Fighting Fake News and Building Trust on the Web

Added on Dec 10, 2019

By Thomas H. Lee, MD, Chief Medical Officer

woman with black laptop State-of-the-art health care requires many costly investments, including well-trained personnel, diagnostic and treatment technologies, and the facilities in which to house them. But it also requires something money can’t buy: trust between patients and their caregivers.

Trust is something in short supply in most aspects of life these days. A Google search for “Fake five-star reviews” produces 86 million hits, including major articles that appeared in The New York Times and The Wall Street Journal on Thanksgiving Day warning shoppers to be wary of sterling ratings posted by people paid to write biased reviews. One company (Fakespot) offers an artificial intelligence-based online tool to help readers spot fake reviews, and 71% of its online reviews are one-star, presumably written by fake reviewers who have been outed.

What are the implications of this dubious social media climate for health care providers? If 70% of consumers use the Internet to look up provider ratings, but people are often cynical and skeptical about what they find online, that’s not a promising start to a trusting relationship with their clinicians. What are the positive lessons to be learned from other business sectors?

The first insight is that the best way to build trust is to earn it. One definition of trust that I like is confidence that you will be treated fairly in situations that you have not even thought of yet.  That means readers/consumers/patients must do more than believe that what an organization is asserting about itself is true; they must have a reason to believe that anything the organization might assert is likely to be true so that ongoing confidence is never in doubt.

The second insight is that trust depends on performance and improvement. Patients are assuming their providers are reliably safe, technically excellent, coordinated, and empathic, but they are also assuming their providers are not resting on their laurels and are working relentlessly to improve. Anything that undermines this perception destroys trust.

The third insight is that this image of providers as reliably excellent and still trying to improve must be supported by what consumers find on the Internet. Just doing a good job is not enough. The first thing many patients do when they have a question related to medicine or their care is go to the Internet. The Web is thus a place where trust can be built or destroyed. Being transparent about provider ratings and patient comments is not merely a strategy for “owning the message,” it is a strategy for demonstrating trustworthiness.

These three insights point providers to a clear game plan that is increasingly being adopted by leading organizations. These organizations seek to deserve trust by nurturing highly reliable cultures with a holistic perspective on excellence—one that integrates safety, teamwork, technical excellence, and empathic care. And then these organizations seek to earn trust through transparency that reflects honest depictions of their performance and their commitment to improve.

Look at how the auto industry uses the J.D. Power Quality and Reliability ratings, which are based on hundreds of questions asked of car owners after the first 90 days of ownership, and Dependability ratings from detailed surveys obtained after three years of ownership. Automobile manufacturers are intensely interested in the findings because they recognize the need to understand a host of critical issues that influence how consumers feel about their cars. These same issues are at play in a health care setting where organizations need to understand and measure all of these elements and be able to prioritize both the key drivers of loyalty and the eroders of loyalty that may diminish the patient experience.

Here is our take on the implications for health care organizations.

  • Your patient experience is your brand. There is no simple way to gain the trust of your patients/consumers. You must understand and consistently meet the needs of every patient, every day.

  • Patient experience, workforce engagement, clinical excellence, and safety are interdependent. Health care organizations must have highly coordinated, enterprise-wide improvement strategies that recognize and manage the interdependencies of these critical domains.

  • Your workforce must be unified under one clear and integrated vision driven by reliable data. The data strategy must reside on a foundation of relevant, scientifically rigorous measures of performance to provide an enterprise understanding of performance and a unified improvement plan.

  • You must commit to High Reliability principles with a holistic understanding of excellence. This means embracing a goal of Zero Harm, as well as a goal of endless improvement in patient experience, technical quality, and workforce engagement.

  • You must commit to transparency on the outcomes that matter to patients, using the feedback patients have invested their time in presenting to you.

While the Internet is a tremendous source of information for consumers across the purchasing landscape, health care is unlike any other industry in that the trust placed in our hands is far more important and the ultimate outcome to the consumer is far more personally critical than in any other purchasing decision. The need for such trust is the reason Press Ganey introduced its Seal of Integrity. The seal helps consumers be confident that the provider performance data they are looking at are valid. Ensuring reliable online data is critical, but equally so is the deeper commitment to building brand through the practice of High Reliability principles each day.