Opinion: Surgeon Scorecards Can Be Cutting

Opinion Surgeon Scorecards Can Be CuttingThe following is a guest contributed post from Dr. Anthony Oliva of Nuance.

I’m a family medicine physician who has been training residents and medical leaders since President George Bush, Sr. was in office. In that time, I’ve found very few things that get physicians to spring into action or worry outside of a “code blue.” We’re trained to stay calm, methodical in nature, after all, we are trained in a profession steeped in knowledge, science, and statistical proof. And we are a competitive bunch.

When training a group of physicians on the importance of clinical documentation last week, I brought up a screen from an online site that showed “Surgeon Scorecards,” listing specific facilities by location and specialty where I drilled down to show specific physicians’ names. This had a “shock and awe” effect, and left my audience with mouths agape.  Immediately, every doctor in the room whipped out their phones and frantically typed their names in search of reviews, uttering a sigh of relief when they discovered this potentially damaging online scorecard site published performance stats for surgeons only. I had their full attention now.

Physician scorecards are a game changer

With online reviews, reputations are at stake, and this transparency of clinical performance is not coming soon, it’s here now.  Physicians and healthcare providers alike want (and need) to know what can be done to prepare and get in front of this new, and somewhat scary, development in the world of healthcare consumerism. Knowing what patients are looking for in their healthcare experience and what they expect from their providers is key.

The good news is there are methodologies, tools, and people on all sides of them that can help them monitor their reputations when data finds its way into the public eye.  Here are a few suggestions on how to manage online clinical performance metrics:

  1. Manage information input from the start:Accurate documentation of clinical notes at the point-of-care is not only an important part of diagnosing a patient, but also of managing performance metrics.  Record the patient story in detail and avoid gaps in information that can make the documentation unclear or unfamiliar, which can cause coding or payment issues, and make you look bad. Carefully input clinical practices, orders, and recommendations ensuring missing details in clinical documentation are few and far between.
  2. Do a visual scan: See what online profiles exist today for you and your organization, and how they look. You and your team already have a sense of wait times, complications, mortality rates, and patient satisfaction scores.  Assess how closely these published metrics compare to what was expected— and what you can do to fix them.
  3. Consider the source:Take a holistic look at your online reviews and feedback: is it a few grumpy patients commenting on a general site, is it data from claims, or scores from patient satisfaction surveys such as Press Ganey, HCAHPS)?  All of these can be helpful or harmful, so look at the source and quality of these reviews, and plan your attack.
  4. Remember, medicine is a team sport:  Seeing many patients quickly while practicing theArt of Medicine is a careful balancing act. A short visit can feel fulfilling and provide a positive experience if it’s combined with eye contact, communication, and focused attention. The many people involved in the process from door-to-doctor can positively impact the experience.

I recently heard Hal Baker, senior vice president for Clinical Improvement and CIO, WellSpan Health System say: “Our quality improvement efforts are really driven around the whole care team.  The high quality of care that is attributed to me, and that my practice is being measured on, is probably determined more by the other people in my office than by me.”  I couldn’t agree more.  We all chose to work in healthcare because we want to achieve a singular goal: to help people to the best of our abilities.  And helping starts with listening.

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