New health data outs doctors whose patients die more often

Most of us 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,
we have 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.
The British government is taking bold
steps to rectify this problem.
This month, the U.K. government
introduced a new plan for a more
transparent National Health Service
(NHS), requiring doctors and consultants
to hand over performance data, including
the number of patients that die in their
care 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 plan,
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, the 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 consumers can use to
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
permit patients to 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. The 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.