CTCA Program Meets Consumer Needs, Boosts Physician Accountability

Added on Jan 9, 2020

ratingsCTCA Meets Consumer Needs, Boosts Physician Accountability with Online Review Program
By Whitney Fishburn

One year after making internal physician performance data public and easy to understand, Cancer Treatment Centers of America (CTCA) saw a dramatic improvement in physician accountability and engagement and an increase in overall and individual physician ratings. Website traffic also increased significantly since implementation.

Because health care consumers increasingly rely on online ratings when choosing a physician, leadership at CTCA sought a way to funnel prospective patients away from dubious self-reported third-party sites and toward accurate and verifiable ratings instead. To further leverage Press Ganey survey data that were already being collected on patients’ perceptions of their experience of care across its five hospitals and national network of outpatient care centers, CTCA developed the Electronic Physician Rating and Review process (e-PR2) in 2018. The new protocol publishes CTCA’s medical, radiation, and gynecologic oncologist ratings and reviews on the organization’s public-facing website so that prospective patients and referring medical professionals can easily access all the data they may need when choosing a physician.

“By creating this comprehensive data portal on our website, we took an approach that is very much in line with the reality of consumerism in health care,” said Scott Hartman, CTCA’s director of patient-reported outcomes. “In the everyday economy, consumers want to see validated and transparent data on everything they seek to buy. When patients consider their health care options, the reasoning for choice is not much different.”

In order to include voices from all levels of the organization, CTCA leadership tasked a multidisciplinary team from the patient outcomes and operations, quality, and marketing departments with designing and implementing the e-PR2 process. The team kept physicians within the organization aware of and engaged in the new protocol.

The goal was to create a clear, public-facing compendium of ratings culled from survey data on CTCA’s nearly 5,000 annual inpatient admissions and 188,619 outpatient visits, its 13,117 annual outpatient surgeries, and its 5,330 annual inpatient surgeries.

The team was also responsible for establishing parameters on data published to CTCA’s website and reviewing the verbatim patient comments in a regulatory and legal framework prior to posting them. They did this while also maintaining a continuous cycle for uploading new data from the more than 10,000 new patients seen by CTCA physicians annually, and while considering any appeals from physicians.

The e-PR2 team developed a process that converts Likert-scale data on patients’ ratings on their level of confidence in a certain physician’s ability to care for them, and the likelihood of their recommending that physician to others, into a 1- to 5-star rating for the respective physicians. To allow ample time for physicians to appeal any negative comments that concern them, an email prompting them to review comments regarding their delivery of care is sent 15 days before the survey data and comments are posted. An advisory committee consisting of physicians and e-PR2 support staff reviews all physician appeals and reaches consensus on whether to deny or approve them.

After the physician review period, both positive and negative patient comments are published verbatim, along with an overall star rating for the physician. Physicians’ ratings are posted once they have received a minimum of 30 reviews, and comments are maintained on a 12-month rolling basis. Any comments containing protected health information, profanity, or slanderous content are filtered out before they are posted.

“The e-PR2 team’s ongoing communication with physicians was vital to establishing awareness and comfort among employees in the ‘why’ and ‘how’ behind the project,” said Hartman. The result was that very few barriers to success were experienced in the e-PR2 launch, given that the project proposal was prepared and vetted by both executive and physician leadership prior to implementation.

Working closely with the organization’s IT team from day one was critical to the protocol’s success, since the only challenges CTCA experienced were either technical or maintenance-related, according to Hartman. Challenges included keeping a current physician roster, responding to physician appeals in a timely manner and with a personal touch, creating a working case law on handling verbatim comments that are flagged, and establishing the data feed necessary for the initial setup of the site.

One year after implementation, CTCA has seen physician performance scores increase from 4.7 stars to 4.8 stars, with 78.3% of the network’s medical oncologists, radiation oncologists, and gynecologic oncologists being rated at 4.8 stars or above on the 5-star scale. This is in comparison to the start of the program, when only 74.5% of the network’s oncologists were rated 4.8 stars or above. Physicians’ engagement with the review process has increased by 41% since implementation, indicating a strong desire to understand their own data and act on improvement opportunities with patient care.

“This translates to a culture of accountability and a deepened understanding of patients’ perceptions of their care experience,” said Diane Denny, CTCA’s vice president for quality, patient safety, and clinical outcomes.

Also, since the program was launched, CTCA physician bio page views have increased by 26,000 overall, with an average increase of 641 views per bio page in 2018. This equates to a 59% jump in overall CTCA website traffic. With 49 CTCA physicians now participating in e-PR2, the organization is able to showcase more than 11,000 ratings and 4,200 comments on its website. Currently, all eligible oncologists for which there are attributed survey data participate in e-PR2, and CTCA is working to increase the participation of all its physicians, with surgeons next in the pipeline.

“Since we began making physician ratings and reviews available online through the e-PR2 process, our physicians have become more engaged with their patient experience data and work to identify improvement opportunities in their delivery of care,” said Hartman.