Benchmarking healthcare providers- finding Dr. Right ain’t that easy

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Today’s consumers have the ability to quickly and efficiently compare a wide variety of options when making purchases.  Whether you want to buy a car, shop for a competitive mortgage, or reliably choose a contractor to fix a problem with your house, sites like Kelly Blue Book, Yahoo Finance, and Angieslist provide the requisite comparison data.  When you’re traveling and want to seek out a place that serves a delicious brunch, Yelp is at your side with a ton of crowd-sourced reviews.  It’s a real surprise then that finding objective ratings for medical providers is so difficult to do.  Indeed, while there have been a slew of new online consumer sites both public and private emerge (cool ones include iTriage, Castlight Health, and Hospitalcompare), there is scant basic benchmarking data available to consumers today for choosing Dr. Right.

To bring the problem to life, let’s say someone (hypothetically a healthy couple in their early 40’s in suburban Boston) is looking for an OB/GYN or midwife practice to deliver their baby in the next few months.  The vast majority of expecting mothers have an OB/GYN who they’ve seen for a number of years.  But let’s say that you’re new to town, have a health plan that provides freedom of choice and you want to find out who has a solid track record of delivering babies to like-minded people.  The answer to that takes two forms—subjective, personal opinion, and objective, quantifiable data.

Subjective or personal opinion is a valuable source of information especially when it comes to bedside manners, patient experience and the like.  Surprisingly, consumer reviews sites have very little to offer on this particular subject.  Sites including Yelp and Angieslist have few reviews available on OB/GYN practices.  In fact, there were only seven reviews of “OB GYN doctors” on Yelp.  In the case of AngiesList, while there were a relatively large number of practices reviewed (over 400 in total), there were only 14 with more than four reviews and just seven with more than five.  The content left much to be desired with negative reviews for practices for non-clinical reasons such as “the billing lady in their office is just plain mean”, or positive reviews for reasons like “they even serve coffee to you in the waiting room”.

So, what exists for hard, objective data on provider or facility performance?  The answer is very little.  Turning to statistical sites like whynotthebest, Hospital Compare, and Healthcare Blue Book there was no information specific to child birth procedures as distinct from all treatments.

A simple, “Just the fact’s, ma’am” approach to provider benchmarking is what is sorely needed.  Here are some of the questions that we were hoping to answer:

  • How many babies has the provider delivered in the past 6-months, year, lifetime?
  • What is the socio demographic mix of their patients (race, age ranges, etc.)?
  • What treatments do they most commonly administer (% of vaginal vs. caesarian deliveries)?
  • How do they compare to other providers locally?
  • What prices do they charge for specific treatments and how will that affect my out of pocket expense for my healthcare plan?
  • What has been the rate of their complications as compared to others?
  • Have they been found guilty in any medical malpractice lawsuit(s)?

In the final analysis, the one and only source of data that had any objective measures specific to childbirth was made available through our health plan.  Their site allowed me to compare the most commonly measured statistics for childbirth at local hospitals including percentage of caesarian births, length of stay, percentage of vaginal delivery for previous caesarian births, and percentage of episiotomies.  While this is good information, the basic level of detail on providers still eludes us and we are left to make one of life’s biggest decisions with mostly subjective, non-quantifiable data.

Healthcare Intelligence (HI) is the industry domain where this problem and a host of others facing stakeholders across the healthcare system are being addressed.  Please view my past and future entries related to HI on this blog.

 

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