"The toughest thing about the power of trust is that it’s very difficult to build and very easy to destroy.” The famous founder of IBM, Thomas Watson, wasn’t talking about health care specifically when he said this, but he well could have been.
Trust is fundamental to health care delivery. It is the cornerstone of effective physician-patient relationships, as well as those between physicians and colleagues and between staff and managers.
Similarly, the ability to build and maintain trust in the quality of performance data being shared online is vital to an effective transparency program. A lack of trust in the data translates to a lack of trust in the system. For this reason, hospitals and health systems embarking on transparency journeys must be constantly mindful of how their efforts might influence patient and physician trust, and they must vigilantly build and protect it at every turn.
To be meaningful, transparency has to be more than “pulling the curtains back” on whatever data happens to be available. It requires a thoughtful assessment of the type and volume of the data being collected and a commitment to sharing scientifically rigorous data in an objective manner that stakeholders can readily understand and easily navigate.
To this end, transparency requires openly sharing only those metrics that represent a statistically valid sample collected through a process that is reliable and consistent over time. Anything less will result in an inaccurate representation that will misinform patients and alienate physicians, as will deliberately manipulating the performance picture by suppressing selective information.
Health systems that collect operational data by significantly increasing the volume and depth of patient feedback
are in the best position to fuel robust transparency programs and build stakeholder trust. When physicians are confident that the data being shared is truly reflective of their performance, they will pay attention to it and buy into improvement strategies derived from it. When patients believe the information is an accurate indicator, they will rely on it rather than turn to consumer web sites like Angie’s List or Yelp to make important care decisions.
Further, to support an objective understanding of the data, the information must be presented clearly and concisely in a manner that minimizes bias and promotes comprehension. A composite measure or rank for each physician that reflects all of the patient experience feedback received for that physician is immediately comprehensible, actionable and statistically meaningful. Coupled with complete, unedited patient comments about their experience, transparency strategies built on this model promote confidence in the integrity of the data and, importantly, in the integrity of your organization.
Transparency of physician performance data is good for health care. It can empower patients to be active, informed participants in their care choices, drive caregiver accountability and build brand loyalty. But first, there must be trust.