Thursday, 19 January 2017

#ClinicSpeak & #BrainHealth: online rating sites - good or bad?

Is your MS centre ready for open online reviews? #ClinicSpeak #BrainHealth

For the last year I have been promoting the concept of an msAdvisor for the field to help promote the 'Brain Health: Time Matters' policy document and to get adoption of the MS management principles we are promoting as part of the initiative. Therefore the following perspective piece in this week's NEJM is very timely. It is clear the US healthcare system is way ahead of the game with several online rating sites already established. The article describes some of the many issues linked to online rating sites. My personal opinion is that they need to offer disease-specific ratings. Why? Each disease has specific issues that are unique to that disease. In the case of MS this could for example refer to the use of MRI, or not, to monitor the disease, allowing pwMS access to their own results, etc. I don't want the msAdvisor to be used to 'name and shame' people and centres, but rather as a tool to nudge or encourage the adoption of 'best practice' as defined by peers. The app could also be used to educate and help pwMS self-manage their disease. The tool could also be used as an information resource. The app would have the ability to keep reviews anonymous and for a 'neutral moderator'.


What I would like to hear from you is the msAdvisor an app you would use? Do you think we should develop it? If, yes what content should we include in it?




Vivian Lee. Transparency and Trust — Online Patient Reviews of Physicians. N Engl J Med 2017; 376:197-199.

....... After years of academic debate over the role and value of patient-satisfaction scores and reviews of health care providers,1,2 Yelp, the online powerhouse of documenting customer satisfaction, is forcing the issue. With more than 102 million customer reviews to date, 6% of them in the health care arena, Yelp easily dwarfs longer-standing commercial physician-review sites such as Healthgrades and Vitals....

....... A recent analysis used natural language processing tools to evaluate 17,000 Yelp reviews of 1352 hospitals and showed that they revealed information similar to that covered by 7 of the 11 categories of patient satisfaction included in the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS), along with 12 categories not included in the HCAHPS, such as costs, billing, and scheduling......

....... I believe patient reviews and feedback can serve three main goals. First, like the peer-level perspectives on consumer products and services posted on Amazon, TripAdvisor, and Yelp, reviews of physicians or hospitals can help patients make more informed consumer decisions. Publicly available reviews can help address information asymmetry in the health care market and increase patients’ confidence in their own decisions. Collectively, by making clear their preference for higher-performing systems, patients can become a market force driving quality and value in health care.....

...... Second, patient reviews offer clinicians valuable performance feedback for learning and improving, both individually and across a system. Receptivity to performance feedback, which depends heavily on physicians’ acceptance of the data’s validity, facilitates a culture of continuous learning and patient-centeredness......

....... Third, health care systems and physicians who voluntarily share patient-review data visibly foster a spirit of trust with patients and the community. Patient reviews offer the opportunity to improve health care delivery while strengthening the provider–patient relationship......

3 comments:

  1. A good idea but one complication I can foresee is that many PwMS in the UK receive care related to MS from more than one hospital / medical trust. For example : My local MS nurse and physiotherapy work for our local hospital trust, my GP works for a local CCG and I receive my DMT, and monitoring, from a London hospital trust.

    In addition to the categories you have listed in the slide, I would like to see :

    1. Responsiveness (how quickly the appropriate staff respond to patient queries about potential relapses and other MS-related problems)
    2. Whether the MS service, at a minimum, meets the NICE guidelines for MS Management. Eg : Ensure all people with MS have a comprehensive review of all aspects of their care at least once a year

    ReplyDelete
    Replies
    1. Yes and when it says review of all aspects who is the review with? the MS nurse or the neurologist.
      I would only be confident with the yearly review being done by a neuro who is a neuro with an interest in MS.

      Delete

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