Transparency as a Catalyst for Transformation

Added on Mar 21, 2016

Transparent marketplaces and health care consumerism are transforming the U.S. health care system into one driven by competition on the “right” things: the safety, quality, experience and cost of care, Press Ganey Chief Medical Officer Dr. Thomas H. Lee told industry leaders at the 2016 Transparency & Innovation Summit held in Salt Lake City in early March.

“Transparency is one of the most powerful catalysts for moving health care in the right direction,” Dr. Lee explained. “Those organizations that are able to quickly, accurately and consistently provide patients with the information they want and need to make informed decisions will come out on top.”

Online reporting of patient experience data is an important step along the transparency journey. Fully delivering on the transparency promise also requires organizational alignment with the mission and vision, physician engagement, a commitment to robust data quality and quantity, and a strategy for driving continuous improvement.

During the Summit, executives from health care systems that have made transparency a strategic imperative shared their unique insights into the best practices and innovations that are driving successful transparency efforts in their organizations.

In a panel discussion with Dr. Lee, Matt Gove, chief consumer officer of Piedmont Healthcare in Atlanta, and Dr. Thomas Miller, chief medical officer of the University of Utah Hospitals and Clinics, discussed innovative ways to meet consumer demand for more information. To help patients further connect with their potential caregivers, organizations are taking steps to supplement their online review sites with additional assets, including physician videos.

“Patients want to see, hear and know as much as possible about the doctors they are going to see,” said Gove. Providing this information is a way to build trust, which is the cornerstone of patient-centered care, he noted.

“Patients build relationships with caregivers,” Dr. Miller stressed. Focusing on physician performance and providing patients with the tools they need to assess that performance helps them make care choices and supports those relationships, he said.

From a marketing perspective, according to David Perry, chief marketing officer at the University of Utah Health Care, transparency with performance data not only meets consumer demand for information, it allows organizations to own their online reputation. “If you don’t own it, others will,” he stressed. It also supports search engine optimization to increase online visibility, ensuring that patients are able to readily find providers in the organization.

Following are additional insights on transparency innovation and challenges shared by leading executives:

Chrissy Daniels, Director, Strategic Initiatives, University of Utah Hospitals and Clinics

“When we talk about patient experience reviews, the most powerful weapon we have as patient experience leaders is the quantity of our data,” Daniels said. Realizing this, University of Utah relies on data collected through electronic surveying to power its transparency engine. “We’ve gone 100% eSurvey, which really works for our demographic,” she explained, noting that Utah has the highest rate of high-speed Internet access in the country and the highest Internet use among patients over age 65 and among patients below the poverty level.

With the move to electronic surveying, “we went from 15,000 surveys per year to more than 65,000,” Daniels said. Ironically, even if they were not collecting more data, “we would still stay with eSurveying, because it eliminates the lag between the patient visit and the survey response,” she said. “We get feedback five to seven days after the care is delivered, and that has transformed our patient experience. The staff are able to connect the feedback to the care they delivered.”

The dramatic increase in survey data has also led to an increase in the quality and quantity of patient comments. “We were getting about 300 comments per week, and now we’re getting 2,000,” Daniels said. Furthermore, she said, the comments themselves are more detailed, averaging 34 words per comment compared with 12 words per comment on paper surveys.

“We think capturing the voice of the patient is what has driven the transformation of our system,” Daniels said. “When we get comments, we don’t have to help our staff guess what their patients like and what they think needs improvement. They tell us in great detail. Being able to have a conversation with patients in this way is changing our system faster than anything we’ve ever seen.”

Dr. Greg Burke, Chief Patient Experience Officer, Geisinger Health System

“Our CEO David Feinberg has encouraged us to remember that our real competition is disease, it is not other health systems,” Dr. Burke said. “If we stay driven to those higher callings, all of our efforts to share our performance with the patients we serve make more sense.”

In addition to supporting transparency by posting its physician ratings and consumer comments online, Geisinger actively pursues transparency through other activities. “We recently did our first mortality and morbidity conference, inviting the family to come in and present the case,” Dr. Burke said. “That was a very powerful experience. There were no major areas of concern on the medical side, but the message from the patient’s family was totally different. There were missed opportunities in communication, delays in the waiting room, a lost consent for a procedure. Those are things you don’t see in the medical record.”

Efforts such as this, which seek to close the gap between provider and family perspectives on care experiences, represent “true transparency,” Dr. Burke said. “The questions we have to ask ourselves are ‘Where do we go next? What are the limits?’”

Dr. Ira Nash, Senior Vice President and Executive Director, Northwell Health Physician Partners

The first and largest integrated health system in New York, Northwell Health Physician Partners, formerly the North Shore-LIJ Health System, recently became one of the first large medical groups in the region to post patient reviews online. As with all such transparency efforts, physician engagement in the process was a fundamental steppingstone to the launch of online reporting. Leaders also hoped the corollary would be true, that the system wide adoption of online reporting would build a sense of engagement among the more than 2,300 physicians practicing in the group’s hundreds of outpatient offices and hospital-based practices located throughout the New York metropolitan area.

“We have the challenge of taking what has really been a confederation of independent practices and creating the sense that we are one single practice,” said Dr. Nash. “We saw the opportunity to use transparency as a unifying force, to say something like, ‘We’re all in this together. It’s going to be part of the cultural transformation of our group,’” he said. “We are all swimming in the same sea, and we all understand what’s going on with the rise of consumerism and patient choice. This became a catalyst for change.”

Dr. Vivian Lee, MD, PhD, MBA, Senior Vice President for Health Sciences, Dean, School of Medicine; CEO, University of Utah Health Care

The success of transparency efforts is conditional on two things: engaging patients and engaging providers, Dr. Lee said. “Nationally, the discourse is clear that we need to engage patients, but I think the ‘secret sauce’ is the provider engagement. You can’t engage patients if you don’t have really successful provider engagement,” she explained. “We’ve all seen the burnout data, we’ve all seen the stats on how physicians are feeling about their lives right now. In order for transformation to happen, we have to engage providers.”

In this regard, Dr. Lee stressed, data should not be considered a “gotcha.” Rather, she said, “we’re trying to show physicians how data can be used productively to drive improvement across all of health care.”