The Internet offers an array of websites designed to help patients evaluate doctors and hospitals. But which one is best? Here, Dr. Bruce Minsky, chief quality officer at the University of Chicago Medical Center, and Cynthia Barnard, director of quality strategies at Northwestern Memorial Hospital and chair of the Quality Measurement Advisory Task Force of the Illinois Hospital Association, offer their reviews of several online resources.
• Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, ahrq.gov:
In addition to free consumer guides in such areas as choosing quality care and comparing medical treatments, this site also provides lists of questions to ask doctors and surgeons; lists of symptoms for common diseases and conditions; and podcasts and videos. Dr. Minsky: “The site presents safety information such as acute infections, complications and mortalities that occur during treatment. This information, however, is derived from billing and coding data, which do not always correlate perfectly with what happened clinically. Physicians are beginning to document these adverse effects in the medical record so they can be captured more accurately.”
• Castle Connolly Medical Ltd., castleconnolly.com:
This company’s annual guide, America’s Top Doctors (now in its ninth edition), is based on online, phone and mail surveys that ask more than 230,000 health professionals to nominate the top doctors in every specialty in their region. Credentials and other important background information are reviewed, and doctors do not pay to be included. Castle Connolly also publishes America’s Top Doctors for Cancer. The books range in price from about $30 to $80.Dr. Minsky: “The physicians listed are generally well-regarded by their peers, but if a doctor is not on the list, that doesn’t mean that he or she is not as competent as someone who is. Consumers should be aware that it is subjective measurement.”
• Consumers’ Checkbook, checkbook.org:
This nonprofit company’s Guide to Top Doctors ($24.95) features 23,000 doctors chosen by 340,000 physicians who were asked to identify the specialists they would choose to care for their own loved ones. The website also offers other free medical information for patients. Dr. Minsky: “This is one of a number of commercial sites that relies [directly] on subjective ratings. Although there is some value in these results, only the submitted comments (positive or negative) are listed.
• HealthGrades, healthgrades.com:
This independent healthcare-ratings organization provides information on more than 750,000 doctors, 5,000 hospitals and 16,000 nursing homes. While its grading system is based on data from the Centers for Medicare and Medicaid Services (CMS), HealthGrades adds its own measures. Physician reports include basic background information as well as results of patient surveys and histories of sanctions and malpractice. There is a fee for some reports, but much of the information is (or soon will be) free. Dr. Minsky: “This site uses publicly reported data (such as those available in hospitalcompare.hhs.gov), but consumers should be aware that HealthGrades then uses its own internal measurements and methodologies to develop its unique scoring system.”
• Hospital Compare from the Centers for Medicare and Medicaid Services (CMS), hospitalcompare.hhs.gov:
Launched in 2005, this site offers objective data (collected from more than 4,700 hospitals) that relates to the quality of care for patients undergoing surgery and those being treated for heart attack, heart failure and pneumonia; such CMS data provides the foundation for many other healthcare websites. The site also features subjective results from patient surveys about hospital experiences (known as the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS). Taken together, the information helps consumers make better decisions about their healthcare and encourages hospitals to improve their programs. Barnard: “This is the place to go if you want hard, comparative data. It allows you to look at how well different hospitals do on certain processes, and it even lets you line up several hospitals to compare them. And looking at [surveys about] whether patients were satisfied with their healthcare providers is part of what you take into consideration when choosing a provider. The site also has an interesting nursing home component and a home healthcare component that are very useful.”
• Illinois Hospital Report Card and Consumer Guide to Health Care, healthcarereportcard.illinois.gov:
Launched by the Illinois Department of Public Health in 2009, this site amalgamates Illinois hospital information from a variety of sources including Hospital Compare, the Surgical Care Improvement Project (SCIP) and the National Healthcare Safety Network (NHSN). It offers data about quality of care, number of procedures performed, nursing staff, patient survey results and cost comparisons. Barnard: “This is a very good resource that has a good fundamental collection of data, and it’s absolutely unbiased. It brings together so much information from many different sources, which is very convenient. It is well-organized, easy to use and totally free. The real weakness is that it’s still somewhat young. Over time, it should have a lot more information.”
• Illinois Hospital Association, illinoishospitals.org:
This association, which represents more than 200 hospitals and health systems in Illinois, was formed in 1923 with the goal of making affordable, high-quality healthcare available to everyone in the state of Illinois. The organization’s Caring for You website lets consumers search hospitals by name or location for information about medical specialties, particular services, quality performance results, patient satisfaction results and nursing staff information. Barnard: “This free and easy-to-use website pulls together highly credible information from many sources. It’s a good place to start, but it does overlap a bit with the Illinois Department of Health website (Hospital Report Card and Consumer Guide). The Hospital Report Card makes some judgments about what is better or worse than expected, whereas the Illinois Hospital site just presents the data. If you are researching a hospital, it would be natural to use both.”
• The Joint Commission on Accreditation of Hospitals, jointcommission.org:
This website offers a series of guides titled Selecting a Healthcare Provider: Helping You Choose. It covers such topics as ambulatory care, hospital care, laboratory service, long-term care and others. The site’s Quality Check feature (qualitycheck.org) offers quality reports for a comprehensive list of healthcare providers. It also offers a guide to other Internet healthcare resources. Barnard: “The Quality Check lets you look up a particular hospital, but you can’t pull up several hospitals at once to compare them. And you can find a lot of performance data on a few core measures, but other sites (such as CMS and the Illinois Hospital Report Card) have richer data. This site can tell you an institute’s accreditation status and how well it’s doing on the National Patient Safety Goals, a set of standard practices that covers [even details] like checking a patient’s ID before giving medication.”
• National Comprehensive Cancer Network, nccn.org:
This nonprofit alliance of 21 of the world’s leading comprehensive cancer centers offers a variety of relevant information, such as overviews (including the most widely used treatment options) of the most common cancers. Experts from NCCN member hospitals regularly participate in panels to provide guidelines for the best physician strategies for the evaluation and treatment of cancer patients; these recommendations are then mirrored in guidelines for the patients themselves, according to Dr. Al Benson, a member of the executive board of the NCCN and the associate director for clinical investigations at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Dr. Minsky: “These guidelines provide a number of cancer guidelines used at some comprehensive cancer centers. However, consumers should keep in mind that [the recommendations] are only from the network’s members. Not all National Cancer Institute (NCI) Comprehensive Cancer Centers are represented.”
• U.S. News and World Report’s “Best Hospitals 2010–2011,” health.usnews.com/best-hospitals/rankings:
This free annual survey evaluates nearly 5,000 hospitals, based on such criteria as death rates, patient safety and the reputation of 16 adult specialties. The rankings can be searched by hospital name, specialty, special service/feature or location. Dr. Minsky: “The magazine has a sound and transparent methodology for its rankings. It takes into account many factors; for example, the nurse/patient ratio, availability of technology, the patient safety index of the Agency for Healthcare Research and Quality and others. Still, a major component of the ranking is based on subjective recommendations from other physicians. Furthermore, it is important to remember that, in most cases, there is little difference between hospitals ranked closely (such as numbers four and five), but there is with a hospital ranked number eight and one ranked number 80.”
For additional information on these and other resources, please read “Critical Choices: Which Hospital and Physician is Best for You”.
Published in Chicago Health Winter 2010