Using web-based quality data to
choose a primary care physician:
which information do patients
rely on most?
Gary Fanjiang, Ted von Glahn, Hong Chang,
William H. Rogers, Dana Gelb-Safran
Funding provided by RWJF and AHRQ
Background
• Despite growing demand, quality of care
indicators are often ignored.
• Patients are most interested in data to
inform their physician choice but few data
are available.
Study Aims
• To examine if patients seeking a new PCP
make use of web-based physician specific
information.
• To evaluate which types of information
users find most important.
The Website
• Information on physician credentials and
characteristics, office location and hours,
and patient survey scores.
• Patient survey scores from the Ambulatory
Care Experiences Survey (ACES).
Patient Survey Scores
(ACES)
• Five summary measures:
– Appointment access
– Interpersonal quality
– Coordination of care
– Health promotion
– Willingness to recommend the physician
Website
Doctor A
Doctor B
Doctor C
Doctor D
Doctor E
Doctor F
Doctor G
Doctor H
Study Sample
• 2225 adult patients seeking a new PCP at
two California medical groups were invited
by mail.
• 17 percent viewed the website (n=382).
• 80 percent of those viewing the site
completed a follow-up questionnaire
(n=306).
Ratings of Importance
Type of information
% who cited as important
Office hours & location
39
Physician characteristics
25
Physician credentials
38
Survey-based ACES measures
51
Advice from professionals
27
Advice from friends
24
Relative Importance of Survey Measures
Among Patients Who Said Survey Measures were
Important to Their Choice
Survey-based ACES Measure
% who cited as
most important
Appointment access
16
Interpersonal quality
37
Coordination of care
5
Health promotion
2
Willingness to recommend
physician
41
Concordance between survey-based
measures priority and PCP chosen
Distribution of patients’ physician choices
(Rows sum to 100%)
Survey-based measure cited
by patient as most important
Scored best
Scored
highly
Scored
average
Scored
lowest
Score
unavailablea
Willingness to recommend
physician (n=64)
36
(56%)
18
(28%)
6
(9%)
0
(0%)
4
(6%)
Interpersonal quality (n=57)
N/Ab
50
(88%)
2
(4%)
0
(0%)
5
(9%)
Appointment access (n=25)
N/Ab
13
(52%)
7
(28%)
3
(12%)
2
(8%)
Coordination of care (n=7)
N/Ab
4
(57%)
1
(14%)
1
(14%)
1
(14%)
Health promotion (n=3)
N/Ab
0
(0%)
2
(67%)
0
(0%)
1
(33%)
a
b
Physician chosen did not have survey-based data presented on the Find a Doctor website.
No physicians presented on the Find a Doctor website scored in this range.
Limitations
• Limited to only 2 medical groups.
• Information priorities may be different in
people who do not use the internet.
• Unknown if participants formalized their
physician choice.
Conclusions
• One in six patients seeking a new
physician logged-on and used the webbased data to inform their choice.
• High participation rates suggest the value
of “just-in-time” information.
Conclusions
• Of the different types of information, patient
survey results were widely regarded as a
priority.
• Of the survey results, interpersonal quality
and willingness to recommend the physician
were valued most.
• Choice of physician was highly concordant
with patients’ stated priorities – suggesting
users are capable of using web-based
information to inform their choice
appropriately.
Conclusions
• The results underscore the value of
developing a national standard for
measuring patients’ experiences with
individual physicians and their practices.
Acknowledgements
•
Dana Gelb-Safran, Tufts-New England Medical Center, Boston, MA
•
Ted von Glahn, Pacific Business Group on Health, San Francisco, CA
•
Hong Chang, Tufts-New England Medical Center, Boston, MA
•
William H. Rogers, Tufts-New England Medical Center, Boston, MA
•
Michael Nelson and the participating medical groups
•
Andrew Maxfield, Margaret Gerteis, and BearingPoint, Inc.
•
Kara Cassidy, Pacific Business Group on Health, San Francisco, CA
•
Angela Li, Tufts-New England Medical Center, Boston, MA
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