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“Trust my rating and review, I’m a patient” – yet more evidence for web reviews of doctors

February 25, 2012

In the week that the UK’s health quality watchdog, the CQC, was once again reported to be inadequate and failing to meet its objectives to protect hospital patients; and when yet another charity highlights variation in the quality of primary care across the NHS, it is timely to highlight and discuss new evidence for why web-ratings by patients have to be at the centre of replacements to the failed traditional methods of monitoring and improving healthcare quality.

Ratings by patients predict quality care, allow the public to make informed choices and give real insight to those organisations that make them part of performance management metrics.

In the last few weeks alone, there have been another two publications providing yet more evidence that web-ratings by patients are accurate predictors of quality. This work comes from organisations including Harvard and Imperial College, London – making them important additions to the body of work validating such methods.

1.Felix Greave’s study found that hospitals with better ratings tend to have lower death rates and lower readmission rates, while hospitals rated by patients as being cleaner have lower rates of MRSA infections. This has implications for both patients and hospitals.

a. Patients wanting to choose a safe (in infection terms) hospital with lower death rates (probably most of us!) should read the reviews and ratings of other patients – and should look for organisations which collect and openly share such reviews in a systematic manner. Whenever possible, avoid hospitals which have lower ratings from patients, or which do not carefully measure the perception of patients and hospital visitors.

b. For hospitals, collecting detailed patient ratings and reviews at the level of  individual wards and departments, may predict infection risks, allowing preventive action, before patients are harmed. But this requires proactive, real-time systems – as opposed to the reactive, reporting systems used across most of the NHS today.

2. Gao et al have published a review of doctor ratings over 5 years and – whilst calling for more use by doctors and hospitals to increase the number of reviews – the evidence allows them to make the following conclusions:

Online physician rating is rapidly growing in popularity and becoming commonplace with no evidence that they are dominated by disgruntled patients. There exist statistically significant correlations between the value of ratings and physician experience, board certification, education, and malpractice claims, suggesting a positive correlation between online ratings and physician quality.

It is interesting to watch the medical literature catch up with what “the wisdom of crowds” already knows, that it is sensible when assessing quality of care (GP, specialist, hospital, dentist or pharmacy) to give consideration to the reviews of other patients.

More encouragingly, some of the best doctors in the UK are now making real-time patient feedback part of their process of professional development, and by doing this in a completely open way (they have no editorial control over what is published) have found it a powerful route to build the trust and confidence of patients.

At the same time,”early-adopters” amongst hospitals and health organisations are embedding real-time, continuous patient feedback across all their services – leaving behind ineffective, expensive “track-pads”, paper or phone-based attempts to understand quality.

Real-time, comparative “ratings and reviews” must be at the heart of the forthcoming Information Revolution publication from the Department of Health, and central to the next attempt to create a modern, effective and trusted system to monitor and ensure quality across UK health and social care.


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