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Article Revised: March 28, 2019
According to a recent article published on Healthcare Informatics, the University of Utah Healthcare System has been experimenting with a new way of motivating its physicians to improve patient care: let patients review the physicians as though the physicians were restaurants or bars on Yelp.
Jeremy Stoppelman, Yelp’s founder and CEO, sat on a panel at Health Datapalooza conference in Washington D.C., and told the audience how his search for a doctor helped give him the idea to start his company. In 2004 Stoppelman was sick, and so naturally looked up local doctors on Google. The lack of relevant data appalled him. He wanted to see what their patients thought of their services, but couldn’t find that.
Of course Yelp is better known for reviews of restaurants, but it does have reviews of doctors and hospitals. They are now looking to augment the reviews with useful data on emergency rooms, dialysis centers and nursing homes.
Vivian Lee, CEO of the University of Utah Healthcare, shared the same panel with Stoppelman. In 2012, her system became the first healthcare system to post patient satisfaction ratings and reviews online. Patients rated doctors on such factors as how well they communicated, how well they shared the decision-making process and how long people had to wait to see them.
According to Lee, the results have been highly impressive. The doctors received no financial reward, but half of them rated in the top 10 percent nationally for patient satisfaction. 25 percent were in the top 1 percent, nationally.
Most doctors are highly competitive high-achievers, and therefore getting publicly rated by patients spurred them to seek improvement. Some doctors took training to improve their communications skills. They suggested ways to make the Electronic Health Record easier for patients to read. They learned to engage with and listen to patients.
Charles Ornstein, a senior reporter for ProPublica and the panel moderator, asked Lee how she and the University of Utah Healthcare System dealt with physicians who received poor reviews. She replied they took poor reviews as an opportunity for the physicians to learn, and so the university does not penalize them for it. Also, some poor reviews are due to factors outside their control, and so management watches for that.
She also noted that newer physicians were not only not surprised by getting patient reviews, but expected to receive them.
A critical part of the Six Sigma process is the Voice of the Customer in the DMAIC phase. It helps to establish key requirements, Critical-to-Quality characteristics. Patients are external customers in the healthcare system. Clearly, the ability to post their feedback and reviews of doctors has spurred the physicians to improve their own quality of patient care.
Founded by quality-control expert Thomas Pyzdek, The Pyzdek Institute is a major online provider of information and certifications on Six Sigma. The Institute offers Lean Six Sigma Training and Certification. Pyzdek wrote the standard handbook, The Six Sigma Handbook. The Yelp approach to improving healthcare quality is an interesting example of using feedback to improve service quality in a traditional industry.
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