Public Reporting – Can it improve healthcare outcomes?
Every day there is an article or expert commentary about the importance of big data and data analytics. No industry, business or public sector is immune to the constant pressure of how to improve products or services and big data and analytics is being seen as the hip new enabler.
The healthcare sector with its massive amounts of data is clearly an area that deserves close attention and scrutiny.
From my 18 plus years working in Australia and globally in the area of ICT and health informatics I strongly believe that there are numerous benefits from public reporting of healthcare metrics that will lead to healthcare improvement through greater patient choice.
With increased competition, service providers are highly influenced by consumers & their choices. Public reporting can also enhance the profile, reputation and market share of healthcare entities through encouraging transparency and allows patients to make informed choices for better care. Cumulative effects of informed choices encourages improvement across the entire healthcare system and can be an important driver of engagement to help focus on what matters most to patients.
Expanding your public reporting and feedback approaches can help to unlock greater value from your existing information to provide valuable evidence for accreditation and standards compliance for consumer engagement. This is an area that many healthcare organisations currently struggle with in devising a set of policies, procedures, systems and frameworks for good governance.
However, public reporting initiatives present many challenges and pitfalls. Generally, consumers don’t believe that there is actually a quality gap in healthcare. They assume that healthcare services are safe, efficient and of high quality. Consumers define quality differently to providers which means that any public reporting projects must ensure that performance information is meaningful and easy to understand for the purpose of patient choice in making decisions about their care.
Data reported by health care services for internal quality improvement is generally more comprehensive than what is required for public reporting to consumers. Many quality indicators are appropriate for public reporting but some should be reserved for internal only use to avoid misinterpretation by the public.
There are key differences between the data reported to healthcare services for quality improvement and what is useful for reporting to consumers to support them in making treatment choices. An example is high rates of unplanned readmission. This is generally regarded by the healthcare system itself as an indicator of poor performance. However, from a public reporting perspective consumers typically see this as an indicator of improved access to care. The urgency of care needs also affects public reporting effectiveness as those patients in the most urgent need of healthcare services are often the ones that are least able to make considered choices. Consequently public reporting initiatives are often most successful when they target patients who need elective treatment and have the time and mindfulness to compare services and associated performance.
On the flip side there are also dangers in making too much information available which can be counter-productive. Data literacy is much lower in the general population and healthcare language can be confusing. Added to this are tensions between internal and external reporting requirements which can inadvertently encourage gaming, cream skimming & blame shifting by healthcare providers if not done carefully within an environment of trust and transparency.
The benefits from public reporting of healthcare performance can be enhanced through additional support and services for patients to make informed choices about their care.
Publicly reported information should help guide the consumer in making choices and actions about healthcare services according the things that they value and the needs that matter to them.
Isn’t that what we all want?