- Clinicians often fare better on hospital-issued patient satisfaction surveys and online provider review websites, according to a recent study presented at the American Academy of Orthopedic Surgeons Annual Meeting in New Orleans.
The study, published in August 2017 in Orthopedics, compared the nature of online provider reviews and patient satisfaction levels posted on hospital-hosted websites compared to commercial review websites such as Vitals or HealthGrades.
Online provider reviews are an emerging issue for healthcare professionals. With the rise of social media and other review websites – think of Yelp or even the comments section of Amazon – healthcare consumers have also wanted their voices to be heard.
Conversely, healthcare consumers have been looking up hospital quality and patient satisfaction scores for providers from whom consumers are going to seek care. The prevalence of online provider reviews is yet another signal of a consumerization of healthcare.
But as with any other form of social media, online provider reviews on third party websites can often raise questions. Who are these patients? Did they truly receive care from their provider? And are they embellishing their comments?
How, exactly, do online reviews posted on hospital websites compare to those posted on third-party websites?
A research team from the Hospital for Special Surgery (HSS) in New York City compared both hospital-hosted and third-party reviews for 12 hospitals or health systems across the country. Participating organizations included Duke University, Midwest Orthopedics at Rush, Vanderbilt University, Northwell Health, Cleveland Clinic, University of Utah, University of Arkansas, Stanford University, University of Pittsburgh, Wake Forest University, Southern California Orthopedic Institute and Piedmont Healthcare.
The researchers compared each hospitals’ own review websites with those posted on HealthGrades, Vitals, RateMDs, UCompareHealthCare.
Overall, hospital websites received more provider reviews. Reviews posted to a hospital website also tended to be more positive, said researcher Alexander McLawhorn, MD, an orthopedic surgeon at HSS.
"Compared to commercial ratings websites, we found that provider-initiated patient satisfaction surveys yielded a higher number of ratings for each doctor, higher average patient satisfaction scores and a lower percentage of negative comments," said Alexander McLawhorn, MD, an orthopedic surgeon at HSS. "We saw a small association between increased years in practice and the likelihood of a negative rating, while academic practice settings and those in the Northeast had a lower percentage of negative comments."
Overall, the ratings left on hospital-sponsored review websites tended to be more credible, McLawhorn and colleagues found. This is likely because hospitals have extensive comment vetting processes in place, compared to less stringent strategies in place on third-party websites.
"While hospital surveys are distributed to patients who received care from a specific doctor, ratings on sites such as Healthgrades and Vitals are often anonymous, and you really don't know who is posting a review," explained Bradford Waddell, MD, also an orthopedic surgeon at HSS. "We believe hospital surveys filled out by patients provide data of a higher quality and are a better indication of patient satisfaction."
Most of the healthcare organizations studied had common practices for collecting and publishing online provider reviews on their own websites, the researchers pointed out. Each organization asked between six and 20 patient satisfaction survey questions. Most of these included questions about patient-provider communication, trust in providers and care decisions, time spent with the patient, and the overall willingness for the patient to recommend the provider.
All of the hospitals used a five-star review scale, with five being the highest score. The hospitals and health systems also stated that they posted all patient reviews except for those that may be libelous, offensive, profane, or compromising confidentiality and privacy rules.
The HSS researchers explained that online provider reviews are valuable because they are a good resource for patients and because they help providers improve their practices.
Hospital-sponsored websites, especially, provide an opportunity for improvement because they offer a wealth of information, according to Waddell.
"In contrast to a limited number of random online reviews, health care provider surveys can gain insights from a much larger population of patients,” he explained. “The more information we have, the more we can improve patient care."
Many healthcare professionals maintain that hospital-sponsored online review websites are more valuable than third-party websites. A 2017 study published in the Journal of General Internal Medicine found that providers have more trust in those websites than third-party websites. That same survey revealed that third-party review websites cause added provider stress and burden.
Donna Hill, a marketing strategist at the University of Arkansas Medical System (UAMS), also implemented a hospital-run review website because she said third-party websites offer insufficient information.
“Third-party websites have different ranking rating systems. They publish when they have fewer than 30 comments,” Hill said in a recent interview with PatientEngagementHIT.com. This can create misrepresentations of provider competency.
“You might have three comments, and a doctor has a 2 star-rating, but in our system they're a 4.9. The physician really provides excellent patient care, but if you have just a few people who are really happy or unhappy, it can really skew the results.”
Hill shared similar insights with Waddell and McLawhorn, the researchers from HSS. Online provider reviews help patients research their providers, but also give providers the chance to improve their own practices.
“As high-deductible health plans become more common and people are spending more out-of-pocket for their healthcare bills, they're doing a lot more research online,” Hill stated. “They don't necessarily take the referral given to them by their physician. They want to go look and see, and they love having this type of information to help them make decisions about their healthcare.”