews correlate with HCAHPS reviews, but also provide additional domains of patient experience not otherwise captured by HCAHPS, and therefore may provide a broader set of useful feedback to providers and healthcare organizations. Through online reviews and patient satisfaction surveys, providers have learned that patients want to take an active role in their healthcare. They want to feel like participants instead of spectators. They want to be able to have two-way dialogues with their physicians, and they want to feel heard.
Rather than opening a Pandora’s Box of complaints that could damage the reputations of physicians, online reviews have been teaching providers how to deliver better, more patient-centric care.
A Happier Patient is a Healthier Patient
In 2012, University of Utah Health Care, an academic medical center, became the first provider in the country to put patient reviews online. Like reviews found on Yelp and other review sites, these reviews were unedited and featured a ranking system.
Vivian Lee, a radiologist and former chief executive of UUHC, has written extensively about how the online reviews led to better communication between physicians and their patients. Quality metrics at the institution went up when UUHC instituted this new way of listening to patients, she said. Hospital revenues began trending in the same direction as satisfied patients began referring other patients.
Information used to flow from the provider to the patient. But with information now flowing both ways, patients are far more likely to feel satisfied with their care, to give their physicians high scores, and to refer their friends and family to the same provider.
And while this is good news for any provider concerned with how patient satisfaction scores will impact Medicare reimbursement, there is an even more compelling reason to keep patients happy: A happier patient tends to be a healthier patient.
In a paper published in Academic Medicine, Dr. Lee presents data that shows a clear link between the satisfaction of patients with their healthcare and improved health outcomes. And they similarly reported that with more satisfied patients, came a lower rate of malpractice litigation. This means that doctors are not just fulfilling the goals that sent them to medical school in the first place, but the institutions they work for are functioning better as businesses.
Getting to the Next Level
Giving the patient a platform to speak can build trust, increase satisfaction, and even boost hospital revenue. But are there other ways to amplify the voice of the patient? Is an online review the only way to gather this important information?
Online reviews have proven to be a powerful tool, but they only offer a snapshot of a patient’s satisfaction. Patients are unlikely to review their provider repeatedly, so reviews can’t be the only means of patient engagement.
Daily dialogue between providers and patients is the way to get feedback on a constant basis, and to turn the snapshot into a moving picture. It’s also the way to get the right information to the right patient at the right time, which is another way to ensure healthier, happier patients.
HealthLoop’s solution automates this daily dialogue. Not only do we enable two-way dialogue, but we give patients another vehicle to review their physicians and the medical care they receive.
With more than 100,000 patients using HealthLoop, we have seen:
• 72 percent of activated patients completing their patient satisfaction surveys
• 92 percent of patients reporting outstanding satisfaction with their healthcare
• HealthLoop physicians enjoying a net promoter score (NPS) of 89, which is higher than top consumer brands in the world
• 67 percent of patients agreeing to rate their physicians publicly when prompted by HealthLoop
Online reviews have helped the healthcare system by enabling information to flow both ways. But meaningful patient engagement is the way to keep that information—and all the benefits that come with it—flowing every day.
HealthLoop scales the impact of care teams through the power of patients.