Susan Mende: Making Health Care Decisions Easier — and Reliable

Guest blogger Susan R. Mende, BSN, is a senior program officer at the Robert Wood Johnson Foundation, the nation’s largest philanthropy devoted exclusively to health and health care. She is engaged in the Foundation’s efforts to help consumers take an active role in improving the quality of health care in their communities.

As patients and consumers, we are constantly faced with making decisions with limited or what could often be called misguided information. From restaurants to cell phones to airlines, we all have different and unique experiences that play into our reviews. Of course, while the downsides of a bad dinner choice might be a lighter wallet and disappointed palate, there are other decisions that can have much more serious consequences.

Consider the quandary faced by millions of Americans looking for a good doctor. We know that across the country both good care and bad care is being delivered in doctors’ offices. How do we judge the quality of care they provide? Many of us ask friends, especially friends who are doctors, for a recommendation. This sometimes works but has many of the same downsides as subjective food reviews.

Once, I asked my physician friend for a primary care doctor recommendation for my husband and received a glowing reference. But once he was in their office it was a different story. Upon discovering that my husband is Australian (the second he opened his mouth to say “G’day, mate!”), the doctor spent the whole time complaining about his low reimbursement. Not a good way to fill you with confidence about the focus of the care they are delivering.

The truth is that without reliable and easy to understand public reporting it is nearly impossible for the average patient to know the quality of care they and others are receiving. Filling in this gap has long been a core focus of the Robert Wood Johnson Foundation (RWJF) Aligning Forces for Quality (AF4Q) initiative. Alliances in all 16 AF4Q communities have publicly released consumer-friendly comparative quality information on the care being provided in their regions.

The reports provide information that health care consumers can use to become the ultimate “e-patients” –well-informed, empowered and engaged patients making informed decisions about their care and treatment. The reports also give providers important clinical quality information they can use to identify areas for improvement. And closing the loop in our quest for high quality in every community, the AF4Q Alliances then follow up to make sure the providers have the resources to make those changes to their practice.

Taking this work a step further, this month marks the second of three partnerships between RWJF and a name trusted and turned to by consumers for making every day choices, Consumer Reports. Starting in May, three AF4Q communities are working with Consumer Reports to release quality reports about medical groups in their communities as special magazine inserts.

The first insert for Massachusetts was released in June with statewide patient experience ratings of 329 adult practices and 158 pediatric practices. The second insert, hot off the presses this in Minnesota, contains ratings on chronic disease control, specifically diabetes and cardiovascular disease, including heart disease, stroke, and peripheral artery disease for 552 practices in the state.

The Minnesota partnership is also helping health care consumers understand the important issue of value in the care they are receiving. Publishing a chart with cost and quality data from one local network, Health Partners, the data show that patients don’t always get what they pay for and that one can’t always judge quality of care by cost alone. The ratings also uncovered some pretty interesting information including variation among well known medical groups such as Mayo Clinic.

Early next year a third AF4Q alliance, this one in Wisconsin, will release comparative information on how well local medical groups did on screening tests for cancer, health disease and other conditions. Stay tuned for that.

This is all an extremely important step forward for public reporting of health care information that is useful, understandable and actionable by patients. Consumer Reports is a trusted resource that millions already turn to and RWJF is thrilled to be a part of this movement. Of course, we are funding this partnership in only three AF4Q regions and recognize that efforts still need to be made to reach more people, including some of the most vulnerable low literacy or lower income Americans. The good news is that this work has started to make that happen, and the Massachusetts AF4Q team is already planning a lower literacy version of some of the content from the insert.

Wouldn’t it be great to have reliable, easy-to-understand health care quality and cost information at our fingertips the next time we need to choose a provider? Thanks to the work of AF4Q communities and this partnership with Consumer Reports that will soon be a reality. And before you know it we will all have the power and resources to be e-patients.

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Posted in: e-pts resources | general | reforming hc | shared decision making

 

 

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