Although current hospital rankings offer a valuable look at how well different providers are performing, a more customizable experience can make those data more usable for patients and researchers, according to a new study.
RAND Corporation developed a prototype of a tool that could improve that experience, using data from the Centers for Medicare & Medicaid Services’ Hospital Compare site. The tool allows users to weigh measures in the star ratings based on what matters to them or what their needs are.
For example, a patient seeking the best hospital for obstetrics care may not necessarily weigh readmission rates as highly as another patient would. Mark Friedberg, M.D., director of RAND’s Boston Office and the study’s senior author, told FierceHealthcare composite scores make those value judgments for the user, cutting down an element of choice.
“Every public score should have these features so people can personalize the ranking for what they need,” Friedberg said.
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What works best for the “average” patient isn’t likely to benefit many people, because few people actually fit into that box, Friedberg said.
RAND’s tool allows users to search for local hospitals and then assign weights to seven metrics: mortality, the safety of care, readmissions, patient experience, timeliness of care, the effectiveness of care and efficient use of medical imaging. By adjusting the weights for these measures, users could see an entirely different star rating and rank for local facilities.
A tool like RAND's is also useful for researchers, who may be seeking data they can better customize, Friedberg said. It would also allow providers who may earn low scores from CMS or on other rankings to dig more into where they can improve.
Since the world has gone digital, it’s much simpler to offer tools that allow people to get more granular with measurement data, Friedberg said. When reports like CMS’ were in print, having just the composite measure made far more sense.
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Friedberg said RAND’s tool is just the first stab at a more customizable way to look at hospital rankings and that further research and refinement are needed to offer one that really is useful for patients.
Patients, for example, are unlikely to have the health literacy to effectively determine how much value they place on something such as “effectiveness of care,” and what exactly a measure like that means can vary from person to person. But, Friedberg said, that doesn’t change that future hospital ranking systems could benefit from more personalization features.
One beneficial tweak, for instance, could be to ask certain survey questions up front to help patients better understand how their priorities translate to clinical measures, he said, such as “What procedure are you considering?”
“These are things that are all going to result in different settings of weights, and those are things that people can answer instead of looking at individual measures,” Friedberg said.