Health care consumers are in the dark. U.K. plan gives them a flashlight
Most of us will peruse reviews and check out diner ratings before booking a fancy restaurant. But when it comes to selecting a doctor to perform life-saving surgeries, there’s no equivalent to Yelp. People typically rely on their social networks or a trusted family doctor for referrals, but those recommendations are often biased or based on a one-off experience, not real data.
In fact, consumers lack the requisite data to compare hospital and physician costs, as well as assess the quality of care. The reality is that far more information exists online about that trendy new eatery than your child’s pediatrician.
Britain is taking bold steps to rectify this problem. This month, the U.K. government introduced a new scheme for a more transparent National Health Service (NHS), requiring doctors and consultants to hand over performance data, including the number of patients that die on their operating tables each year. The measure was introduced under the Data Protection Act.
The intention for the scheme is to show patients how well surgical teams in hospitals across England are performing, compared to one other. A spokesperson for the NHS told the U.K. press that it will “shine a light on variation and unacceptable practice.”
Those who refuse will be “named and shamed,” the local press is reporting. About 4 percent of physicians have already opted out, according to the Guardian. Among the concerns expressed by doctors is that it will lead to specialists turning down risky surgeries to avoid increasing their morbidity rates. Also, it’s not often clear who’s responsible for patients with multiple doctors — if something bad happens to the patient, which doctor’s ratings take the blame?
Despite the controversy around the scheme, the NHS Commissioning Board has heralded the new doctor ratings system as a “revolution” for patients. It’s a first step to providing information about real health outcomes — and not just patient satisfaction.Will this transparency “revolution” reach the U.S.?
The NHS isn’t acting in isolation. In the United States, the Obama administration is making a concerted effort to put health data in the hands of consumers, doctors, and accountable care organizations.
One of the overarching goals of the Affordable Care Act, introduced in 2009, is to ensure that doctors get paid based on the quality of care they provide — and the outcome for patients — rather than the quantity of expensive procedures they perform.
“Data that supports medical decision making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices,” U.S. Department of Health and Human Services Secretary Kathleen Sebelius wrote in a May 28 blog post.
Another goal is to lower nationwide health care costs and lift the veil on prices for procedures and tests, which vary wildly across the U.S.
It’s not just talk and empty promises. In recent months, the U.S. Department of Health and Human Services released a pile of data on what 3,000 hospitals charge for the top 100 services they provide. HHS is the cabinet-level agency that regulates the $2.8 trillion U.S. health care market, and stores an enormous amount of data.
However, patients are still in the dark when it comes to assessing and comparing individual doctors. This information is often used internally in hospitals, but nobody has released it to the public.
Malay Gandhi, chief strategy officer for health accelerator Rock Health, said the NHS’s doctor-rating scheme is “more sweeping” than anything we’ve encountered in the U.S., because in the States, the government and insurers still lock up most of the performance data.
With this data on lockdown, the private markets are developing new ways for patients to pursue the optimal course of treatment. In Silicon Valley and other tech hubs, health investors are eager to fund startups that enable consumers to find higher-quality health services.
“Broadly speaking, we have an intense interest in transparency solutions that can change consumer behavior as it relates to selection of doctors,” said Gandhi.
Bryan Roberts, a health investor at venture firm Venrock, agrees that we’re entering a time of “huge opportunity” to create an actual market for goods and services in health care.
“The confluence of dramatically increased information and changing incentives in healthcare that will reshape this industry,” he explained in an email interview.Health startups to help you find better quality care
Already, we’re seeing signs of progress. Here’s a short list of startups that are assessing doctor performance, and bringing much-needed transparency to health care.Practice Fusion for doctor reviews
Electronic health record provider Practice Fusion recently launched its ‘Yelp for doctors’ service, aptly named Patient Fusion. On this new website and smartphone app, patients can browse reviews before booking an appointment.
The app went live in April with the 27,000 doctors and 1.5 million reviews. A goal for the service is to use patient’s data stored in Practice Fusion’s electronic medical record to help them find the best doctor. If you suffer from diabetes, for instance, the app will begin to prioritize physicians in the search rankings with relevant expertise.ZocDoc for star ratings
ZocDoc is one of several startups that lets patients book appointments online (by proximity and plan), and peruse Yelp-like reviews and star ratings for physicians in every specialty. With bookings up 200 percent and doctors clamoring to gain access to new patients, the company is poised for major growth. And it just raised a huge pile of cash, $55 million in convertible debt.
Doctors are fans of the service, too. Optimists like this USA Today columnist hope that ZocDoc’s transparency will “foster cutthroat competition and inevitable price shopping and price cutting.”
You’ll get the sense when browsing ZocDoc and Patient Fusion that it’s just the beginning. We’re still in the dark when it comes to physician’s outcomes, but the reviews are a start. My guess is that it won’t be long before pricing comparison information on doctors visits and procedures becomes available — think “Expedia for doctors.”Castlight for employers
Castlight Health gives self-insured employers a look into their overall health care spending and costs, as well as providing information to employees about quality of patient care. It’s a fairly easy sell to enterprises, given that cost of employee insurance is surging. Customers include Tesla, CVS and Honeywell.
The company has shifted direction from targeting consumers to corporations. It’s tough to engage people to care about their health and wellbeing in between doctor’s visits — but employers have a vested interest in keeping their teams fit and healthy.PokitDok for cost visibility
A newcomer on the scene, PokitDok just raised $4 million in funding for its website that lets consumers research doctors and potentially book appointments. In addition, providers can set up a virtual storefront to market their services, whether it’s traditional medicine or alternative healing.
The startup secured its first major customer, United Physicians, which is using PokitDok to publish prices, and lets patients directly book and pay for doctor’s appointments.BetterDoctor to ward off bad doctors
Entrepreneur Ari Tulla is on a mission to fix the country’s broken health care system. New website, BetterDoctor, is a good start.
The website claims it can help you find the best, available doctor nearby. What sets it apart? The founding team spent 18 months building a verification service and has deliberately excluded doctors with negative ratings and those who are fighting malpractice lawsuits. Physicians listed on the site have been internally vetted based on their experience, education, and more.
What services do you use before booking a doctor? Do you browse the Web or ask friends and family for recommendations? Let us know in the comment box below.