Consumerization and Transparency in Healthcare Outpace Reform

A revolution in healthcare is under way, and it is not in the form of the much heralded reform effort building on Capitol Hill. The consumerization of healthcare is happening now. Patients and their families increasingly approach healthcare decisions as they would other significant consumer decisions, which give patients and their families greater control.

The consumerization of healthcare is changing how we do business. Recent articles in The Hospital Review reported that the Cleveland Clinic was making transparent its physician-business relationships and that CMS is calling for greater consumerization (along with improved healthcare IT) for the industry. Consumerization and transparency are leading what may prove to be a radical transformation in the delivery of healthcare services.

Greater physician and patient control
Consumerization of healthcare is driven by Americans wanting more control over their healthcare decisions and the greater availability of information on the Internet. Hospital rankings, physician ratings and pricing details are examples of just some of the information available online.

More and more, hospitals are using their Web sites to provide detailed information about the services provided at a facility; the procedures performed there; how often that facility has performed the procedure in question; what physicians perform procedures; comparisons of how that hospital has performed over time; and what the patient satisfaction level is for that hospital. Patients and their families have unprecedented access to information about a patient's possible condition and treatment options and the level of information available to patients will only increase.

As treatment decisions become more consumer-driven and are made by patients evaluating how treatment fits into their lives, healthcare providers must respond with innovation, information and flexibility. Patient safety, appropriate treatment and quality must come first, but more and more we are personalizing care as we respond to patients and compete for their business.

Transparency
Transparency is accurate information reliably and easily accessed by patients and their families regarding treatment options and the healthcare providers who deliver them. Clear data about hospitals, about doctors, about the hospital's and the doctor's respective experience and other essential details now shape a patient's decision about his or her healthcare. At the Indiana Orthopaedic Hospital (for which I am the CEO), we want to be transparent and we are working to develop and make available much of this information and more.

Visitors to our Web site will soon find what we feel is very good information, such as the 2009 HealthGrades report. HealthGrades rated our hospital five-stars for joint replacement surgery, total knee replacement, total hip replacement, spine surgery and back and neck surgery (spinal fusion). By informing patients that we have done more than 1,500 joint replacement procedures, patients and their families know that we are experts in this field, that the patient will go home faster and the procedure will cost less.

Meaningful data and improved outcomes
For the information to be accurate, meaningful data must be developed and used. We evaluate the entire Indiana Orthopaedic Hospital experience to develop meaningful data; we ask questions such as how did the facility perform as a whole; staff attitude and responsiveness toward patients; cleanliness; was the food good; did the patient and family feel welcomed; etc. Still, for this data to be meaningful it must impact decisions — decisions by the hospital to improve patient outcomes and decisions by patient-consumers about where to obtain care.

If the surveys identify an area that needs action, or I get a call from a nurse with an idea that will improve patient care, I can make the change within hours. If the idea requires board review and approval, the change is a matter of days. The focus is always patient care and meaningful data that leads to improved patient outcomes.

For the Indiana Orthopaedic Hospital, the 2009 HealthGrades report complemented our internal findings, and we will make this information available so patient-consumers can make more informed decisions.

Comparing healthcare providers
Not all hospitals survey the patient's experience, and not all that do probe deeply enough. Compounding this, not all hospitals act on or publish the information they do develop. For these reasons, we often lack meaningful data. Add to these discrepancies the absence of standardized measurement for some issues, such as infection rates. Patient-consumers then should compare data from various sources to ensure accuracy and should be very careful about which comparison tools they use. HealthGrades and the hospital comparison data on the Health and Human Services Web site are options.

Patients and their families should examine a hospital's Web site. What level of information is available? Is the facility a community hospital or specialty hospital? Does the facility have a specialty and what is it? How long has a facility been performing the patient's procedure and how many of these procedures have been performed? Will the patient and their family need to travel to obtain treatment, and if so, how far? What is the impact of ever-increasing deductibles?

For healthcare providers, this is a brave new world with patients more in control than ever before. We must be ready to provide more information as patients demand to better understand their choices as they consider their healthcare decisions.

Patients as consumers means competition
Implicit in the consumerization and transparency of healthcare is competition. America was built on competition, and healthcare, like other areas of the economy, benefits from competition. We have seen competition improve the quality of the services delivered by hospitals resulting in larger, private patient rooms that reduced infection, improved amenities, shortened patient stays — which reduced cost — and higher patient satisfaction.

Without competition, improvement is unlikely, and that is a disservice to patients and the coming efforts to reform healthcare. We have already seen the benefits of competition with improved quality and better outcomes and if we hope to continue this trend, we should welcome competition. The coming consumerization and required transparency demand it. The result will be good for patients, good for healthcare providers and good for American healthcare.

Ms. Keller is the CEO of the Indiana Orthopaedic Hospital in Indianapolis. A graduate of Ball State University with a degree in nursing, Ms. Keller has more than two decades clinical experience as a nurse, patient care manager, clinical manager/shift coordinator and director of perioperative performance. Learn more about Indiana Orthopaedic Hospital.